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Some Advice About How To Present This Research


CCC

Question

OK I've spent about a year compiling research and I'm ready to get it ready to send to the VA. I was wondering if anybody had a good idea on how I could put it all together, in like one page. Maybe a spreadsheet or something that says "He was here, he has lung damage, this is the chemical that caused the lung damage, this is his duty station that had the chemicals, etc."

Something like that. Does anyone have any ideas? I've been stuck here for a few days, not knowing how to do it. I would love to be able to have everything in one page, if at all possible, because I feel like it will make the most impact if they can look at it and see it all at once glance.

I just don't think I can do it that way. Between medical records, contaminant documentation and the like, I have 6 binders of information. I don't see how I can do it all on one page, but I'm open to suggestions.

Thanks in advance, if anyone has any ideas.

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The best I could offer is to create an index (pages, paragraphs) tabbed to indicate the issue and progression of the diseases/conditions. I usually send them all the documents with a cover letter/index with a binder clip. As usual, remember to page number all documents, your case file/name on each (sure you already know this...)..

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Yeah, I've got all that. I just wondered if there was a way to do it where it was a neat presentation, that itself could reference back to the binders and binders and binders of research. laugh.png

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How about using a process type flow chart? Starting from his entry into the military (entry physical), all his duty stations (with locations, contentions etc) along with see Binder whatever for further info.

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That's a good idea, and it would make an impact at first glance. That's kind of what I am looking for. I want something that they are going to look at and not throw it away or toss it into a pile.

Thanks. biggrin.png

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  • HadIt.com Elder

I don't know about one page. Things like indexes, "executive summary", "foot notes",

and time line flow charts come to mind.

When you state that this caused that, you will need medical opinions that validate the cause and effect for the individual case.

In an ideal situation, you setup things so that the RO cannot take the position that the evidence is "general", and may not/does not directly pertain to this specific case. Even with this accomplished, the RO may, (seemingly randomly) decide to deny or approve.

My experience with the Nehmer review was that they actually read, listed, and weighed the evidence, unlike the original denying Atlanta RO and DRO,who ignored, downplayed, and tried to discount positive evidence.

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  • HadIt.com Elder

D,

This claim sounds rather complex. I would start the letter with a current diagnosis and work backward to the chemical exposure in the military. If you provided me with a current diagnosis and the amount of time between the chemical exposure and the first report of symptoms I will research BVA cases for similar cases. If you have not researched BVA cases you will benefit greatly by having this research. Additionally, if you want to research BVA cases I can give you some tips on how to perform BVA searches.

Also, focus on establishing a potential nexus with the literature which would get a C&P exam or better yet get a doctor to write a nexus letter. See the nexus letter protocol on this website.

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I don't know about one page. Things like indexes, "executive summary", "foot notes",

and time line flow charts come to mind.

When you state that this caused that, you will need medical opinions that validate the cause and effect for the individual case.

In an ideal situation, you setup things so that the RO cannot take the position that the evidence is "general", and may not/does not directly pertain to this specific case. Even with this accomplished, the RO may, (seemingly randomly) decide to deny or approve.

My experience with the Nehmer review was that they actually read, listed, and weighed the evidence, unlike the original denying Atlanta RO and DRO,who ignored, downplayed, and tried to discount positive evidence.

Yeah I've got so much documentation - I just thought it'd make a bigger impact if I could do it all in one page, but I think you're right - one page ain't gonna cut it.

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If I got denied on this claim I would take it to lawyer. These chemical exposure cases are tricky and can take years.

I've already talked to one, and he told me to call him back if (when) it gets denied. I wish he'd go ahead and take it now. That way he could familiarize himself with everything while we are waiting.

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You got good advise here.

My experience with studying chemical exposure claims at the BVA is that they need strong evidence that a specific chemical caused the disability and it takes a strong medical opinion to back up any research to prove the point.

You made a good start:

"Maybe a spreadsheet or something that says "He was here, he has lung damage, this is the chemical that caused the lung damage, this is his duty station that had the chemicals, etc."

I dont get the spreadsheet part but if you can identify the actual chemical,prove the actual place you were exposed to it,in service, and that this chemical does cause lung damage (of the exact medical type of lung disability you have)and if a doctor agrees with that (IMO docs will review research far more diligently then the VA does) you could succeed.

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thanks, Berta. I do have all that information - just trying to find a way to get it all compiled together for a neater package. We do have a great doctor, too - outside the VA. We've already talked to her about our research, and when it's finished, and neatened up, I'm going to give the entire bundle to her for her own research. She seemed favorable that, as long as the research we found was valid, that she'd back up our claims re: the illnesses starting based on the chemical exposure.

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Hello,

Been a while, I hope your Summer went well!

So, while reading this post, I felt compelled to redact and share "how" I assembled and organized my claim. I wish I had my Claim straight before all the "amended stuff" on page one; but, oh well.

Hopefully, it serves as a decent model for others with complex Claims too. Likewise, I got a little concerned about the "chemical exposure" part of this post and "how specific" our Elders sage experience says we need to be.

Further, I posted in the hope that Hoppy may know Case Law that weights on my facts and circumstances, in the event it gets denied. I'd be surprised if I get an NOD, but never underestimate the V.A..

After searching the site; I'm asking if someone can point to:

  1. Where/how Fed/State SSDI or what other benefits are available?

  2. Info on Retro?

Thanks,

PJ

AUG 1997 CHRONIC SINUITIS - PANSINUSITIS.pdf

Edited by ping jockey (see edit history)
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Thanks for the info, Ping Jockey. I will read more in detail after I've had coffee. smile.png

I don't know if you realize this, but you helped me in more ways than one. My husband had chronic sinusitis in the Army, for years and years. He now has severe sleep apnea. I had no idea the two were connected.

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Could you clarify something?

The BVA decision downloaded here is dated May 2010.

Is that BVA decision regarding your claim or some one else's claim?

BVA decisions are really not good evidence at all. The BVA will be quick to say their decisions are relevant solely to the veteran who got the decision.

If BVA decisions however involve a complex legal issue, they could be submitted as evidence in that regard.

Did the "buddy" you mentioned in the 4138s ever prepare a formal buddy letter?

We have SSA info here under a search.

The VA Schedule of Ratings is linked here at hadit and contains the criteria and rating info for sleep apnea and sinusitis.

The VCAA letter should have told you exactly what info VA needs.

I will read the downloads again because I am missing any nexus statement.....then again I think need more coffee too!

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  • Moderator

The way I do it is a first paragraph summary, something like this:

The Veteran disagrees with the Board decision dated 1-29-12 for 4 reasons:

1. Medical Evidence or research is in conflict with decision.

2. Legal bases conflicts with board decision

3. Faulty "reasons and bases".

4. The Board decision failed to address the Veteran's theory of entiltlement for EED, and failed to address the issue of tinnitus.

Medical Research in Conflict with Decision

The Board decision stated ......while the research, as follows, supports the Veterans position.

a) American Medical Association Journal, dated 11-19-04 links "........" to Agent Orange.

b) etc., etc.,
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The BVA decision downloaded here is dated May 2010.

Is that BVA decision regarding your claim or some one else's claim?

Someone elses.

I included it with my Claim so "some V.A. Rater" couldn't say there is "no link between Chronic Sinusitis and OSA secondary too". At my first C&P Exam the Nurse Practioner said out right "there are no links, so I'm going to deny your claim today, do you want to continue with the Exam"? I knew he was wrong, didn't argue, and said "I want to go see my Pulmonologist and the Neurologist first, and talk to them first before any decisions are made here".

BVA decisions are really not good evidence at all. The BVA will be quick to say their decisions are relevant solely to the veteran who got the decision.

Understood.

I wanted to illustrate that OSA can be secondary too CRS, and that the V.A., needs to do a better job applying the law as implied in that decision - as stated in that dx...[it's obviated here that the V.A.'s administration of the law must be...]

If BVA decisions however involve a complex legal issue, they could be submitted as evidence in that regard.

Understood.

Does submitting a BVA Case with similar facts & circumstance hurt the Vet?

Did the "buddy" you mentioned in the 4138s ever prepare a formal buddy letter?

My sister, brother, and wife provided statements.

I didn't submit any third party statements, but I could get them for an Appeal; if necessary.

We have SSA info here under a search.

Tried searching SSDI, no real hits; no rush, but if someone can drop a link, I'd appreciate it.

The VA Schedule of Ratings is linked here at hadit and contains the criteria and rating info for sleep apnea and sinusitis.

Berta is correct, and I used these to help understand what I should look for in my medical records before submitting my Claim:

RESPIRATORY MISC.pdf

NOSE - SINUS - LARYNX & PHARYNX.pdf

The VCAA letter should have told you exactly what info VA needs.

Submitted everything I could identify.

I will read the downloads again because I am missing any nexus statement.....then again I think need more coffee too!

Coffee is good stuff smile.png . I hope the Progress Notes from my SMR are sufficient.

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Hi BV:

That is a good model/approach, have you used it successfully? My Claim status is "decision recommended; preparing supporting document for final review..." in E-benefits.

Again, good model; Hope I don't need it.

Regards,

PJ

Hadit is..........."AWESOME".............smile.png

It may take me longer, but with this place, I know I'll get there.

NEVER, NEVER, NEVER GIVE UP!

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The BVA decision downloaded here is dated May 2010.

Is that BVA decision regarding your claim or some one else's claim?

Someone elses.

I included it with my Claim so "some V.A. Rater" couldn't say there is "no link between Chronic Sinusitis and OSA secondary too".

ping - first off "some V.A.Rater" can't say if there is or is "no link" - that's for a medical provider

to state, not a VA decision maker. - carlie

At my first C&P Exam the Nurse Practioner said out right "there are no links, so I'm going to deny your claim today, do you want to continue with the Exam"?

ping - C&P examiners can not grant or deny claims - VA decision makers do that. - carlie

I knew he was wrong, didn't argue, and said "I want to go see my Pulmonologist and the Neurologist first, and talk to them first before any decisions are made here".

BVA decisions are really not good evidence at all. The BVA will be quick to say their decisions are relevant solely to the veteran who got the decision.

Understood.

I wanted to illustrate that OSA can be secondary too CRS, and that the V.A., needs to do a better job applying the law as implied in that decision - as stated in that dx...[it's obviated here that the V.A.'s administration of the law must be...

ping - that decision relates solely to THAT veteran and exactly what is stated in THAT veterans medical evidence.

THAT decision sets no precedence. - carlie

If BVA decisions however involve a complex legal issue, they could be submitted as evidence in that regard.

Understood.

Does submitting a BVA Case with similar facts & circumstance hurt the Vet?

ping - YES it could hurt the vet as right away the decision maker can refer to it

in support of a denial, because of the two things I posted above. - carlie

JMHO

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Thank Carlie,

Your assessment makes a lot of sense in context. Maybe I provided to much info and should have stuck to ONLY the "medical facts and nexus" stuff.

If this is a mistake:

[Does submitting a BVA Case with similar facts & circumstance hurt the Vet?

ping - YES it could hurt the vet as right away the decision maker can refer to it

in support of a denial, because of the two things I posted above. - carlie

JMHO]

If so; Then, I will have to follow the NOD/Appeals process below by Bronco Vet. In other words, the error of my ways, may cause me to wind up on the long Appeals road, b/c the V.A. can seize upon an opportunity and reason to "NOD" me.

That would really be disappointing! Time to prepare for the worst and hope for the best.

I will NOT give up though, never, never, never!

PJ

Edited by ping jockey (see edit history)
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  • Moderator

I agree that citing a BVA case could be an "excuse to deny". This being said, many times the BVA cases cite precedential CAVC cases, and you can, too.

Another way to go is to be a "little dumber" than you are. In other words, sometimes people who THINK they are smart are better off to let their opponnet underestimate them, rather than try to pretend they are Perry Mason. Judges tend to be very egotistical, and may just take offense to a layperson pretending to know more than the judge. A little humility goes a long way. Its ok to say something like...gee...wasnt similar to this already decided in Roberson?

Rather than "cite" a BVA case, and try to be your own lawyer, just keep this information "under your hat". Its ok to use similar wording, but you can make it sound like your opinion...which just "happens" to be that of a CAVC panel of judges.

Example:

Suppose you want the Va to give a "sympathetic reading" to your claim. You could cite one of these cases, Roberson, Ingram, etc.

Or you could just say something to the effect that you think a sympathetic reading of your evidence submitted should be required.

Then, if the Board does not address your issue, your lawyer can cite one of these cases:

http://veteranclaims...son-no-03-2196/

Edited by broncovet (see edit history)
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