Ibs Presumptive Nod.

[Scout Swimmer]

This is my rating decision followed by my NOD in response to my denial for IBS presumptive to Gulf War. I never have written one of these before but decided that its time to be my own advocate.

Hopefully I didnt screw this up.

Thanks again,

Phil

Service connection for Irritable bowel syndrome (IBS) due to undiagnosed illness.

Service connection may be granted for a disability which began in military service or was caused by some event or experience in service.

While your service treatment records reflect complains, treatments, or a diagnosis similar to that claimed, the medical evidence supports a conclusion that a persistent disability was not present in service. The VA medical opinion found no link between your medical condition and military service.

You are claiming current IBS as related to Gulf War exposures. The Persian Gulf War Veterans Benefit Act authorizes VA to compensate any Gulf veteran suffering from a qualifying chronic disability, resulting from an undiagnosed illness or combination of undiagnosed illnesses, appearing either during active duty in the Southwest Asia theater of operations during the Gulf War, or to a degree of 10% or more within a presumptive period following service in theater. Section 202 of the Veterans Education and Benefits Expansion Act of 2001, expanded the definition of "qualifying chronic disability" to include (1) a medically unexplained chronic multi-symptom illness that is defined by a cluster of signs or symptoms and (2) any diagnosed illness that the Secretary of the VA determines in regulations warrants a presumptive of service connection.

The VA examiner noted all references in your service treatment records were to gastroenteritis, which is self-limited. There is no evidence that you were treated for IBS while on active duty, also, while you have a current diagnosis of IBS, current symptoms do not warrant a compensable evaluation.

Service connection for IBS is denied since this disability neither arose during service in the Gulf theater, nor was it manifested to a compensable degree after the last date of service in the Gulf theater during the Gulf War,

....NOTICE OF DISAGREEMENT.....

After reviewing all information pertaining to my rating decision claimed as Irritable Bowel Syndrome presumptive to Gulf War", I would like to request reconsideration for the following reasons.

The C&P examiner did not find that my IBS diagnosis was at least 10% disabling thus presumptive status to gulf war exposure was denied on the basis of not warranting a compensatable evaluation of at least 10% disabling.

At no time during the C&P examination did the examiner discuss my IBS issues. She never questioned me about my symptoms, frequency of irritability, over the counter medications used, or incapacitating episodes, even after I presented an IBS diagnosis from a Gastroenterologist that listed my symptoms. Also I currently take medications for this condition, (Dulcolex, magnesium citrate).

It is important to note that my IBS diagnosis from my Gastroenterologist is listed as chronic in the area of constipation. "stools once every 4 to 5 days that are hard and scybalous. The patient states that with time he notes progressive abdominal bloating, discomfort, and cramping. The cramping is always in the lower quadrants. Because of persistent symptomatology we are asked to see and assist in this patients future evaluation and management".

The 30% criteria is "alternating constipation with more or less constant abdominal distress". I fit the criteria because it takes nearly a week for me to have a bowel movement which leaves me in constant abdominal distress.

I am also requesting a new C&P examination based on the specific reasons stated in this report.

Respectfully Submitted,

P Grenier

Edited December 13, 2014 by Philgrenier

[K9MAL]

Not to put too fine a point to it, but reading a denial is often the route to a reversal. K9MAL makes a good point but glosses over the rater's rationale for Mr. Grenier's denial. Therein lies the secret to success...

<<<<<<<<<<<<<The VA examiner noted all references in your service treatment records were to gastroenteritis, which is self-limited. There is no evidence that you were treated for IBS while on active duty, also, while you have a current diagnosis of IBS, current symptoms do not warrant a compensable evaluation.>>>>>>>>>>>>>>>>>>>>>>

This is why you need the nexus. I don't blow bubbles here when I give advice. I've been doing this since 1989...

Thanks for your input.

It takes practice to learn how to objectively read a denial, especially when you also are dealing with the emotions involved in being denied. Thinking back, most of the holes I've found in denials, once I settle down enough to dissect the denial into is various parts, are based on the following:

1. Evidence I submitted was not listed on "Evidence" list and not discussed under Reasons and Bases.

2. Evidence I submitted would be listed under "Evidence," but not addressed under the Reasons and Bases section in any way, shape or form.

3. Evidence I submitted would be listed under "Evidence" and "discussed" in Reasons and Bases, but only superficially mentioning its existence, without providing an explanation WHY it was being dismissed.

4. Lack of evidence being treated as negative evidence.

5. C & P exams that are flawed due to the procedures followed or not followed to properly evaluate a condition, or the examiner was not qualified to conduct such an exam.

6. In the case of Board remands, the C & P examiner did not answer the Board's questions, and the Board denies the appeal instead of addressing the fact that the RO didn't follow directions.

Asknod has written about these issues in depth.

This is very succinct and easy to understand. Thanks!

[Scout Swimmer]

Just hit Pending Notification. No change in ab8. I will follow your advise as closely as possible. I expect to be denied, and if I am, I will go hard at them, guns blazzing.

[Scout Swimmer]

What we still need frpm you. Send evidence showing service in the Southwest Asia Theater of Operations (i.e., official orders, travel vouchers, performance evaluations or receipts from purchases made.)

Date Requested: 12/29/2014 (Today)

Date Due 01-29/2014.

Umm, whay the heck? BOX 13 of my DD214 says right on it. (Armed Forces Expeditionary Metal (Persian Gulf).

This is dumb.

[FormerMember]

I showed VA my orders for Vietnam in 1994 with my NOD. They finally admitted I was there in 2007. They're always running a little slow, sir. Maybe VA thinks those Combat Vs on medals stand for Vodka. Don't worry. Send it in (again). If the poop hits the fan, we'll cover your 6 and lead you out of the jungle. You have my word. Happy New Year.

[lotzaspotz]

One of my husband's denials referenced his being in Vietnam in 1977, when U.S. involvement had long ended before then. I swear that too many of these raters have absolutely no idea what they're looking at or any basic knowledge of the military involvement that brought disabled veterans to seek benefits from the VA in the first place.

[63SIERRA]

the first persian gulf war ended officially as a cease fire, thats why we had to go back again and again,. hell I think its Still in a official status of cease fire .

Evidently standing on a destroyer with a large banner saying _ " WE WON AGAIN" doesnt cut the mustard anymore

If Ganghas Khan would have been our leader we would have finished the job the first time, have oil to burn, and saved a trillion green backs/