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How can I prove OTC NSAID Usage

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Armypilot44

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Hello all, I have been using Ibuprofen and Aleve for well over 18 years (2000) to help with chronic arthritis symptoms from Lyme Disease.  I was service connected in 2009 for the Polyarthralgia and have since have major issues with my esophagus and stomach since 2006.  I have undergone 5 Endoscopies, 2 Barium Swallows, a Bravo PH Test, and a Manometry Study since 2007.  I departed the National Guard in 2010.  Today I had my C&P Exam at the VA and the Dr said I had a very strong case with only one link missing in the chain.  I have no record of being prescribed NSAID's.  After the arthritis symptoms started, I basically took a daily dosage of Ibuprofen and Aleve.  Between 2001 and 2007, I didn't regularly see doctors because my health was generally good besides the arthritis pain.  I substituted my Army Flight Physical for an annual physical as it was more stringent.  I told my current Dr that I took NSAID's but he never really documented it.  There is no prescriptions because obviously my insurance will not pay for simple OTC NSAIDs.  My roommate from Iraq said he would write a "Buddy Letter". stating he witnessed me take Ibuprofen Daily and how I needed to walk the PT test instead of running due to the Arthritis.  Is there any other ways that I am not thinking of to prove I was taking NSAIDs since 2001.  I wish I had kept the receipts.  Thank you

 

Edited by Armypilot44
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Unfortunately you answered your own question. Since you did not get prescribed by a medical professional, you do not have medical evidence, and trying to get a "buddy letter" that will perjury himself will only back fire for the both of you.

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You dont have to "prove" you used nsaid's.  Focus on the Caluza elements, and dont get distracted by what others, even if they are a doctor, say.  Instead of proving you took nsaid's, this is what you do need to prove:

 

1.  Current diagnosis

2.  In service event or aggravation.

3.  Nexus.

    If you have these, then it boils down to "symptoms", and taking Nsaid's are not a symptom, they are a treatment.  

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Broncovet, thank you.  I have a DBQ completed by my Gastroenterologist along with his 3 Endoscopy Reports.  I also included my second opinion Endoscopy Reports from a another Gastroenterologist.  I have a IMO Nexus letter stating it is as least likely as not that the NSAID usage caused the long list of GI complications.  I also included surveys that I completed with the DOD Millennium Cohort Study from 2001, 2004, 2007, 2011, and 2014 showing that I had GERD issues back in 2006.  For some reason the VA Comp and Pen Doctor today is insisting on proof that I was taking NSAIDs.  She said I have a great case and shouldn't have an issue, especially since the symptoms are so severe, she just needs the NSAIDs script.  As I stated in the initial post, I have many other pilots I flew with that can affirm that I took these all the time.  And for someone ill informed to say that it "will perjury himself will only back fire for the both of you" is ridiculous.  To perjure oneself, you need to be untruthful.  Not sure of what other ways to prove it. 

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A Veteran is competent to testify "simple" things, like whether or not you took an over the counter Alleve, according to the CAVC.  I cant look that case law up right now, maybe others can chime in.  

Absent the Vets testimony being deemend, "not credible", your testimony that you took Nsaids should be accepted.  This means if VA caught you in other lies, where your testimony conflicted with surrounding facts, you are toast.  However, if your testimony is "consistent" with the surrounding medical facts, then you are competent to describe whether or not you took an Alleve each day.  You would not be competent to diagnose yourself, or even treat yourself, but you can administer over the counter or "home" remedies.  

 

Understand the difference between "competence" and credibility.  If you are "Competent" this means you have had medical training to make a diagnosis.   "Credible", however, means you told the truth.  You are not "competent" to diagnose your condition, but your testimony can be deemed "credible" if you have told the truth.  

You dont need an MD to testify, "I took 1 Alleve each morining".  

You do need a MD to testify, "I have degenerative arthritis of the patello femoral joint".  

The first is a simple statement to which you are competent to describe.  

The second statement requires a doctors diagnosis, and you are not competent do self diagnose.  

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If the doc refuses to give you a nexus because he can not confirm you took nsaids, then you will need:

Another doctors opinion. 

READ what the doc said.  He will either have a nexus statement or not.  

If his nexus states, "If the VEteran took Nsaids, then its at least as likely as not that these nsaids caused the stomach and esophegeal problems."  

Then I suggest you get an IMO/IME, your "nexus" is "iffy", and you dont want it "iffy".  

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"And for someone ill informed to say that it "will perjury himself will only back fire for the both of you" is ridiculous."

I agree.Ridiculous.

I would get at least one if not more "buddy statements".

The Buddys should either make their statement on a 21-4138 and sign the oath,at the bottom,  or state in their written statement that they are stating the truth to the best of their knowledge and be willing to give the VA their contact info.

Buddy statements have helped many veterans prove situations that there is logically no 'documentation' of.

You have an IMO, as well, in addition to the C & P exam.

VA would be hard pressed to come up with some other medical reason for your disability.

" I had GERD issues back in 2006"

I dont  see anywhere in this BVA decision that this veteran was prescribed Ibuprofen orAlleve but had used them consistently.

"The Veteran asserts that he has GERD and hypertension as a result of medications used to treat his service connected left shoulder disability."

He claimed NSAID use caused his GERD  and his hypertension.

 

ORDER Entitlement to service connection for GERD is granted. Entitlement to service connection for hypertension is granted.

https://www.va.gov/vetapp18/files2/1809328.txt

 

 

 

 

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