Advice For New Claims

[angryemu]

Hello,

I am new to this site and am happy to see that there are a lot of folks on here who know the ins and outs of filing claims with the VA. Hopefully someone will be able to offer me advice on how I should proceed. I did not know until recently the issues I've been dealing with were covered by the VA, otherwise I would've started this years ago. I'll try to provide adequate detail.

Background: Navy; Honorable discharge in 2003; Persian Gulf; did just about every job imaginable on the boat.

Claims and questions:

• Scarring/pain: service medical record contains detailed record of surgery for removal of Basal Cell skin cancer on my face, including drawing, measurement and procedure details. The nexus seems very clear.
  • Question: How does the VA actually measure scars, and what rating should apply? My t-shaped scar runs from the inside of my right eye down the side of my nose (about 2 inches), and across under my eye (about 1 inch). My right nostril is now asymmetrical as a result of the skin pulling and settling after the surgery, and there is a small scar "pocket" on the side of my nostril. Also, the skin changes color with hot/cold, becomes irritated by sweat, tingles/throbs and is prone to sores and infections.
• Functional Gastrointestinal Disorder: Nexus: Record contains one instance of gastroenteritis (vomiting/diarrhea), along with "sea sickness". I have civilian medical records for multiple gastro events after leaving service, including hospitalization and surgery (the doc mistakenly diagnosed appendicitis) for gastro and non-specific gastro problems. Not in my records is that I constantly have gastro issues including dyspepsia, frequent vomiting, and bouts of constipation and diarrhea. Also, I am by definition a Gulf War vet, and I understand that this condition falls under "Special Gulf War Rules" as a "Qualifying Chronic Disability".
  • Question: Is this adequate for nexus, or do I need an IMO? How do "Special Gulf War Rules" come into play vs. a standard claim for gastro issues? And, what rating does this condition entail?
• Tinnitus/hearing loss: my service record contains evidence that I was qualified in multiple weapons, and was a sonar tech. The sonar I worked on was I believe one of the loudest man-made noises on earth, and I had my bell rung more than few times when that thing went active.
  • Question: There is no mention of tinnitus in my medical records, but is there enough evidence to establish nexus? My ears ring 24/7 and it drives me nuts to be in silence.
• Question: Will the VA most likely require me to take more tests? What if I'm in good shape the day of the tests? Do they understand the "flare up" nature of certain illnesses?

I've obtained copies of all of my military and civilian medical records (and made more copies), and plan to meet with a VSO before submitting. I hope I have enough documentation and evidence to satisfy what the VA is looking for. I have a few other claims as well, but didn't want to post too much.

I greatly appreciate any feedback on the items above, as well as any other advice that can help make my claims as painless as possible. Thank you all for your service.

[USN_HM_VSR]

Sorry I'm ADD, brain moves way too fast most of the time. All you need is GW Service in Iraq Kuwait Saudi Arabia The neutral zone between Iraq and Saudi Arabia Bahrain Qatar The United Arab Emirates (U.A.E.) Oman Gulf of Aden Gulf of Oman Waters of the Persian Gulf, the Arabian Sea, and the Red Sea The airspace above these location. to qualify for a Gulf War Gen Med. Exam. As a result of the exam a GW opinion is received from the examiner whether they think the conditions are related to GW.

For example you served in Iraq, later down the road you get dx of sleep apnea. You can file a claim get your GW Gen exam and you can get connected for it as a presumptive.

The benefits of having GW Service is you have access to a Gen Med exam for everything underneath the sun. Unlike the regular Gen Med exam which you only qualify for if you're within 12 months of SEPS from AD, you can get a GW exam at any point for conditions that have not been denied related to GW.

If you don't have GW service and its been more than 12 months from SEPS in order to get a VA exam you need to have the link to service, current dx/tx and hopefully theyll order you the VA exam so that you can get a Nexus direct SC opinion from the examiner.

if you want to go the private DBQ route you can as well, send your privated dbq, your link to service and make sure you have the direct MO.

Yes the dx will help its always good to have a dx.

If it were my claim I would submit proof of GW service tab it and submit it don't rely on someone else to find it. Submit your service treatment records with your link to service. Send you private medical records with dx/tx. This will greatly improve your chances of getting connected. One its an easy way to get an exam thru the VA. You'll get a GW presumptive opinion and with your link to service they will request a direct SC opinion all at one time. Just depends on how you want to go about it.

On another topic related to the GW Gen Med is you've been previously denied for a condition for direct SC and are stuck in N&M evidence hell, you can give it a go and request a GW opinion and hopefully get connected.

[angryemu]

Thanks USN for clarifying the difference between GW illnesses and SC. Looks like my claims will be split, gastro stuff is GW, tinnitus and scar is SC. My worry is that my MSR and civilian records attempt to diagnose the gastro issues. There's a few mentions of gastroenteritis, and they even performed an appendectomy, with results stating the appendix was not the problem (at least now I don't have to worry about my appendix rupturing on me, haha).

Service connection to GW shouldn't be problem since I deployed there three times with my ship. Sailed every inch up and down the Persian gulf, Gulf of Oman and spent lots of time in port at Bahrain, UAE, and Oman.

I have to say it's a pain in breaking out a lot this medical stuff into specific conditions, given how interdependent a lot the issues are. It's like a cascade of events often triggered by something small, and then all hell breaks loose.

[USN_HM_VSR]

Remember that we are using whats in you mil records as a link to service. Be that tx dx complaints. That's why we need a current dx. Which usually what you be SC for.

So take your gastro. Issue you have in service dx. You now have a current dx from private medical records of gastro.

Since you have the above criteria for direct service connection all you need is a nexus opinion.

You qualify for the GW exam so since you're there for an exam they can provide both MO'S on one exam.

When you leave the exam you'll have two opinions one directly related to service, the other Related to GW and in theory increases your chances of getting connected because bc if one is denied then hopefully the other is a grant.

direct service connection - means directly related to service. That's why we need to find something in your records to relate to your current condition as a link to service.

Presumptive service connection - I'll use Agent Orange as an example since a lot of people are familiar with it. To get connected for AO all you need is proof of in country service in Vietnam and a current dx. Bc is presumed they font really know for sure so they use blanket technique to cover everyone just in case.

Aggravated Service connection - you have a pre service condition that was made worse by service.

secondary service connection -you're service connected for your right knee and favor your left and now have a LF condition.

These require MO's with exception of AO it just need a confirmed dx and severity.

GW is a bit cloudy it's presumptive but not really and I'm not too familiar on how it's rated. So if someone can chime in that would be great.

[angryemu]

I think the GW presumptive service connection is exclusive to certain undiagnosed illnesses, or clusters of illnesses. From what you've told me, my gastro issues could be service connected based on the diagnosis in my records (gastroenteritis), but since there are other undiagnosed related gastro issues (as a cluster) it could also fall under GWI as functional gastrointestinal disorder. If the VA rates both service connected and GWI connected, do you get both or just one?

Also, does the VA interview you to discuss what's in my service record medical files? There's some inaccurate information in there that I'd like to clarify.

[USN_HM_VSR]

I think the GW presumptive service connection is exclusive to certain undiagnosed illnesses, or clusters of illnesses. From what you've told me, my gastro issues could be service connected based on the diagnosis in my records (gastroenteritis), but since there are other undiagnosed related gastro issues (as a cluster) it could also fall under GWI as functional gastrointestinal disorder. If the VA rates both service connected and GWI connected, do you get both or just one?

Also, does the VA interview you to discuss what's in my service record medical files? There's some inaccurate information in there that I'd like to clarify.

No GW Gen Med exam covers everything. It will likely be one or the other. If you have a Gulf War service that is the easiest way to get an exam for a condition whether is direct SC or related to GW.

[bolt_vet23]

Hello,

Regarding tinnitus, I separated in 2005 but did not file a claim for tinnitus until 2008. I submitted a detailed letter how the ringing impacted me at work and home as well as a letter from my wife supporting the claim. Based on the test results and supporting documentation I was awarded 10% SC disability. Best of luck!