Re-Opening a 2016 GWI claim - Fibromyalgia DBQ

[IMEF-Gunny]

So, before I knew much about the VA and their love for vets, I submitted my first GWI claim. I filed for symptoms (Stomach issues, sleeplessness, bi lateral arm/shoulder pain, short term memory loss). I had a forgetful C&P doc, I had no idea beforehand what the eam was for, I was nervous as shit and I didn't know enough to press him on examining other issues.

I went 26 years without touching the VA and here I was at a C&P exam. I was rated 30% for IBS, all other contentions denied because dr said I denied having any other issues.

This week I was diagnosed by a family practice NPC with fibromyalgia, they ordered bloodwork to exclede Rheumatoid Arthritis and scheduled me with a rheumatologist in February. Here is my DBQ. Thoughts?

I'm considering a re-open or reconsideration for my initial 6/2016 claim. My NOD is already in for this claim with a request for DRO review. I don't care about back pay  money, just principle, so not worried about losing my initial claim date..

DBQ1 001Redacted.bmp

DBQ2 001Redacted.bmp

DBQ3 001Redacted.bmp

[Dr_Dave]

I'm not the biggest expert on this Gunny, but I'll tell you what I think, and others can chime in. I'll also tell you where to go for the BEST advice on your question.

First, I feel ya about being confused and lost filing that first GWI claim and not knowing what the hell was going on. I did the same thing, and in fact it's been 9 years and my first GWI claim has been denied completely numerous times and is waiting in line for the first shot at the BVA. I have no doubt it will take many more years, and that I'll be dead before it's resolved.

I don't really see anything in your first claim that would connect to fibromyalgia (FM) that would justify you asking to reopen the claim with your new evidence. But you could tie it to your shoulder pain and sleeplessness, so if you want to try that, you probably could. If you don't care about the effective date, a new claim would work just as well. FM is a presumptive under 38 CFR 3.317 as a "Medically Unexplained Chronic Multisymptom Illness." As long as your doctor and you can show that it is FM and not something else (although that diagnosis from the expert rheumatologist would be much more helpful), that it is at least 10% or more disabling, and that it has lasted 6 months or more (chronicity), then it should be presumed as a CMI under this section. 

That means you can claim it connected to the previous claim, if you can tie it to that claim, or file it as a new claim, since it has surfaced prior to the closing date selected by the Secretary of the VA (31 Dec 2021).

For the best help, go to the Self Help Guide at the National Gulf War Resource Center (NGWRC) 

Hope this helps.

Dr. Dave

 

2017-ngwrc-gulde.pdf

Edited November 5, 2017 by Dr_Dave
updated link to self help guide

[IMEF-Gunny]

My first claim was for sleeplessness, bi-lateral arm pain, bi-lateral shoulder pain, memory loss-short term and stomach issues. The stomach was rated 30% as undiagnosed illness (IBS) w/constipation/diahrea.

Since that time, I've been diagnosed with Major depressive disorder, PTSD, sleep disorder NOS.

So, my re-open with new & material evidence is in the context that I filed for symptoms of Fibromyalgia, which I have now been diagnosed with.

Much like anything, it's a crap shoot......but, I am a tenacious Marine and will never just go away! Thanks for the input!

[broncovet]

Ok, marine, go "armed with knowledge".  Order your claims file and look for THESE 3 things (Caluza elements) documented in your file.  

1.  Current diagnosis.

2.  In service event or aggravation

3.  Nexus, or doc statement that number one is connected to number 2.  

      Most claims fail to number 2 or number 3 which is missing.  An IMO/IME can fix number 3, but you can not fix an undocumented event EXCEPT by

documenting it, which usually involves buddy letters, or in depth military records which may not have been initiallly available.  If you find a document which confirms number 2, then you can reopen due to new and material evidence by resubmitting evidcence.  

[IMEF-Gunny]

Is the burden of proof more stringent for a Gulf War veteran to prove, in service event/aggravation when it comes to a FM claim?

[IMEF-Gunny]

All of the lab work to rule out Rheumatoid Arthritis came back clean, so I will upload to Ebennies. That will help support the previously undiagnosed Fibromyalgia claim. Also, have an appointment with a Rheumatologist coming up in December.

[SincityCJ]

Gunny,

The lack of a diagnosis with R/A will actually work in your favor.  The lack of that condition strengthens the credence to the FM, and it gives you leverage from them writing off your condition as not SC.

Remember, GWI claims involve either:

A:  an undiagnosed illness (within the set of symptoms)

(or)

B:  a diagnosable but medically unexplainable condition.  

 

GWI is used similar to Agent Orange in that it qualifies a set or set(s) of conditions, just like your IBS.  The VA won't award you with GWI, but rather X condition, i.e IBS, FM, etc... diagnosed or not, attributable to service in the GW theater.  For GWI, you do not need a specific incident in service, so long as you were in theater, during the time frame and have either X condition or a set of symptoms that fit within their criteria.  It is not the same as say, a knee injury, that you must corroborate. You can certainly have more than one condition which impacts disparate body systems and it sure sounds to me like you do.  

 

I suggest reviewing the GWI conditions thoroughly as the VA will look at them.  Research the conditions, symptoms of both diagnosed and undiagnosed illnesses and try your best to meet each criteria with some form of evidence.  

So, this means you should present your claim as:

1.  You are a qualified vet with service in one or more of the AOR's, within the timeframes specified.

2.  You have been diagnosed with X condition, that is related to the environmental hazards of the Gulf war, (No other sound medical explanation).

3.  Backed up with whatever lay evidence you can get,  any relevant medical records and an Independent Medical Opinion (IMO).  

*If it is within your means, I would highly recommend an IMO, spelling out the lack of other conditions and connecting the FM to the Gulf war.  

 

The DBQ, in my opine, looks favorable for the FM.  I could also see you filing an additional claim after that would be for the memory, sleeplessness etc...

 

Then you have to sit and wait unfortunately.    How long really depends on the work load at the DRO.  I waited 15 months for a DRO hearing.  I've only had one but it worked in my favor, so I recommend them if at all possible. Others may feel otherwise.  Keep at them, maintaining your original date if at all possible, as it should work out the best for you in the end, imho.