I Hear All's Fair In Love And War . . .

[carlie]

I hear all's fair in love and war . . . . . . . . .

Well I have 2 new C&P appointments over the next couple of weeks,

I love the VA compensation but they force me to go to war with them

to get it.

Time to get out the boxing gloves again . . . . .

No, on second thought I prefer the idea of a handfull of sand directly into the face

then jabbing a sharp blade from the trachea down completely into the pit of the stomach !

The above, is known otherwise by many as . . . . evidence.

[Guest terrysturgis]

Carlie, most of us only know you from the Hadit forum. Should any one inquire of me if I thought Carlie would get tired of the game and give up on her claim my answer would be "Hell No!" Keep the pressure on. Terry

[carlie]

Well the C&P for tomorrow, one issue is for GERD - with regurgitation (gross)

on a very regular basis.

A prior C&P examiner stated my diagnosis was GERD and my upper GI showed a small hiatal hernia.

That I take NSAID's several times weekly for my SC'd headaches but to relate the GERD to the

NSAIDS's would be mere speculation.

Since that C&P and denial for GERD, I have gotten SC'd for Asthma and Chronic Bronchitis,

which the VAMC RX's me oral steroids and bronchial inhalers with steroids.

I will be asking the C&P examiner to comment on if it is as at least likely as not that the

NASID's, Steroids and Inhalers I take for SC'd conditions, are a contributing factor in

the aggravation of my GERD, thereby a secondary condition.

I will be printing out and taking the following BVA decisions with me, so if the examiner tells me

NO - to the above statement I can show the examiner these decisions and ask the examiner

what is so different and special about my GERD, that would make the above less likely than not,

a contributing factor of aggravation.

How does this plan sound ?

- - - - - -

The three threshold requirements that must be met to establish secondary service connection are: (1) Competent(medical diagnosis) evidence of current disability for which service connection is sought. This requirement is met as GERD is diagnosed. (2) Evidence of an already service-connected disability. This requirement is also met, as the Veteran's left knee disability is service connected and (3) Competent evidence of a nexus between the service-connected disability and the disability for which secondary service connection is claimed.As there was conflicting evidence regarding whether the Veteran's GERD was secondary to NSAIDs prescribed for his service connected left knee disability, the Board sought an advisory medical opinion from a VA expert in this matter. The consulting VA gastroenterologist reviewed the record, and opined that the Veteran's GERD was likely due to his service-connected prescriptions of NSAIDs; and furthermore, that it was very likely that any underlying and pre-existing GERD was aggravated by the NSAIDS. The consulting physician based the opinion on a review of the record, and explained the rationale for the opinion, with citations to medical literature. As he clearly has expertise in determining the etiology of the disability at issue, and his opinion provides the best explanation of the medical principles involved, the Board finds the VHA specialist's opinion probative and persuasive evidence that establishes that the NSAIDS prescribed in treatment for the Veteran's service connected left knee disability likely caused (and in the event mild GERD pre-existed such treatment, aggravated) the Veteran's GERD. In light of the foregoing, the Board finds that the third (and final) requirement for establishing secondary service connection is also met, and that service connection for GERD as secondary to NSAIDs prescribed in treatment for the Veteran's service-connected left knee disability is warranted.ORDERSecondary service connection for GERD is granted.- - - - - - http://www.va.gov/vetapp09/Files1/0902694.txtWhile steroids and NSAIDs may not have caused GERD, certainly these medications can exacerbate reflux symptoms. Furthermore, these medications can cause espophagitis, gastritis, and ulcers, complications [that] the veteran has been found to have on endoscopy.He concluded that a number of factors can worsen or aggravate reflux including steroids as well as smoking; and, that it was as least likely as not that steroids and/or NSAIDs aggravated his GERD.- - - - - - - - - http://www.va.gov/vetapp09/Files1/0902694.txt

While both VA examiners concluded that the medications taken

for the service-connected low back disability and COPD did

not cause the veteran's GERD, at least one VA examiner

concluded that the medications taken for the service-

connected back disability and COPD aggravated the GERD. When

the aggravation of a non-service-connected disorder is

proximately due to or the result of a service-connected

disorder, service connection is warranted. Allen v. Brown, 7

Vet. App. 439, 448 (1995). The Board finds the statement of

the VA examiner, combined with the private positive nexus

opinions submitted by the veteran, to be sufficient medical

evidence of a link between the medications and the veteran's

claimed aggravation of his GERD. Overall, the preponderance

of the evidence is in favor of the veteran's claim, as such

service connection is warranted on a secondary basis.

ORDER

Entitlement to service connection for GERD, to include as

secondary to the service-connected conditions of COPD and

cervical disc back disability, is granted.

[USNDW]

I always thought it was funny to take a lit cigarrette and jam it up a guy's nose and then grab the nose and pinch it shut for as long as you can hold on. It doesn't take very many of those before people will leave you the hell alone.

I haven't figured out a way to jam burning embers up the VA but I am working on it.

[Tbird]

Well as usual our Carlie is loaded for bear :)

[evandc]

As a good veteran friend tells me "I don't tink this is her first RODEO."

Go Carlie,

Don

[Wings]

Carlie, I imagine you have copied contemporary, supportive evidence --to show the service-connected medication can aggravate the NSC Gerd? Also, the diagnosis of hernia is minimized in the course of the arguments presented presented; what's up with the hernia? Can the hernia cause Gerd? Is the herniia another issue to be service connected? You keep fighting, I am proud of your gumption, and you weild a sharpened sword!! ~Wings