ptsd Alcohol Abuse/cirrhosis Secondary To Ptsd

[SigBnSoldier]

In April 2013 I had an initial exam for PTSD, the diagnoses were-

Axis I

1. PTSD

2. Bipolar NOS

3. Alcohol abuse in full sustained remission (5 years)

When I got my award 5 months later I was connected for "PTSD with bipolar disorder" but no mention of alcohol abuse. The examiners rational DID state, "claimant started drinking to deal with symptoms of ptsd".

So, six weeks ago I filed a claim for Alcohol Abuse, secondary to PTSD with Bipolar disorder and submitted a copy of that C&P as a nexus statement. Will that suffice for a nexus or do I need to go out and get another one?

My whole goal eventually is to get the cirrhosis covered, which I have very firm documentation of.

Thank you

[Berta]

I strongly suggest that you ask a vet rep to read the claim to see if the wording is correct.

Or state here exactly how you worded it.

If PTSD or any SC condition is found as a cause of alcohol dependency to the point of having a physical disability due to it, then the claim should be adjudicated under principles of Allen V. Principi:

In Part:
THE ISSUE

"Entitlement to service connection for liver cancer, claimed
secondary to alcoholism with cirrhosis, claimed secondary to
post-traumatic stress disorder (PTSD)."

"Service connection may
be awarded for an alcohol abuse disability which arises
secondarily from a service-connected disability. Allen v.
Principi, 237 F.3d 1368 (Fed. Cir. 2001). However, the
Federal Circuit Court in Allen cautioned that such
compensation would only result "where there is clear medical
evidence establishing that the alcohol or drug abuse
disability is indeed caused by a veteran's primary service-
connected disability, and where the alcohol or drug abuse
disability is not due to willful wrongdoing." Id., at 1381.
http://www.va.gov/vetapp06/files4/0627302.txt"

http://www.va.gov/vetapp06/files4/0627302.txt

This is aremand revealing exactly what evidence the veteran needs. A good read.

Here is the Fed Circuit Allen case:
http://caselaw.findlaw.com/us-federal-circuit/1178591.html

That statement there is not a nexus. I feel you will need a strong IMO from a real doctor.

These claims can succeed. They need very strong medical evidence however.

"3. Alcohol abuse in full sustained remission (5 years)"

That says nothing regarding a diagnosis of cirrosis of the liver, and nothing as to it's relationship to your PTSD.

Does the VA treat the cirrosis of the liver?

Do you have a complete copy of your VA and private medical records?

An IMO doc will need them......

Unless you get a C % P doctor who can make the nexus statement with a full medical rationale. That doesn't happen too often , regarding any type of claim.

Edited May 23, 2014 by Berta

[SigBnSoldier]

Thanks Berta.

Yes, the cirrhosis is diagnosed by VA and private hospital and linked to abuse of alcohol.

I have continuity evidence since discharge regarding alcohol abuse due to symptoms, but there are a few damaging entries in those notes too. One of them is a rogue psychiatrist statement, "starting drinking at age 11"

Where that came from I don't know, and it isn't true, and I don't ever remember speaking to this psychiatrist back in 2004, but there it is in my CPRS notes. The only other damaging note is a different psych said my drinking dated back to my "teenage years" which, if you don't count age 19, is also not true. My stressor event happened when I was 20 and that's immediately when I started drinking to go to sleep. I have 5 buddy statements from my last PTSD claim that all mention how much I started drinking after the stressor.

[Berta]

Good on the buddy statements. They are already in the record.. I had a great friend who died before he reached 40 due to cirrosis of the liver.

VA did all they could for him but he would not stop drinking.

He was 100% PTSD Vietnam.

His wife had inadvertently made statements to VA that he was a big drinker even before he joined the Army.

I dont think she has ever been able to attain DIC.

I learned that, if the VA can make something up, they sure will...it has happened to me many times ,as a long term hardcore claimant.

I get right on them over anything they say that they have no proof of.

I still get angry as to how they deliberately manipulated a C & P report many years ago.

I raised all sorts of Hell.

You might actually get a fair C & P exam. That would be GREAT

[Pete53]

Congrats on your sobrierty and Berta has given good advice.

[SigBnSoldier]

Here's the examiners rational word for word:

The multiple axis 1 diagnoses are related and the secondary diagnosis is a progression of the primary diagnosis because the claimant used alcohol to self medicate in an attempt to cope with symptoms of PTSD. The Bipolar was exacerbated by the traumatic event and subsequent PTSD.

Based upon examination, the claimant needs to seek follow up treatment. The claimant requires ongoing medication as well as participation in individual and group psychotherapy. This information was conveyed to the claimant during the examination. The claimant does not appear to pose any threat of danger to self or others.

This is the exam that resulted in my 70% "ptsd with bipolar disorder" IU/P&T. The evidence is sure in my file at the time of rating of alcohol abuse dating back to the day I discharged. So why no "alcohol abuse" with this exam?

[Berta]

Thanks for the clarification.

That is an excellent nexus--- it seems to me they SCed you for PTSD with some consideration of the alcohol problem BUT you need to formally claim the cirrhosis because VA cannot connect the dots....even if they are obvious ones.You will need to send them that med statement to make sure they use it.

I commend you too for years of sobriety as Pete did.

My first date with my husband was the Movie "Platoon" (1985)

The second date..he said he would introduce me to his friends.

We pulled into a church parking lot about 7 PM and the church was not our same religion and the parking lot was packed..I thought it was a Penny Social. I was wrong.

Of course you guessed it..... It was a closed meeting but someone allowed me to peek in and someone was just starting their story. I could hardly see them because there were about 100 people in the room and of course in those days the room was completely filled with smoke.

I didn't drink at all and he proposed not long after that.

Since that second date I had the privilege of attending hundreds of open AA meetings with him. He had plenty of clean time when he died.

The first beer he ever drank was in Vietnam. He was 17 when he joined USMC. His parents had to sign for that.

Edited May 23, 2014 by Berta