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"Denied because disability not clinically diagnosed"

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AFMedic09

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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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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

Edited by doc25
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  • Content Curator/HadIt.com Elder

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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