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The Missing Nexus?


lp56
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Question

I have been waiting for 2 years on a BVA appeal of my PTSD claim due to MST and have accepted the fact that I may still have to wait for some time to come. I am having to appeal because the C&P doctor could not conclusively state there was a connection between my PTSD and the MST I suffered in service. When I went for an appt. last week, I stopped to get a copy of my medical records that were dated AFTER I submitted my paperwork for the BVA appeal. As I read through my records, I came across an entry by my VA psychiatrist in 2013 that's says, "A lengthy review of her records shows the patient has for years reported symptoms, signs, memories, dreams, intrusive thoughts, etc. all related to MST and documented in her chart. In a 1/27/10 note when first seen in the clinic she reported a history of MST. In notes, pt reports symptoms of related to MST and described rape and sexual harassment. In other notes, pt was advised to seek inpatient therapy for MST and numerous notes since then reflect ongoing issues with MST and attempts to work thru these issues in individual therapy with psychologist, groups, and psychopharmacology. In my opinion, the MST reported by veteran is very likely the largest traumatic events leading to her PTSd and may be the precipitating event for later traumas. Veteran would indeed benefit from inpatient treatment and is now showing signs of readiness to fully participate in therapy." Have I just found the missing nexus in my medical records? If so, what do I need to do regarding my BVA appeal? I am represented my my states veterans group. I am hoping with this new evidence, I can send it to my RO and not go through another tortuous appeal. I appreciate any advice on what to do next.

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Sounds like a good start. Do you have anything showing a decrease in performance in your military service record? An increase in medical complaints? Anything you have that shows a change in your performance/status will help.

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I have been waiting for 2 years on a BVA appeal of my PTSD claim due to MST and have accepted the fact that I may still have to wait for some time to come. I am having to appeal because the C&P doctor could not conclusively state there was a connection between my PTSD and the MST I suffered in service. When I went for an appt. last week, I stopped to get a copy of my medical records that were dated AFTER I submitted my paperwork for the BVA appeal. As I read through my records, I came across an entry by my VA psychiatrist in 2013 that's says, "A lengthy review of her records shows the patient has for years reported symptoms, signs, memories, dreams, intrusive thoughts, etc. all related to MST and documented in her chart. In a 1/27/10 note when first seen in the clinic she reported a history of MST. In notes, pt reports symptoms of related to MST and described rape and sexual harassment. In other notes, pt was advised to seek inpatient therapy for MST and numerous notes since then reflect ongoing issues with MST and attempts to work thru these issues in individual therapy with psychologist, groups, and psychopharmacology. In my opinion, the MST reported by veteran is very likely the largest traumatic events leading to her PTSd and may be the precipitating event for later traumas. Veteran would indeed benefit from inpatient treatment and is now showing signs of readiness to fully participate in therapy." Have I just found the missing nexus in my medical records? If so, what do I need to do regarding my BVA appeal? I am represented my my states veterans group. I am hoping with this new evidence, I can send it to my RO and not go through another tortuous appeal. I appreciate any advice on what to do next.

Was your MST documented on active duty ?

If no, has VBA checked for markers of alternative evidence in your file ?

Has any of the above been mentioned in prior decisions ?

In any of your prior decisions has VBA conceded your stressor of MST ?

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Also don't solely rely on your representative. I'm sure you've seen this on hadit before, no one cares about your claim as much as you do. I've been there, dealing with some of these memories is excruciating but it's necessary.

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The MST was not documented on active duty. Only documentation of complaints or request for transfer is no where to be found. VBA does acknowledge MST occurred and acknowledges PTSD diagnosis. However, the C&P examiner did not link the two together and thus the claim was denied. The C&P examiner tried to connect other non-service traumatic events to PTSD, but still conceded couldn't conclusively say service connected MST caused PTSD. This is first instance a VA doctor gave an opinion linking the two together; the critical piece that was missing in my claim.

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First thank you for your service!

I am in the final stages of my claims that include PTSD (secondary to personal assault). My C&P exam is on hadit regarding my MH exam for my Eating Disorder and PTSD/MST. I will tell you this - I NEVER reported my rape! I hid the harrassment and rape for years. I became pregnant as well but miscarried. All of this was back in 1992. I got out in 1996 and went on with my life never knowing I should have gotten help/treatment for so many disabilities.....Fast forward - May 2013 I initiate my claims - Fast Forward June 2014 - while in my MH Walk-In appointment to seek help for my eating disorder I disclosed my MST and upon doing so the examiner referred this to the RO office - I was called by a woman coordinator who asked that I submit the PTSD form VA 21-0781a (PTSD secondary to Personal Assault) along with a statement form to describe to the best of my ability the situation, where the assault took place, where I was stationed, any material evidence I could provide. At this time I couldn't even remember his NAME let alone his description. I did however have the pregnancy test (positive) and loss of the pregnancy noted in my SMR. This is what they call a "clear marker". Upon submitting all I could on Ebennies I did receive a C&P exam for my MH to include the PTSD/MST. My C&P examiner was truly patient and nice and comforting as I went through my exam. I read her notes and for the most part agreed with her EXCEPT she stated I did not meet the DSMIV Criteria for PTSD...Strange but I did however meet "other mental disorder" MST...Whatever that is...Along with the Eating Disorder C&P she stated I had Anorexia Nervosa since 1992 - directly linking to my in-service.

I had my MH therapy appointment the following week and my therapist noted that she disagreed with the examiner and stated I did meet the DSMiV criteria for PTSD. I made sure those notes were included in my claims - I got them to the rater and now I am in Preparation For Notification.....

Not sure of my entire outcome but where I am going with this is that you are your own best advocate. MST doesn't have to be necessarily documented now a days. You do however have to have "clear markers" to indicate the service connection.

I think what you have found is viable/useful info and I would get it to your rep ASAP!

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Thank you as well and for responding to me. You are very fortunate you had a nice and patient C&P examiner. I had a female examiner also, but there was no attempt to make me feel at ease whatsoever during the entire exam. Basically my VA MH doctor has also disagreed with the examiner, but I am just now seeing that documented opinion in my records. I made copies of my records today and will take them to my rep this week. Because I haven't had my BVA appeal yet, I was hoping I could send this new evidence to the RO without adding more years to my wait.

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