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[Guest rickb54]

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Edited February 19, 2007 by rickb54

[free_spirit_etc]

Sounds like my husband's claim for Gulf War syndrome -- when they stated about his headaches :

Service connection is denied for headaches as they have been diagnosed as headaches."

???????????????????????

Yeah..in the sinus thing they are making a leap statement that the sinus problem in service is not the same as the diagnoses after service -- but they didn't give any medically sound reasons for doing so.

Unless they had a doctor who explicitly said the two are not connected AND gave some medically sound reasoning for HIM to make such a statement --- it seems like they are WAY OFF on this one.

Sounds like they are making an UNSUPPORTED medical JUDGEMENT.

I bet you could prove them wrong if you have 10 or 15 years to spare.....

Free

Free Spirit,

Excellent question glad you asked.....

Here is what the va said on the denials:

denial #1:

Service medical records show veteran has complaints of sinusitis, but sinusitis did not occure on active duty

denial #2:

Service medical records show that you were seen on several occasions during service for sinus symptoms, service connection is denied because the evidence does not show sinusitis in service or show the current sinusitis to be the result of service. Sinusitis not actually diagnosed unit 12 Apr 1993, 7 years after discharge.

Seems to me the va is speaking out of both sides of their mouth, I am not sure how to rebut there findings. I don't understand how the va can say there was no active duty diagnose seems to me if he was treated there had to be a diagnoses. What say You.

[Hoppy]

Rick,

A doctor needs to review these reports and make an assessment as to whether or not there is an etiological link between the symptoms in service and the current symptoms. Are the in service symptoms early symptoms of the condition that exists post service or is it actually the same condition in service as post service. If the condition in service is the same as post service was the inservice condition chronic and or do the post service symptoms represent continuity of the inservice disease. There is no medical report making this assessment that I see. Such a report should be necessary and there are probably all kinds of cases you could site. There is no medical report that addresses the etiology of the post service disease that is based on the entire record. The only determination is that the rater could not make a connection based on the medical records. A doctor needs to review the file and the VA should have scheduled a C&P prior to the denial.

This is what all the hype was about in 1999. Thompson went to congress and testified that adjudicators did not need to seek medical opinions prior to a denial. The congress did not buy it and it was my understanding that the intent of the veterans assistance act of 2001 was to cause the raters to schedule a C&P exam any time there was a post service diagnosis that the veteran thought was related to something in the SMR. I did not know that the rater had discretion. I thought discretion was eliminated and a post service diagnosis was cause to schedule a C&P prior to a denial. You should think about getting a senator to look at this case.

Edited November 20, 2006 by Hoppy

[Guest jstacy]

Rick, It appears to me this Vets main problem is Asthma. Is his Asthma service connected to was it pre existing?

This Vet needs a nexus letter as soon as possible.

[Berta]

He might be able to get secondary SC if there is a link of this to this SC asthma-

he could try for both direct and also secondary SC.

Seems to me they diagnosed it right in his SMRs.

Whose SMRs did the VA read?

This abstract might help:

It shows a definite relationship between asthma and sinusitus:

http://www.postgradmed.com/issues/2000/10_00/muller.htm

He could also go another way too- a veteran can suggest to VA any potential way at all to get service connection-

he could potentially claim that his SC asthma aggravated and excerbated his NSC sinusitis, thus service connection on that basis too would be warranted.

[Hoppy]

Berta,

They did the same thing to me on my angioedema claim. First denial they said I was not treated in the military for the disease. I was in fact treated in the military and it was noted as chronic on my discharge exam. The rater did not use an ICD-9 and he could not figure out the numerous differnet diagnostic terms used for the same condition. On the second denial they claimed that the disease did not manifest until after my discharge. This was a hard one to overcome. How can I have the disease in the miliotary and then they say it did not manifest until after my discharge. I requested a C&P for five years and never got one. In 1996 I could not get a VA doctor to write a nexus letter. The VA where I sought treatment had a policy of not allowing doctors to write letters when requested by the veteran, They only wrote reports for the RO when asked by the RO. It took me five years to finally get a nexus letter after the VA mandated doctors to write letters for veterans in 1999. There was an addditional two year delay because the doctors were not trained on adjudication proceedure and tried to tell me the diagnosis in the military was not accurate and at the same time they told me I did have the disease that I sought SC for. These idiot doctors were contacted by the RO and told to tell me this. I was able to determine that the RO was talking to my treating doctors by using a technique I was taught in private investigator school called mis information.

Eventually, I got an appointment with a specialist and the head of the department at another hospital who read the SMR and wrote a report that the disease I had in the military had no known cure and it is the same disease I asked to have service connected. The guy was a board certified immunologist and department head at a VA hospital for thiry years. The VA could not get around this and I was SC'd. I was SC'd by a DRO based only on the existing evidence and my arguments showing them there errors of there ways. No new medical evidence was introduced between the second denial and the decision by the DRO.

Rick,

What RO is this. I am serious this is as bad as what I went through. After I beat them they then started falsifying evidence and stated that the record clearly indicated the disease was the result of post service employment. Not one medical report in the file even addressed the issue of this disease being the result of post service employnment. Once they make a big mistake like this they will run it into the ground rather than admitt they screwed up. You really need to get a Senator involved as to why a C&P was not scheduled prior to the denial and let this rater know he is being watched.

I have to wonder if sinusitus is another disease with no cure or requires surgery for a cure. They said the disease did not start until years after his discharge. What medical report did they cite. The idiot rater who denied me said that the medical reports indicated that the first angioedema reaction occurred 7 years after my discharge. When you read the report cited by the adjudicator the doctor did not determine that the first reaction occured 7 years after my discharge. My subjective statement to the doctor which he wrote in the report was that the first severe angioedema reaction occured 7 years after discharge. Thus the rater cited my subjective non medical opinion about a disease I knew little about as having the force of the doctor making the statement as the result of his medial findings. The rater confused the issues on numerous aspects of my claim. The medical record clearly indicated that I had minor chronic angioedema when I was in the military. It was true I was not admitted to an ER and told that I was near death until 7 years after my discharge.

Edited November 20, 2006 by Hoppy

[Hoppy]

Rick

It sounds like the same thing I went through. The first vist to a doctor doing a history by writing the patients recollection of treatment history The doctor probably did not reference any medical documents reviewed. You need to dispute this report based on the fact that the doctor was not inpossesion of the entire medical record when making the assessment. Then take the entire medical history to a doctor and get an opinion from him. A VA doctor worked for me. Got service connected without a C&P. Or wait for a C&P. I waited 5 years and never got a C&P

It still bothers me that no C&P was scheduled. This was a huge issue in the veterans assistance act. They wanted raters to quit making decisions without an initial C&P. The congress claimed the VA had the horse before the cart. Without the initial C&P a veteran was put in a place where he had to prove the claim prior to the VA scheduling a C&P. The congress wanted to stop this practice. Thompson went to congress and sited some statistics that cases that were denied without a C&P were only reversed less that 1% of the time and said it would cost to much. The congress did not care about the expense and wrote in the the veterans assistance act that a post service diagnosis was sufficient to schedule a C&P.