What's your opinion, light at the end of the tunnel or not?

[Bigkevo44]

I finally received a hard copy of my recent C&P exam. I had to travel to the actual VAMC in DC to retrieve it even though I submitted a paper request about a month ago. Anyway, here are the results… Please tell me what you think my chances of receiving a favorable rating are. My claim was remanded back to the VARO by the BVA for further development and a C&P exam. Here are the results…

 

ICD code: 309.28 (F43.23)

Mental Disorder: Adjustment Disorder with Mixed Anxiety and Depressed Mood

Under #3 Occupational and social impairment
[X] Occupational and social impairment with reduced reliability and productivity is checked

For VA rating purposes, check all symptoms that apply to the Veteran’s diagnosis:

[X] Depressed mood
[X] Anxiety
[X] Suspiciousness
[X] Chronic sleep impairment
[X] Mild memory loss, such as forgetting names, directions or recent events
[X] Impaired judgement
[X] Disturbances of motivation and mood
[X] Difficulty in establishing and maintaining work and social relationships
[X} Difficulty in adapting to stressful circumstances including work or a work like setting
[X] Impaired impulse control such as unprovoked irritability with periods of violence

Remarks: The diagnosis obtained was based on the criteria contained in the Diagnostic and Statistical Manual of Mental Disorders -5 (DSM-5)

TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ]

a.       The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness.

b.       Based on this examination and veteran’s current symptoms described in the examination report, the veteran meets diagnostic criteria for Adjustment Disorder with Mixed Anxiety and Depressed Mood (with alcohol use) as outlined in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). Therefore, the current diagnosis is at least as likely as not related to the veteran’s fear of being deployed to the Gulf War during his Active Reserve Duty Training in 1990.

Thanks in advance for all your help and advice.

[Bigkevo44]

Thanks for your response Buck. From the beginning I contended that I suffered from psychiatric issues like depression and anxiety as a result of consuming contaminated water while at Camp Lejeune. The PTSD was secondary. Unfortunately the doctor didn't seem to review any of the materials included in my file regarding the materials from the VA and USMC created listing Neurobehavioral Effects as one of the 15 conditions it condends that veterans station at Lejeune from 1953 to 1987 may suffer from. She seemed to place more weight on the secondary issue and that could be a problem for me. I have included psych records dating back to 1995 to present...no family history. This is frustrating!

[Buck52]

you can request another C&P to the C&P Director   and let him/her know why?  you call it an inadequate exam. especially if the examiner had your c-file...just make sure those records are in it.

other than that  you need to file NOD,and get an IMO from a specialist , use as new material evidence.

if you been diagnose with Neurobehavioral Effects by VA, then the secondary PTSD should be considered, if your symptoms are enough to show with the DSM 5 criteria, as which in my opinion they do,   but not reading ALL your C&P it's hard to say? 

This is not your regular type claim  its quite unique. so your going to need records and more records to put a nexus together, S.C. is ok but when you get a rating   they rate from the symptoms and there severity ...so legal Documents is what you need...and of course make sure they read them.

next time you get a C&P Take your records with you...> that you want them to read!

 you can ask if   so & so records are in the computer or C-FILE, IF NOT  LET THE EXAMINER KNOW YOU DO HAVE THEM ON YOUR PERSON & YOUR  WELCOME TO LOOK AT WHAT YOU BROUGHT TO YOUR C&P.

JMO

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

Edited July 13, 2016 by Buck52

[Bigkevo44]

Fantastic advice Buck and I really appreciate it. My only question is do I wait until I am denied before I request another C&P exam and when should I file my NOD and get the IMO?

By the way, this claim was remanded by the BVA for further development. Does that matter?

Here what the judge said: REMAND

The Board finds that further development of the record is needed for proper consideration of the issue on appeal. The appellant asserts that during his training at Camp Lejeune, he was exposed to contaminated drinking water, and contends that his claimed psychiatric disability is related to such exposure...

VA Compensation and Pension Service Training Letter 11-03 indicates that persons residing or working at the U.S. Marine Corps Base at Camp Lejeune from the mid-1950s to 1987 were potentially exposed to drinking water contaminated with volatile organic compounds (VOCs), incloding benzene, Vinyl Chloride, trichloroethylene (TCE) or tetrachloroethylene (perchloroethylene, or PCE). The Letter also provides that service connection for a disability caused by contaminated water at Camp Lejeune requires evidence of a current disease, evidence of service at Camp Lejeune during the period of contamination, and a medical nexus between the two, justified with a rational scientific explanation.

The appellant's service records confirm that on ACDTRA he was stationed at Camp Lejeune (falling within the range of subjects identified as potentially exposed to VOCs during such service. His VA treatment records show that he has a history of depression and has received VA treatment for such disability.

The appellant has not been afforded a VA examination in connection with this claim. Given the circumstances outlined above, the Board finds that the low threshold standard for determining when VA is obligated to provide an examination (under McLendon v. Nicholas, 20 Vet. App. 79, 81 (2006)), is met and that a remeand for an examination to secure an advisory medical opinion in this matter is necessary...

 

Thanks in advance for your help sir.

 

Edited July 13, 2016 by Bigkevo44

[Buck52]

Ohhhhh  Okay

No  you don't need to request another C&P or NOD  ,NOD's are if your flat out denied. I didn't know you had a remand on this?

  Actually the BVA Judge is in your favor here according to this remand, you will probably be given another C&P respectfully because this judge is telling them about the camp Lejeune contamination and the causes and effects it has on veterans.  from the VA compensation training letter  dated 11-03 you mention as your evidence.(at least he/she read your records further) =

''Here what the judge said: REMAND''

The Board finds that further development of the record is needed for proper consideration of the issue on appeal. The appellant asserts that during his training at Camp Lejeune, he was exposed to contaminated drinking water, and contends that his claimed psychiatric disability is related to such exposure...

So sit tight and you should get instructions, they may want to send you to another C&P ?

 SO check ebenny's periodically ....they may go ahead and approve your claim based on what this judge mention.

They are looking at Medical records I'm sure  to see how your symptoms and the severity.

  you going and getting treatment and seeing a VA Counselor helps and it helps you cope with your problems ,  so stay in treatment.

in My opinion this is a good remand   now its up to RO. 

but don't get your hopes up  this is just my opinion   you can't underestimate the VA.

Hang in there my friend.

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

others may chime in here  Ms berta?

[Bigkevo44]

Okay thanks Buck,

I guess that I should've mentioned that it was a remand from the beginning. So what if the RO denies my claim, will I have any recourse? Can I appeal or does the judge make the final decision?

[Buck52]

The Judge wants RO to take another look at your records for further development  ( which is a good thing)  I don't think you will be denied......but you maybe lowballed on your rating so check the criteria for your symptoms as for as what they rate you.

If your denied  yes Definitely NOD this.