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]

Another thing I have noticed is that at the top of my 2015 c and p questioneer the doctor states under diagnosis that I was diagnosed constipation chronic in 2001. 

[Vync]

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.

I visited Camp Casey when I was living in Seoul, Korea, back in 87-88. I guess you filed and was examined before you got out.

The 2003 C&P exam should have been found in your c-file. Check your denial letter from 2004 and see if it is listed under evidence - it should be listed there. They had to have had a copy of it because they mention the C&P examiner in their write up. It might also be in your service treatment records. If you still cannot find it, I recommend you request a copy of them, unless you already have them.

Another thing I have noticed is that at the top of my 2015 c and p questioneer the doctor states under diagnosis that I was diagnosed constipation chronic in 2001. 

It appears your 2015 C&P doc was quoting your service treatment records from 5/31/01 and 8/26/03. Dig these out. See if they say chronic or constant. While there, also see if the doc diagnosed constipation or if it was just a symptom.

There is a difference between the two terms chronic or constant. The VA likes to look for the exact phrase "chronic". If they think a condition is not chronic (symptoms were acute and transitory, and no residuals were evident at separation or during VA examination), then they tend to deny it in the absence of a positive nexus from a doctor. Personally, I think that the "chronic" policy is counterproductive, primarily because veterans were trained to be tough and urged to avoid going to the doctor.

 

 

[leadbelly1981]

Exactly we were discouraged from going to sick call. Only shit bags go there right? I'll look into my records for the word chronic or constant. Thanks for your help.

[Vync]

Exactly we were discouraged from going to sick call. Only shit bags go there right? I'll look into my records for the word chronic or constant. Thanks for your help.

Sad, but true. Back before I got out in 1995, I went to a class to teach us how to transition to civilian life. During part of it, they encouraged everyone to go ahead and go to the doctor to get as much medical issues documented and/or treated before getting out. They explained that it is possible to file VA claims and why. One guy stood up and said his knee has been bugging him for years since a basic training injury, but he wasn't a sick call wimp and just sucked up the pain and took tylenol. The instructor advised him to go to sick call first thing in the morning to get it documented. No clue if he went, but I hope he did.

[leadbelly1981]

Under evidence for the 2004 rating decision it list

C and P exam dated November 17, 2003

 

I request my records and when they arrived there is not a c and p exam record included but

 

In reading the decision closer I do notice that it states,

 

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.

 

 

 

 

The physician concluded that you suffered from " Constipation" , which is a symptom and not a medical diagnosis.

 

The way that this is written really sounds like the Physician stated in his notes that I suffered from "constipation" . Pretty straight forward, and that the rater stated "which is a symptom and not a medical diagnosis". Why would a C and P Doctor state that I suffered from constipation which is a symptom not a diagnosis? Wouldn't that be an incomplete exam rendering no real finding? Basically like saying hey he suffers from constipation which is a symptom of something but ill let you guess what it is? It just doesn't seem like something a doctor would put in his report. I could see a Doctor stating, the veteran suffers from constipation further tests are required, or just simply stating that I suffer from constipation. I cant really see a doctor stating the veteran suffers from constipation which is a symptom not a diagnosis. At least not on a c and p  exam which its purpose is to render a medical opinion. Anyone agree that this is does not fall in line with a medical opinion?

 

The physician concluded that you suffered from " Constipation" , which is a symptom and not a medical diagnosis.

 

 

1. Vync I really think you nailed it with If the doctor said this, then they obviously don't understand § 4.20 (see below). If the rater said this, then they obviously don't understand § 4.20 (see below) and it could also be what is called a Colvin violation (unqualified person incorrectly tries to interpret a medical data on their own).

 

 

 

Edited January 2, 2016 by leadbelly1981

[Vync]

The physician concluded that you suffered from " Constipation" , which is a symptom and not a medical diagnosis.

The way that this is written really sounds like the Physician stated in his notes that I suffered from "constipation" . Pretty straight forward, and that the rater stated "which is a symptom and not a medical diagnosis". Why would a C and P Doctor state that I suffered from constipation which is a symptom not a diagnosis? Wouldn't that be an incomplete exam rendering no real finding? Basically like saying hey he suffers from constipation which is a symptom of something but ill let you guess what it is? It just doesn't seem like something a doctor would put in his report. I could see a Doctor stating, the veteran suffers from constipation further tests are required, or just simply stating that I suffer from constipation. I cant really see a doctor stating the veteran suffers from constipation which is a symptom not a diagnosis. At least not on a c and p  exam which its purpose is to render a medical opinion. Anyone agree that this is does not fall in line with a medical opinion?

1. Vync I really think you nailed it with If the doctor said this, then they obviously don't understand § 4.20 (see below). If the rater said this, then they obviously don't understand § 4.20 (see below) and it could also be what is called a Colvin violation (unqualified person incorrectly tries to interpret a medical data on their own).

Try to request a copy of the 2003 C&P exam. At my VAMC, they were stored in my medical records. I went to the Release of Information office and filled out a form. Some of my older documents were on paper and they had to send off for them (took about a month), but the rest were on the computer and they printed them out on the spot.