Diagnosis Change Or Not

[Rockhound]

Veteran has a current sleep apnea diagnosis supported by a sleep study. Veteran submits a claim for sleep apnea and was scheduled for a C&P examination;

The results of the examination are as follows The VA examiner states, at this time my prefered opinion is that Veterans represents as having Nocturnal Hypoxia and based on the history given, it would be difficult for this examiner to fully support a diagnosis of sleep apnea.

The VA Adjudicator then denies claim stating that a diagnosis change was made and that the Nocturnal Hypoxia was the correct alternative diagnosis.

thus a claim for sleep apnea is declined, since the correct diagnosis was for Nocturnal Hypoxia and veteran's medical hystory is mute on this issue.

Is this a change in a diagnosis and/or was it properly changed?

Yea it's a twist on my claim, but some people just don't get it.

[carlie]

My only bone of contention is that since I use them as my only source of medical care and treatment, why then can't I use them like I would an IMO and why are they provented from giving me a nexus letter, even if I can provide them with the same medical records that are a part of my C-File and necessary for such a opinion?

RR B)

What prevents them from providing you with a Nexus statement ???

carlie

Edited June 23, 2008 by carlie
sp

[Teac]

I would say that you need not worry, since this is an exercise to see how the average person would look at the claim. However, the later presentation was based on my actual claim and even after 30 plus years, the same VARO insists on denying the claim based on the same flawed reasons they gave 30 plus years ago.

If you must know, it is the Nevada Office of Veterans Services, Reno Nevada. I would be tempted to seek out a more favorable VARO, but the VA Health System here is probably as good as it gets and I have few complaints of their care and treatment. My only bone of contention is that since I use them as my only source of medical care and treatment, why then can't I use them like I would an IMO and why are they provented from giving me a nexus letter, even if I can provide them with the same medical records that are a part of my C-File and necessary for such a opinion?

RR B)

Regarding Medical opinions VA must honor all requests for the provision of medical statements,

See attached PDF:

VHA_directive_2007_024_dr_statements.pdf

[john999]

Rock

You got screwed, but you are not alone. The people that screwed you have no honor. It really pisses me off but you have to play by their rules. Otherwise they lock you up. This is why I got a lawyer. I want emotional distance between me and them. They tought me how to hate.

[ruby]

Rock,

While I don't know alot I am learning, since I have screwed up my claim for reactive arthritis 3 times by not asking for it the correct way. What I am saying is your going to have to fight this using thier rules.

In order to do that you have to know what both DX means.

I am not saying you don't have sleep apnea. I am saying they are splitting hairs and for you to win you will have to show them they split the wrong hairs.

You can only do that by knowing the difference between the 2 dx and the treatment for both of them.

You asked for sleep apnea, they are saying its denied you don't have sleep apnea, since the comp doc said its nocturnal hypoxia, since thier is a difference in the dx one is for loss of respiration, the other is for decreased or shallow respiration.

Whether its right or wrong is not the question, its how do you fix it.

From what I have learned the rated must have asked for an opinion whether you had sleep apnea or not and the Comp Doc said no. End of claim as far as the VA is concerned.

Whats the difference in treatment for either, would nocturnal hypoxia be classified as sleep apnea by the CFR or does it have its own section.

If there is no difference in the rating, let them eat thier words. File for nocturnal hypoxia using this comp exam as proof.

Sorry they are screwing with you.

Ruby

[Hoppy]

Rock,

It sounds to me like you are saying that you were treated in the military for a psych condition that was determined to be a personality disorder by military shrinks and you are trying to link it to a current psych condition. Is this what is happening?. If yes, there are several people on the bosrd who were sucessful in getting the diagnosis made by military shrinks changed to an anxiety disorded and or PTSD and who eventually won their claims. There are several people who have come and gone and lost their claim.

I would be willing to help as I did several other veterans if the evidence from the military is available. It required that the veterans re-enter therapy at a VA and have the VA shrinks review the military records and write a report that you were misdiagnosed in the military. One veteran was sucessful without re-entering therapy at a VA and got an IMO to review the reports and write a report of misdiagnosis. I have not seen any case where C&P exams alone resulted in a change of diagnosis based on misdiagnosis by military shrinks. Believe it or not there are VA shrinks who are of the opinion that the personality disorder diagnoses were misused by military shrinks and they will fight for you tooth and nail. If you are interested in making this effort and you want my assistance I will need to know some specifics before I decide to get involved.

Edited June 24, 2008 by Hoppy

[Josephine]

Rock,

I am one that went for the Independent Medical Opinion.

I did travel to D. C to an expert Forsensic Psychiatrist.

This is what he wrote and located in my military records for me to

receive a grant and retro pay.

Summary of Professional Opinion:

My review of the records show no documentation which would support

the diagnosis of Personality Disorder.

There simply are no data which would support

that diagnosis under the criteria provided

in the Diagnostic and Stastical Manual of the

American Psychiatric Association.

No psychological or personality testing was done.

There was never any showing of an " enduring pattern

of inner experience and behavior that deviates

markedly from the expectations of the individual's culture...

is inflexible and pervasive across a broad rage of personal

and social situations... is stable and of long duration...

(and) is not better accounted for as a

manifestation or consequence of another mental disorder.

" DSM IV TR, pages 287 - 288.

The " other mental disorder" which she clearly

DID and DOES have, and for which she has been

treated for 43 years, is Anxiety Disorder.

The veteran had no childhood psychiatric,

difficulties or treatment, Her anxiety disorder

began during her time in service.

She has been treated for anxiety disorder

for 43 years by a number of physicians.

Diagnosis: 300.00 Anxiety Disorder,

NOS,Chronic, Severe, with Depressive Features.

This chronic, and in this veterans' case,

disabling, mental disorder first manifested

itself while in service and has required

treatment ever since.

There is no evidence to support

the diagnosis of personality disorder made in 1964

and used as a basis for her separation from service.

Sincerely.

B. Cxxxx M.D. D.L.F.P.A.

Hope this helps.

Betty