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Va Denied Roommate's Claim

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kent76

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I thought that the claim was pretty much iron-clad; however, the rater seemed to use the opinion of the c&p examiners who seemed bias in my opinion to pretty much deny the claim. One note to this matter is, my roommate is transgendered which seems to make all the difference in the world as to how this claim was decided.

My roommate had 3 medical conditions for which compensation was filed, first, acne vulgaris which was rated at 0% and is probably acceptable given the reasons state. Second, my roommate has an extensive treatment record for depression and was granted SSDI for having depression along with a personality disorder. And finally, stomach problems which has been occuring since 2001. We have a psychotherapist who gave my roommate a gaf score of 45 along with a diagnosis of major depressive disorder. My roommate has been treated at the VA hospital in Hampton, Va. for depression and stomach problems as well. Can someone please explain to me why the VA denied this claim as I will type what the letter states.

Service connection may be granted for a disability which began in military service or was caused by some event or experience in service.

Your service medical records show you were diagnosed with or treated for signs and symptoms of depression and personality disorder while on active duty. A disability which began in service or was caused by some event in service must be considered "chronic" before service connection can be granted. Social Security Adminstration records show that you have personality disorder with depression. At the Department of Veteran Affairs examination on June 4, 2007 (Just a 10 min examination) you revealed you continue to have depressive moods. The examiner noted that you are in transition from male to female. After extensive interview the examiner determined that your depression is related to your gender confusion that pre-existed your active duty service. Service connection for depression is denied since this condition neither occurred in nor was caused by the service.

My roommate was hospitalized while on active duty for depression because of problems with a girlfriend and had suicidal ideation noted in the medical notes from his visit. I think that the VA is overlooking the depression and wants to pin it all on something that S(he) decided to pursue after the military. I have know my roommate for 6 years now and the gender issue is clouding the depressive issue which should warrant in my opinion a rating of 70% according to my research. We are filing a NOD of course.

Also, for the stomach problems they wrote.

Service connection may be granted to a disability which began in the military service or was caused by some event or experience in service. Service connectiion for stomach problems is denied because the medical evidence of record fails to show that this disability has been clinically diagnosed. (We have a diagnosis from the VA as IBS in March, 2007, also GERD from roommates military treatment records.) Your service medical records show you were diagnosed with and treated for stomach problems that did not result in chronic residuals ( what! almost 6 years) A disability which began in service or was caused by some event in service (minocycline related) must be considered "chronic" before service connection can be granted. At the Department of Veterans examination of June 4, 2007 you revealed you continue to have epigastric pain.

The examiner did not find any evidence of stomach problems and did not render a diagnosis. (This was a joke, i watched the examiner just rub my roommates stomach and asked how it felt) Medical evidence of record fails to show that you have a current diagnosis of stomach problems that has been clinically related to your active duty. Service connection for stomach problems is denied.

I am about to file my own claim for my back but this is really disturbing to me! I am the payee representative for my roommate because SSA determined that she can't make financial decisions based on her disability.

It is a shame that they treat veterans this way and even the treatment at the VA hospital has been quite rude for my roommate. I met my roommate in 2001 while in the reserves. At the time, he had a girlfriend and only after he got out of the Navy did he reveal his desire to become a female; nonetheless, the depression issues were already there and he attempted suicide while on active duty(which is documented also). My roommate recently changed her name to a female name so I will not disrespect her anymore by using his/him/he, but my point is, depression is not being treated seriously enough by the VA!

Can someone please tell me what they think and the best way to approach this denial letter. Thank you! ken

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Kent,

I sure wish you'd drop the big chip off your shoulder and open your mind enough to understand the damned question. I'm not attacking your friend so you can drop being defensive. The question

that I've asked twice now has yet to be answered.

*************************************************************************

"QUOTE(Berta @ Sep 26 2007, 07:44 AM) post_snapback.gifThis case might help you :

http://www.va.gov/vetapp04/files2/0417844.txt

If a veteran can prove a pre-existing condition was "aggravated" by service they can succeed in a claim like this."

*************************************************************************

I'll post this question a third time to see if I can get an answer, it happens to be pertinent

to the contentions of the claim you are helping your friend with.

If this vet shows pre-existing conditions -- will that then open the door for VA

to fire back with fradulent enlistment ? ?

Also:

1) a claim for depression doesn't require a stressor.

2) the mother of the girlfriend and the officer and the phone call etc...

I would not put any of that info into the claim.

jmho,

carlie

Carlie passed away in November 2015 she is missed.

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Kent,

I sure wish you'd drop the big chip off your shoulder and open your mind enough to understand the damned question. I'm not attacking your friend so you can drop being defensive. The question

that I've asked twice now has yet to be answered.

*************************************************************************

"QUOTE(Berta @ Sep 26 2007, 07:44 AM) post_snapback.gifThis case might help you :

http://www.va.gov/vetapp04/files2/0417844.txt

If a veteran can prove a pre-existing condition was "aggravated" by service they can succeed in a claim like this."

*************************************************************************

I'll post this question a third time to see if I can get an answer, it happens to be pertinent

to the contentions of the claim you are helping your friend with.

If this vet shows pre-existing conditions -- will that then open the door for VA

to fire back with fradulent enlistment ? ?

Also:

1) a claim for depression doesn't require a stressor.

2) the mother of the girlfriend and the officer and the phone call etc...

I would not put any of that info into the claim.

jmho,

carlie

Sorry about that Carlie! I really don't know how to answer your question! There is no evidence of a pre-existing condition other than the statements given to the examiner during the C&P exams and during a MH evaluation by the VA! The clinic that she checked herself into really didn't provide a clinical diagnosis! How could the VA claim a fraudulent enlistment without any documentation stating otherwise? Again sorry about the misunderstanding! BTW, thanks for the info on the depression and stessor because that is something that I didn't know! I was trying to suggest a stessor for the hospitilization! Thanks again to you and everyone trying to help. I definitely am not up here to berate or argue with anyone because we all have opinions and sometimes we won't agree on things. I am glad that you brought up the argument but I never imagined that someone would take it to that next level.

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"If this vet shows pre-existing conditions -- will that then open the door for VA

to fire back with fradulent enlistment"

VA has no power to determine if a military enlistment was fraudulent.

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"If this vet shows pre-existing conditions -- will that then open the door for VA

to fire back with fradulent enlistment"

VA has no power to determine if a military enlistment was fraudulent.

I feel the same way but you never know! The reasons for denial appears to be based solely on the opinions of the C&P examiners. I believe the the DRO will reverse this decision once we hit him with the presumption of soundness argument and the burden will be on them to prove that my roommate had a pre-existing condition since it's not documented upon entry into the service. I am a little confused about the denial for stomach conditions due to not having a clinical diagnosis! We have VA records with a diagnosis of IBS just this year and there is a notation in her SMR of having GERD. I guess they overlooked that!

My question is, does IBS qualify as diagnosed clinical condition? Also, if the DRO reverses the decision, shouldn't depression with suicidal ideation, a gaf score of 45, IBS/GERD, and SSDI disability for depression warrant 100%? Just curious as to what these things would rate!

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"I feel the same way but you never know! The reasons for denial appears to be based solely on the opinions of the C&P examiners..."

no kent, you are not understanding me. VA is not the Department of Defense, and has no influence whatsoever on determinations which belong appropriately under the jurisdiction of the military services. VA has no power under law to determine if an enlistment was fraudulent. period.

i'm a little confused about your comment regarding the opinions of the VA examiners. why do you think they would not be relevant?

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"I feel the same way but you never know! The reasons for denial appears to be based solely on the opinions of the C&P examiners..."

no kent, you are not understanding me. VA is not the Department of Defense, and has no influence whatsoever on determinations which belong appropriately under the jurisdiction of the military services. VA has no power under law to determine if an enlistment was fraudulent. period.

i'm a little confused about your comment regarding the opinions of the VA examiners. why do you think they would not be relevant?

Maybe I am the one confused here! I feel the same way about the VA having no power as you say to determine that her enlistment is fraudulent! I don't understand the reference toward the Department of Defense.

I just feel that the examiners were a little bias and solely focused on gender with being the cause of her depression! Being that I live with her, I would liken her condition more to being mild retardation! There is definitely a cognitive issue involved her thus requiring us to have a psychotherapist!

I was also seeking comments on what a determination could render if the DRO reverses the decision based on the conditions that I stated earlier!

Thanks for your inputs because this is a learning experience for me although it's quite confusing sometimes!

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