ptsd Aggravation Of Nsc

[Guest Berta]

In many years I haven't seen too many claims that consider this facet of service connection.

Within 38 CFR 3.310 (a) an "Increase in nonservice connected disability caused by aggravation from a service connected disability will also be service connected."

(Allen V Brown ,7 Vet App,4391995)

Here an example: the vet's SC PTSD aggravated his NSC HBP and the HBP was service connected.

http://www.va.gov/vetapp05/files2/0510693.txt

Just as a medication needed for an SC condition can cause additional nsc BUT secondary disability that can be rated as SC, many other conditions that are NSC disabilities can be caused or aggravated by SC.

Say you have a SC back problem and develop problems with your knee-there is chance that the SC back is aggravating the NSC knee so the knee could be service connected as secondary or as part of the initial SC condition.

This takes medical evidence and always a good med opinion will help-

A veteran has the right to suggest within their claim, any possible avenue to lead to service connection.

Along with my present AO claim I filed two additional claims that could lead to direct service connected death of my husband.

Although the AO claim is the best medically documented one-

still the c file and other documents revealed two other potential ways to SC PTSD directly to Rod's death.

Also VA medical information clearly had associated his PTSD with his major stroke

yet my SO at the time of my award under 1151 did not advise me to attempt a claim for direct SC death.

My point is that in order to obtain SC for an NSC condition that might even seem remote- if the medical evidence suggests (or if you can get a doctor to state this) that the SC disability is aggravating it, that it becomes "proximately" due to the SC one and is service connectable.

Here is the M 21-1 version of this reg:

7.06 CLAIMS FOR SECONDARY SERVICE CONNECTION BY AGGRAVATION

a. Under the provisions of 38 CFR 3.310(a), disabilities which are proximately due to or the result of a service-connected condition will be service connected. An increase in nonservice-connected disability caused by aggravation from a service-connected disability will also be service connected under 38 CFR 3.310(a). (Allen v. Brown, 7 Vet. App. 439 (1995).)

b. In order to adjudicate a claim for secondary service connection for an incremental change in an otherwise nonservice-connected disability, first establish the baseline level of nonservice-connected disability and the level of additional disability which is considered proximately due to the service-connected disability. Request a medical examination, including review of the claims folder, for this purpose. Identify for the examiner the evidence of particular relevance in the claims file. Request that the examiner separately address each of the following medical issues. A medical report that fails to address these issues will not be considered sufficient for rating this type of claim:

(1) The baseline manifestations which are due to the effects of nonservice-connected disease or injury;

(2) The increased manifestations which, in the examiner's opinion, are proximately due to service-connected disability based on medical considerations;

(3) The medical considerations supporting an opinion that increased manifestations of a nonservice-connected disease or injury are proximately due to service-connected disability.

c. An examination which fails to identify baseline findings, or the increment of increased disability due to service-connected causes, would not be adequate for rating purposes.

d. When all potentially relevant records have been obtained, or it is determined that no further evidence can be obtained, order an examination. The examiner must have all available evidence for review when providing an opinion on the issues of aggravation and the degree of increased disability.

7-I-4

[Guest Jim S.]

When have you ever seen the VARO in its C&P instruction, telling the Examiner to do a base line test on the Vet's NSC problems?

Unless the Vet has the forethougt or his SO knows what he's doing, the VARO certainly isn't going to bring it up.

ADDED: In my case, they certainly never considered that the later diagnosis they took as a change, a personality disorder, was the proximate result of my Acute schizophrenic episode. In all the literature I have read, any schizophrenic episode was bound to have a lasting effect on ones personality. That is basic psycholgy 101. Just as PTSD has shown, it to have a lasting effect on personality. Nor did they concider that a head injury I received, didn't have some effect on my personality and other mental facters, discribed by the examiner.

Edited September 12, 2005 by Jim S.

[Guest HankHill]

Berta, would this apply to me? I am service connected for left ankle, left knee and left hip. Last year I fell and tore my ACL in my right knee and underwent a right knee ACL reconstruction. My right leg had always been my GOOD leg until I tore the ligaments and had surgery. Now my right leg is in nearly as bad a shape as the service connected left one. I have no doubt that the SC left leg has aggravated the right ACL and was wondering if I would have a chance at getting the right knee service connected by way of aggravation. Any thoughts?

[KennyJ]

I don't come close to the knowledge of Berta, but I think you would have a good claim for secondary condition caused by your SC condition.

[john999]

Berta, would this apply to me? I am service connected for left ankle, left knee and left hip. Last year I fell and tore my ACL in my right knee and underwent a right knee ACL reconstruction. My right leg had always been my GOOD leg until I tore the ligaments and had surgery. Now my right leg  is in nearly as bad a shape as the service connected left one. I have no doubt that the SC left leg has aggravated the right ACL and was wondering if I would have a chance at getting the right knee service connected by way of aggravation. Any thoughts?

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[john999]

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Hank Hill

I think you will need a medical opinion to say that due to SC condition you fell and this resulted in injury to healthy leg. I think you need some kind of medical rational to show that weakened leg contributed to your fall or that your NSC leg was weakened by having to bear the burden for both legs. This is just my opinion. You want medical evidence to make your case and not rely on VA to do the right thing otherwise the VA will say " there is no evidence of in service injury blah, blah, blah."

[Guest Berta]

Yes- I agree with John999 and this sure would need a strong medical opinion, even though it is a logical claim and a good example of service connection by aggravation. Berta