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

[Berta]

"I honestly think that the depression is a manifestation of a complex array of things but certainly not being transgendered"

I sure agree- my only point was the depression claim seemed to be based on depression resulting in some way from her service and I tried to consider various scenarios in which that could gain service connection.I certainly considered that she might have exhibited signs of transgender behavior that could have caused an inservice assault like the Marine in the BVA decision suffered from and was award direct PTSD SC for it.

She could also -based on what you just posted-potentially have a claim of depression due to aggravation of a pre-existing condition.

I am not familiar with how VA Service connects aggravation of pre-existing conditions.

The regs are in 38 USC 1110,1111,1131, 1113 , 38 CFR 3.306 And Wagner V Principi.

If the inservice depression aggravated a pre -existing condition-that is also a way to attempt to gain direct service connection.

The BVA web site can be searched for claims like this.

Edited September 25, 2007 by Berta

[kent76]

"I honestly think that the depression is a manifestation of a complex array of things but certainly not being transgendered"

I sure agree- my only point was the depression claim seemed to be based on depression resulting in some way from her service and I tried to consider various scenarios in which that could gain service connection.I certainly considered that she might have exhibited signs of transgender behavior that could have caused an inservice assault like the Marine in the BVA decision suffered from and was award direct PTSD SC for it.

She could also -based on what you just posted-potentially have a claim of depression due to aggravation of a pre-existing condition.

I am not familiar with how VA Service connects aggravation of pre-existing conditions.

The regs are in 38 USC 1110,1111,1131, 1113 , 38 CFR 3.306 And Wagner V Principi.

If the inservice depression aggravated a pre -existing condition-that is also a way to attempt to gain direct service connection.

The BVA web site can be searched for claims like this.

Thank you so much for your help! I will certainly explore those avenues you've mention! ken

[Berta]

This 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.

There is a lot to doing that though-and there is the fact that the vet did not have the past problems documented at induction or with the recruiter.Maybe this is not the best way to go-

Ken- these are complex issues-I know you are doing your best to help this veteran but I would-if I were you-try to seek a good vet rep to help your friend with these claims.

And by all means stay aboard here too-

the NOD has to be prepared and this is where you can raise argument on their decision.

Also -did the veteran get a legal VCAA letter telling her exactly what she needed to succeed in each claim?

Did the SSA also consider the GERD and IBS as part of her inability to work?

That might be the BEST avenue of approach here-

one more question- if this is a Gulf War veterans please look up the Persian Gulf War regs as to the IBS- etc.

Whether GW vet or not this case shows how VA rates IBS:

http://www.va.gov/vetapp07/files2/0717227.txt

Many vets have had GERD associated to SC ISB for additional SC ratings.

With some documentation in her SMRS- as to this condition and proof that it is current and at a ratable level-these are points you can make in the NOD.(I would send them highlighted copies of the SMRs too as to which ones show inservice stomach problems)and also send copies of anything whatsoever in the SSA findings that would help this claim as to the IBS and GERD.

[LarryJ]

and, regardless of whether or not she had problems prior to enlistment, if these problems are NOT noted on her induction physical, then she entered the service under the assumption of physical/mental fitness. In other words, if it wasn't noted on her entrance exam, then she didn't have it. And, if it was noted on her physical, then comes into play the "aggravation" argument i.e. Was her noted condition worsened by or during her enlistment..........?

[entropent]

the entrance exam may not have noted anything, but that is based on the vet's history alone. if the vet displayed a significant level of disablity within a short enough period of time after entry onto active duty, the presumption of soundness can be rebutted.

that said, service connection by aggravation can still be pursued if it can be shown that the condition objectively worsened WHILE ON ACTIVE DUTY. it is not service aggravation if the condition worsened after discharge.

Edited September 26, 2007 by entropent

[carlie]

Not to PO anyone regarding this thread, but my question is:

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

to fire back with fradulent enlistment ? ?

jmho,

carlie