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

[kent76]

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.

I really can't figure you out!

You want to make this into something it's not! Again, you want to throw in an accusation of fraud when there is none to be had! There is no law that states that you have to give the military information about sex especially since the gender issue wasn't acted upon until she got out of the military. Therefore, there is no basis for your reasonings. Also, the military's don't ask/ don't tell policy prohibits that line of questioning that you are speaking of! The pre-enlistment physical is a mute point since she completed her enlistment honorably and the fact she didn't have a documented pre-enlisted diagnosis, she was not obligated to disclose that information. She was a male before she joined and a male when she existed the military.

So please tell me your basis for fraud.

[entropent]

"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..."

if there is a reference to mental health treatment which pre-existed service in the service medical records relating to the in-service treatment, that is not a good thing. VA is not prohibited from using statements of the veteran that are detrimental to his case, provided the entirety of the evidence supports a rebuttal of the presumption of soundness. which it sounds like the rater got with your roomate's va examination medical opinion. if matters whether the in-service hospitalization provide a specific diagnosis of depression, or "adjustment disorder."

if there was a period of several years before your roommate was diagnosed with depression after discharge, that is also not a good thing, unless there was a specific diagnosis of depression in service.

"The rater's decision seemed to specifically refer to the examiner's references in making his decision on denying the depression claim"

the va examination medical opinion is strong evidence from the rater's point of view. you need to have a copy of that examination in order to know how to specifically rebut the examiner's medical opinion if you want a chance of prevailing in this claim.

i don't think i am going out on a limb when i guess that both the rater and the va examiner have been influenced by their personal feelings about transsexualism. if you want to prevail, you are going to have to focus very specifically on the evidence in the service medical records and directly rebut the VA examiner's medical opinion with a strong independent medical opinion of your own. to do that, you have got to have a private psych review the records of in-service treatment and discuss them in the medical opinion. so my best advice is to write VA and request a complete copy of the claims file under the Freedom of Information Act. and you are going to have to settle in for the long haul, because this will not be an easy claim to pursue.

i wish you luck.

[carlie]

Chess,

You posted, "I answered your question..you just did not like the answer."

1) I don't find any post in this thread where you answered my question.

2) It's irrelevant here if someone likes or doesn't like an answer to a claims/research question.

What matters is if an answer is adjudicatively correct, by VA rules and regs.

Kent,

The reason I posted my question in this thread,

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

to fire back with fraudulent enlistment"

When trying to get the depression service connected by aggravation of a pre-existing condition

and you show a suicide attempt prior to enlistment, I think you'll run into problems because

this mental health information was not disclosed prior to entry. This is where my question comes in. The question has nothing to do with her sexuality.

As it has already been suggested by myself and other members, as far as VA disability claims go, it would be in the best interest of the claimant to stay away from discussing those issues and all of the additional drama involved in this claimants life. I promise you these issues will only have a negative impact on a claim for service connected disability.

jmho,

carlie

[kent76]

Chess,

You posted, "I answered your question..you just did not like the answer."

1) I don't find any post in this thread where you answered my question.

2) It's irrelevant here if someone likes or doesn't like an answer to a claims/research question.

What matters is if an answer is adjudicatively correct, by VA rules and regs.

Kent,

The reason I posted my question in this thread,

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

to fire back with fraudulent enlistment"

When trying to get the depression service connected by aggravation of a pre-existing condition

and you show a suicide attempt prior to enlistment, I think you'll run into problems because

this mental health information was not disclosed prior to entry. This is where my question comes in. The question has nothing to do with her sexuality.

As it has already been suggested by myself and other members, as far as VA disability claims go, it would be in the best interest of the claimant to stay away from discussing those issues and all of the additional drama involved in this claimants life. I promise you these issues will only have a negative impact on a claim for service connected disability.

jmho,

carlie

I agree Carlie! We are prepared to go the distance with this! And you asked some valid questions and gave some very imformative advise. I thank you for doing this.

I will definitely stay away from anything that could harm our claim and will follow the advise of our representative while pursuing the NOD. I will also keep you informed as to how this claim process goes.

[sixthscents]

OK, I actually took the time to read this entire thread.

Kent... as an ex-recruiter let me point out a few FACTS... your "roomate" he/she WAS asked REPEATEDLY during her entrance screening and physical if she/he/it had ever attempted to commit suicide or had ANY mental conditions. REPEATEDLY.... like over and over again. He/She signed he name on countless documents stating that he/she had no know mental or physical problems and they ask specific questions about mental health. He/She denied it, or would not have been allowed enlistment.

Could His/Her recruiter have told her to lie... well heck yeah. They do all the time. Does that mean that shes not responsible for her lie, and further actions?

Nope she/he what the heck ever lied about a pre-existing mental condition. You said so. I dont care if its not documented, because if it was this would be a moot point because he/she would never have gotten in.

So basically you are saying she should be compensated even IF she lied since her recruiter "told" her to do it. Trust me buddy he wasnt in the medical section when she/he answered all those questionaires. He wasn't there for inprocessing and the "moment of truth" at basic. He wasn't there for the entire enlistment when she/he COULD have admitted the pre-existing condition. So I'm sorry but the idea the she/he is entitled to compensation NOW is plain bull. She/He doesnt deserve a penny of compensation and actually should have her/his character of service changed since she/he fraudulently enlisted. I would suggest if she/he is an honorable person that they submit a request for correction of records and come clean about it.....

Nobody MADE her/him or what the heck ever lie... they did it all on their own.

So this is a simple issue. She/He isn't entitled to crap.

Now I have had enough of this.... Carlie I hope I'm not pissing you off cause your right but this is an admittedly fraudulent claim so I am closing this thread....

Kent go peddle your crap elsewhere... we have enough really service disabled veterans who need help without spending 20+ posts on an admitted liar.

[Tbird]

well what can i say about this...i understand sixthscents frustration, this claim just seems like a non starter before you even get to the transgendered issue, which will i almost sure not be easy to separate from anything that may have happened in service, then you got the personality disorder and that's a non starter. it sounds like she is struggling and i hope you continue to support her, but really if she lied on the enlistment contract and then wants to say that service caused her pre existing condition to get worse, a pre existing condition she lied about then i mean what are we suppose to tell you.

if you have a valid claim we can assist with regulations laws manuals interpertations research, but you have to have a valid claim. not one we think is valid one that the va thinks is valid don't get mad at us we go by the book they use because it's the only way to win.