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

[leadbelly1981]

ok here is the exact wording in my rating decision in 2004 also following this Is information from the c and p I was at this month in 2015

 

 

Rating Decision 2004

 

Service connection for constipation claimed as bowel movement problems.

We are unable to grant service connection for constipation claimed as bowel movement problems because the evidence fails to show a medically diagnosable condition was incurred or aggravated by active duty. The service medical records show a health care practitioner treated you for probable constipation in January 2001, however no professional rendered a medical diagnosis. according to the evidence you did not obtain treatment for a chronic condition thereafter. During the c and p exam the doctor noted normal bowel sounds there was no tenderness to palpitation, heptosplenogalyy or guarding. the physician concluded you suffered from constipation, which is a symptom and not a medical diagnosis. we can revisit this issue if you provide crediable objective medical evidence showing a chronic medical condition was incurred or aggravated during military service.

 

 

 

 

compensation and pension dec 7 2015

 

 

was the veterans claim file reviewed

yes

 

1. diagnosis

does the veteran now have or ever been diagnosed with a intestional condition

yes

ibs 564.1  12/7/2015

chronic constipation 564.0 5/31/01

 

describe history of veterans intestinal condition

 

Mr. B was in the army from 2000 to 2003. his service medical records show that he was seen on 5/31/01complaining of stomach pain due to lack of bowel movement for several days. he was treated with kolace and fiber supplement. prior to his discharge from the army his smr notes on 8/26/03 constant problems with constipation for the past two and a half years. I use a tea called smooth move and other laxatives. stool is covered in mucus if not producing one for a few days.

 

when he was first seen at the sr va clinic he on 4/1/09 his record notes chronic constipation patient gives 10 year history of constipation only producing small round hard stools  2  to 3 times a week only after taking laxatives. patient has used daily supplimental fiber without improvement in symptoms.

 

at present he follows a high fiber diet and tries to manage his chronic abdominal bloating and constipation on his own. he drinks coffee in the morning and then works to stay hydrated through out the day. he carries a bottle of water with him at all times. he tries to move his bowels 2 to 3 times a day there are times where he doesnt have a movement for a week. he has movements mixed with mucus and blood. stool is usually in round hard balls.

 

 

is continuous medication required for control of condition

yes

 

has the veteran has surgical treatment

no

 

does the veteran have any signs or symptoms attributable to any non surgical no infectious intestinal condition

yes

has chronic abdominal distention, relieved temporaily by bowel movement. he feels irritable when bloated and cannot eat. he has to wear his pants below his bloated abdomen or his pants would be to comfortable.

nausea

he gets nausated if he hasnt had a movement for a couple days. he also gets nausated when bearing down trying to have a movement.

 

does the veteran have episodes of bowel disturbance of with abdominal destress

yes

episodes of bowel disturbance with abdominal distress

more or less constant abdominal distress

weight loss

no

malnutrition

no

 

remarks

In my opinion as a gastroenterologist, 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 recognizing that his medical condition present since 2001 , is irritable bowel syndrome, constipation predominant.

 

 

 

 

[Vync]

Vync

 

Thank you very much for you insight. I have another question. When is the correct time to do the CUE. On e benefits the claim is in gathering of evidence stage. Is this somthing I do immediately or do I wait to get the decission and if the decission is not favorable then file a nod stating that there is a CUE? 

 

Of course I'll be posting the exact wording of 2004 decission tonight as well.

 

Thanks again

 

VYnc, I do agree with you. I did post that maybe leadbelly may have to file an appeal but it really depends on the evidence in his records, and the C & P exam back in 2004. What I disagree with is filing a CUE or asking VA to Cue themselves unless a veteran has a solid grip on VA regulations and laws like Ms. Berta has it is a gamble they may not win and filing a simple NOD could prevail with the right evidence.

Regarding CUE, I am definitely not a CUE expert, but it looked like an error to me. The way the 2004 claim was denied sounded pretty fishy. Given the fact that I am SC for the condition, I know it is possible. I'll have to defer to others regarding CUE.

 

 

[Vync]

I think you have a pretty good chance of getting SC with your 2015 C&P exam, but the icing on the cake would be if you could get your effective date back to 2004.

I looked over your 2015 C&P exam. Dig out your medical records and look for any visit you had for constipation or stomach problems. Definitely look at the SMR note from 8/26/03 and check for the diagnosis.

Do you have your initial C&P exam from the 2004 claim? That's the one where you need to see if the doctor or the VA rater concluded constipation as a symptom, not a diagnosis.

Additionally, were you ever deployed to the Gulf? (per Harrysday's above comment)

[Guest]

Service connection for constipation claimed as bowel movement problems.

Wow, This is one of the reason the VA really p*ss me off.  Your 2004 claim was not for IBS but it was for constipation claimed as bowel movement problems and they are playing games with words.  It is no doubt that veterans are not doctors but VA will play this game all the way up to CAVC (Courts of Appeals for Veterans Claims) until a judge or a joint remand holds their (VA) feet to the frying pan.  Please read over my earlier post. You will need a clear diagnosis dated prior to your 2004 rating decision for an earlier effective date. Go through your SMRs/STRs page by page, front and back and any and all medical records after that time frame to see if you have a clear diagnosis. As stated before your  nexus letter dated 2015 links your condition to your military service but VA may or may not accept this for an EED.  Only time will tell.

First things first, VA can only go by the evidence you submit and the evidence of record at the time of any rating.  Keep in mind to be granted service connection a veteran must have: 1. An in-service injury or disease, 2. A current diagnosis, and 3. A nexus connecting 1. and 2. together.  The problem I see is you did not get the nexus statement until 2015.  Even though it is a great nexus, VA will most likely go by the date of this nexus. I truly hope I am wrong but if you did not have a diagnosis of IBS back in 2004, how can VA pay you any type of retro.  Even though you got you a nexus this evidence was not (available )in your records until recently so VA will look at the 2004 rating as a solid/good rating.  It is possible to win a EED but you will most likely have to file an appeal and you may not get the EED. That is why I posted that I hope you have/had a diagnosis of IBS prior to you 2004 rating decision.

Edited December 31, 2015 by pete992

[Vync]

Service connection for constipation claimed as bowel movement problems.

Wow, This is one of the reason the VA really p*ss me off.  Your 2004 claim was not for IBS but it was for constipation claimed as bowel movement problems and they are playing games with words.  It is no doubt that veterans are not doctors but VA will play this game all the way up to CAVC (Courts of Appeals for Veterans Claims) until a judge or a joint remand holds their (VA) feet to the frying pan.  Please read over my earlier post. You will need a clear diagnosis dated prior to your 2004 rating decision for an earlier effective date. Go through your SMRs/STRs page by page, front and back and any and all medical records after that time frame to see if you have a clear diagnosis. As stated before your  nexus letter dated 2015 links your condition to your military service but VA may or may not except this for an EED.  Only time will tell.

Agree 100%. Regarding the CAVC correcting all the mistakes at the BVA and RO level, that tends to be all that happens. I don't think anything is actually done to help prevent those mistakes from being made again and again with other veterans.

[leadbelly1981]

When I was seen for my c and p exam in 2003 it was while I was stationed at camp Casey south Korea. I requested all my records c file and received them. There are no notes from my c and p that I can find. I do remember telling the doctor I have constant constipation for the last 2 plus years with relief only after laxatives. 

 

In My 2015 c and p exam the doctor looked thru all of my records right there with me he had access on his computer.  This is how he developed his opinion.