ptsd Just Looked At The Notes From The Comp & Pen For Ibs

[hedgey]

I'm so upset, I'm in tears. I didn't even look to see what the examiner wrote about my feet.

Her conclusion about my Irritable Bowel was that it was less that likely that my IBS was related to my PTSD and she attached some medical finding that said there was no concrete evidence of comorbidity.

She also said something about amplification of symptoms that could not be connected to my state of mental health.

I understand what amplification of symptoms means - it means that she thinks I was overstating my distress. All I know is that I was sitting there with cramps that were making me sweat. My DH was there and chimed in that I suffered from "tummy trouble" constantly and that it was running our lives.

So I had handed her my Gastroenterologist's DBQ that specifically stated the IBS was definitely caused or aggravated by my PTSD. I also came home and submitted that DBQ via IRIS because even though I had already submitted it back with my original claim, but the examiner didn't have it or see it in my records.

My question is whether there is any point in asking my Gastroenterologist to write a statement for me. He already filled out the DBQ, and the VA has requested my records.

But is there any hope? I have always gleaned that whatever the C&P examiner says goes, never mind that they see you for 45 minutes out of your life and they are a NP at best. Is there any hope at all that the VA might actually take the word of my MD - specialist??

:(

Edited September 29, 2014 by hedgey (see edit history)

[Navy04]

Sorry to hear of your troubles bud, as I have Crohn's Disease. Remember that you can always appeal any condition, or reopen a denied condition. God Bless and good luck

[hedgey]

Thanks, man, I appreciate the support. I freaked and came here first. As always, there's someone here who "hears" me.

I'm much calmer now (thanks to lorazepam and some time in the dark). It's not the first claim I've ever had denied, but it always hurts. It always feels so dang personal.

[Mikemmlj]

C&P examiners that write about "amplification" of symptoms are on dangerous ground-I believe the VA specifically says not to accuse people of malingering.

[WVSERVER]

If you have a strong DBQ from the outside I would say it would cover up any negative remarks of the C&P examiner. The VA had made negative marking on my C&P concerning Tinnitus but I had a letter from an outside ENT and was granted service connection even thought the examiner marked less then likely. Never give up hope especial when you already have medical evidence from a reputable source.

[WVSERVER]

Straight from 38 CFR

§4.23 Attitude of rating officers.

It is to be remembered that the majority of applicants are disabled persons who are seeking benefits of law to which they believe themselves entitled. In the exercise of his or her functions, rating officers must not allow their personal feelings to intrude; an antagonistic, critical, or even abusive attitude on the part of a claimant should not in any instance influence the officers in the handling of the case. Fairness and courtesy must at all times be shown to applicants by all employees whose duties bring them in contact, directly or indirectly, with the Department's claimants.

[georgiapapa]

As long as your gastroenterologist provided reasonable medical rationale in the comments section of the DBQ to support their opinion that your IBS was caused by the PTSD, you should be alright. The opinion of a gastroenterologist should carry more weight than the opinion of an NP.

However, if your gastroenterologist just gave an opinion without supporting the opinion with reasonable medical rationale, you should get with your gastroenterologist ASAP and ask him/her to provide you with an IMO citing his opinion and the medical rationale behind his/her opinion. You would need this to countermand the medical findings of the NP which states there is no concrete evidence of comorbidity. You don't concrete evidence, you just need enough evidence to reach the benefit of the doubt threshold. JMO

[Vync]

Hedgey,

If that C&P doc is amplifying anything, it is them amplifying the BS

Look at the facts:

- Your GI doc (a specialist), said it was "definitely caused or aggravated by your PTSD". Definitely = 100% (case closed). Plus, they probably have cared for you for a while.

- Your C&P doc (a crabby moron, probably not a specialist either), said "less than likely". That's 25%

Apply relative equipoise, then throw in the fact that your doc is a specialist who knows you much better, and that should definitely put you over the mark.

I agree with everyone else's comment. Even if the rated who has your case cannot see these facts, you can still file reconsideration or NOD it. Remember, most claims are won on appeal.

[westcoastlv]

Hedgey,

I would get a copy of the C&P Exam from the Information Office and I would read through it line by line. Write a letter, quoting the C&P Exam where you dispute anything that you don't agree with and cite your DBQ, any other medical notes, and the VA's own rules about C&P Exams. I would then send that entire letter, with all the back up (highlight what you quote) to the VA by certified mail. I would also fax it and upload it to ebennies. You don't have accept or agree with any examiner that has seen you for a few short moments, especially when it contradicts what you know is true. My husband received a C&P that was full of misinformation, almost to the point where it seemed like the examiner was looking at someone else's chart. I wrote that letter to the VA, highlight all the stuff that didn't make sense and stated what was accurate. I pointed out where the examiner contradicted herself and I cited the rule where if the info is 50/50 then the VA must rule in the favor of the Veteran. He is now 100%. Good Luck

[hedgey]

THANK YOU, EVERYONE!!

I cannot express how much your words of support mean to me. It's like having a big ol' life raft of comrades pull me out of the water after the ship went down. A life raft with truly good buddies and complete with loads of rations and fresh water. Plus a box of flares and a solar satellite radio. You have thrown me life lines (that is not too strong a phrase, believe me.)

I have placed a call to my Gastroenterologist and will talk to her today or tomorrow. She's always been very compassionate and helpful, so I'm sure she will write a statement, complete with citations of medical findings.

The DBQ she wrote for me is very strongly worded and includes the DX codes for PTSD, MDD, OCD and GAD. In my records, she has repeatedly noted that my IBS is worse when I'm stressed, etc. So I feel confident that I will have the best possible support in that respect.

Thank you so much, again. My dear spouse thanks you too - I've been like a caged puma for the last 24 hours!!

[Navy04]

I would definitely in my case agree with when my Mental Health is bad, my Crohn's sure is worse.

[Notorious Kelly]

Hedgey,

If C&P examiners approved everyone, they wouldn't have a job.

Which means they are predisposed to downplay at least Some of their clients if they wanna keep working for the VA, so try not to take it personal.

I have read Statement of case where VA doesn't give greatest weight to what C&P examiner said so your DBQ can weigh heavily in your favor with VA under fire for appeals backlog and error rates.

I think you'll be fine.

[Navy4life]

Apparently getting IBS S/C is quite difficult for most. I on the other hand got lucky and was S/C 30% (Max allowed under IBS rating) but I believe it was heavily due to all the evidence I provided to the VA. I never even had a C&P exam for my claims on IBS. I submitted a DBQ filled out by my Private Gastro doctor to include my colonoscopy as well as I had copies of all my medical treatments while on AD. This apparently was enough to prove my S/C for IBS.

Keep in mind I have been out of the military since 1996 and only in 2013 did I initially file my claims for disability to include IBS. I had an "uphill battle" but b/c my p/w was flawless and noted well and my evidence was concrete, I got S/C for IBS.

[Patrick428]

Hedgy,

Don't be discouraged, as a C and P exam is only one part of many parts in rendering a decision. If your examner was not a specialist in Gastroenterology, and your treatment specialist is, the VA will generally takes the conclusions of your treating specialist. I had the similar problem with Parkinson's Disease. My Neurologist wrote what I consider an fabulous DBQ. However, the VA sent me to a C and P with an Internal Medcine Specialist. He tried to undercut my Neurologist at every step. When the decision came, the raters determined that one, I should have never sent to a C and P, as they took my Neurologist's information and treatment records over that of the C and P examiner. The decisions basically said, "since your Neurologist is your treating specialist and has been treating you for Parkinson's Disease, the C and P was not considered and we established service connection based on your treatment specialists DBQ and treatment notes. I was granted 70% for Presumptve Parkinson's due to Agent Orange.

On a side note, I did my stint as a MH C and P examiner for the VA. Often as is the case, the C and P examiner may not have read your C-file and based his/her conclusions on simply what he/she had on hand. Let the raters do their job. If they feel the C and P was inadequate, they will no doubt give greater weight to your treatment specialist.

Patrick428