What Does Probably Mean In Nexus Statement?

[Rockhound]

I was looking at the Nexus form that was posted on Hadit here and in the boxes where it lists, "Related to", & "At least as likely as not related to"' it also lists, " Possibly related to." I have the results of a neuropsychiatric exam that states that indicated I have both a cognitive depression disorder and a cognitive personality disorder/syndrome that is probably due to the head injury I sustained in service.

Shouldn't the nexus statement form conform to the VA standards and read thusly, "less Likely than," "as likely as," & " more likely than"?

Why can't the Dr's and examiners use this form of language, and why don't they? They know that an injury occured, because of the medical records clearly show it, and it is even shown backed up by a fracture of the nasal bone from a fall, further that a minor concussion was diagnosed supported by an EEG test. also that their was a short period of unconciousness and a period of retrograde amnesia of the time before the injury.

Why then must they use a seperate language, such as Probably or possibly, and if they do, what weight do they carry as apposed to the more formal and definite statements used in VA claims?

The use of these seperate languages only make it necessary for us to seek out private IMO, so that the language can then be formalized to meet the VA Claims standards, so that our claims can have at least a fighting chance of winning.

I am frustrated that now, once again, in order for me to win my claim, I must once again be forced to pay out of my own pocket for an IMO who will be willing to write an opinion that uses the VA's claims more formal nexus statement language.

Right now I am waiting on an appointment with a Neurologist, to see what he will do for me after review of my latest neuropsychiatric exam results and whether or not he will concure with the findings and give me a statement to put in my medical files that is probative to my claim and not some statement that continues to say my head injury may have been the cause or was probably the cause

Where does probably stand for anyway, is it less than 50%, equal-50/50%, or is it greater than 50%? Is their some Precident Opinion on this somewhere?

Rockhound Rider

[Ricky]

Rock - probably is equal to "more likely than not". Most VA raters who can read will translate it this way for they are used to seeing it due to the fact that most if not all civilian doc's write this way. They use probably to mean more likely and possibly to mean less likely than not.

probably - with considerable certainty; without much doubt;

[Rockhound]

Rock - probably is equal to "more likely than not". Most VA raters who can read will translate it this way for they are used to seeing it due to the fact that most if not all civilian doc's write this way. They use probably to mean more likely and possibly to mean less likely than not.

probably - with considerable certainty; without much doubt;

I was hoping their was some clarification or opinion that states what you have said above. without the VA proper verbage, I'd rather not depend on a Rater to make the distinction.

I once read an opinion which had the VA changing its verbage to more represent the legal language of the courts, but it's been awhile since I read that opinion and it's going to take some more digging I guess to see if it is of any help here, I was hoping someone may have had this cross reference somehow to make this search easier.

Thanks for the imput, but I would feel better if I had it in writing from the VA or the Courts.

Rockhound Rider

[Rockhound]

I went through all the VAGC precedent opinions and came up with nothing on the definition of probably, but in looking at BVA cases I came across one that relates "probably" to have the same weight as "as likely as not" to have 50% against and 50% for and if their is no evidence to the contrary, then the evidence stand in equipoise. which means when the evidence stands equally for or against the Veterans claim, it shall be ruled in the Veterans favor.

Now if I can also get the neuro doctor to at least agree with the neuropsychiatric exam results, then it looks like I may be able to prove my claim. But to be on the safe side, I am hoping to get the neuro doctor to use the VA's terminology which would bolster my claim. I also need him to officially diagnose me with one or both of a cognitive depression disorder and/or cognitive personality disorder or syndrome. Hopefully getting him to say that the personality disorder the VA C&P Examiner in 1974 had opinioned on and the cognitive personality disorder were as likely as not one and the same.

I say this because of the statement my previous Psychiatrist put into my progress notes that she didn't see that I exibited any personality disorder as defined by the DSM IV schedule of mental disorders.

Man I hope that nerology appointment date comes soon. I'm sure it's going to lead to quite a few tests and exams after seeing the examination worksheet for TBI's.

One of the symptoms that is asked about is sleep disturbances, don't you have to be asleep first for you to have sleep disturbance? Hell, most times I can't get to sleep. LoL

I guess I better try, I need to give my eyes a brake, they've been open way to long today, come monday I will have to buy another bottle of liquid tears, my eye lids feel like sandpaper on my eyes.

Rockhound Rider

Edited October 26, 2008 by Rockhound

[rentalguy1]

A neuro doc's diagnosis of a depressive disorder would carry the same weight as that same diagnosis from a OB/GYN or a veterinarian. Get that diagnosis, in writing, with a correctly worded nexus from a board certified psychiatrist (preferably) or a board certified psychologist. I would also strongly suggest printing off the nexus form (there is a link in my signature) and having the doc(s) fill it out for all diagnos(es). I used a few of them in my claims, and they were both used and given the utmost weight by the rater. This is stuff that cannot be left to chance or open to speculation. I'm also sure that you don't need to be riminded that BVA cases are not precedent setting. They can be very useful in proving a point to the RO, and dangling a impending appeal in front of them if they don't take the proper course of action on your claim, but they don't really carry any weight.

It really is as simple as priniting off the form, taking it to the VA doc, and requesting them to fill it out. They HAVE to either sign the nexus form or provide you with a detailed statement of your diagnosis, per VHA Directive 2007-024.

Edited October 26, 2008 by rentalguy1

[Josephine]

You need a Board Certified Psychiatrist to place this into writing.

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 range 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 --- - .

The " other mental disorder" which he clearly *DID* and *DOES *have,

and for which he has been treated for --- years, is *----- Disorder.

The Best,

Betty

[Ricky]

This is how the board weights the word probably. Although a denial probably was taken to equal more likely than not.

supported by the service treatment record that contains a diagnosed of hepatitis, probably secondary to improper use of heroin and amphetamines. See October 1973 narrative summary. As drug abuse is considered willful misconduct, and the in-service medical evidence establishes a link between the veteran's abuse of heroin and amphetamines and the diagnosed hepatitis,direct service connection is precluded.