ptsd Train Wreck - Help!

[SgtAFMOB]

This is my first post although I monitor the forums frequently and have gleaned much valuable infomation. Thanks to all who help! I am a Air Force, Rvn Vet 66 -67, Tan Son Nhut, Tay Ninh and other locations. With the advent of the new AO presumptives I filed in Nov for IHD, CAB 94 and recent Thallium Stress, 39% LVEF and already had my C&P for same with Dx of IHD. (should be rated at 60%) Also filed for PTSD after 43 years, had my C&P and was Dx with PTSD by examiner, did not ask the GAF score. Am now waiting for rating on IHD pending final rule. Have inquired via IRIS on my PTSD claim status no response yet. My question revolves around other conditions I have that are diagnosed by private doctors and results of tests etc. that I will file for after I get my hearback on the two conditions I have noted. I need suggestions as to what direction to take Secondary, P&T etc. am trying to stay away from nexus letters as much as possible, but will solicit "likely as not" letters if needed.

Mitral Valve Regurtation - Dx - 94 Secondary to IHD?

Aterial Fibulation - Dx - 97 Secondary to IHD?

Digenerative Disc Disease C-5-7 Dx 09 NSC

Hernated Disc NSC

Total Hip replacement L&R done 2007

Need R knee replaced Dx 2007

Nephrectomy L Kidney done 2007 (Renal Cell Carcenoma) Not presumptive but found 5 appellate cases awarded AO associated.

Three incisional hernia repairs secondary to nephrectomy 2007 - 2009

Multiple Lipomas - 1967 to present, found three appellate cases awarded AO associated

Anxeity - Secondary to PTSD?

Depression - Secondary to PTSD & IHD

ED - Secondary to PTSD & IHD ?

Any help in sorting this out would be appreciated. Thank You in advance.

[Berta]

The "nexus" factor is the most important facet of most claims-

Can you prove a stressor that caused you PTSD?

Or do you have CAR, CIB or the PH on your DD 214?

You have many issues here but you should claim anything as secondary to the IHD-such as:

"Mitral Valve Regurtation - Dx - 94 Secondary to IHD?

Aterial Fibulation - Dx - 97 Secondary to IHD?"

However I dont know how they would rate these and it would take medical evidence to show the "nexus" to the IHD-if in fact they would raise to a ratable level beyond the IHD rating.

The rest of the disabilities:

"Digenerative Disc Disease C-5-7 Dx 09 NSC

Hernated Disc NSC

Total Hip replacement L&R done 2007

Need R knee replaced Dx 2007" All would need a nexus to your service- are any of these disabilities mentioned in your SMRs or sdo you have something in the SMRs to establish them as SC?

"Nephrectomy L Kidney done 2007 (Renal Cell Carcenoma) Not presumptive but found 5 appellate cases awarded AO associated." Those BVA decisions will not help you.

Is this a soft Tissue sarcoma? If so then VA might award as STS AO cancer.I dont think this would be a STS however.

"Three incisional hernia repairs secondary to nephrectomy 2007 - 2009" needs inservice nexus or relationship to the renal problem whioch woul;d have to become SC first.

"Multiple Lipomas" - 1967 to present, found three appellate cases awarded AO associated ( BVA cases wont help you)

Any possibility that these are Soft Tissue sarcoma types of cancers? If so they will possibly award due to SC.

Could they be due to sun exposure? Did these show up as skin lesions during your service?

"Anxeity - Secondary to PTSD?" VA will lump all mental health issues into one rating.

Depression - Secondary to PTSD & IHD " and to associate the depression or PTSD as secondary to the IHD will take a strong medical opinion.

ED - Secondary to PTSD & IHD ? Your meds might be the cause of this- claim it as either due to the meds or to these conditions as well.Check the side affect list for any meds you take and if they could cause ED copy this as evidence for this claim.

If you are considering getting Independent Medical Opinions to support your claims please check out the IMO criteria here in the IMO forum.

[SgtAFMOB]

Thanks for your input Berta. Although TSN listed as RVN duty station it was the headquarters location, spent most of my time with the Army at forward operating locations, Tay ninh, Dau Teing, Min Than, Phouc Vinh, Loc Ninh, Soui Dau, Trang Sup etc. Have orders, weapons cards, photo's, moring reports, after action reports, to support stressors ie, handling human remains, mortar attacks, handling crispy critters as a result of chopper crash, etc. Also Distinguished Unit Award w/ V device and two personal letters from General Commanding 196th Light infantry Brigade. There was only one question regarding stressor at C&P as I had submitted a extensive package and after my response the examiner said enough. The awards you mentioned are not always needed to substantiate stressors and I am well aware of that. It seems like it is always the case when you indicate AF the eyes roll when it comes to PTSD.

Again I appreciate your response and had deduced much of the same regarding the other conditions described. There was a Vets forum not to long ago in my small community and I spoke with a woman from the RO. I posed the question regarding use of apellate cases. Her answer was that they would be considered as supportive on appeal.

Thanks for the help.

[Testvet]

Thanks for your input Berta. Although TSN listed as RVN duty station it was the headquarters location, spent most of my time with the Army at forward operating locations, Tay ninh, Dau Teing, Min Than, Phouc Vinh, Loc Ninh, Soui Dau, Trang Sup etc. Have orders, weapons cards, photo's, moring reports, after action reports, to support stressors ie, handling human remains, mortar attacks, handling crispy critters as a result of chopper crash, etc. Also Distinguished Unit Award w/ V device and two personal letters from General Commanding 196th Light infantry Brigade. There was only one question regarding stressor at C&P as I had submitted a extensive package and after my response the examiner said enough. The awards you mentioned are not always needed to substantiate stressors and I am well aware of that. It seems like it is always the case when you indicate AF the eyes roll when it comes to PTSD.

Again I appreciate your response and had deduced much of the same regarding the other conditions described. There was a Vets forum not to long ago in my small community and I spoke with a woman from the RO. I posed the question regarding use of apellate cases. Her answer was that they would be considered as supportive on appeal.

Thanks for the help.

the appellate cases the lady from the RO meant was cases heard and decided by the CAVC not the BVA BVA decisions are not binding on any other decision. where CAVC rulings are, where the medical issue and cause are the same

[Berta]

Any Precedent setting CAVC decision is binding on the VA.

Sgt- It sure sounds to me that you have your ducks in a row here.

"It seems like it is always the case when you indicate AF the eyes roll when it comes to PTSD. "

Yep- I bet that attitude can be found at VA sometimes as well as even with vet reps.

Another thing too- so many USAF vets records were burned in the ST Louios fire years ago that the VA has had the audacity to state to some USAF vets that their records were burnt in the fire and they never attempted to get them.

I helped a USAF vet get his so-called Burned and destroyed military records.His rep asked me to help him reconstruct his records-

"This is all the VA has" -the rep said as he handed me 2 SMRs and the decision that said the records have been lost in the fire.

I was appalled at how stupid this was-

the 2 SMRs had no water marks or charring marks-the firemen sure didnt select certain stuff to save at that fire.

We sent a SF 180-he got his complete Mil records- and of course they contained the nexus he needed.

Another USAF vet I helped got this BS too-they told him same thing but this vet had enlisted YEars AFTER the fire!

We squared that away too.

VA has a list of the alphabetized last names of predominately USAF personnel whose records were in fact lost in the St Louis Fire.

I don't think they even read the list and sometimes- if they see USAF-they don't even attempt to get the records and they tell the vet the fire story so they can deny the claim.

[SgtAFMOB]

Berta: Thanks for your supportive comments, not many of us AF types out in the field, Combat Controllers, FACs and their mechanics and us Aerial Port Mobility Operations people. I stared this process with a bad VSO experience, before IHD was announced. The VSO took my information, took a month and a half to develop the materials. When I went in to review the material before submission I looked at the first paragraph she had written and said "I can't let this go I'll be in Jail". She took the forms off the rabbit ears and tore them up infront of a couple in the waiting room and a secretary. Her parting comment was that she had a hard time getting AF people PTSD, she had what I call a bad case of the "I's". I am a 25 year retired Vet of the U.S. Department of Justice and if she had worked for me she would still be on probation. Needless to say I removed the AZVS as my advocate and began the process all over again myself. There is no other ball game in town and the Legion and VFW defer to her. Closest other VSO"s are 2 and 3 hrs away.

I sent for my records and your dead right destroyed in the 1973 fire. I fortunatly had saved all my orders and important documents and sent them off for reconstruction purposes, have not heard back yet. I also sent same with appropriate form to Randolf AFB for reconstruction and admendments to my DD 214. No medical records also, but I never went to sick call and whatever injuries I sustained I sucked it in as I was a Team Leader.

I would like to think I put together a good package and will do the same with the other disorders I referenced. I will continue to use this site for reference and I thank all of you for your assistance. If you have not go to VAwatchdog.org and pick up on the most recent VACO scandle and comments by Chief Justice Roberts on the CAVC situation regarding the volume of denials.