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!

[Berta]

"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?? "

No- it does not matter-it does matter if the symptoms are documented and show consistent evidence that is symptomatic of schizophrenia.

But you are right- I am confused here----and lost ---

It would be be good to let the psychiatrist know you get SSA for schizophrenia.And tell the VA too.

Perhaps the SSA records would even reveal a service nexus.

[Hoppy]

Scout,

To enlighten you on this medical question. The condition I am diagnosed with "has no known cure". Once you are diagnosed with this condition you will have it the rest of your life. It is kind of like Hep C. Even though you can not find the indicators it still lurks in the shadows. Another feature of this condition is that in some cases the symptoms become much more severe later in life. According to the center for disease control in Atlanta Georgia the reason some people develop more severe symptoms and other do not is "UNKNOWN". The condition I am diagnosed with involves the Immune response. This response is considered by medical principals to be permanent. I have been treated in ER's on thirty + ocassions. It has reached a level of severity that is life threatening

I will admitt I was really fortunate in finding the VA immunologist. It took me five years to even find a VA doctor who would look at the SMR. These doctors did not want to get involved no matter how long the first treatment was after service. They did not even ask before telling me to get out of their office. One on ocassion I was escorted out by security cops. I do not attribute much to luck. I reasearched the disease and found an on line support group for people with this disease. The fact that it was denied contridicted even known medical principal I found in the literature. The VA never responed to any literature I sent them. The hadit JD's kept pushing me to find a doctor to review the SMR.

From what you are saying it sounds like adjudication is still in the dark. When you develop a condition in service with no know cure I would expect that any manifestation after service would be service connectable. The rating schedule has frequency and severity requirements that are used to assign a rating. There is no specific code. They rate it using the schedule for a condition that produces similar symptoms. I would think that in many cases an extra schedular rating might be in-order. Try finding a job when you have condition that can be aggratated by employment that can kill you. City govt. told me there was no job I could do. The EEOC made a determination that supported the cities position.

I have seen BVA decisions whereby they waive the entire requirement for a nexus statement. The BVA decisions merely say "the board recognizes the chronic nature of ????". The reason I put in ??? is because I have seen the BVA use this waiver on serveral types of conditions. I agree the regs will work on most stuff. Additionally, I have seen BVA decisions that circumvented the nexus statements by citing that there is no evidence the in service condition resolved. They might use this approach when there are no regs or case law to guide them.

My posts have been in response to this persons psych claim. I have seen psch diagnoses change. Psych is really hard to figure out. Clark Evans who was an attorney who used to post on hadit got a person SC'd for schizo-affective disorder when the first post service treatment was fifteen years after discharge.

Although I have read the M-21, case law and many CFR's, when a question arises I read BVA cases. When reading these cases not only do they include the regs. you can see how they are applied. Something I learned long ago is the way courts apply laws will define the laws. Laws are subject to intrepretation and it is the courts job to intrepet the laws. I am sure you already know this. I threw it in as advice to others who might have read this far.

[Hoppy]

Scout,

I just picked up on something. I do not think the main reason it was denied was because of the time frame for initial post service treatment. It was denied by the RO because they thought the condition was the result of post service employment. The immunologist made the statement that the disease had "no known cure". I think the RO was unaware that the disease had no cure. I then had the immunologist address the question as to how I would develop a condition with no known cure after service when I was known in fact to have this conditon develop for the first time while in service. Additionally, the RO determined that there was a report in the file that the condition was the result of post service employment. The report in the file was for a different and unrelated condition.

[Hoppy]

I will re-phrase. The claim was not fully developed. I do not see why we are even discussing suicide or stress. The reason for the lesions could be that they were self inflicted without intent to commit suicide. If a psychiatrist thinks that self inflected minor injuries are an early symptom of schizophrenia then there is a link. Whether the link is significant would be the question. I am not suggesting that this is the case. However, when I was studying psychology at a university we did labs at a local VA hospital. I am not sure of the specific diagnoses with all patients. However, writing on onself with a pen and other minor injuries were seen on our tours of the wards.

If you have a psychiatrist who is willing to help you keep going with this claim then keep working with this shrink. I think at this point you will need a doctor to help you develop NEW and MATERIAL EVIDENCE. I recall that they asked for this type of evidence. You can always appeal without the NEW and MATERIAL and hope that they will remand a complete evaluation of the SMR, personnel file and post service records.

I have seen post service psych claims awarded when linked to one notation of "somatization" while in service. There are a lot of other questions that have not been discussed. Why were you discharged or did you exit after reaching the end of your enlistment contract. Is there any evidence in your personnel file that needs to be reviewed. Get your personell file and have the shrink review it.

[tssnave]

I concur - you need a very strong IMO who can review ALL military/VA/civilian records and links your symptoms from service (suicide, stress induced lesions, any other health issues or conduct issues, etc) to your current schizo. As I understand it, you are not that far out of service:

2002 - suicide attempt while in service

2002 - treatment for depression, though no formal depression diagnosis

xxxx - VA pension awarded

2009 - current treatment for schizo that you want to service connect

A good shrink, if your case is sound, can link everything together and write a nexus statement and you can prevail.

I got out almost 30 years ago and won my VA claim for sc bipolar disorder that started in service. I had treatment off and on in the civilian sector over the next 30 years with many years of no treatment because I had no insurance. The IMO shrink (and for that matter, the C&P shrink) understood that my lack of continuity of treatment was a function of funds, not a lack of mental illness and both wrote strong nexus statements.

Get your records together, all of them to include your cfile and SMRs, and sit down and talk to a shrink who can determine if the whole picture fits together and if it does, then get an IMO and send it to the VA.

An IMO in conjunction with your lay statements will make for a strong case.

Good luck.

Thanks to Hoppy and others for the great posts on this thread.

TS Snave