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Hello everyone and thank you for accepting me in to the forum.
Last year I filed a new claim for Generalized Anxiety Disorder and Major Depression. For the past 3 years, I have been seeing a civilian psychiatrist for my anxiety and depression. She had already diagnosed me with GAD and Major Depression, and I have been on anti-anxiety medications, antidepressants, and sleep medication. I was on differing types of the same medications since coming out of the service, but it wasn't until about 3 years ago, that I admitted to myself that I needed mental help, and that is when I started seeing my civilian psychiatrist, and that is when I first heard of GAD and Major Depression, when she said she had diagnosed me with them. It was at her suggestion, that I file a claim with the VA for GAD and Major Depression. She said she very much felt like my conditions were associated with my time in the service. When it was finally time to have my C&P exam, I was interviewed by a VA psychologist. I told her about my civilian psychiatrist, and her diagnosis for me, and the medications she had me on. I also talked to her about my time in the service, me being overseas in the Gulf War, and me being in a humanitarian mission in Ecuador. I told her about my friend who was with me during basic training. And how he was shot and killed right in front of me, in a horrible accident, during one of our live ammunition training exercises. I told her how all this had affected me from those moments on, all the way until now. At the end of our meeting, she told me that she felt like my condition was more PTSD, rather than Generalized Anxiety Disorder and Major Depression. At the time I didn't think anything of what she said; that is until I was sent my denial letter. In my denial, it stated that my 2 claims for GAD and Major Depression, was changed to GAD (to include PTSD) and Major Depression (to include PTSD). So the VA psychiatrist did what she said she would. She essentially changed what I had claimed, and added (to include PTSD) on each of my 2 claims. So, for the basis of PTSD, there has to be a proven stressor. The VA used what I had talked to the psychiatrist about the death of my friend during boot camp, as my stressor. The VA said they searched records during the time I was at boot camp, and found no incidents related to what I was saying. So, because the VA psychiatrist took it upon herself, to change my claimed conditions from GAD and Major Depression, to GAD (to include PTSD) and Major Depression (to include PTSD), now it was up to me to prove a stressor, because with claims associated with PTSD, you must prove your stressor. I knew from talking to other Army buddies of mine, how difficult it could be sometimes to find old records of deaths. The death of my friend during boot camp happened in 1962 at Ft. Jackson, SC. My civilian psychiatrist never suggested to me that I had PTSD. She always said it was Generalized Anxiety Disorder and Major Depression. If I had wanted to file a claim for PTSD, I would have done so. But I knew how difficult it would be for the VA to search for and find any record of the death of my friend at boot camp. So I filed GAD and Major Depression, because I was told those claims did not require a specific stressor (exact time, place, person, etc). I was told that GAD and Major Depression, could be claims based on your entire military career, with everything you've done and everything you've experienced, all amounting to intense anxiety and depression. So that is why I claimed GAD and Major Depression, over that of PTSD. But because the VA psychiatrist took it upon herself to change my 2 claimed conditions, and added the words (to include PTSD) to each of my claimed conditions, it was not just GAD and Major Depression any longer; it includes PTSD, which requires a specific and provable stressor. I had a stressor, and very specific one - the death of my friend during live ammunition exercises during our time at Ft. Jackson, SC boot camp in the summer of 1962. But the VA said neither they nor the JSRRC could find any record of that taking place. If my 2 claims had remained what they were suppose to be, simply GAD and simply Major Depression, I do not think I would have been denied. But because the VA psychiatrist added PTSD to each of my conditions, the VA asked for my stressor, the VA and JSRRC said they could find no record of my stressor, so my claims were denied. I believe I would have been approved if not for the VA psychiatrist adding PTSD to my 2 claimed conditions.
So with all that said (and I apologize for the length of it), is there any hope for me, if I appeal my denial? And do any of you know how I would go about appealing it? Would I simply say to the VA that I disagree with the VA psychiatrist adding PTSD to my 2 claims, when I never claimed PTSD myself?; that that was her decision entirely. I have had a VA Disability Representative for the past couple of years, but he was utterly useless. He never answered my calls or emails. He basically never helped me at all. I did most all myself over eBenefits. But now, since I've had this recent denial, I have considered hiring a VA Disability Law Firm to take my case. I've spoken with 2 so far. They both told me I had a very strong case and that I could win. But they also said they couldn't take my case because of their huge client load. I think it was simply that they could probably win my case, but there wouldn't have been much in the line of backpay, so they wouldn't have gotten much compensation for their work for me. So I guess I will continue searching for other VA Disability Lawyers, or I may have to appeal my denied claim myself over eBenefits.
Could any of you, please help me with this? I have read many questions on here regarding GAD and Major Depression, but I haven't come across one yet, where they filed a claim for GAD and Major Depression, and then the VA psychiatrist during the C&P exam, decided to change the claim (to include PTSD), thereby changing the criteria for acceptance, by now making me prove a specific stressor, instead of it she had just left my 2 claimed conditions alone, without including PTSD to them, then no specific stressor was required - it would simply go by your overall experiences while in service. I am a 20 year Veteran by the way, with most of my time served in the National Guard. But I was activated numerous times during my 20 years, including during the Gulf War. It isn't my fault that the death of my friend during boot camp, isn't something the VA or JSRRC can locate in records. If the VA psychiatrist had just left my 2 claimed conditions alone, instead of tacking on (to include PTSD), then the VA wouldn't have even had to search for a specific incident, they would have just based my conditions on my overall military experiences.
Thank you for any help, assistance, or advice you might be able to give.
The veteran's use of opiates, cannabis, and alcohol began prior to service, thus current/recent use/abuse is not caused by an in-service related event. Given
the veteran's consistent diagnosis and treatment of PTSD, and the frequency of relapse of substance use, it is as least as likely as not that his substance use
(to include opioid use disorder) is aggravated beyond its natural progression by his PTSD symptoms.
Per 3/15/2017 initial PTSD exam the veteran was diagnosed with PTSD, alcohol use disorder, cannabis use disorder, and opioid use disorder, all of
which were in early remission. The 3/15/2017 medical opinion, the examiner opined that the veteran's opioid use disorder, and substance use in general,
was made worse by his MST. The 6/20/2017 review PTSD examination indicates that symptoms present at that time were due to PTSD and not
substance use as he had been abstinent from drug use with the exception of his opioid maintenance therapy. The veteran is service connected for the
combination of PTSD and substance use disorders however per 11/20/2017 medical opinion regarding unemployability, the examiner noted that the
veteran was service-connected only for PTSD and not substance use which is incorrect. Per rating decisions 3/27/2017 and 10/11/2017, the veteran was
service connected for "PTSD with secondary alcohol use disorder, cannabis use disorder, and opioid use disorder." They are separate disorders, and not
all symptoms are present all of the time. The examiner commented specifically on the veteran's PTSD symptoms and separated the veteran's substance
abuse disorder symptoms. The veteran's substance use predated his military service, thus it was not caused by his reported assault. It was, however,
likely aggravated by the residuals of his assault as described in treatment notes which indicate that with worsening PTSD symptoms, the veteran has
reported relapsing on substances, particularly heroin.
I had infant asthma with all signs and symptoms of asthma gone by the time I was 9 or 10 years old. On my pre-enlistment questionnaire, I marked I that I had had asthma (question says do you have or have you had) I had it as a kid and it was gone. I enlisted in the Navy in 1979 and based upon all the research I have been able to find, with any history of asthma, I don't think I should have been allowed to enlist. I have my service records and they are silent of any respiratory testing to enlist. The best I understand is they accepted me with a presumption of soundness.
I had not had any sort asthma symptoms for at least 8-10 years prior to service. During rigorous running and physical training in boot camp, I had an asthma attack and had to go to the dispensary.
I filed a claim recently for service connection for asthma because it was aggravated in service and I was treated for an attack in service. I also have a 40% rating for a knee condition and have not been able to do much to be active over the years. At my most recent yearly VA physical, my cholesterol and weight were both going up so I figured I needed to do something to get some exercise. Swimming laps is something suggested to me so I tried that and after about 20 minutes of laps I had to quit because I was having asthma breathing problems. I told my VA doctor who treated me with a daily inhaler and a rescue inhaler. Both have helped improve symptoms.
The VA denied my claim for asthma saying it was preexisting. I had been asthma free for almost a decade prior to service. If regulations at the time I enlisted say I should have been disqualified for service, but they let me in with a presumption of soundness, what steps do I take in my appeal?
My mother has written a lay statement of the chronology of my childhood asthma and when symptoms were gone. How do I show aggravation v exacerbation? What should a doctors IMO say?
Good news, I filed three CUEs and now have three C&P exams. Great news, it's with the VES and not the VA. The best news, I've seen one of these VES Doctors before and he rated the disability exactly correct!
My question is, since I was given the C&Ps for the three disabilities that I filed the CUEs against, does this mean that the VA is agreeing that they made a CUE? I understand the exams still have to happen for the rating portion, but does this mean the bureaucratic part of the VA agrees there was a mistake? Logic tells me "yes, why would they schedule an exam if they were just going to deny the CUE." However, this is the VA and logic is hard for them.
Last night I was going through my records to get them ready for the C&Ps. While I was doing this, I found another CUE that if accepted will net me another 10% back to 2005. Go through your records, DBQs, and Rating Decision letters, you might have CUEs just waiting to be found!
So they deny me and say they don’t have vocational evidence for a grant but they can opinion to deny based on not even the doctors opinion they sent me too but DDS adjucator. They requested a Voc expert for the hearing and as such I had an assessment done by another Voc expert to see his opinion which was a grant. I used Mylar Disability and am worried about not having a hired attorney yet for my claim. Stress is besting me again much my VA claim until I was found P and T. My judge approval rating is 70% in all his cases this year but just don’t want myself to get complacent so I don’t forget details. Is there anything else I could possibly get to help my SSDI case other then the mental RFC my primary VA doctor filled out and the Voc assessment I had done?
Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
Vync posted an answer to a question,I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:
2003 asthma denied because they said you didn't have 'chronic' asthma diagnosis
2018 Asthma/COPD granted 30% effective Feb 2015 based on FEV-1 of 60% and inhalational anti-inflamatory medication.
"...granted SC for your asthma with COPD w/dypsnea because your STRs show you were diagnosed with asthma during your military service in 1995.
First, check the date of your 2018 award letter. If it is WITHIN one year, file a notice of disagreement about the effective date.
If it is AFTER one year, that means your claim has became final. If you would like to try to get an earlier effective date, then CUE or new and material evidence are possible avenues.
I assume your 2003 denial was due to not finding "chronic" or continued symptoms noted per 38 CFR 3.303(b). In 2013, the Federal Circuit court (Walker v. Shinseki) changed they way they use the term "chronic" and requires the VA to use 3.303(a) for anything not listed under 3.307 and 3.309. You probably had a nexus and benefit of the doubt on your side when you won SC.
It might be possible for you to CUE the effective date back to 2003 or earlier. You'll need to familiarize yourself with the restrictions of CUE. It has to be based on the evidence in the record and laws in effect at the time the decision was made. Avoid trying to argue on how they weighed a decision, but instead focus on the evidence/laws to prove they were not followed or the evidence was never considered. It's an uphill fight. I would start by recommending you look carefully at your service treatment records and locate every instance where you reported breathing issues, asthma diagnosis, or respiratory treatment (albuterol, steroids, etc...). CUE is not easy and it helps to do your homework before you file.
Another option would be to file for an increased rating, but to do that you would need to meet the criteria for 60%. If you don't meet criteria for a 60% rating, just ensure you still meet the criteria for 30% (using daily inhaled steroid inhalers is adequate) because they are likely to deny your request for increase. You could attempt to request an earlier effective date that way.
Does this help?
Buck52 posted an answer to a question,Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.
The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.
Picked By66 bricks,
JKWilliamsSr posted a question in VA Disability Compensation Benefits Claims Research Forum,A couple months back before I received my decision I started preparing for the appeal I knew I would be filing. That is how little faith I had in the VA caring about we the veteran.
One of the things I did is I went through the entire M21-1 and documented every CAVC precedent case that the VA cited. I did this because I wanted to see what the rater was seeing. I could not understand for the life of me why so many obviously bad decisions were being handed down. I think the bottom line is that the wrong type of people are hired as raters. I think raters should have some kind of legal background. They do not need to be lawyers but I think paralegals would be a good idea.
There have been more than 3500 precedent setting decisions from the CAVC since 1989. Now we need to concede that all of them are not favorable to the veteran but I have learned that in a lot of cases even though the veteran lost a case it some rules were established that assisted other veterans.
The document I created has about 200 or so decisions cited in the M21-1. Considering the fact that there are more than 3500 precedent cases out there I think it is safe to assume the VA purposely left out decisions that would make it almost impossible to deny veteran claims. Case in point. I know of 14 precedent setting decisions that state the VA cannot ignore or give no weight to outside doctors without providing valid medical reasons as to why. Most of these decision are not cited by the M21.
It is important that we do our due diligence to make sure we do not get screwed. I think the M21-1 is incomplete because there is too much information we veterans are finding on our own to get the benefits we deserve
M21-1 Precedent setting decisions .docx