National Peronnel Records Center

[HorizontalMike]

QUESTION: How can I be absolutely sure I get a copy of my COMPLETE medical records from 1972-1975?

2013, I requested and actually DID receive SOME medical records (I did not know they were incomplete) from NPRC.

2014, I requested(*see attached) medical records from 1972-end of 1975, and got this response from the NPRC:

"ORIGINAL MEDICAL RECORD NEEDED TO ANSWER YOUR INQUIRY IS NOT IN YOUR FILES; THAT MEDICAL RECORD IS WITH THE DEPARTMENT OF VETERANS AFFAIRS (VA)"

Attached are the TWO NPRC responses to the TWO medical requests that were just under one year apart. In one case I received information, and in the most recent case I was told it does NOT exist at NPRC. Please understand that my mind is racing with "WTF!", anger, puzzlement, etc. Understanding that the records I am requesting are over 40yr old and existed with the NPRC last year, how can they now be "missing"?

FWIW, my disability rating came in Dec 2013 (for a 1972 TBI) and the examiners had way more medical records information in front of them on their PCs than I had ever received after my 2013 request for that SAME information. Some of that EXTRA medical records that I did NOT receive, but the examiners had and used, actually DID help me in receiving my 50% rating, BUT I am lost, feeling that the records that have been kept from me, could and probably do, indicate I should have a much higher rating than what was awarded.

I am about ready to launch a letter writing campaign including several Congressmen, the VA Secretary, and others. Is THAT my next step?

Edited August 23, 2014 by HorizontalMike

[NavyWife]

A VA claim needs 3 things:

1. a diagnosis or symptoms of an issue in service

2. a current diagnosis. This can come from your VA doc, the VA C&P exam or from a private physician.

3. a nexus statement showing the link to service

Did you already file an appeal or a reconsideration with new and material evidence?

Regarding the depression denial, I think it is fairly straightforward how to get it approved. The depression was denied due to no nexus statement-the statement tying your depression to service. At the C&P exam, the examiner did not give you the nexus statement. You can try again with a new VA C&P exam, but the best thing to do is get a IMO/IME done by a doc familiar with VA protocols. In their letter, they will need to directly rebut the previous doctors statements, especially the one about the incorrect dates of 2010 depression onset.

Doctor Valette may be able to do it. http://www.shrink911.net/services.htm

If not, any qualified psychologist or psychiatrist...

They should also fill out the DBQ for depression.

Reading the denial for depression, under Item #4, paragraph 2, they did not consider it as "secondary to TBI". They evaluated it as a direct service connection. Which is fine. A direct service connection or a secondary service connection both workout the same, just different evidence is needed, depending which way you are seeking the service connection. The letter states you had symptoms of depression in 1973 during service. That satisfies part 1. It sounds like you have a current diagnosis of depression. That satisfies part 2. But part 3, the nexus statement was not given.

Have you bought the Veterans Benefit Manual yet? I think it would give you a lot of insight into this process. http://www.lexisnexis.com/store/catalog/booktemplate/productdetail.jsp?pageName=relatedProducts&prodId=12734

[NavyWife]

The new TBI presumptive rules are nice and will benefit a few vets, but the rules are so narrow, many will not be able to use it. For the depression to be presumptive to TBI, the depression has to be actually diagnosed within 1 year of a mild TBI or within 3 years of a moderate or severe TBI. No diagnosis during that timeframe, then no presumption. The only thing the presumption does is alleviate the need for the nexus statement. So unless you had a actual diagnosis of depression during those timeframes, you still need the nexus statement.

[HorizontalMike]

Did you already file an appeal or a reconsideration with new and material evidence?

Yes, this past March. At the time I did not have the above "initial psych eval" Progress Notes (post #13). Those came within a week after I submitted the Appeal. Now that I have that, do you think that that initial evaluation would provide that nexus?

Regarding the depression denial, I think it is fairly straightforward how to get it approved. The depression was denied due to no nexus statement-the statement tying your depression to service. At the C&P exam, the examiner did not give you the nexus statement. You can try again with a new VA C&P exam, but the best thing to do is get a IMO/IME done by a doc familiar with VA protocols. In their letter, they will need to directly rebut the previous doctors statements, especially the one about the incorrect dates of 2010 depression onset.

• Regarding the IMO, should I seek a neuro-psychologist, neuro-psychiatrist, or a run of the mill psychologist or psychiatrist?
• Should I probably seek more than one IMO/IME?... One for the nexus and one for current disability (remember "increase" of TBI + "initial rating" of depression)

They should also fill out the DBQ for depression.

Got it. Will do.

Reading the denial for depression, under Item #4, paragraph 2, they did not consider it as "secondary to TBI". They evaluated it as a direct service connection. Which is fine. A direct service connection or a secondary service connection both workout the same, just different evidence is needed, depending which way you are seeking the service connection. The letter states you had symptoms of depression in 1973 during service. That satisfies part 1. It sounds like you have a current diagnosis of depression. That satisfies part 2. But part 3, the nexus statement was not given.

Will work on clearing up the nexus. I am thinking the my initial psych consult (in post#13) will/should go a long ways in helping establish nexus since it shows continual use of depression medication (for about +20yr at this point), but understand the need for IMO.

Have you bought the Veterans Benefit Manual yet? I think it would give you a lot of insight into this process. http://www.lexisnexis.com/store/catalog/booktemplate/productdetail.jsp?pageName=relatedProducts&prodId=12734

I will put this on my wish list, though as many hours/days that I am on VA.gov I have found much of what is in the table of contents. In another month or so will have the $$$.

[NavyWife]

No, that letter will not be enough for a nexus statement. Here's a link explaining more about the nexus statment.

http://www.benefits....stBySymptom.asp

---Refer to the VA rating guidelines

http://www.vetsforju...n’s Guide.htm

or

http://www.americanb...uthcheckdam.pdf

Each DBQ must include multiple parts:

1). Diagnosis

2) Statement that Dr. reviewed the pertinent medical records or check the applicable box if available.

3) Nexus Statement from Dr. that says "condition X is at least as likely as not due to condition Y".

4) Rationale Statement from Dr. explaining how he came to his conclusion on the Nexus. Must give specific reasons why one condition caused or aggravated the other.

5) Statement from Dr. regarding his medical degree and qualifications, his CV

On most DBQ forms only #1 and #2 are part of the form. You must have your Dr. write in #3, #4 & #5 if they are not part of the form. I'm NOT saying a DBQ without each of these 5 Items can't be approved. I'm saying these are 5 of the things that if any of them ARE missing, VA has used as an excuse to deny a claim.

[HorizontalMike]

No, that letter will not be enough for a nexus statement. Here's a link explaining more about the nexus statment.

http://www.benefits....stBySymptom.asp

---Refer to the VA rating guidelines

http://www.vetsforju...n’s Guide.htm

or

http://www.americanb...uthcheckdam.pdf

Each DBQ must include multiple parts:

1). Diagnosis

2) Statement that Dr. reviewed the pertinent medical records or check the applicable box if available.

3) Nexus Statement from Dr. that says "condition X is at least as likely as not due to condition Y".

4) Rationale Statement from Dr. explaining how he came to his conclusion on the Nexus. Must give specific reasons why one condition caused or aggravated the other.

5) Statement from Dr. regarding his medical degree and qualifications, his CV

On most DBQ forms only #1 and #2 are part of the form. You must have your Dr. write in #3, #4 & #5 if they are not part of the form. I'm NOT saying a DBQ without each of these 5 Items can't be approved. I'm saying these are 5 of the things that if any of them ARE missing, VA has used as an excuse to deny a claim.

[NavyWife]

Sorry about the broken links. I copy and pasted them and it didn't carry over. See if these work.

http://www.benefits.va.gov/COMPENSATION/dbq_ListBySymptom.asp DBQ list

http://www.benefits.va.gov/compensation/dbq_disabilityexams.asp info on DBQ's

http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5 rating guidelines

more TBI info, including link to TBI clinicians guide.

http://www.hadit.com/forums/forum/79-tbi-traumatic-brain-injury/ TBI section of hadit, in case you havent already read it

　

At this stage, your claim has been denied for depression, so another option is to seek out a veteran claims disability lawyer. They do not charge anything upfront and usually take 20% of the backpay. They can help you get these IMEs as well as focus your correspondence to VA on the issues that need the focus. Chris Attig is one that posts occasionally here on hadit. http://www.attiglawfirm.com/about-the-firm/about-chris-attig/

---might be worth having a conversation with him.