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.
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tylerb333
Denial...really?
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.
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vetquest
Tylerb, please reply in one thread or the other and let the other thread go away. It gets confusing when you are using two different threads for the same denial.
Navy4life
Not all assaults are reported. A lot of MST never gets reported but a lot of claims are approved based on the Veteran's statement and clear markers. Also, I don't believe a Forensic Psych doctor is
Gastone
I'm aware of what you address regarding late MSA reporting. When there is no actual MSA official Report Filed, no private or Service medical records supporting the MSA Claim, it all comes down to
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