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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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"Denied because disability not clinically diagnosed"


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I filed a claim for GERD in April of this year.  I had a C&P last month.  I loaded medical records from service of an upper GI that was done and the reason it was ordered according to the medical form filled out by the doctor was "DYSPHAGIA HX GERD" .  I just received my denial letter stating "the medical evidence of record fails to show that this disability has been clinically diagnosed".  I don't know what more I could have sent to them to prove this was diagnosed in service?  I have been treated by the VA since I got out of the military in 2009 with Prilosec daily, and still have some days when the reflux is terrible. I sleep with 5 pillows under me so that my head is elevated to keep the acid from waking me up.  Just wondering what I should do now to appeal? I found some medical evidence today that was not included when I filed this claim where I was seen for a cold, but it shows my medications of prilosec at that time (2004), and others show I was taking Prilosec, Tums, and that list problem list of GERD. I cannot find the medical note where I was diagnosed with GERD, but I have been treated for it since I was in service, and the scope showed an irregular Z-line which the doctor explained to me after the procedure was likely due from my history of reflux.  Any advice?

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There are two basic sections to a clinical report: Subjective: Your complaints Objective: Doc's assessment If they say "HX GERD", it just means you either complained about having GERD or have a histor

Vync , That's a good Ideal to use the Meds Fact sheets & high-light the parts for them to read. Since I was a victim of Identity Theft...I shred all my med fact sheets. or I let my 5 year old gran

Andyman, absolutely, if you have been on NSAIDS like ibuprofen and naproxen for long periods of time, they are well known to cause gerd and stomach issues. AFMed09, I would take a DBQ into your doctor

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On 12/21/2015 at 5:47 PM, ArNG11 said:

AFMedic09 Hopefully you won't have to go through the hassle. However, most likely you might.  Absence of evidence is NOT negative evidence.  Symptoms in service is obvious from what you wrote.  That is the essence of the validity of the claim that the disease occurred in service, it is a problem now and you are continuing to get treatment whether by VA or private doc.  Diagnosis is horse crap. Verifiable symptoms, diagnosis is a plus but not necessary.

 Am I mistaken or isn't GERD a presumptive on Gulf War Vets/Iraq/OIF OEF. ?  

Hopefully you won't have to get an IMO/IME but if you do make sure to get one and don't put up with that crap.  VA raters are so full of it I'm surprised that the crap doesn't change their eye color and just spews out their mouths onto their desks.    

Sorry not feeling to hot and having problems of my own too close to the LZ.  Give them hell!

Still fighting....had a second C&P exam Nov. 11th. and now movement in ebene.(see below)

I'm guessing they have denied me again despite my evidence and being on Prilosec all these years...unbelievable. I have just signed up for representation through DAV as I have been doing all of this myself up until this point. I have completed the POA for them...I will call them and see what they can tell..

Table of Claims
Latest Progress Status Description Received
03/02/2016 Appeal Pending - Statement of the Case (SOC) VA has received your Form 9 and will begin completing final actions regarding your appeal before it is sent to the Board of Veterans’ Appeals. Date not available
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Quick question:

Are you SC for any painful condition or have a SC mental health condition that requires continuous medications?

Secondary-connection might be another route to consider, should your appeal be denied.

Opioids and other medications are known to cause  or aggravate stomach problems such as GERD.

Since your claim is on appeal, let the process take its course.

Just keep it in mind about Secondary-connection.

 

Also, you'll need to request a Freedom of Information Act for a copy of your ENTIRE Claims file folder, immediately. 

2017-01-18+Claims+Intake+Fax+Coversheet-1.pdf

 

va3288.pdf

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AFMedic09,

I agree totally with Vync.  And for what it's worth, at least you have in your STR where you were prescribed the Prilosec.  Some of us, who where/are on a daily regimen of some type of pain reducer, have no listed GERD type ailment or treatment there of, in our records.

I've been on NSAIDs or tylenol, for 23 years, now, but not sure if or how I can file a claim for the side effects of that long term usage.

Vync is correct saying about spoon feeding the VA.  They give no quarter, and you must prove everything, guilty until proven innocent, such as it is.

Semper Fi.

Andyman

Hey Andyman,
The NSAIDs are the culprit more than the tylenol. If the NSAIDs are for treatment of a SC condition, just file for it as secondary. Include a list of the dates when you were prescribed them to show a long history and also include several instances showing treatment for the SC condition where they prescribed the meds. If you get the meds from the VA, include a copy of the papers send with the med and circle the GERD-like side effects. Expect the VA to probably run a heliobacter pylori test because it can cause GERD. If it is positive, they'll put you on antibiotics. If you can get that out of the way before your C&P and you continue to have the problem, it will be more promising because the VA can't use h. pylori against your claim. They also might send you for an upper GI and/or an endoscopy.
If you can get a good IME ahead of time, that would help.

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