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Gulf War Syndrome Nexus Letter

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usmc0331

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I was a 0331 machinegunner in the USMC. I was awarded the Combat Action Ribbon, Naval Achievement medal for actions in Iraq, and PUC. I have been disgusted by the VA so far. My file has been on hold because they sent my records to another veteran. I thought it was a prank call until the veteran started rattling off my SSN, address, phone number, DOB, etc.

I recieved a C & P Exam and the examiner noted in the report:

Diagnostic Impression: 1. Fibromyalgia. 2. Irritable Bowel Syndrome.

Discussion: Based upon the classic history for both irritable bowel syndrome and fibromyalgia, I do think that the Veteran suffers from both of these disorders primarily, but it would be speculation on my judgement to say that it is truly Gulf War Syndrome when he is so classic for each in and of themselves.

I have already provided a nexus letter from my doctor stating that my fibromyalgia and IBS "is due" to the activities and exposures while he was in Iraq. After the C & P Exam i will submit the following nexus:

To Whom It May Concern:

Veteran has been a patient of mine for several years. I have also reviewed his Military Service Medical Records. While in Iraq he was constantly exposed to Industrial Pollution, Raw Sewage, Smoke from Burning Trash and Feces, Solvents, Pesticide-Treated Uniforms, DEET, Raw Sewage, Vehicle and JP8 Exhaust Fumes, and Environmental Pesticides. He was also given numerous vaccinations to include Anthrax vaccinations.

In 2003 upon returning from Iraq, as evident in his Military File, he complained of Diarrhea, Chronic Fatigue, Difficulty Remembering, Muscle Aches, Headaches, Swollen Stiff and Painful Joints, Weakness, Dizziness and Light Headedness. He also listed he had health concerns about the exposures and events during his deployment.

In regards to his Fibromyalgia:

His Fibromyalgia is characterized as widespread musculoskeletal pain and tender points, with associated fatigue, sleep disturbance, stiffness, headaches, irritable bowel symptoms, depression, and anxiety. These symptoms are constant and refractory to therapy.

In regards to his Irritable Bowel Syndrome:

His Irritable Bowel Syndrome is characterized by constant daily abdominal distress. The symptoms consist of constant episodes of severe diarrhea and constipation with mucous in the stool.

In regards to his Migraine Headaches:

His migraines are characteristic of prostrating attacks occurring on average of two to three times per month.

It is my medical opinion that these medically unexplained chronic multi-symptom illnesses are more likely than not a direct result of his exposures and military service.Sincerely,John Smith, M.D.

Before I submit the Nexus letter, does he need to change any wording?

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Are you saying even with the VA Doctors findings of:

VA Examination:

Diagnostic Impression: 1. Fibromyalgia. 2. Irritable Bowel Syndrome.

Discussion: Based upon the classic history for both irritable bowel syndrome and fibromyalgia, I do think that the Veteran suffers from both of these disorders primarily, but it would be speculation on my judgement to say that it is truly Gulf War Syndrome when he is so classic for each in and of themselves.

They still must be SC'd. Should I not worry about submitting a nexus to combat the "speculation" wording in the discussion.

NO, you can still get a letter but I am trying to say is you must first have a diagnosis of each disorder. A nexus letter saying that your SMRs proves that you were diagnosed and treated with these conditions while still on active duty or that your SMRs proves that you were having the symptoms on active duty and they continue. Most SMRs will not say that a veteran was or was not exposed to anything but you should have records that you were treated and the dates you were treated and any hospitalization would be helpful. Example: 01/02/2002 treatment for diarrhea, 01/015/2003 treatment for recurring headaches, patient also had this condition on 11/06/2002, 11/15/2002 and 12/04/2002. Patient was admitted on 01/15/2003 for nausea, vomiting, diarrhea and severe stomach cramps. Have your doctor write a nexus letter that connects your military treatment records to a current diagnosis of IBS and fibromyalgia instead of being exposed of something that you can not prove.

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I agree that the word "speculation" is something the VA might sure pounce on.

I have the criteria for IMos here under the IMO topic.

I developed the criteria (the VA doesnt have this published anywhere at all) based on 2 IMOs I got because my IMO doc was also former VA doc and he knew exactly what they needed.

Also a PA's opinion which attempted to go against my claim contained the word "speculation" on the PA's part so the BVA rejected his entire opinion.My rebuttal to his opinion, my IMOs- 3 by then with one more on order, and my extensive medical evidence was enough evidence for any VA doc (or even a 12 year old) not to 'speculate' on the claim but this was only way the PA could try to squeeze out of agreeing with my claim.

Also words like "conjecture' are often found in C & P exams.

It is usually just more VA BS for trying to deny a claim.

Also the VA will possibly hinge on fact that you are OIE-OEF and not PGW vet-

I mentioned this -does your vet rep have the VBM and could he copy part of this page (181)if this becomes an issue with your claim?

Or you could call or email NVLSP and ask them if Berta Simmons -NY -can have their permission to copy and attach at this thread the statement above that they published, then I will attach it here and you could use this for the claim.

The VBM has a copyright law. However you could simply use the above citation to the VBM from, NVLSP and I think VA would have to consider it.

If you have further problems with the claim- by any denial from the VA I also suggest you contact Lawyers for Warriors (NVLSP lawyers) and their contact info is at the NVLSP web site.

"The VBM published by the National Veterans Legal Service Program makes the point on page 181 (2009 Edition) that they believe "beneficial rules created for veterans of the first Persian Gulf War apply to veterans of Operation Iraqi Freedom."

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Berta,

I tried to contact them and they only have voicemail set up now. I also e-mailed them but have yet to recieve a response. The have a message that said due to overwhelming numbers of OIF/OEF veterans they are no longer able to take any new clients. Is there anywhere on the web to view this specific passage on page 181?

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I was a 0331 machinegunner in the USMC. I was awarded the Combat Action Ribbon, Naval Achievement medal for actions in Iraq, and PUC. I have been disgusted by the VA so far. My file has been on hold because they sent my records to another veteran. I thought it was a prank call until the veteran started rattling off my SSN, address, phone number, DOB, etc.

I recieved a C & P Exam and the examiner noted in the report:

Diagnostic Impression: 1. Fibromyalgia. 2. Irritable Bowel Syndrome.

Discussion: Based upon the classic history for both irritable bowel syndrome and fibromyalgia, I do think that the Veteran suffers from both of these disorders primarily, but it would be speculation on my judgement to say that it is truly Gulf War Syndrome when he is so classic for each in and of themselves.

I have already provided a nexus letter from my doctor stating that my fibromyalgia and IBS "is due" to the activities and exposures while he was in Iraq. After the C & P Exam i will submit the following nexus:

To Whom It May Concern:

Veteran has been a patient of mine for several years. I have also reviewed his Military Service Medical Records. While in Iraq he was constantly exposed to Industrial Pollution, Raw Sewage, Smoke from Burning Trash and Feces, Solvents, Pesticide-Treated Uniforms, DEET, Raw Sewage, Vehicle and JP8 Exhaust Fumes, and Environmental Pesticides. He was also given numerous vaccinations to include Anthrax vaccinations.

In 2003 upon returning from Iraq, as evident in his Military File, he complained of Diarrhea, Chronic Fatigue, Difficulty Remembering, Muscle Aches, Headaches, Swollen Stiff and Painful Joints, Weakness, Dizziness and Light Headedness. He also listed he had health concerns about the exposures and events during his deployment.

In regards to his Fibromyalgia:

His Fibromyalgia is characterized as widespread musculoskeletal pain and tender points, with associated fatigue, sleep disturbance, stiffness, headaches, irritable bowel symptoms, depression, and anxiety. These symptoms are constant and refractory to therapy.

In regards to his Irritable Bowel Syndrome:

His Irritable Bowel Syndrome is characterized by constant daily abdominal distress. The symptoms consist of constant episodes of severe diarrhea and constipation with mucous in the stool.

In regards to his Migraine Headaches:

His migraines are characteristic of prostrating attacks occurring on average of two to three times per month.

It is my medical opinion that these medically unexplained chronic multi-symptom illnesses are more likely than not a direct result of his exposures and military service.Sincerely,John Smith, M.D.

Before I submit the Nexus letter, does he need to change any wording?

I have very semilar symptoms as you. I was a Medical Officer with the Marines in 03, and got the same awards, I have a current claim pending for GWS with the following conditions (chronic diarrhia, joint pain, migraine headaches). I have heard nothing yet, but I think it will be denied they have not given C&P exams or nothing. Hope we win but suspect I will lose at this level.

Good luck,

Bergie

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USMC 0331

Thanks for that recent info on the Lawyers for Warriors program-NVLSP has been quite overwhelmed with those claims.

Due to copyright laws I am not able to attach the whole page here -it would involve page 180 as well as 181.

However there is a statement at the NVLSP web site as to their authority on legal citation-I posted that statement here too.

I suggest you send the VA -if they have questioned your claim in a way that this would help it-

"The authors of this Manual believe that all of the beneficial rules created for veterans of the first Persian Gulf War apply to veterans of Operation Iraqi Freedom."

Source :National Veterans Legal Services Program, Washington, DC

As appearing in the Veterans Benefits Manual , 2009 Edition, pages 180-181 referring to 38 USC 1117,and 38 CFR 3.317 et al.

Then refer the VA additionally to Holton V Shinseki decision by sending the VA a full print out of this page from the NVLSP web site:

http://www.nvlsp.org/Information/ArticleLi...Court/index.htm

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For Gulfwar Illness Claims you don't want a diagnosis. If you have a Doc apply a diagnosis and diagnotic code the VA will jump on that and try to deny the claim on the fact you have a dagnosed condintion and need to prove that it was caused by service. If you have not done so already review a copy of 38 CFR 3.317 and memorize it if you can or keep a copy handy. And yes the rules do apply for rhose serving in Iraq currently. There was and hasn't been an end date specified.

The letter you have from your doctor should be sufficient plus a copy of your medical records.

Als far as your records being sent to another veteran with all of your information: I would file an OIG complaint on that one with along of predjudice. THAT violates SO many VA and federal rules that I cant count them. Also any notices that you can show were not sent to you means legally they were not sent or recieved by you.

Frank Clark

NO, you can still get a letter but I am trying to say is you must first have a diagnosis of each disorder. A nexus letter saying that your SMRs proves that you were diagnosed and treated with these conditions while still on active duty or that your SMRs proves that you were having the symptoms on active duty and they continue. Most SMRs will not say that a veteran was or was not exposed to anything but you should have records that you were treated and the dates you were treated and any hospitalization would be helpful. Example: 01/02/2002 treatment for diarrhea, 01/015/2003 treatment for recurring headaches, patient also had this condition on 11/06/2002, 11/15/2002 and 12/04/2002. Patient was admitted on 01/15/2003 for nausea, vomiting, diarrhea and severe stomach cramps. Have your doctor write a nexus letter that connects your military treatment records to a current diagnosis of IBS and fibromyalgia instead of being exposed of something that you can not prove.
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