Va Not Committing To Diagnosis - To Deny Claim ?

[autumn]

i filed a claim and it was denied jan 2009. it was for MS while on active duty. at the time i didn't realize my c-file had zilch in it. i corrected that. all medical tests are in and not surprizingly the MS specialist will not commit to a diagnosis. all mimics have been ruled out. although he does want me to start on MS disease modifying drug injections soon.

so, i now realize that the VA will not commit to a diagnosis due to a disability claim thus they can and will continue to deny it. thousands of us vets i now know have & are going through this.

i'm in the process of trying to raise funds so i can see a non-VA neuro here in town. the National MS Society put me in touch with them. but that will take some time

question: what is the best course of action to get the VA to commit to a diagnosis? is this lawful that they can do this?

[carlie]

autum,

Welcome to Hadit. I will send a shout out to someone

with lots of knowledge on this.

carlie

[JamesBreckenridge]

MS is *very* hard to diagnose. There's a reason that we give it a seven year presumptive period after you leave active duty. File a request for reconsideration and include any new evidence you have so that you can keep that original claim with the effective date (I'm assuming day after discharge).

Maybe the VA doctor really couldn't diagnose it. I've seen MS cases where the vet complains of pain and numbness and tingling for years in service with no apparent cause, and then gets out and finally gets an MRI and a diagnosis of MS, and it turns out it was MS all the while.

If the VA won't diagnose you, get a private specialist to do it. We have to take the specialist's findings as equal in weight to our own doctors. Even better, if you let the private specialist review your service treatment records, he can render a medical opinion that not only do you have MS, but that the symptoms you expressed in service were early manifestations of the disease. That that stuff in with your claim ASAP, and keep your earlier effective date going.

MS is rated at 30 percent by itself by the way, plus any residuals.

i filed a claim and it was denied jan 2009. it was for MS while on active duty. at the time i didn't realize my c-file had zilch in it. i corrected that. all medical tests are in and not surprizingly the MS specialist will not commit to a diagnosis. all mimics have been ruled out. although he does want me to start on MS disease modifying drug injections soon.

so, i now realize that the VA will not commit to a diagnosis due to a disability claim thus they can and will continue to deny it. thousands of us vets i now know have & are going through this.

i'm in the process of trying to raise funds so i can see a non-VA neuro here in town. the National MS Society put me in touch with them. but that will take some time

question: what is the best course of action to get the VA to commit to a diagnosis? is this lawful that they can do this?

[Ricky]

Not much to be said on this post as James is an expert and has provided you the 100 percent solution to your question. The only thing that can be added is do as he has provided.

[Pete53]

Not much to be said on this post as James is an expert and has provided you the 100 percent solution to your question. The only thing that can be added is do as he has provided.

Good Luck and don't give up. Are you able to work?

[MikeR]

If you can afford the private specialist I always recommend that. It has helped me almost every time. MS can be brutal, have several friends dealing with it now.

[timetowinarace]

The advice given is good advice. I also had better luck with private specialist.

I have a question though. Can't an undiagnosed condition be SC when symptoms started in service? A rating would likely be low but it would be a starting point for SC untill a proper DX is made.

Just thinking out loud.

Compensation for Undiagnosed Illnesses.

Many Gulf War Veterans encountered problems when trying to prove that their difficult-to-diagnose or undiagnosed illnesses were connected to military service. This affected these Veterans' access to disability compensation.

In response, VA asked Congress for the authority to provide compensation benefits to Gulf War Veterans who are chronically disabled by undiagnosed illnesses. The 1994 statute authorizes VA to pay compensation for disabilities that cannot be diagnosed as a specific disease or injury, or for certain illnesses with unknown cause, including chronic fatigue, persistent rashes, hair loss, headaches, muscle pain, joint pain, neurological symptoms, neuropsychological symptoms such as memory loss, respiratory system symptoms, sleep disturbances, gastrointestinal symptoms, cardiovascular symptoms, abnormal weight loss, and menstrual disorders.

More than 3,400 Gulf War Veterans have received service connection for their undiagnosed or difficult-to-diagnose illnesses under this authority. Veterans from the current conflicts in Afghanistan and Iraq are also eligible for this special benefit.

Edited September 14, 2009 by timetowinarace (see edit history)

[Berta]

"question: what is the best course of action to get the VA to commit to a diagnosis?"

To get an IMO from a non VA expert in this field.

Has an MRI be done yet to see if there is myelin present?

http://www.webmd.com/multiple-sclerosis/gu...agnosing-ms-mri

Once a definitive diagnopsis of MS is made then any and all symptoms that are documented in your SMRs could be instrumental in getting this service connected.Buddy statements and statement from family members could help prove -once the diagnosis is made- that you have symptoms consistent with MS in service.

If an IMO doc follows the "Getting an IMO " criteria I posted here at hadit (the criteria I developed-which was based on the IMO of a MS disabled veteran Dr. Craig Bash) then the IMO doctor could mention these symptoms as being early in service manifestations of the MS.

[broncovet]

This is a very good example of what is wrong with the VA. Here you have a Veteran with symptoms of MS..and the failure on the part of the Veterans Doctor to diagnose it, does not improve the Veterans condition. Nobody wants to listen to my opinion, but it would certainly appear to me that the Veteran should be compensated for MS even tho there is no diagnosis, because there are Symptoms of MS present.

WM Shakespeare said, "A rose by any other name would smell as sweet".

So, it should not matter if the diagnosis was a "runny nose", if the symptoms presented themself as MS symptoms.

Veterans are not compensated for conditions which are asymptomatic..that is, if a Veteran has a medical condition that causes him zero problems, he wont get compensated for it.

An example of this may be a Veteran who lost a leg due to an explosion in the military. Perhaps no doctor was available to "diagnose" an amputated leg..but certainly, the Veteran suffered symptoms.

If the Veteran got out of the military, the VA could deny his claim for benefits because he was never officially diagnosed with an amputated leg during military service...and thus say the missing limb was not related to military service.

I think the court would not uphold this. The Veteran need only have symptoms of a disease, and not necessarily a diagnosis of the disease. This would not be the first time that doctors made an incorrect/inappropriate diagnosis. JMHO.

Edited September 14, 2009 by broncovet (see edit history)

[Pete53]

This is a very good example of what is wrong with the VA. Here you have a Veteran with symptoms of MS..and the failure on the part of the Veterans Doctor to diagnose it, does not improve the Veterans condition. Nobody wants to listen to my opinion, but it would certainly appear to me that the Veteran should be compensated for MS even tho there is no diagnosis, because there are Symptoms of MS present.

WM Shakespeare said, "A rose by any other name would smell as sweet".

So, it should not matter if the diagnosis was a "runny nose", if the symptoms presented themself as MS symptoms.

Veterans are not compensated for conditions which are asymptomatic..that is, if a Veteran has a medical condition that causes him zero problems, he wont get compensated for it.

An example of this may be a Veteran who lost a leg due to an explosion in the military. Perhaps no doctor was available to "diagnose" an amputated leg..but certainly, the Veteran suffered symptoms.

If the Veteran got out of the military, the VA could deny his claim for benefits because he was never officially diagnosed with an amputated leg during military service...and thus say the missing limb was not related to military service.

I think the court would not uphold this. The Veteran need only have symptoms of a disease, and not necessarily a diagnosis of the disease. This would not be the first time that doctors made an incorrect/inappropriate diagnosis. JMHO.

I agree with you.

[Berta]

This is a good BVA case that shows how symptoms of MS -documented in some way-within servcice period time or presumptive MS period in the regs- can lead to a SC award for MS :

http://www.va.gov/vetapp09/files1/0902012.txt

[allan]

autumn,

welcome to hadit!

The VAMC doctors had no problem treating my MS symptoms without a diagnoses for over a decade until I filed for service connection.

Every MRI result came back normal according to the students & the neurologists I could get in to see.

I finally got it together enough to realize they were lying to me except the PCP that was treating me & some nurses that were very familiar with MS.

When I realized this, I started studying my MRI's. I bought a complete set of the actual MRI photo's & kept them for an IMO Dr to view. VAMC charged me $150 for the set, but it was worth it. The VAMC's throw theirs out after 5 years.

The Radiologists deferential comments on the MRI was it could be, ischemia, gleosis or demialinization,(MS). But The Dr's & student neurologists would only pass it off as "normal" when talking to me during visits.

I continued to show complete absent reflexes, ataxia, babenski sign and many, many other symptoms of MS for well over the decade VAMC studied me.

Their diagnoses at a VA Pension C&P continued to be "neuromuscular disorder of unknown cause" & never would commit to MS.

What makes MS different from brain injuries & other neurological disorders is the locations of the lesions.

With MS, there must be at least one lesion in the "corpus callosum".

My MRI reads, multiple scattered lesions throughout the white matter, with one in the corpus callosum.

When I asked a VAMC neurologists why he missed seeing and commenting on this specific lesion, he only said it's healing well & completely refused to discuss it any further.

Do yourself a big favor & go outside the VA for a firm diagnoses of whether it's MS or something else.

For one, I would think it would be illegal for a Dr to prescribe a drug used specifically for MS, without diagnosing it.

If you show MS symptoms during service or within the seven yrs following, go to someone outside of the VA for an IMO.

Look in your service records for any signs of MS. Fluctuating vision, double vision, ocular inflammation, hearing loss, balance problems, etc.

If the VA comes back & says you had no diagnoses or treatment in service for MS, appeal. It's all about the symptoms, not treatment that will SC MS

Do not expect the VA to provide a diagnoses for MS, unless everything is so easy to diagnoses it, that they can't possibly get around it. Expect the VAMC Dr to work side by side with VARO ratings when it comes to denying these claims.

It's just a personal opinion, but I believe they are trying to keep the number of veterans diagnosed with MS down.

I eventually gathered all my service records, MRI photos, C-file & any supporting medical records I could gather since service & sent them to a specialist named Dr Craig Bash for a complete evaluation.

I realized I could not trust the VAMC Dr's any longer to do this & needed to know once and for all what was wrong with me.

Dr Bash worked at the National Institute of Medicine for over a decade using MRI's to diagnose MS. He was the kind of specialist I needed to view the MRI since this was the major diagnostic tool used for MS. Dr Bash is also a disabled MS veteran & has personal experience with symptoms.

It cost me several thousand for his service, but it was worth it to know the truth.

Once you submit an IMO with a diagnoses from outside the VA system, things will get really weird at the VAMC you go to & the VARO raters. They really don't like it & will let you know it. All my medications were suddenly stopped & every diagnosis on VAMC records were deleted.

The IMO I submitted was lost several times & my claim was burried at the AMC for a couple years. The VA still refuses to grant any weight to the C&P they sent me to, a private IMO by a family Dr & the IMO from Dr Bash.

I filed for VA Pension in 1995 for MS & was granted it right away.

But have been fighting for SC MS ever since.

You have a fight on your hands. Never give up.

[Jayg]

I have a similar problem only with peripheral neuropathy. The doctor positively identifies the degree of damage but as to causality? "idiopathic," ie, "unknown." If it's 'unknown' it must n ot be service connected... right? B)

[Shark]

I have a similar problem only with peripheral neuropathy. The doctor positively identifies the degree of damage but as to causality? "idiopathic," ie, "unknown." If it's 'unknown' it must n ot be service connected... right? B)

PN is secondary to diabetes and also a presumptive condition of agent orange exposure...don't know if either apply to you though.

[halos2]

Autumn, Glad you found hadit. So you were originally diagnosed having ms by a neurologist when? When did you have MRI's done? Did you have any difficulty with your eyes/vision while inservice? Hope you can find a local neurologist to help with a recent diagnosis. Are there any free clinic's, or fee based clinics, or volunteer medical clinics in your area? Check with your county health department, as they may know of one near you, or in your region. Good luck.

i filed a claim and it was denied jan 2009. it was for MS while on active duty. at the time i didn't realize my c-file had zilch in it. i corrected that. all medical tests are in and not surprizingly the MS specialist will not commit to a diagnosis. all mimics have been ruled out. although he does want me to start on MS disease modifying drug injections soon.

so, i now realize that the VA will not commit to a diagnosis due to a disability claim thus they can and will continue to deny it. thousands of us vets i now know have & are going through this.

i'm in the process of trying to raise funds so i can see a non-VA neuro here in town. the National MS Society put me in touch with them. but that will take some time

question: what is the best course of action to get the VA to commit to a diagnosis? is this lawful that they can do this?

[halos2]

allan, I knew Dr Bash was a quadriplegic disabled veteran who types using 2 fingers for all of his reports, but I never knew he was also an MS patient too. No wonder he is so able to distinguish diagnoses and symptoms so many vets experience...personal knowledge and professional knowledge too. Thanks for letting us know this about him too.

Sorry you have had to go through all of this rig-a-morrow with the VA too.

autumn,

welcome to hadit!

The VAMC doctors had no problem treating my MS symptoms without a diagnoses for over a decade until I filed for service connection.

Every MRI result came back normal according to the students & the neurologists I could get in to see.

I finally got it together enough to realize they were lying to me except the PCP that was treating me & some nurses that were very familiar with MS.

When I realized this, I started studying my MRI's. I bought a complete set of the actual MRI photo's & kept them for an IMO Dr to view. VAMC charged me $150 for the set, but it was worth it. The VAMC's throw theirs out after 5 years.

The Radiologists deferential comments on the MRI was it could be, ischemia, gleosis or demialinization,(MS). But The Dr's & student neurologists would only pass it off as "normal" when talking to me during visits.

I continued to show complete absent reflexes, ataxia, babenski sign and many, many other symptoms of MS for well over the decade VAMC studied me.

Their diagnoses at a VA Pension C&P continued to be "neuromuscular disorder of unknown cause" & never would commit to MS.

What makes MS different from brain injuries & other neurological disorders is the locations of the lesions.

With MS, there must be at least one lesion in the "corpus callosum".

My MRI reads, multiple scattered lesions throughout the white matter, with one in the corpus callosum.

When I asked a VAMC neurologists why he missed seeing and commenting on this specific lesion, he only said it's healing well & completely refused to discuss it any further.

Do yourself a big favor & go outside the VA for a firm diagnoses of whether it's MS or something else.

For one, I would think it would be illegal for a Dr to prescribe a drug used specifically for MS, without diagnosing it.

If you show MS symptoms during service or within the seven yrs following, go to someone outside of the VA for an IMO.

Look in your service records for any signs of MS. Fluctuating vision, double vision, ocular inflammation, hearing loss, balance problems, etc.

If the VA comes back & says you had no diagnoses or treatment in service for MS, appeal. It's all about the symptoms, not treatment that will SC MS

Do not expect the VA to provide a diagnoses for MS, unless everything is so easy to diagnoses it, that they can't possibly get around it. Expect the VAMC Dr to work side by side with VARO ratings when it comes to denying these claims.

It's just a personal opinion, but I believe they are trying to keep the number of veterans diagnosed with MS down.

I eventually gathered all my service records, MRI photos, C-file & any supporting medical records I could gather since service & sent them to a specialist named Dr Craig Bash for a complete evaluation.

I realized I could not trust the VAMC Dr's any longer to do this & needed to know once and for all what was wrong with me.

Dr Bash worked at the National Institute of Medicine for over a decade using MRI's to diagnose MS. He was the kind of specialist I needed to view the MRI since this was the major diagnostic tool used for MS. Dr Bash is also a disabled MS veteran & has personal experience with symptoms.

It cost me several thousand for his service, but it was worth it to know the truth.

Once you submit an IMO with a diagnoses from outside the VA system, things will get really weird at the VAMC you go to & the VARO raters. They really don't like it & will let you know it. All my medications were suddenly stopped & every diagnosis on VAMC records were deleted.

The IMO I submitted was lost several times & my claim was burried at the AMC for a couple years. The VA still refuses to grant any weight to the C&P they sent me to, a private IMO by a family Dr & the IMO from Dr Bash.

I filed for VA Pension in 1995 for MS & was granted it right away.

But have been fighting for SC MS ever since.

You have a fight on your hands. Never give up.

[allan]

Halos,

here's a link that lists his specialties.

http://www.craigbashmd.com/specialties.html

and court cases............

http://www.craigbashmd.com/vaboardcases.html

They held my claim for prosessing MS at the BVA for four years, until my final SOC for the spinal issues this last May. Dr Bash provided an IMO back in 2005 and the case is now at the CAVC, so im hoping they'll take the time to see whats in my file.

Im sure he has a neurological disorder. But today I can't remember if he's the Dr Im thinking about that has MS.

I read & read my SMR's and never saw the medical evidence that was there until Dr Bash pointed it out. Than after explaineing medically how everything connected with a complete medical history, it made alot of since.

Allan

Edited October 5, 2009 by allan (see edit history)

[Rockhound]

It seems to me, that at the very least, you are intitled to a written statement in your medical files, why they want to start you on a course of treatment, that is specific to MS. such as to confirm or rule out MS as the diagnosis. Otherwise I would request in your strongest terms, that since they refuse to difinistively make a diagnosis, that you be able to, on a fee basis, seek a second opinion from the private sector for a definite diagnosis as to whether or not watch you have is MS and the course of treatment you are being given is the correct one. IMHO that is.

Rockhound Rider B)

[out_here04]

if true, and i ain't sayin' it ain't, this is pretty messed up:

It's just a personal opinion, but I believe they are trying to keep the number of veterans diagnosed with MS down.

...

I realized I could not trust the VAMC Dr's any longer to do this & needed to know once and for all what was wrong with me.

...

It cost me several thousand for his service, but it was worth it to know the truth.

...

Once you submit an IMO with a diagnoses from outside the VA system, things will get really weird at the VAMC you go to & the VARO raters. They really don't like it & will let you know it. All my medications were suddenly stopped & every diagnosis on VAMC records were deleted.

The IMO I submitted was lost several times & my claim was burried at the AMC for a couple years. The VA still refuses to grant any weight to the C&P they sent me to, a private IMO by a family Dr & the IMO from Dr Bash.

...

I filed for VA Pension in 1995 for MS & was granted it right away.

But have been fighting for SC MS ever since.

You have a fight on your hands. Never give up.

[MikeR]

I had actual paralysis in the right arm and it was such that the EMG was done by the C&P examiner whom said I had no evidence of nerve damage. Well it must have been a miracle, except I was not less paralyzed. Had the IMO from a Neurologist, and my 0% for the arm jumped to 40% on appeal. It never hurts to find the best IMO you can. My neurologist was pretty amused when he read the VA report.