Service connected 40% left median nerve laceration with neuropathy
found unfit for duty due to injury placed on TDRL, and honorably discharged
FDC claim initiated on 12/9/15 for Bipolar Disorder, and TDIU 12/9/15 via ebenefits.
Claim denied service connection for Bipolar Disorder 3/24/16
Background
I submitted Private medical records from two different psych doctors. I submitted a DBQ from a treating physician as well as VA form for unemployability.. the private medical records had two notations that I noticed my symptoms occuring in USMC.
I was diagnosed in 2001.
I had psych c&p exam.. It was less than sufficient.. The "Doctor" barely reviewed my records misquoted me, and spent all of 5 minutes talking to me.. Mispellings all over the report, and providing 0 medical rationale when making the conclusion that i was not service connected.. English was a second language for him.. "He concluded that my bipolar and median nerve injury rendered me able to hold a job presently." He left out the word NOT making it appear because I injured my wrist and have Bipolar I can hold a job...making no sense whatsoever.
After I saw this I got an independent Medical opinion that was very in depth, reviewed all of my records including va records and service records, and used proper va language when making her conclusion that my bipolar was related to my nerve injury.. Her report was approximately 10 pages long, and her Curriculam Vitae was about 23 pages long.. She saw me in her office for 2 hours, and took a week reviewing all my records.
Now, since I filed an FDC I knew if i submitted new evidence my claim would be reverted back to a standard claim.. I submitted her report knowing this while my claim was still in the gathering evidence phase.. I saw the report on ebenefits.. I got no letter acknowledging the report, or a letter removing the claim from fdc.. 2 weeks later my claim was complete and denied service connection.
I do not yet have my decision packet so I am not 100% sure what they looked at, but is it possible they simply "misplaced" the medical opinion, and they made the decision without it being in the claim folder? If I confirm this happened what are my options?
Thank you
Edited by usmc3073 added C&P docs and Nexus Opinion
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.
Question
usmc3073
Former Marine MOS 5534 Musician Clarinet Player
Service connected 40% left median nerve laceration with neuropathy
found unfit for duty due to injury placed on TDRL, and honorably discharged
FDC claim initiated on 12/9/15 for Bipolar Disorder, and TDIU 12/9/15 via ebenefits.
Claim denied service connection for Bipolar Disorder 3/24/16
Background
I submitted Private medical records from two different psych doctors. I submitted a DBQ from a treating physician as well as VA form for unemployability.. the private medical records had two notations that I noticed my symptoms occuring in USMC.
I was diagnosed in 2001.
I had psych c&p exam.. It was less than sufficient.. The "Doctor" barely reviewed my records misquoted me, and spent all of 5 minutes talking to me.. Mispellings all over the report, and providing 0 medical rationale when making the conclusion that i was not service connected.. English was a second language for him.. "He concluded that my bipolar and median nerve injury rendered me able to hold a job presently." He left out the word NOT making it appear because I injured my wrist and have Bipolar I can hold a job...making no sense whatsoever.
After I saw this I got an independent Medical opinion that was very in depth, reviewed all of my records including va records and service records, and used proper va language when making her conclusion that my bipolar was related to my nerve injury.. Her report was approximately 10 pages long, and her Curriculam Vitae was about 23 pages long.. She saw me in her office for 2 hours, and took a week reviewing all my records.
Now, since I filed an FDC I knew if i submitted new evidence my claim would be reverted back to a standard claim.. I submitted her report knowing this while my claim was still in the gathering evidence phase.. I saw the report on ebenefits.. I got no letter acknowledging the report, or a letter removing the claim from fdc.. 2 weeks later my claim was complete and denied service connection.
I do not yet have my decision packet so I am not 100% sure what they looked at, but is it possible they simply "misplaced" the medical opinion, and they made the decision without it being in the claim folder? If I confirm this happened what are my options?
Thank you
Edited by usmc3073added C&P docs and Nexus Opinion
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