Need Advice On Disability Appeal!

[rosypalm]

Hi Vets,

Not too long ago I recieved my decision on a claim and was denied service connection for schizophrenia anxiety depression and I'm going to appeal. My pychiatrist who happens to also work for the Va is also writing a letter along with my NOD to say that I do have schizophrenia that was aggravated from the service because I made a suicide threat and it was in my medical record and also in my denial letter from the c-file. Also I have recently been awarded ssdi for schizophrenia will any of these things help the appeal? My pychiatrist is bringing up a new argument for the appeal and saying that due to the suicide threat which aggravated while in service. In the denial letter the va said "there was no evidence to suspect that I was mentally disabled and that i did state my humour was different" but now there is evidence and plenty that clearly shows I am mentally disabled along with my ssdi. How can I fight this!

[Hoppy]

"that was originally for interlinked to schizophrenia due to stress from BALBOA record."

Who linked this? Was this a statement in an argument you or a SO submitted or did the doctor write a statement linking that event to your current diagnosis?

The benefit of doubt rule applies to a resolution of the weight of evidence when there is both reports of record indicating the condition was the result of service and evidence that supports that it was the result of non service related events.

If the comp and pen examiner did not specifically address the possibility of service connection of the post service diagnosis and you did not have a specific mental health C&P nor did the private shrink write a report based on a review of the records then there is no evidence that meets VA standards that would require consideration of the benefit of the doubt rule.

They should send you a VCAA notice explaining what they need. Take that notice to the private shrink. Hopefully his VA experience will help in getting him to produce the type of evidence in the VCAA notice. The continuity you are reporting can be considered if tied into the current diagnosis. It sounds to me like there is no inservice diagnosis of schizophrenia. That is why you need a doctor to tie those symptoms into the current diagnosis.

[rosypalm]

"and was noted as I recall."

You really need to know exactly what is in the records and not go by what you recall. There could be plenty that you forgot. Sometimes when veterans get their records there is more evidence than they expect. It appears that you are relying too much on the raters to connect the dots.

Doctors will need to write specific reports addressing the issue of this condition being the result of service or aggravated by service. That is what is discussed earlier in this post. You just cannot expect them to read the SMR and make an award based on scars or a notation that the lesions were due to stress.

Typically you need a post service diagnosis and a way to tie symptoms that appear in a writtren record while you were in the military to the current diagnosis. The raters do not do this, doctors do this. This is why they are supposed to schedule a C&P if you have a post service diagnosis. They do not always schedule a C&P. If you did not specifically have a C&P for a mental condition then they did not develop the claim. Did they list any mental health exams on the denial letter??

The fact that they are asking for new evidence can be difficult. I know a veteran where they denied the claim and told hin they would schedule no C&P exams to assist with the claim. This prpoblem was discused in another post I started. It is good that you can get around this with a private shrink who wants to assist. Get all records to this shrink.

It is best to submit medical evidence rather than argue proceedural errors. If you win a proceedural error they will only remand the claim for further development. The medical evidence can win the claim without time consuming remands.

Ok if they did not develop the claim then how could the claim be developed with no evidence? I'm not disagreeing with you, but the my original argument for schizophrenia and importantly keyword here is STRESS to be nexed to the schizophrenia claim was from the BALBOA record that never surfaced. HOPPY its as simple and thorough as that it couldn't be more convincing except that the record never surfaced. Again a lot went on and these claims were written in an ineffectual manner thats why theres confusion. The va workers which didn't have access to all my records from in service basically wrote what I went off of my head. It was even written while I was a patient in the VA psyche ward. I didn't have a c file to look to or else damn I would have nexed the report of suicide before the balboa record. I just never thought it got on record. Yes , I got all of the evidence now from the c file there isn't anything missing except the balboa record. Well I had a doctor work on the claim for me and va workers too I nexed something that never surfaced. Thats why I recieved a non service connected pension and a service connected 0 percent and a blockade towards service connection claim to schizophrenia. Things were out of my control I don't disagree at all for why I never got a comp and pen for schizophrenia there was nothing to suspect them at that time of any chronicity for the service connection towards the schizophrenia claim. Thats why they sent a form mid thru the claims process to submit or find the balboa record or any new record and I didnt but couldn't I just didnt have any excersize to retrieve them. Oh and HOPPY statements made from my doctor were very intimate on my condition due to aggravation. I disagree with you also on STRESS. If a well practioned VA worker doing my claim says "BINGO" the lesions were due to stress how is that for schizophrenia ??? Stress and the schizophrenia claim wont be tied?? :P sounds like aggravation to me.

[Hoppy]

Scout,

I think I would rather advance a claim with a specific report from a doctor rather than rely on a raters intrepretation of case law. I specifically reversed a denial on my claim by rebutting a raters intrepretation of how regs on continuity applied to my claim. In my appeal I refered to the raters determination as a "false onjective standard of law". There are holes in the VA regs.

There was a JD (Alex) and a rater (LL) who both used to post on hadit. Pete has been around long enough to remember these guys. They had a huge argument on the board over my claim. The JD argued that medical principals will dictate an award. The rater kept citing regs. I guess the DRO sided with the JD's opinion that the medical principals noted by the doctor who wrote my nexus were controlling. The doctor who wrote my nexus was a head of immunology at a VA jospital and he had been writing reports since 1970. By the way the raters ignored my repeated requests to schedule a C&P. I guess the raters ignored my requests based on the regs. I had to get this nexus opinion on my own.

[rosypalm]

"that was originally for interlinked to schizophrenia due to stress from BALBOA record."

Who linked this? Was this a statement in an argument you or a SO submitted or did the doctor write a statement linking that event to your current diagnosis?

The benefit of doubt rule applies to a resolution of the weight of evidence when there is both reports of record indicating the condition was the result of service and evidence that supports that it was the result of non service related events.

If the comp and pen examiner did not specifically address the possibility of service connection of the post service diagnosis and you did not have a specific mental health C&P nor did the private shrink write a report based on a review of the records then there is no evidence that meets VA standards that would require consideration of the benefit of the doubt rule.

They should send you a VCAA notice explaining what they need. Take that notice to the private shrink. Hopefully his VA experience will help in getting him to produce the type of evidence in the VCAA notice. The continuity you are reporting can be considered if tied into the current diagnosis. It sounds to me like there is no inservice diagnosis of schizophrenia. That is why you need a doctor to tie those symptoms into the current diagnosis.

It was either my Va worker or va doctor that interlinked that stress from the lesions was due from schizophrenia. It would have been beautiful if the record from balboa surfaced too.

[Berta]

The signs and symptoms of schizophrenia do not include any specific emphasis on suicidal ideation.

Schizophrenia is not an anxiety or stress oriented condition-

I am not suggesting that anxiety and stress as well as suicidal thoughts could not be a part of the overall clinical picture of a schizophrenic- but-

I dont see any strong link here between somehing that might have come from stress as related to this psychosis.

I am not a doctor- I did study mental disorders in college and after working at a Vet center I certainly know what symptoms PTSD and other anxiety/stress related disabilities can cause.

I do believe that your doctor must have a good medical rationale to be willing to support your claim- but I dont see it here-

you got great advise from everyone-

we see things by looking at a claim the way we feel the VA will view it-

What I see lacking is a concrete nexus as well as continuous treatement.But maybe you HAVE the nexus-

I dont doubt your claim at all- but I brought up a few things that VA would question-as others here see too---

Is the "0" % you have now for direct service connection or for NSC for schizophrenia?

If you have award stating "0" SC for schizophrenia-this would show that a nexus HAD been established directly to your service but that VA felt your condition did not raise to a compensable level (at that time)

and all disabilities can get worse with time-

Is your SSA award solely for schizophrenia? If so that would show that SSA had enough evidence -obviously-to make this type of award and that the "0" level certainly has changed.

Is the VA aware of the SSA award? And did they send you an authorization form to obtain it?

"In the denial letter the va said "there was no evidence to suspect that I was mentally disabled and that i did state my humour was different" but now there is evidence and plenty that clearly shows I am mentally disabled along with my ssdi. How can I fight this!"

It looks to me that even if they had the SSA records, they did not consider them as evidence.

Are you able to cover any personal stuff and scan and attach the actual wording of the denial here?

I see the holes in this claim that VA would see but then again-

if you got SC at "0" for schizophrenia and the SSA award is solely for schizophrenia- you should apply for TDIU (the 100% comp rate)as well as appeal this denial-

and make sure the VA gets the SSA records that justified their SSA decision-

those records would contain an independent medical review that could certainly help you-

if the "0" award was for SC and not NSC.

[rosypalm]

The signs and symptoms of schizophrenia do not include any specific emphasis on suicidal ideation.

Schizophrenia is not an anxiety or stress oriented condition-

I am not suggesting that anxiety and stress as well as suicidal thoughts could not be a part of the overall clinical picture of a schizophrenic- but-

I dont see any strong link here between somehing that might have come from stress as related to this psychosis.

I am not a doctor- I did study mental disorders in college and after working at a Vet center I certainly know what symptoms PTSD and other anxiety/stress related disabilities can cause.

I do believe that your doctor must have a good medical rationale to be willing to support your claim- but I dont see it here-

you got great advise from everyone-

we see things by looking at a claim the way we feel the VA will view it-

What I see lacking is a concrete nexus as well as continuous treatement.But maybe you HAVE the nexus-

I dont doubt your claim at all- but I brought up a few things that VA would question-as others here see too---

Is the "0" % you have now for direct service connection or for NSC for schizophrenia?

If you have award stating "0" SC for schizophrenia-this would show that a nexus HAD been established directly to your service but that VA felt your condition did not raise to a compensable level (at that time)

and all disabilities can get worse with time-

Is your SSA award solely for schizophrenia? If so that would show that SSA had enough evidence -obviously-to make this type of award and that the "0" level certainly has changed.

Is the VA aware of the SSA award? And did they send you an authorization form to obtain it?

"In the denial letter the va said "there was no evidence to suspect that I was mentally disabled and that i did state my humour was different" but now there is evidence and plenty that clearly shows I am mentally disabled along with my ssdi. How can I fight this!"

It looks to me that even if they had the SSA records, they did not consider them as evidence.

Are you able to cover any personal stuff and scan and attach the actual wording of the denial here?

I see the holes in this claim that VA would see but then again-

if you got SC at "0" for schizophrenia and the SSA award is solely for schizophrenia- you should apply for TDIU (the 100% comp rate)as well as appeal this denial-

and make sure the VA gets the SSA records that justified their SSA decision-

those records would contain an independent medical review that could certainly help you-

if the "0" award was for SC and not NSC.

Berta your adding confusion to the mist you really are. I appreciate your help though your misinformed thats all. I got service connection not for schizophrenia but for lesions on legs I made that clear in my earlier posts it was supposed to be interlinked to schizophrenia but I had no record from balboa confirming that. Yes the VA does not currently know I was awarded from SSA they know that I was in the process to get SSA. Again how does that matter the va already gave me a nsc pension for perment and total disabilitt, Must mean in their eyes im sick just not nexed from the time I was in service? AGain Berta does it matter if the signs and symptoms of schizophrenia do not include any specific emphasis on suicidal ideation . Key word being include doesn't mean that a report of a threat of suicide is excluded does it from this??