Medical Opinion Of Two Psychiatrist To Amc

[Josephine]

My husband has the letter in his hand and the guy at records did not read it correctly.

I am not sure, if I am on better standing ground, but it sounds better to me.

This is the way it reads:

Reviewed the C-file and Personnel Records, letter of Dr. B.Cxxxx and the 4 letters by Dr. Pxxx with the dates.

It is the honest opionion of these two professional examiners that the etiology is the preponderance of the evidence is suggestive and appears the veterans anxiety may have preceded service.

At least they have admitted that I had ANXIETY IN SERVICE. They have dropped the Personality Disorder also.

They are still using the word " Appears"

What do you think??

Betty

(Josephine)

Edited November 29, 2007 by Josephine

[free_spirit_etc]

Hi. Been busy as heck -- but popped in for a moment. They didn't just use "appears" Geez -- Is SUGGESTIVE and APPEARS the veterans anxiety MAY have preceeded the service.

I am not sure this is better for you or not. Who wrote this.

It sounds wishy washy to me -- like they are trying to give someone an out without going as far as saying more likely than not. But I guess wishy washy is better than strongly against.

It COULD help - as they dropped the Personality Disorder thing --but that is a MAYBE -- because they used the word etiology is suggestive -- so are they leaving themselves the room to move full circle into a "the etiology" is actually the "persoanilty disorder... I.e. that the anxiety is caused by the personality disorder which preceeded the service.

I am not sure - but what other etiology are they giving for your anxiety that would suggest it preceeded the service?

Again - it looks like it is wishy washy enough that they are leaving it open to interpretation.

It could be good - if it is interpreted that it is ONLY anxiety because if they deny you - you can go for in-service aggravation - and even the presumption of soundness.

I think they should come right out and say what they think. However the fact that they didn't may work in your favor. SUGGESTIVE, APPEARS, and MAY have doesn't sound more likely then not to me.

Free

My husband has the letter in his hand and the guy at records did not read it correctly.

I am not sure, if I am on better standing ground, but it sounds better to me.

This is the way it reads:

Reviewed the C-file and Personnel Records, letter of Dr. B.Cxxxx and the 4 letters by Dr. Pxxx with the dates.

It is the honest opionion of these two professional examiners that the etiology is the preponderance of the evidence is suggestive and appears the veterans anxiety may have preceded service.

At least they have admitted that I had ANXIETY IN SERVICE. They have dropped the Personality Disorder also.

They are still using the word " Appears"

What do you think??

Betty

(Josephine)

[free_spirit_etc]

Also - keep in mind the BVA was VERY interested in your minister's lay statements. Those show an EXTREME change in your disposition between pre and post service. So with the wishy washy appears, seems, might be, could maybe opinion, an admission that you DID have anxiety in service, and the lay testimony that you were super person before the service - I would say you have a strong case.

I don't think a maybe might have appeared suggested wishy washing medical opinion that is now too scared to mention the word personality disorder (most likely because they know they didn't diagnose it by adequate means) can over shadow the fact that there are no medical records of anxiety before service, excellent lay testimony of the change in you during the service, and the fact that they are dating it back TO the service (by trying to make it before) actually helps overcome the idea that it may have started after service.

Free

[Josephine]

Also - keep in mind the BVA was VERY interested in your minister's lay statements. Those show an EXTREME change in your disposition between pre and post service. So with the wishy washy appears, seems, might be, could maybe opinion, an admission that you DID have anxiety in service, and the lay testimony that you were super person before the service - I would say you have a strong case.

I don't think a maybe might have appeared suggested wishy washing medical opinion that is now too scared to mention the word personality disorder (most likely because they know they didn't diagnose it by adequate means) can over shadow the fact that there are no medical records of anxiety before service, excellent lay testimony of the change in you during the service, and the fact that they are dating it back TO the service (by trying to make it before) actually helps overcome the idea that it may have started after service.

Free

Free,

So nice to hear from you. I know that you are extremely busy. When my husband made it home from work, I posted the correct wording of the addendum by that nutty woman psychaitrist at the VAMC.

She came up with this stupid letter and etiology and opinion.

If you have the time, please read the new post " Actual letter to AMC " - A Spider Web that gets larger and larger.

Thanks for reminding me of my Pastor, as I placed this into my argument to the AMC.

I faxed the letter this morning.

Again, many thanks,

Always,

Josephine

Edited November 28, 2007 by Josephine

[tssnave]

Betty,

"May have" sounds to me like a 50/50 response (may have, may have not) in which case, under the VA benefit of doubt rule, the tie goes to the veteran and you should prevail. Berta, John, Vike, others who read the court cases, do you agree?

I'm w/ Pete - you're heading into the home stretch and we're all rooting you on for a slide into home plate and when the dust settles the ump will yell "SAFE!" and you will be looking at the biggest retro hadit members has ever had the priviledge of helping a veteran rightfully get and we will all by dancing in the streets for you.

Hang in there, keep us posted, I'm praying for ya,

TS

[Josephine]

tssnave,


Here is the actual letter. It is more stupid now than it ever was.

I have the letter at the computer and I feel that Dr. L is trying to place all doctors into her web.

Here goes:

Examining Provider: L.L. Lxxxxxx, MD

Examined on : November 16, 2007

Examining Results:

The c-file, including personnel records, Dr. Pxxxxx's letters of 4/5/04, 1/23/06, 4/28/06, and 10/9/07, and Dr. B. Cxxxxx letter of 5/10/2005, was made available to the examiners and was reviewed.

The current request involves consideration of letters by Dr. B. Cxxxxxx and Dr. Pxxxx and " to reconcile their opinion as to etiology".

In our professional opinion, the propenderance of the evidence, including the letters by Dr. Cxxxxx and Pxxxx, supports the initial findings and diagnosis of the examiners and suggest that the etiology of her anxiety appears to have preceded her time in service.

Dr. L. L.

Receipt Acknowledged By:

/es/G/ Bxxx

Here is my fax which is being sent first thing this morning.

To the Rating Specialist:

I shall exercise my rights as a Veteran of the United States Navy and a Citizen of the United States and shall expect due process upon the rating of my claim for service connection for anxiety with depression.

I have read the 11/16/2007 Addendum authored by Dr. Lxxx Lxxxx.

She states that Dr. Brian Cxxxxxx and Dr. Michael Pxxxxx supports her findings and diagnosis and suggest that the etiology of my anxiety appears to have preceded my time in service.

I shall expect you to review the four letters authored by my physician of 30 years. Dr. Michael Pxxxxx.

Dr. Pxxxxx has stated many times that it is his medical opinion that my anxiety had its’ origin in service and is vocal in his letter concerning Dr. L. Lxxx in her diagnosis of my “personality disorder”, in fact his letter states, He has read the compensation examination by Dr. Christopher Mxxxx and Dr. L. Lxxxx and states that she is patently incorrect in her facts and I do not have a personality disorder.

I have read each of the four letters and he is in no way in agreement with her diagnosis of personality disorder or her findings. He does agree with her AXIS 1 of Anxiety.

As for Dr. Brian Cxxxxx, he states he is writing to clarify his shorthand and that he added a tranquilizer to my headache medicine for anxiety. Dr. Cxxxxxx has not expressed his opinion of being in agreement with her findings . He states that he was supportive of my early discharge.

Dr. Christopher Mxxxxx VAMC October 18, 2004. Findings do not agree with Dr L. Lxxxx and he in no way has expressed his etiology that my anxiety preceded my service, in fact, he states given the closeness to her treatment to her military service compared to 1979, this makes it more likely that she had been having problems in 1964 as well. In addition, the veteran had two psychiatric referrals within a short period of time in March , 1964 . Given this fact, it makes it more likely that she had some kind of psychiatric difficulty while in the service, and she was judged to be unsuitable for service.

Please refer to VA’s regulation implementing the presumption of sound condition, 38 CFR 3.304(.

Please read the letters authored by Pastor B. O Bxxxxx, April 17, 2005, April 18, 2005 and April 22, 2006.

Letter by Baxxxx B. Mxxxxxxx July 7, 2006

Rate the claim within the next two weeks, as I have advanced on the docket signed by Nancy Robin. March 06, 2006, as you have a copy of this document.

I hereby certify that the information is true and correct to the best of my knowledge and belief.

Always,

Josephine

Edited December 9, 2007 by Josephine

[free_spirit_etc]

The current request involves consideration of letters by Dr. B. Cxxxxxx and Dr. Pxxxx and " to reconcile their opinion as to etiology".

In our professional opinion, the propenderance of the evidence, including the letters by Dr. Cxxxxx and Pxxxx, supports the initial findings and diagnosis of the examiners and suggest that the etiology of her anxiety appears to have preceded her time in service.

So they didn't drop the personality disorder diagnosis - they just didn't mention it by name. However, I think this slight back paddling should help you a bit. The first time they asked them they merely said they hadn't changed their mind.

If that answer was adequate --the AMC should have stopped then. However, they must have found the "we haven't changed our mind" type opinion to be inadequate --because they asked them AGAIN. After all - the BVA said they needed to RECONICLE their opinion - so the AMC gave them another chance to reconcile it (i.e. make it fit with the other evidence.

Their new opinion is just a fluffier way of saying "we haven't changed our mind." They gave no medical rationale for why their opinion remains the same. Geez -- they should have been AT LEAST able to pull SOMETHING out of those reports to say "so and so reported such and such --which is consistent with balh blah blah.."

But they didn't do that. They just fluffed up their first answer and said - in essence - Yep we read everything and it supports what we thought and we haven't changed our mind...

I don't call that reconciling my opinion in light of the additional evidence.

And apparently the VA didn't either - unless they want to pretend the new fluffed up version is "real" because it looks a bit fluffier.

And I think it is good that the quacks backpaddled a bit -- their opinion wasn't that strongly stated. They tried to toss out something that might please someone who would want to deny you - but they didn't back it strongly.

It isn't adequate for what the VA requested -- but I don't know how much I would point that out. WOuldn't want them to decide to take the second option of sending you to another C&P. I think if the AMC doesn't grant your claim - you could do well with the BVA as the "reconcilation" weakened the quack C&P because they weren't willing to stand behind it with any medical rationale. And it should be getting to the point where they have to DECIDE -- they can't keep sending you back to C&Ps forever until they finally find someone who is willing to write you a crappy C&P after doing adequate testing and is willing to give rationale to back their opinion.

One thing I find amazing is that for anything else -- a diagnosis 30 to 40 years later is next to impossible to connect to service. However, YEARS down the road with no personality disorder diagnosis in between - they can just have a couple of doctors spend a bit of time with you - and profess to know what you were suffering from 40 years before. Amazing. Where is THEIR Nexus???

Free