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.

[Rockhound]

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?.

NO! I'm saying that the military treated me for a mental disorder and the VA changed to a PD.

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.

I'm saying they diagnosis in the service was correct and that the VA claim that it was erroneous was incorrect.

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.

Forget that the in-service diagnosis was misdiagnosed as a PD It was the C&P examiner that made the opinion of a PD, but he also did not say the original diagnosis was wrong and that his current diagnosis was a correction for it.

[Rockhound]

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

carlie

I can only surmise that it is an in house directive. or that any statement that could be construed as to possibly being used in a VA Claim, then they are advised not to give such a statement.

I've asked for an a determination as to whether or not if my problems I am having now are related to my inservice psychotic episode and most recently, I am trying to determine if my current problems with attention, memory, fatigue, sleep disturbances, depression, anxiety and a couple of others things are related to the Closed TBI I had in service. I am currently waiting on results from a battery of neuropsychological tests that may be of some indication in that respect. Also they may also be able to conferm a statement I did get put in my medical records, and that is at this time my psychiatrist could not desern from my MMPI and her own observations that I exibited any of the known PD of note. (just a summery not her exact words)

[Rockhound]

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

See attached PDF:

Sorry, here again we will probably agree to disagree. VA does not have to honor all requests for provision of medical statements, nor do they have to provide a nexus statement. They must help you fill out medical forms and they can put a discriptive statement in your medical records, but their is nothing that says they must state that your current diagnosis is related to your in-service diagnosis or SC one. They can say that you have a cureent diagnosis and because of it you are unable to work, or walk and need an electric chair or cart.

I imagine if they want to, they can, but if the policy of the hospital is not to give nexus statements, it's going to be hard to get them to do it. If they don't have your complete medical file on which your claim is based on and also is a part of your C-File, nothing says that if you provide them with a copy, they have to read it and then make a nexus statement.

If I read the VHA directive, giving nexus statements is the preview of the C&P examination dept.

RR B)

[john999]

Rockhound

You need to do what Josephine has done in regards a medical report. All the rest of it is dancing around on rules and regs that are not going to get you anywhere. You need medical evidence in the form of a review of your records. Half a loaf is better than none, so you may get service connection, but the CUE thing is not the way to go if you need money now. You want to get SC'ed and rated at least as TDIU in your life time. I know you are broke but you are just going to be waiting for years with these CUE claims. You will be older and broker by the time you get denied. Pursue the CUE after you get SC'ed for schizophrenia, anxiety, depression or some combination. The VA will probably do all your claims at the same time so you have time to get it together for straight SC. I am pursuing a CUE but I already have TDIU. If I win that would be great and if I lose then too bad, but I still eat. If the VA can demonstrate that any of your rating was due to difference in judgement you lose. That is why almost all CUE claims fail. They made it like that for a reason which is to deny 99% of those who apply.

[Berta]

John made a good point Rockhound-

CUE claims are VERY hard to win-

The VA again denied my CUE claims the other day-

They based this on their statement that my husband had never filed a Section 1151 claim in his lifetime-

He certainly did and it is in the C file-Filed MArch 24, 1994 and confirmed as in the rating board by a Mrs. XXXXX at the RO the AM of his death.I remember her name well and marked the file with her name in 1994.

Hours after he called and spoke to her regarding both of his claims-she was the same 800# rep when I called to report his death.She was extremely upset and remembered talking to him the AM.

I sure might have the Green card from 1994- we saved everything in files-oddly enough- I dont think it would even matter for the CUE if he filed this claim or not but he did.

The problem I have is that VA awarded for multiple malpracticed disabilities but that was at VACO in DC-

The RO failed to rate any of these 1151 disabilities but did pay me Sec 1151 DIC.Even my rep questioned that in 1998 but never advised me to NOD the decision and I should have NOdded it right away-

but still my point here is this-

Fighting a CUE should not be as important as fighting a current claim.

I felt the VA committed a legal error in a past decision you got because- as the BVA case I posted showed- your inservice hospitalization should have generated a rating for residuals of the episode in service.It seemed impossible for me to understand how a vet could have a psychiatric episode in service that he was hospitalized for yet receive no rating for any residuals on it after service.

That seemed to be the point of the BVA case I posted a link to here-

not a CUE but the veteran as I recall did get a SC rating for residuals of something like what you went through.

In the VA denial I just got- not a single piece of the legal evidence I presented was considered.

I have to re-read it carefully to make sure it is not a verbatim denial like the one I already received-

I can raise hell with the RO if it is-

but am not really concerned at this point-

Since the BVA reads claims a heck of a lot better then the RO I will file the I-9 and see what happens with this claim at the BVA.

No sense in me getting upset with it as my main AO claim is what my interest is in-

CUES should be short and only involve legal errors- as a matter of fact not only is there a wealth of info here at hadit on CUES, the VBM is worth the money as to their advise on CUE claims.

You had stated:

"NO! I'm saying that the military treated me for a mental disorder and the VA changed to a PD."

And I agree that this is what seems to have happened.And I felt this was a CUE.

But I have to agree with John- that our current claims are what need our energy on-and your TBI claim makes sense to me and could potentially bring more than the CUE would.

The fact that more and more veterans these days MUST rely on costly IMOs angers me-yet it is often the only way to succeed on our claims.

A C & P doctor can often say anything they want to-and then down the road an IMO can totally knock down their opinion.

It should not be that way.But it is.

I heard from a vet this AM who has been fighting the VA for years and years.

He just had a hearing.

The VA doesnt care what he says as to his condition.

He is not a doctor.

His case might have a chance with an IMO but he has not ever attempted to get an IMO.

The VA knows full well that these IMOs are extremely costly-and that most disabled vets cannot possibly afford to get them.

and then they take the chance that the VARO will ignore them.

Unfortunately as you can see at the BVA web site-

IMOs turn many many claims around.

One claim had four IMOs and the RO had ignored all of them.

The vet was awarded at the BVA.

I would certainly continue the CUE claim if I were you but focus more on your present TBI claim.

[carlie]

I feel another important aspect for the claim to be granted is:

Claimant must show medical evidence of a current disability - and I have no

idea how to show residuals of MH disability as current disability,

the residuals are XXX & XXX.

I feel as far as the paperwork on the change of DC, the certification

of it, is just a huge red-tape entanglement. I see CUE claims as made on

disability decisions, not on the process of the claim.

I would find some different verbage to use when arguing how VA processed

part of my claim.

jmho,

carlie