ptsd New Claim V. Re-opened Claim

[Hoppy]

This is how the VA confuses and delays claims.

The veteran I am helping filed a claim for anxiety disorder when I advised him that the only post service diagnosis he has is for panic disorder with major depression. The RO made a determination that the claim for anxiety disorder was an attempt to re-open a previously denied and closed claim for a respiratory condition. They stated this in a letter a continued to say that they could not schedule any C&P exams until new and material evidence is submitted.

The problem is that there are formal considerations required by law that need to be addressed when making the determination a claim is an attempt to re-open a previously closed claim. The letter did not explain any of the diagnoses that were used to make the determination that the new claim was an attempt to re-open an old claim. No subsequent decision has identified the diagnoses, laws or logic as to how the determination was made that the claim for anxiety disorder is an attempt to re-open a claim for respiratory condition. The veteran has not been notified of any process to appeal this secret decision. The determination that new and material evidence was needed to re-open the claim has resulted in a failure to provided a C&P that would otherwise been required by the VCAA, The RO is making it a difficult as possible for this veteran even if it means obvious defiance of Federal Circuit Court decisions.

This is the way the BVA writes it up.

The United States Court of Appeals for the Federal Circuit has held that claims that were based upon distinctly diagnosed diseases or injuries should be considered distinct claims for the purposes of 38 U.S.C.A. § 7104(:D (West 2002). Boggs v. Peake, 520 F.3d. 1330, 1336 (Fed. Cir. 2008). In his current claim, the Veteran appears to be seeking service connection for a disability that is a distinctly different diagnosis than the one at issue in his prior claim, which was denied in January 1997. See Ephraim v. Brown, 82 F.3d 399 (Fed. Cir. 1996).

In view of the Board's determination that the Veteran has presented evidence of a distinctly diagnosed disorder (PTSD) that is different from one claimed previously (nervous condition), and the RO's adjudication of the Veteran's current claim as a new claim, the Board finds that new and material evidence is not required to reopen the claim. Accordingly, it will proceed to a discussion of the merits.

[Hoppy]

Bob,

We got really good news today. A VA psychologist who has curriculum vitae that is awesome including performing C&P exams looked at my summary of the claim and decided to get involved. I got a preliminary draft of the report the examiner plans to write and it is pretty much a slam dunk. This is the strongest case of panic disorder while in the military I have ever read on the BVA. I guess this is why the psychologist decided to get involved.

The vet centers can be of a tremendous help on mental health claims. I found this clinician at a vet center.

To answer your question. I am trying to find out the procedure by which federal court decisions get codified into the M-21. The fact that this claim was adjudicated as though it was an attempt to re-open a previously closed claim is in direct defiance of a federal court decision that reversed a CAVC decision and was specifically based on a review of VA procedures.

I am going to write a letter to the director of the RO advising him that the claim was adjudicated on the misapplication of the law that caused the process to be fatally flawed and that the claim should never have been adjudicated in a manner that contradicts a federal court decision that was made many years ago. I am going to state that due to the fact the error caused the circumvention of the applicants primary means of obtaining evidence to support the claim. As such the claim should be immediately re-adjudicated in a proper manner. This is not a question of weighing the evidence for or against the claim. The decision to require new and material evidence effects the entire course as to the development of a claim. As such this decision should be taken very seriously.

I am going to suggest to the congress and the federal court that made the original decision that special procedures be developed to ensure that this very important initial decision is not performed by undertrained or incompetent staff. I also am of the opinion that an investigation needs to be initiated to determine how frequently this mistake has been occurring and a determination made whether or not there is an ongoing series of errors which represents willful circumvention of the courts intent.

I am going to advise the director that it appears to me that this was a failure to perform an elementary requirement of the rater’s job duties. As such my training as an insurance fraud investigator would require notification of all interested parties of the possibility of a willful act that caused the claimants civil rights to be violated. How such notification works in the VA system is unknown to me. However, my intent at this time is to notify my local senator and the clerk of the federal court which made the original ruling.

[Papa]

Hobby

Hope life finds you well. I would like to run something by you to get your and whomever else would like to chime in. I have Angioedema, the hereditary form. While it would be next to impossible to make it direct; how hard would it be to prove thtat it was aggravated? I have also been rated for PTSD, now a lot of the symthoms of PTSD are triggers for Angioedema attacks. Would this be a good bases for a claim PTSD aggravating my Angioedema?

Papa

[Hoppy]

Papa,

If you are rated for PTSD as service connected then secondary angioedema is a valid position. This is because angioedema is known to be triggered by any event that increases what is called circulating immune complexes. Stress causes an increase in circulating immune complexes.

File a claim for angioedema attacks as secondary to the PTSD. There is some confusion that might occur if the angioedma was denied on a direct service connection basis. The confusion would be that they won;t schedule a C&P. Ask your SO to file the claim. If they do not schedule a C&P the confusion can be dealt with by getting a statement from a doctor that the PTSD has caused either an increase in frequency or severity of the aangioedema.

They will not give much weight to your statements of frequency or severity. You absolutely need to go to the doctor every time you have symptoms of angioedema and tell the doctor what you think the trigger was. Your claim will rest heavily on the medical reports from treating doctors. If you have no reports from treating doctor it will make it impossible for a C&P examiner to verify your symptoms during a single exam. I never had a C&P when I won my angioedema claim. However, I had a stack of treatment reports that went back twenty years.

[Papa]

Hobby,

Thanks for the valuable information. I actually have an appontment with a Doctor tomorrow that is suppose to be the leading authority on Angioedema. Several years ago I was suppose to have major surgery for Obstructive Sleep Apnea. My Primary Doctor sent me to him for consultation, and he highly recommended that I do not do the surgery, and recommended that I use the CPAP machine even if they had to have the settings up real high. I have made a major error in that the only time that I go for medical treatment (Emerency Room) is when it affects my throat area. My arms and hands I just suffer through it like when I was a kid. Not anymore.

I don't know if this has ever happened to you, but about 6 months ago, I had to go to a Peradontists so he could operate on my gums. I wrote down that I had Angioedema, and told him verbally about it. Well during the procedure apparently I stopped breathing. They got me breathing again, but I stopped, and restarted... My wife said the Doctor was in tears because he admitted that he did not pay attention to what was written or told to him.

Papa

[Papa]

Just had a very interesting week at my Hemotogoist. He could not believe that he had someone in his office with Hereditary Angioedema (HAE), and I guess that I have never realized how rare this was. He said that I was the only person in San Antonio with this. The first day they took 10 tubes of blood from me as I did not fast, and 10 more the next day after I did fast. They are sending this to the Mayo Clinic for testing and Genetic mapping, etc. He wants to make sure that this is what I actually have, and wants to pin point the exact Gene??? God, I hope my insurance covers this Mayo thing :P . I also ask him about the connection of HAE and PTSD, and he said that if HAE has an emotional element to it, then there is a connection. But, he wants to wait for the test results come back from the Mayo Clinic. Now, how in the world would the VA rate something like this if this is so rare? This doctor ask me how did I get in the military, I was walking upright and breathing B) .

Papa

[Papa]

Bump