constipation claim, ibs ?

[leadbelly1981]

I started having trouble with constipation pretty bad while I was in the army. Upon my ets at the exam I told the doctor that I had a lot of trouble going. I had also been seen twice for constipation while in the service

 

I received a letter from the va a few months after getting out stating that consipation is a symptom not a diagnosis and that my claim was denied and if I could provide new and material evidence the claim could be revisited. That was in 2004. 

 

I reopened my claim september 2015 and went to a c and p in San Francisco.  The doctor was a gasteroentrologists and he was pretty helpful. He stated that I have ibs constipation predominate. this is his exact medical opinion in the remarks section of the disability questioner.

 

In my opinion as a gastroenterologists, mr. B 's condition of abdominal bloating and chronic constipation represents irritable bowel syndrome, constipation predominate. It is more likely than not this this is the same condition for which he was seen in the army  on these dates. His complaint was never properly evaluated by the army prior to his discharge on. this condition has been continuously present by history and has been documented to present in va records at least since presentation to the sr va in 2009.  In my opinion his prior denial of va service connected status was in error in not recoginizing that his medical condition present since 2001 , is irritable bowel syndrome, constipation predominant.

 

Edited December 29, 2015 by leadbelly1981

[Berta]

"One question I have is , is this not enough to get the VA to reverse their decision or at least sc me for the New diagnosis?"

I feel it should be enough to SC you for the new diagnosis.

Are you 100% sure the VA has this 2015 favorable opinion?

Was it sent in with a cover letter or 21-4138 or anything that specifically stated: Attention to and then followed by the initials that appeared in the numerical-aphabetic code above the date on the decision letter?They are the initials of the last person who handled your claim.

Did the lawyer who advised CUE, offer their legal bases for the CUE?

Did they also recommend filing for Reconsideration with this N & M pro0bative medical evidence? I dont think that would work though for a better EED

 

 

1. "Dr. Owens a VA Medical doctor specializing in Gastroenterology medically opined at a C and P dated December 7, 2015 “In my medical opinion his prior denial of service connected status on 2/13/04 was in error in not recognizing that his medical condition, present since 5/31/01, is irritable bowel syndrome, constipation predominant”.

Did you have VA medical care 'since 5/31/01' for the constipation?

If so, did the lawyer suggest you might also even attempt  a Section 1151 claim, since I assume the treatment for IBS is different than for

constipation.( I think) and I also wonder if improper constipation treatment by VA could have made the IBS get worse.

Others might well disagree with my 1151 question...but we have to not only think out of the box but try every way possible to succeed sometimes in our claims.

The medical statement of 2015 calls error in the rater's lack of knowledge of the actual condition, but that could be used to show a lack of knowledge in the VA doctor's ability to properly treat you for the right condition....if the VA treated you for the constipation prior to this recent decision.

 

There are more ways than one to skin a cat..

I think the lawyer didn't mean to file CUE on the recent decision...I think he/she meant to file CUE on the 2004 denial.

Can you scan and attach here the 2004 denial (cover C file # etc prior to scanning)?

Unless I am misunderstanding this, that 2004 decision might well hold the legal error for more retro but hard to tell without reading it....to include the Rating sheet.

The VA will need a copy of it too ,if you CUE the 2004 denial.

 

Edited February 2, 2016 by Berta
convoluted

[leadbelly1981]

On 1/22/2016 at 3:43 PM, Navy4life said:

The letter you provided was a very good/solid one by your doctor who performed the C&P.  I am sure it will help!

Berth thank you for your input. I ets in 2003. Above you can see the 2004 denial the 2015 c and p opinion and the 2016 decision.my computer is not letting me upload for some reason right now. Also the lawyer ants me to cue the 2004 decision.

[Berta]

Great.Thanks for clarifying that.

By ETS do you mean End of time in service?

Reason I ask is because if the 2004 claim was filed within that first year after service discharge date (it appears it was) then the EED would be the first day after your discharge ,if the CUE claim succeeds.

[leadbelly1981]

40 minutes ago, Berta said:

Great.Thanks for clarifying that.

By ETS do you mean End of time in service?

Reason I ask is because if the 2004 claim was filed within that first year after service discharge date (it appears it was) then the EED would be the first day after your discharge ,if the CUE claim succeeds.

The c and p exam was in 2003 a few days before my enlistment was up or ets. The decision is dates Feb 2004. I reopened it on e benefits Sep 2015. I was just awarded 30 percent based on the DBQ from doctor Owens on Dec 7 2015. I want to get this claim back dated to the initial claim date which would be the when the va first received it in 2003 Or maybe their decision in 2004. I have little understanding of this process but in the denial in 2004 the rater said the physician stated I suffered from constipatiin, which is a symptom not a diagnosis. I believe this is a Colvin violation because the rater said constipation is a symptom not a diagnosis, which is not true. Also even with my smr history the rater should have applied 4.20 analogous ratings for my chronic constipation instead of denying. What is your opinion Berta? On sorry if I was unclear in earlier statements. I'm trying to present as clear of a picture as possible. Thank you.

[leadbelly1981]

6 hours ago, Navy4life said:

At minimum constipation is found in 2016 ICD - 10 – CM diagnostic code K59.00 constipation unspecified.

 

^^^^^

i would not out this in your NOD. your basis for this entire fight is the fact they should have awarded you in 2004. That there above indicates you could agree with a 2016 award thus losing any possible retro or SC to 2004!

just my .02

Navy4life

 I'm sure the icd diagnostic books for 2003 Also have a diagnostic code for constipation unspecified I just haven't found it online yet but your point is well taken thank you

 

[flores97]

Leadbelly, your CUE looks pretty good to me, except for one thing. You filed your claim for constipation within one year of discharging from the military, is that correct? Your effective date, if you filed within one year of discharging, WOULD NOT be Feb 2004, it would be the day after your last day in the service. For example, let's say you discharged on Oct 2, 2003. If you filed the claim within one year, they owe you retro back to Oct 3, 2003. For most claims, the effective date is not the day the decision is made, it is the day VA receives your claim. UNLESS you file a claim within one year of your last day in service, then the effective date is the day after(or of, i can never remember), your last day in service. So if you succeed on this EED, and you filed the original claim within one year after ETSing from service, they owe you retro back to your last day in service. Good Luck, and be sure to have the attorney read your proposed CUE.