Va Denied Roommate's Claim

[kent76]

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

[entropent]

kent, i have reviewed the entire thread, and i have some questions for you. if you want to answer them, maybe i can figure out why the rater made the decision that he did, and give a guess as to whether your claim has a chance of ultimately prevailing. i have reviewed your initial post which quotes part of your roommates rating denial.

1) your roommate was apparently treated for symptoms of depression briefly while on active duty. how long after entry onto active duty did this happen? how long was the treatment? what was the specific diagnosis? was your roommate returned to duty without restrictions? was there any repeat episode documented in the service records? how long after discharge was it before your roommate was treated again for his/her depression, and do you have documentation of this? what is the diagnosis provided by the va examiner? do you have a copy of the va exam that you could quote the examiner's opinion from?

2) stomach complaints. was your roomate treated for unspecified stomach complaints while on active duty, or was there a specific diagnosis, such as viral gastroenteritis? what were the symptoms on active duty (stomach pain, constipation, diarrhea..)? how many times on active duty is there documentation of treatment? how many times after service have the same symptoms been treated? what are the symptoms now? what is the diagnosis now?

these are the type of questions a rater or dro will ask when reviewing your claim. if you feel like answering, i'll take a stab at it.

[kent76]

kent, i have reviewed the entire thread, and i have some questions for you. if you want to answer them, maybe i can figure out why the rater made the decision that he did, and give a guess as to whether your claim has a chance of ultimately prevailing. i have reviewed your initial post which quotes part of your roommates rating denial.

1) your roommate was apparently treated for symptoms of depression briefly while on active duty. how long after entry onto active duty did this happen? how long was the treatment? what was the specific diagnosis? was your roommate returned to duty without restrictions? was there any repeat episode documented in the service records? how long after discharge was it before your roommate was treated again for his/her depression, and do you have documentation of this? what is the diagnosis provided by the va examiner? do you have a copy of the va exam that you could quote the examiner's opinion from?

2) stomach complaints. was your roomate treated for unspecified stomach complaints while on active duty, or was there a specific diagnosis, such as viral gastroenteritis? what were the symptoms on active duty (stomach pain, constipation, diarrhea..)? how many times on active duty is there documentation of treatment? how many times after service have the same symptoms been treated? what are the symptoms now? what is the diagnosis now?

these are the type of questions a rater or dro will ask when reviewing your claim. if you feel like answering, i'll take a stab at it.

[/quot

Thanks again, let me see if I can answer your questions.

My roommate entered the service in November of 2000 and I met her while I was in the reserves about a year later in 2001. She appeared to be a normal male with a girlfriend but was having problems with a his relationship with her. Ironically, the girlfriend was the daughter of someone I had worked with while in college so I knew her mother. Her mother discovered an email my roommate sent to her expressing how he wished someone would kill her because she was being a b*t*h. She forwarded the email to his division officer and navy Lt. and he began mentally and verbally assaulting my roommate with threats and assigning punishments not in accordance with the UCMJ. He even insulted me over the phone when I intervened on my roommates behalf. This led to a mental collaspe by my roommate and a week of hospitalization because of suicide ideation and depression. The officer was later reprimanded and my roommate was transferred to another command.

My best friend and I and her son, the yet to be marine I mentioned earlier in my post, went daily to visit my roommate while hospitalized. She would constantly cry and was afraid that she was going to be kicked out of the military and how disappointed her family would be in her. It was near Thanksgiving so we decided to let her move in with us because we feared she would try killing her self in her state of mind if left alone.

My roommate was also prescribed minocyline for acne while on active duty, she quit taking them after 6 months because she started having stomach problems shortly afterwards. The stomach problems has be constant since 2002 and she has had many episodes and treatments for it. She was diagnosed with GERD on one occasion in her service records and on her exist physical, it was also noted that the stomach pain was still prevelent.

My roommate was given a choice whether to continue with her service or receive a discharge, she chose to stay in because I was there to encourage her along with some of my friends. The treating doctor during the hospitalization was instrumental in having the harrassing officer reprimanded and helped with getting her a transfer to another command. He was a navy Captain!

He told her to call him personally if she ever needed his help in the future.

My roommate actually signed an extension for 2 years in return for orders to Japan near the end of her enlistment; however, once in Japan, about 4 months later, she was found to be not eligible for overseas duty and returned stateside with orders to the same command she transferred from. Japan was her dream assignment but now she had to return to her former command with a 2 year extension on top of that. The depression returned worst than ever. She was able to have the military waive one year of that extension but she had to go on a deployment for 6 months. She made it through the deployment but was only allowed to work cleaning heads and painting because she was not focused enough to do her job which was on the flight deck working around airplanes. She told me that she almost lost her life on one occasion thus being relegated to cleaning duties.

She was honorably separated in November of 2004. She had found a new girlfriend and things were going fine until she revealed to her in 2005 that she had always wanted to be a girl. She lived with me for several years before she told me this. She was afraid that I would abandon her so she kept this from me the whole while. Her girlfriend dumped her and I was concerned enough to seek therapy for her for depression and talk of her electrocuting herself. The first therapist was a female who specialized in transgender issues but she made matters worst by showing little empathy for her problems which btw still included intense stomach pain, nausia, and vomitting. We sought out another therapist who she liked and we continue to see today. He was the one who recommended that we apply for SSDI and he gave her an extensive evaluation that concluded that my roommate suffers from a major depressive disorder with suicidal ideation. The GAF score was 45. The transgender issue was an issue; however, he felt that and noted that he felt that his parents were problematic with the father being an alcoholic and abusive and the mother was neglective of her kids. The separated when my roommate was 9 and she stayed with the mother. The mother was acccording to my roommate, ADD and once in a cult. She remarried to a man named Bill who was more a father to her than her biological father. The mother divorced him also and has had many relationships with men since.

Once my roommate revealed her gender decision to her family, they abandoned her and this only complicated things. This is where we stand today.

In 2005 we sought treatment also at the VA hospital for both depression and stomach problems. The MH clinic therapist referred in his report to my roommate as a "homosexual male" which is totally wrong! He stated that she suffered from depression with suicide ideation positive and had a personality disorder or Gender Identity Disorder. He gave her a GAF score 45. The medication he precribed actually made her more suicidal and depressed and he seemed very uninformed and uncomfortable about transgenderism. My roommate asked for another therapist but the VA would not comply with this request. So we pretty much only see the VA now for the stomach problems.

Speaking of stomach problems, the VA actually gave my roommate a diagnosis of Irriatible Bowel Syndrome in March of this year and the C&P exams were in June.

Finally, the C&P exams were very short and I was present for both examinations. The first examiner checked for signs of acne which was present but only qualified at 0% rating. Next he touched her stomach and asked if she had any pain. He noted that there was still problems but he failed to give a diagnosis and he noted that he didn't find any stomach problems. I am still scratching my head on that one!

The next examiner was funny, he thought that he had the wrong patient because he expected a female! Anyway, the exam lasted only about 15 mins and he basically focused on the transgender issues and not so much the depression. I felt that he steered the exam toward his conclusion. My roommate stated that she felt like she has known since an early age that she wanted to be a girl. So, I guess that he took that and ran with it! I feel that the depressive issues were intentionally ignored.

[entropent]

kent, i realize the va claims process is pretty bewildering for you and your roommate, and you don't know where to even begin, but you are going on about issues that are not relevant. i need very specific answers to my very specific questions. it sounds mean, and i don't want to hurt your feelings, but you have to understand that neither the rater nor the dro care about your roommate's rather dramatic life story. when you meet with the dro it will hurt you more than it helps to go on about all that stuff because it is just irrelevant. what the rater or dro wants to know is, was there a diagnosed mental disorder in service? is there a current diagnosed mental disorder? is there a link between the in-service mental disorder and the current mental disorder? if there was a diagnosis in service, was it part of a process that pre-existed service? is the presumption of soundness rebuttable? if it pre-existed service, was it measurably aggravated WHILE IN SERVICE? the answer to these questions will determine if service connection is warranted. in order for me to answer these questions, i need you to specifically answer, one by one, the questions i raised in my previous post. don't worry about the stomach issues right now.

[kent76]

kent, i realize the va claims process is pretty bewildering for you and your roommate, and you don't know where to even begin, but you are going on about issues that are not relevant. i need very specific answers to my very specific questions. it sounds mean, and i don't want to hurt your feelings, but you have to understand that neither the rater nor the dro care about your roommate's rather dramatic life story. when you meet with the dro it will hurt you more than it helps to go on about all that stuff because it is just irrelevant. what the rater or dro wants to know is, was there a diagnosed mental disorder in service? is there a current diagnosed mental disorder? is there a link between the in-service mental disorder and the current mental disorder? if there was a diagnosis in service, was it part of a process that pre-existed service? is the presumption of soundness rebuttable? if it pre-existed service, was it measurably aggravated WHILE IN SERVICE? the answer to these questions will determine if service connection is warranted. in order for me to answer these questions, i need you to specifically answer, one by one, the questions i raised in my previous post. don't worry about the stomach issues right now.

[/quot

Thanks again for your help! We are going to see a representative and let him/her review the decision with us to determine which way to approach this on Monday. I will let you know all the issues at that time. This way I can give you some informed material rather than speculation and opinions. I know that you are trying to help me so I truly appreciate your assistance.

I will definitely let everyone know the outcome of this!

[kent76]

kent, i realize the va claims process is pretty bewildering for you and your roommate, and you don't know where to even begin, but you are going on about issues that are not relevant. i need very specific answers to my very specific questions. it sounds mean, and i don't want to hurt your feelings, but you have to understand that neither the rater nor the dro care about your roommate's rather dramatic life story. when you meet with the dro it will hurt you more than it helps to go on about all that stuff because it is just irrelevant. what the rater or dro wants to know is, was there a diagnosed mental disorder in service? is there a current diagnosed mental disorder? is there a link between the in-service mental disorder and the current mental disorder? if there was a diagnosis in service, was it part of a process that pre-existed service? is the presumption of soundness rebuttable? if it pre-existed service, was it measurably aggravated WHILE IN SERVICE? the answer to these questions will determine if service connection is warranted. in order for me to answer these questions, i need you to specifically answer, one by one, the questions i raised in my previous post. don't worry about the stomach issues right now.

Entropent, those questions are something that I can't begin to answer because there is not much information for me determine what the rater based his decision on as far as the pre-existing of her diagnosis of depression and personality disorder other than the SMR reference while on active duty. Every other diagnosis of depression and personality disorder came after the military service. The first diagnosis came from our therapist for her having a major depressive disorder with suicidal ideation with a GAF score of 45. Next came the VA hospital therapist who first stated the depression and personality disorder as being a gender identity disorder. He also gave her a GAF score of 45. We also had the SSA therapist diagnose her with a personality disorder with depression. We were awarded SSDI for her condition. The C&P examiner focused entirely on the gender issue. The rater's decision seemed to specifically refer to the examiner's references in making his decision on denying the depression claim.

[chess]

Carlie

I answered your question..you just did not like the answer. Again, if your roomate had preexisting conditions that (s)he DENIED on their Pre Enlistment Physical, then that is fraud.

What did your roomate put down for "Sex" on the form? Did (s)he put "Yes", or "not sure", or "Female soon to be male", or "male soon to be female" in answer to that question? If (s)he answered even that question falsely, then that is fraud.