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Evidence Of A Prolonged Period Without Medical Complaint

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Domepeace

Question

I've seen and read cases that are denied because of:

"Evidence of a prolonged period without medical complaint and the amount of time that elapsed since military service, can be considered as evidence against a claim."

I would like to know any thoughts on how to combat this. I'm not sure if stating that a veteran cannot afford health insurance is a viable answer. I'm curious to know, what would be considered a prolonged period; one year, five years?

Thanks,

Domepeace

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  • Content Curator/HadIt.com Elder

What type of prolonged period are you talking about?

I have also seen the opposite, indicating that prolonged period does not matter. I will see if I can dig up a BVA case.

I am appealing my back, but have a prolonged period from 1995-2004 only because I do not currently have the medical records. I am in the process of requesting copies from the VA and other sources, but the other sources seem to have destroyed or lost them. Crossing my fingers about the VA treatment records. Checking mailbox anxiously every day.

If they are denying you because of a prolonged period, an IMO might be your only chance.

"If it's stupid but works, then it isn't stupid."
- From Murphy's Laws of Combat

Disclaimer: I am not a legal expert, so use at own risk and/or consult a qualified professional representative. Please refer to existing VA laws, regulations, and policies for the most up to date information.

 

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If you have a condition go and see a VA doctor. Since you are service connected, the next time you see your VA PCP or VA specialist have them examine/treat you for the condition. Referring to getting service connected, you may not be able to get any back pay but if you start getting treated now you can claim it, once it gets in your records. Then you can file a claim.

My intentions are to help, my advice maybe wrong, be your own advocate and know what is in your C-File and the 38 CFR that governs your disabilities and conditions.

Do your own homework. No one knows the veteran’s symptoms like the veteran. Never Give Up.

I do not give my consent for anyone to view my personal VA records.

 

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The VA statement makes sense-

because the VA LOVES paper-and it is the documented medical paper trail that justifies many awards made years after service.

Even an IMO doctor might not be able to fully support some claims when there was a long period between treatment records.

Take back injury claims-they can be problematic.

my neighbor -retired USAF 20 years- filed a back injury claim 2 years ago and was awarded in 8 months.

His injury was well documented in his SMRs but didnt begin to bother him a lot until he was employed at the local VA-years after the injury.

A long period of time had passed from his treatment to the current problem.

But the MRIs they gave him were a solid nexus to the type of inservice type of injury he had.

He had no other nexus at all for what the MRIs revealed and the fact that on the job problems were related to the inservice injury.

But another vet I know had back injury after service.

He tried to claim inservice injury caused it but only began treatment records when he injured his back on a job many years later.He gets SSA for this severe back problem but cannot establish any relationship to any inservice event.

The VA's rationale makes sense.

If there is a disability, then most of the time the vet will get treatment for it.

"I'm not sure if stating that a veteran cannot afford health insurance is a viable answer." I dont think that would work.

" I'm curious to know, what would be considered a prolonged period; one year, five years?"

That could depend on the disability.

Some disabilities like PTSD can show up decades after the fact and the VA understands that-as it is the nature of PTSD.

Other disabilities usually don't.

Then again the AO presumptive disabilities can show up any time after service.

I am sorry I forget if you mentioned here what disability you have and need to establish as due to your service.

SOme can show manifestation by symptoms in SMRs that are not properly diagnosed in the Mil and the vet needs to establish how those symptoms are due to their present disability.

I had vet whose claim was at CAVC TWICE= over 12 years of fighting.

I found in his SMRs (the VA does NOT read them as carefully as we hope they would) a lot of proof of his current problems,which the Mil failed to diagnose at all.He went a long time without medical treatment.

Decades later after his service they awarded him because we proved his SMRs contained documented symptoms of his SC disability.

It wasn't easy. He also got an IMO but the IMO would have been no help whatsoever-if I had not found the evidence in the SMRs for the IMO doc to opine on- the IMO doc had never dealt with SMRs before and they were almost illegible.

Claims without treatment periods can still succeed but it makes sense that-if the disability is there- the veteran will get some sort of treatment for it.

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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  • HadIt.com Elder

x

x

x

It would be helpful to know the specific disability at issue; some injuries or disease have a natural progression; others are more acute or chronic. You could provide "alternative" documentation of said "complaints". ~Wings

USAF 1980-1986, 70% SC PTSD, 100% TDIU (P&T)

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RIGHT Wings---very good point!!!!!!!-

and one reason why MS has a 7 year presumptive period in the chronic SC disability regs.

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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  • Content Curator/HadIt.com Elder
Take back injury claims-they can be problematic.

my neighbor -retired USAF 20 years- filed a back injury claim 2 years ago and was awarded in 8 months.

His injury was well documented in his SMRs but didnt begin to bother him a lot until he was employed at the local VA-years after the injury.

A long period of time had passed from his treatment to the current problem.

But the MRIs they gave him were a solid nexus to the type of inservice type of injury he had.

He had no other nexus at all for what the MRIs revealed and the fact that on the job problems were related to the inservice injury.

But another vet I know had back injury after service.

He tried to claim inservice injury caused it but only began treatment records when he injured his back on a job many years later.He gets SSA for this severe back problem but cannot establish any relationship to any inservice event.

Berta has quite a point there. Granted I am still waiting for copies of my VA treatment records, those situations sound a lot like mine. If your claim is related to your back, like mine, you might want to perform research to determine if the onset of the symptoms takes a considerable amount of time and also review other BVA decisions related to yours to see how they were rated. Check these out:

BVA case - SC granted. Despite the gap, it looks like he had a IMO.

http://www.va.gov/vetapp09/files3/0921830.txt

The Board recognizes the large gap in time between the

Veteran's 1982 separation from active duty and his first

being diagnosed with degenerative disc disease of the lumbar

spine in 2008. Nonetheless, given the diagnosis found in the

record and the fact that the most credible medical evidence

of record related this disability to a documented in-service

injury, the Board finds that with granting the Veteran the

benefit of any doubt in this matter that service connection

for degenerative disc disease of the lumbar spine is

warranted. 38 U.S.C.A. § 5107; 38 C.F.R. § 3.102; Gilbert v.

Derwinski, 1 Vet. App. 49, 56 (1990).

This is a workers comp case in Minnesota where someone had DDD and tried to claim it was the result of their accident. Because this is not Federal, I doubt we could use it as a precedent.

http://www.workerscomp.state.mn.us/2008/Zi...an-09-03-08.htm

"Finally, the employer and insurer argue that A[t]he nature of the Employee's low back condition is something that takes years to develop, and would not have been caused by the February 2007 incident."

WebMD - Info explaining how DDD starts

http://www.webmd.com/back-pain/tc/degenera...-topic-overview

"A sudden (acute) injury leading to a herniated disc (such as a fall) may also begin the degeneration process."

Cedars Sinai medical center - DDD explained

http://www.csmc.edu/5757.html

Unlike other tissues of the body, there is very little blood supply to the disc. Once a disc is injured, it cannot repair itself, and a spiral of degeneration can set in with three stages that appear to occur over 20 to 30 years

Causes and Risk Factors

Several factors can cause discs to degenerate, including age. Specific factors include:

* The drying out of the disc. When we are born, the disc is about 80% water. As we age, the disc dries out and doesn't absorb shocks as well

* Daily activities and sports cause tears in the outer core of the disc. By the age of 60, most people have some degree of disc degeneration. Not everyone at that age has back pain, however.

* Injuries, which can cause swelling, soreness and instability. This can result in low back pain.

"If it's stupid but works, then it isn't stupid."
- From Murphy's Laws of Combat

Disclaimer: I am not a legal expert, so use at own risk and/or consult a qualified professional representative. Please refer to existing VA laws, regulations, and policies for the most up to date information.

 

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