New To Forum-Need Help/advice

[soaringeagle17]

Greetings Fellow Veteran's,

First, I want to thank all of you for your service and for your time to advice to everybody on this Forum and thanks to the founder of the site. This is a copy of a post I put in the new members welcome area. I copied and pasted a reply with some questions one of the members asked me. Anyway, please take a look at what I provided and any assistance would be greatly appreciated. Have a great and blessed day. See below...

On the issues you want to re-open :

they are for what disabilities ? I had 11 items (Benign prostate hyperthrophy-20%, Right triceps tendonitis-had elbow surgery to fix tricvep tendon that ripped out while fighting a fire-10%, Left wrist sprain-10%, cervival spine degenerative arthritis clained as cervical DDD and spondylosis-10%), that were listed when I received my decision letter form the VA back on 2007. Of the 11 items four of them I received a service connection and a percentage. the others were listed as service connections and a zero percent assigned. The zero % assigned issues included Thoracolumbar degenerative arthritis-intervertebral disc degeneration, Right shoulder rotator cuff tendonitis, Left thumb carpometacarpal joint sprain, left knee patellofemoral syndrome, impotence, surgical scar right elbow, left carpal tunnel syndrome-minor) They did not give a rating for the high cholesterol that has been an issue for many years during my 21 years of military service.

I have been having issues with five of the areas and they have gotten worse. I have not gone to a doctor for all these issues because I had started a new job and did not have sick time and vacation built up and I have always been a person with a strong work ethic and not wanting to take time off for me to take care of my issues. I know that probably has not been the smartest thing to do, but I have been dealing with the pain and not complaining about it for many years to include before I retired. I was one of those guys that never complained very much when on active duty and lived with issues rather than complain because I loved the military and did not want to get kicked out for a Medical Board or anything like that. Also, some of the issues were personal and embarassing to discuss with doctors.

However, it is at a point now where all these things are impacting me. I also had questions about the Gulf war syndrome because I served in the Gulf war and never gave a lot of thought to filing any type of claim for the Gulf War Illness/Syndrome. I do and have had a lot of the symptoms such as sleep issues, gastrointestinal problems, joint and muscle pain, weakness, and fatigue. Anyway, I was not sure if I could have that addressed since it was not specifically mentioned in my claim when I retired.

On the Rating Decision that denied the issues -

what did it state in the Reasons and Bases Section - A lot of the reasons they stated were because I went to the doctor once or only a few times and a lot of other things they said about the issues I got zero % for. Some things said that at the mediccal appointment I was abIe to tie my shoes and button a shirt, etc... Well, just because I was able to do those things did not mean it was painful. Unfortunately I did not appeal during that first year because I had so many things going on in my life at the time. So, that is why I am asking about what I need to do to re-open my case for the issues to attempt to get the ratings changed. I now have some leave and vacation days to make some appointments to get some of my issues looked at and documented in my records. I am guessing I have to have a current documented history before I attempt to ask the VA to re-open my claim. I just want some advice on the best way to go about this whole situation.

what is the date on that Rating Decision ? The date of the rating decision is March 20, 2007.

Anyway, as I said in the first forum post I did yesterday, I was wondering if someone had any advice on the best way for me to go about re-opening, what I should do, how long I need to wait, and if I have to have doctors visits on file before I can re-open and then does anybody have a good recommendation of which service agency in San Antonio I should use to file, such as Texas Veterans Commission or some other agency. Any suggestions, support, or assistance is greatly appreciated.

Sincerely

SG

Soaringeagle17

[Pete53]

From what I read in your post you really are asking for a review and increase in service connection. All you need to do is to ask the VA to do it and yes I am sure they have a form for it.

I hope someone here will link it for you.

Good Luck

[Berta]

I am not sure if you saw my reply in the other forum-

This is where you will find the 21-4138 form that yo need. You also will need to send them new evidence. It is a good idea to get some medical attention if you have not done that yet since the last denial.

"I now have some leave and vacation days to make some appointments to get some of my issues looked at and documented in my records. I am guessing I have to have a current documented history before I attempt to ask the VA to re-open my claim. I just want some advice on the best way to go about this whole situation."

You are on the right track.

http://www.hadit.com/vaclaimslibrary/forms/214138SSOC.pdf

I suggest you get a vet rep from the TVC ASAP >They might want to file the 4138 for you.

VA will not re-open the claim unless you present them with new and material evidence that your disabilities have gotten worse and hopefully the results of some medical appointments will reveal they are now at a ratable level.

The TVC also will advise you as to any Gulf War related illnesses you should file for.In my opinion you seem to have a "qualifying chronic disability" -using the VA's definition and criteria for a service connection for Gulf War illnesses.

I am not a doctor however and the TVC will know what I mean as to claiming some of your conditions as directly due to service in SW Asia.

They did not give a rating for the high cholesterol that has been an issue for many years during my 21 years of military service."

High cholestrol or hyperlipedimia is not a ratable condition but can progress into more serious problems.

You will need some new evidence to re-open the claims.

"I have been having issues with five of the areas and they have gotten worse. I have not gone to a doctor for all these issues because I had started a new job and did not have sick time and vacation built up and I have always been a person with a strong work ethic and not wanting to take time off for me to take care of my issues. I know that probably has not been the." etc

They will want to see some evidence since the last decision that these conditions have gotten worse and are at least now at a ratable level.

"I also had questions about the Gulf war syndrome because I served in the Gulf war and never gave a lot of thought to filing any type of claim for the gulf War Illness/Syndrome. I do and have had a lot of the symptoms such as sleep issues, gastrointestinal problems, joint and muscle pain, weakness, and fatigue. Anyway, I was not sure if I could have that addressed."

We recently did a show on the 9 proposed new GWV presmptives as well as mentioning Gulf War illnesses.

Also there is much info hereas to Gulf war illness and havbng a "qualifying chronic disability" that would warrant service connection. It looks as though yo might fall into that category:

"I do and have had a lot of the symptoms such as sleep issues, gastrointestinal problems, joint and muscle pain, weakness, and fatigue. Anyway, I was not sure if I could have that addressed."

By all means claim these conditions as due to your Gulf War service.

Do you have copy of your complete SMRs?

As I said on the SVR show - the original Gulf War regulations are quite confusing.

These new proposed presumptives are by far clearer to understand but I also said I hope the VA understands these new disabilities and the potential for any GWV to have gotten anyone of these diseases.

If you read over some of the claims at the BVA web site on Gulf War illnesses it shows what types of illness they consider as a qualifying chronic illness and what evidence the veterans needed to support their claims.

http://www.svr-radio.com/archives.html

Its the June 16,010 show

Edited June 26, 2010 by Berta

[Berta]

This is the regulation I mean. A good vet rep should be able to shape some of your symptoms into the VA's definition of a "qualifying chronic disability" due to your Persian Gulf War Service and file a new claim on that basis whle helping you to re-open the other claims with some new evidence.

You don't need a lot of evidence right away to establish a re-opened claim but the VA will need something that medically shows your disabilties have gotten worse since their last decision.

"Under the relevant laws and regulations, service connection

may be granted for a disability resulting from disease or

injury incurred in or aggravated by active service. 38

U.S.C.A. §§ 1110, 1131 (West 2002). If a chronic disease is

shown in service, subsequent manifestations of the same

chronic disease at any later date, however remote, may be

service connected, unless clearly attributable to

intercurrent causes. 38 C.F.R. § 3.303(b) (2009). However,

continuity of symptoms is required where a condition in

service is noted but is not, in fact, chronic or where a

diagnosis of chronicity may be legitimately questioned. 38

C.F.R. § 3.303(b) (2009).

Further, service connection may also be granted for any

disease diagnosed after discharge, when all the evidence,

including that pertinent to service, establishes that the

disease was incurred in service. 38 U.S.C.A. § 1113(b) (West

2002); 38 C.F.R. § 3.303(d) (2009). The Board must determine

whether the evidence supports the claim or is in relative

equipoise, with the appellant prevailing in either case, or

whether the preponderance of the evidence is against the

claim, in which case, service connection must be denied.

Gilbert v. Derwinski, 1 Vet. App. 49 (1990).

Because the Veteran served in the Southwest Asia theater of

operations during the Persian Gulf War, service connection

may also be established under 38 C.F.R. § 3.317. Under that

section, service connection may be warranted for a Persian

Gulf Veteran who exhibits objective indications of a

qualifying chronic disability that became manifest during

active military, naval or air service in the Southwest Asia

theater of operations during the Persian Gulf War, or to a

degree of 10 percent or more not later than not later than

December 31, 2011. See 38 C.F.R. § 3.317(a)(1).

For purposes of 38 C.F.R. § 3.317, there are three types of

qualifying chronic disabilities: (1) an undiagnosed illness;

(2) a medically unexplained chronic multi symptom illness;

and (3) a diagnosed illness that the Secretary determines in

regulations prescribed under 38 U.S.C.A 1117(d) warrants a

presumption of service connection.

An undiagnosed illness is defined as a condition that by

history, physical examination and laboratory tests cannot be

attributed to a known clinical diagnosis. In the case of

claims based on undiagnosed illness under 38 U.S.C.A. § 1117;

38 C.F.R. § 3.117, unlike those for "direct service

connection," there is no requirement that there be competent

evidence of a nexus between the claimed illness and service.

Gutierrez v. Principi, 19 Vet. App. at 8-9. Further, lay

persons are competent to report objective signs of illness.

Id. To determine whether the undiagnosed illness is

manifested to a degree of 10 percent or more the condition

must be rated by analogy to a disease or injury in which the

functions affected, anatomical location or symptomatology are

similar. See 38 C.F.R. § 3.317(a)(5); see also Stankevich v.

Nicholson, 19 Vet. App. 470 (2006).

A medically unexplained chronic multi symptom illnesses is

one defined by a cluster of signs or symptoms, and

specifically includes chronic fatigue syndrome, fibromyalgia,

and irritable bowel syndrome, as well as any other illness

that the Secretary determines meets the criteria in paragraph

(a)(2)(ii) of this section for a medically unexplained

chronic multi symptom illness.

A "medically unexplained chronic multi symptom illness" means

a diagnosed illness without conclusive pathophysiology or

etiology, which is characterized by overlapping symptoms and

signs and has features such as fatigue, pain, disability out

of proportion to physical findings, and inconsistent

demonstration of laboratory abnormalities. Chronic

multisymptom illnesses of partially understood etiology and

pathophysiology will not be considered medically unexplained.

38 C.F.R. § 3.317(a)(2)(ii).

There are currently no diagnosed illnesses that have been

determined by the Secretary to warrant a presumption of

service connection under 38 C.F.R. § 3.317(a)(2)©.

"Objective indications of chronic disability" include both

"signs," in the medical sense of objective evidence

perceptible to an examining physician, and other, non-medical

indicators that are capable of independent verification. 38

C.F.R. § 3.317(a)(3). Signs or symptoms that may be

manifestations of undiagnosed illness or medically

unexplained chronic multi symptom illness include, but are

not limited to, the following: (1) fatigue; (2) signs or

symptoms involving skin; (3) headache; (4) muscle pain; (5)

joint pain; (6) neurologic signs or symptoms; (7)

neuropsychological signs or symptoms; (8) signs or symptoms

involving the respiratory system (upper or lower); (9) sleep

disturbances; (10) gastrointestinal signs or symptoms; (11)

cardiovascular signs or symptoms; (12) abnormal weight loss;

and (13) menstrual disorders. 38 C.F.R. § 3.317(b).

For purposes of section 3.317, disabilities that have existed

for six months or more and disabilities that exhibit

intermittent episodes of improvement and worsening over a

six-month period will be considered chronic. The six-month

period of chronicity will be measured from the earliest date

on which the pertinent evidence establishes that the signs or

symptoms of the disability first became manifest. 38 C.F.R.

§ 3.317(a)(4).

When all the evidence is assembled, VA is responsible for

determining whether the evidence supports the claim or is in

relative equipoise, with the Veteran prevailing in either

event, or whether a preponderance of the evidence is against

a claim, in which case, the claim is denied. Gilbert v.

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

Compensation is not payable if there is affirmative evidence

that 1) an undiagnosed illness was not incurred during active

military service, 2) an undiagnosed illness was caused by a

supervening event or condition, or 3) the illness is the

result of the Veteran's own willful misconduct or the abuse

of alcohol or drugs. 38 C.F.R. § 3.317©. The disability

must not be attributed to any known clinical diagnosis by

history, physical examination, or laboratory test. 38 C.F.R.

§ 3.317(a)(1)(ii)."

[john999]

The best way to start to document your disabilites is to start going to the VA and complain about these conditions. You can't expect to not go to the doctor for years and then believe the VA is going to increase your ratings. The way to generate new medical evidence is to see a doctor. Think of this as a long term project. If you are well enough to work and you have a retirement you are not going to starve. Use FMLA to go to the VA, and get all these conditions reviewed. When you ask for an increase the evidence will be there in your VA medical records in detail. You might want to do the Gulf War Registry exam.

[soaringeagle17]

The best way to start to document your disabilites is to start going to the VA and complain about these conditions. You can't expect to not go to the doctor for years and then believe the VA is going to increase your ratings. The way to generate new medical evidence is to see a doctor. Think of this as a long term project. If you are well enough to work and you have a retirement you are not going to starve. Use FMLA to go to the VA, and get all these conditions reviewed. When you ask for an increase the evidence will be there in your VA medical records in detail. You might want to do the Gulf War Registry exam.

Thanks for the info John999. I appreciate it. I was wondering if you could provide me with more info on what the gulf War Registry exam is and who does it and how do I request it??? Thanks and any other info you can provide would be greatly appreciated. Have a great and blessed evening.

[soaringeagle17]

This is the regulation I mean. A good vet rep should be able to shape some of your symptoms into the VA's definition of a "qualifying chronic disability" due to your Persian Gulf War Service and file a new claim on that basis whle helping you to re-open the other claims with some new evidence.

You don't need a lot of evidence right away to establish a re-opened claim but the VA will need something that medically shows your disabilties have gotten worse since their last decision.

"Under the relevant laws and regulations, service connection

may be granted for a disability resulting from disease or

injury incurred in or aggravated by active service. 38

U.S.C.A. §§ 1110, 1131 (West 2002). If a chronic disease is

shown in service, subsequent manifestations of the same

chronic disease at any later date, however remote, may be

service connected, unless clearly attributable to

intercurrent causes. 38 C.F.R. § 3.303(b) (2009). However,

continuity of symptoms is required where a condition in

service is noted but is not, in fact, chronic or where a

diagnosis of chronicity may be legitimately questioned. 38

C.F.R. § 3.303(b) (2009).

Further, service connection may also be granted for any

disease diagnosed after discharge, when all the evidence,

including that pertinent to service, establishes that the

disease was incurred in service. 38 U.S.C.A. § 1113(b) (West

2002); 38 C.F.R. § 3.303(d) (2009). The Board must determine

whether the evidence supports the claim or is in relative

equipoise, with the appellant prevailing in either case, or

whether the preponderance of the evidence is against the

claim, in which case, service connection must be denied.

Gilbert v. Derwinski, 1 Vet. App. 49 (1990).

Because the Veteran served in the Southwest Asia theater of

operations during the Persian Gulf War, service connection

may also be established under 38 C.F.R. § 3.317. Under that

section, service connection may be warranted for a Persian

Gulf Veteran who exhibits objective indications of a

qualifying chronic disability that became manifest during

active military, naval or air service in the Southwest Asia

theater of operations during the Persian Gulf War, or to a

degree of 10 percent or more not later than not later than

December 31, 2011. See 38 C.F.R. § 3.317(a)(1).

For purposes of 38 C.F.R. § 3.317, there are three types of

qualifying chronic disabilities: (1) an undiagnosed illness;

(2) a medically unexplained chronic multi symptom illness;

and (3) a diagnosed illness that the Secretary determines in

regulations prescribed under 38 U.S.C.A 1117(d) warrants a

presumption of service connection.

An undiagnosed illness is defined as a condition that by

history, physical examination and laboratory tests cannot be

attributed to a known clinical diagnosis. In the case of

claims based on undiagnosed illness under 38 U.S.C.A. § 1117;

38 C.F.R. § 3.117, unlike those for "direct service

connection," there is no requirement that there be competent

evidence of a nexus between the claimed illness and service.

Gutierrez v. Principi, 19 Vet. App. at 8-9. Further, lay

persons are competent to report objective signs of illness.

Id. To determine whether the undiagnosed illness is

manifested to a degree of 10 percent or more the condition

must be rated by analogy to a disease or injury in which the

functions affected, anatomical location or symptomatology are

similar. See 38 C.F.R. § 3.317(a)(5); see also Stankevich v.

Nicholson, 19 Vet. App. 470 (2006).

A medically unexplained chronic multi symptom illnesses is

one defined by a cluster of signs or symptoms, and

specifically includes chronic fatigue syndrome, fibromyalgia,

and irritable bowel syndrome, as well as any other illness

that the Secretary determines meets the criteria in paragraph

(a)(2)(ii) of this section for a medically unexplained

chronic multi symptom illness.

A "medically unexplained chronic multi symptom illness" means

a diagnosed illness without conclusive pathophysiology or

etiology, which is characterized by overlapping symptoms and

signs and has features such as fatigue, pain, disability out

of proportion to physical findings, and inconsistent

demonstration of laboratory abnormalities. Chronic

multisymptom illnesses of partially understood etiology and

pathophysiology will not be considered medically unexplained.

38 C.F.R. § 3.317(a)(2)(ii).

There are currently no diagnosed illnesses that have been

determined by the Secretary to warrant a presumption of

service connection under 38 C.F.R. § 3.317(a)(2)©.

"Objective indications of chronic disability" include both

"signs," in the medical sense of objective evidence

perceptible to an examining physician, and other, non-medical

indicators that are capable of independent verification. 38

C.F.R. § 3.317(a)(3). Signs or symptoms that may be

manifestations of undiagnosed illness or medically

unexplained chronic multi symptom illness include, but are

not limited to, the following: (1) fatigue; (2) signs or

symptoms involving skin; (3) headache; (4) muscle pain; (5)

joint pain; (6) neurologic signs or symptoms; (7)

neuropsychological signs or symptoms; (8) signs or symptoms

involving the respiratory system (upper or lower); (9) sleep

disturbances; (10) gastrointestinal signs or symptoms; (11)

cardiovascular signs or symptoms; (12) abnormal weight loss;

and (13) menstrual disorders. 38 C.F.R. § 3.317(b).

For purposes of section 3.317, disabilities that have existed

for six months or more and disabilities that exhibit

intermittent episodes of improvement and worsening over a

six-month period will be considered chronic. The six-month

period of chronicity will be measured from the earliest date

on which the pertinent evidence establishes that the signs or

symptoms of the disability first became manifest. 38 C.F.R.

§ 3.317(a)(4).

When all the evidence is assembled, VA is responsible for

determining whether the evidence supports the claim or is in

relative equipoise, with the Veteran prevailing in either

event, or whether a preponderance of the evidence is against

a claim, in which case, the claim is denied. Gilbert v.

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

Compensation is not payable if there is affirmative evidence

that 1) an undiagnosed illness was not incurred during active

military service, 2) an undiagnosed illness was caused by a

supervening event or condition, or 3) the illness is the

result of the Veteran's own willful misconduct or the abuse

of alcohol or drugs. 38 C.F.R. § 3.317©. The disability

must not be attributed to any known clinical diagnosis by

history, physical examination, or laboratory test. 38 C.F.R.

§ 3.317(a)(1)(ii)."

Berta, thanks so much for your responses and your time. I really appreciate it. I am adding it to my homework and research and will put the information to use. Have a wonderful and blessed evening and thanks for taking the time to help others. It is a blessing.