C & P Notes, seem fishy?

[TALON II FE]

This was noted in one of my C & P's, aren't most if not all of my diagnosed issues he lists associated with GWI?  They slid this into my initial claim post-retirement C&P for general medicine.  I had plenty of exposure incidences, besides the daily issues we all dealt with living of there...I think they are already covering things up, there is no other reason for this to be there, other than for them to manipulate it at a later date. 

"The Veteran's diagnosed obstructive sleep apnea, headaches, chronic sinusitis, joint pain, nerve pain, skin condition, muscle pain and irritable bowel syndrome represents conditions with a clear and specific etiology and diagnosis. They have not been associated with exposure to environmental hazards such as burn pits exposure, inhalation of fine grain sand, fuel or solvent fumes, insecticides or pesticides or multiple vaccines. Therefore, it is less likely as not (less than 50 percent probability) that these diagnosed conditions are related to a specific exposure event experienced by the Veteran during service in Southwest Asia."

[TALON II FE]

I also saw where he (PA 'specialist') overrode my old AD Navy Fellowship-Trained Hand Surgeon on multiple diagnoses.  Craziness abounds in the World of the VA...

[DocC03]

"The Veteran's diagnosed obstructive sleep apnea, headaches, chronic sinusitis, joint pain, nerve pain, skin condition, muscle pain and irritable bowel syndrome represents conditions with a clear and specific etiology and diagnosis. They have not been associated with exposure to environmental hazards such as burn pits exposure, inhalation of fine grain sand, fuel or solvent fumes, insecticides or pesticides or multiple vaccines. Therefore, it is less likely as not (less than 50 percent probability) that these diagnosed conditions are related to a specific exposure event experienced by the Veteran during service in Southwest Asia."

I believe that the highlighted areas are presumptive to service in Iraq (Assuming you were in Iraq). I am not sure how much weight his final statement about not being related to a specific exposure holds. I would like to believe that a rater would dismiss his final statements since these issues are presumed to be caused by service in Iraq but we all know how the V.A. does things. Its hard to say which way that will go. But also it would nice to know what the diagnosis is that he is claiming??? I don't believe nerve pain, skin condition, and muscle pain is a diagnosis but I could be wrong. I think it is a symptom caused by something that may or may not be diagnosed.

One issue I see it that Sleep Apnea can cause headaches, pain, and fatigue so I can see the rater using that against you unless you have documentation from doctors that say otherwise.

One thing with issues from gulf war service is that your symptoms can not be caused by anything else. 

Search for my post about WRIISC in Palo Alto and read through the details. If you have not been there yet it might be worth trying to get your PCP to send you there. 

One more thing. Not knowing where you were stationed in Southwest Asia make sure that the presumptives cover where you were and that you have the time needed in that area. If they don't then I do believe that you have to prove a cause for your conditions such as exposure to chemicals. 

 

[TALON II FE]

I am rated 100%.  I was a C-130 Flight Engineer, both on traditional C-130's and Special Operations variants.  I did multiple deployments to both theatres, as well as participating in Bosnia and OIF-P (Philippines) and many, many JCETs and other 'trips' as a Special Operations Aviator.  I helped breakdown K2 in Uzbekistan when we closed it (known old, Soviet nuclear waste dump), lived in Balad in both 2005 and 2007, with the burn pits blowing directly across our tents and later on our trailer quarters under the prevailing winds.  I inhaled aircraft hydraulic fluid during an aircraft emergency, bathed in JP-8 Jet Fuel in Al Assad,  during a fuel truck malfunction while refueling the aircraft, ate more terrible food in terrible places than I could remember as well as environmental exposures all across Asia 'proper' as a special operator.  I was medavac'ed twice while stationed in Asia based off of issues that could not be easily diagnosed with numerous abnormal EMGs, imagery, etc.  The end result was being medically disqualified from flight, and that was prior to at least 1/2 my surgeries.  I have about 2000 pages of SMR's, so there is the documentation available, I guess they just need me to hold their hands and point out the mistakes.

  I receive 30% "headaches"(Migraines), 50% "sinusitis", 10% seborrheic dermatitis ("skin condition")...I guess joint pain, nerve pain and muscle pain all were tied into my spine, a few dead nerves and other injuries without really addressing the fact that those were individual diagnoses in addition to the others awarded and were almost all diagnoses were made by Fellowship Docs. They denied my IBS off of a lack of evidence, since they did not have all of my most current records, supposedly, so I will NOD that as well as many other incongruities once I receive my C-File or I hit 11 months from my decision, whichever comes first.  Too many 0% and 10%'s, tbh, and lowballs in general and I believe I should be P&T not just T.

To me, they rated me on many of the items, but are saying it is not related, even though they don't say what caused any of it. I believe they are stacking the deck against later claims and trying to keep the "statistics" down.  I believe that this is probably the standard rather than the exception, unfortunately.  They are covering their bases to avoid another AO type issue with the public and their purse strings.  "we had a registry".  "we gave them the opportunity to come forward".  And on-and-on...

[DocC03]

I am still sticking with my original response since several of your issues are presumptive based on your time at Balad at a minimum let alone other areas.

Have you received your denial letter? I can't tell if these notes were from the C&P or from the denial? I think they were the C&P. 

Presumptive means that you do not need to have specific exposures. Time is country is your exposure.  I am guessing that the C&P doc did not know that time in country is considered your exposure!?!!? You do not need to prove that you drank biological agents anything else. ( Make sure you have proof of time in country) Make sure its on your DD214 or some other official document.

The only exception that I know is that you can not have any other medical condition that is causing your problems.  

From your list I would conclude that sinusitis, headaches, joint pain, nerve pain, muscle pain and IBS MAY all be presumptive as long as the are not caused by Sleep apnea or anything other problem.

What I have done in the past that seemed to work and maybe some one else can chime in if its a good idea but when I read something that is major such as C&P doc concluded that he did not have a clue what presumptive meant then I would go on Ebenefits and upload a statement to the rater that asks them to consider the V.A. position on presumptive illness caused by service in Iraq. I include the V.A. letter that explains the guidelines.

Again I have done this in the past with MAJOR things. I personally don't want to bring attention to small things that may or not become and issue. It has worked for me. Maybe its right to do this and maybe its not but I have had positive outcomes bringing attention to major errors in C&P exams while my claims are still open. 

Any thoughts from other people on whether this is a good technique or not would be great.

I am currently pending decision approval for several things that you have listed here. Although my C&P went different then yours from the sounds of it.

Lots of luck my friend.

Doc

[Buck52]

On 4/14/2016 at 0:53 AM, TALON II FE said:

This was noted in one of my C & P's, aren't most if not all of my diagnosed issues he lists associated with GWI?  They slid this into my initial claim post-retirement C&P for general medicine.  I had plenty of exposure incidences, besides the daily issues we all dealt with living of there...I think they are already covering things up,   there is no other reason for this to be there, other than for them to manipulate it at a later date. 

"The Veteran's diagnosed obstructive sleep apnea, headaches, chronic sinusitis, joint pain, nerve pain, skin condition, muscle pain and irritable bowel syndrome represents conditions with a clear and specific etiology and diagnosis. Thesuch as burn pits exposure, inhalation of fine grain sand, y have not been associated with exposure to environmental hazards fuel or solvent fumes, insecticides or pesticides or multiple vaccines. Therefore, it is less likely as not (less than 50 percent probability) that these diagnosed conditions are related to a specific exposure event experienced by the Veteran during service in Southwest Asia."

Unfortunately the VA Believes the C&P Examiner...and this will probably be denied or low balled

Fortunately   you can NOD this decision if you don't agree....but you need to have records putting you there with the  burn pits and exposure for your evidence. if you need to get a IMO and have the Dr to give his/her impression  to these elements/conditions  that its likely as not(more than 50%) the cause of your current diagnoses/ disability from your prior military service

your correct some time we need to hold there hands and spoon feed & kiss ass....but that's the VA.

JMO

............Buck

 

Edited April 20, 2016 by Buck52

[DocC03]

You only have a few things to prove.

1. You were there.

2. You have a diagnosis of anything listed below. 

3. Your diagnosis is not caused by something not listed.

Cut and dry. That simple. Or it should be but we all know this is not always the case. 

Like I said above....you might be able to catch this before it is denied thus saving you a bunch of time. 

 

Gulf War Veterans who meet the criteria below do not need to prove a connection between their military service and illnesses in order to receive VA disability compensation.

VA presumes certain chronic, unexplained symptoms existing for 6 months or more are related to Gulf War service without regard to cause. These "presumptive" illnesses must have appeared during active duty in the Southwest Asia theater of military operations or by December 31, 2016, and be at least 10 percent disabling. These illnesses include:

• Chronic Fatigue Syndrome, a condition of long-term and severe fatigue that is not relieved by rest and is not directly caused by other conditions.
• Fibromyalgia, a condition characterized by widespread muscle pain. Other symptoms may include insomnia, morning stiffness, headache, and memory problems.
• Functional gastrointestinal disorders, a group of conditions marked by chronic or recurrent symptoms related to any part of the gastrointestinal tract. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues. Examples include irritable bowel syndrome (IBS), functional dyspepsia, and functional abdominal pain syndrome.
• Undiagnosed illnesses with symptoms that may include but are not limited to: abnormal weight loss, fatigue, cardiovascular disease, muscle and joint pain, headache, menstrual disorders, neurological and psychological problems, skin conditions, respiratory disorders, and sleep disturbances.

- See more at: http://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp#sthash.YSSvBsgo.dpuf