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Attached is my Decision Letter. I think they may have made a mistake.
Background: Retired 2014. Claimed IBS in 2015 but was denied due to no diagnosis. Didn’t fight it. Starting in 2017 to today started having more and more issues. Was diagnosed in 2017 with IBS by Doctors at Naval Hospital.
Leads us to Decision letter
Oct 29, 2020 – Requested IBS Service Connection via Gulf War Syndrome 38 C.F.R.3.17
1. Received Decision Letter today 13 Jan 2021.
2. A 10% evaluation is established for IBS and added to the previously established non-compensable evaluation for hiatal hernia/GERD (I did not ask for this or ask to be reevaluated for hiatal hernia. I realize they often combine the two.
3. Examiner provided opinion that current disability is at least as likely as not (50% or greater probability) incurred in or caused by the in-service Injury, event or illness.
4. Service Connection established. Huge Win
However, I think they may have made a mistake.
1. On page 3 of decision letter:
a. Paragraph 1 – Hiatal hernia warrants non-compensable evaluation
b. Paragraph 2 – Irritable colon syndrome warrants 10% - Moderate symptoms
c. Paragraph 3 – Additional symptoms – Alternating Diarrhea and Constipation
d. Paragraph 4 – I don’t understand what this means
e. Paragraph 5 – they agree and state that I do have alternating diarrhea and constipation in my records. I also have constant bloating and gas in my records as well.
f. Paragraph 6 – Hiatal Hernia 0% I agree with, No argument. I wasn’t trying to get an increase.
g. Paragraph 7 – A higher evaluation of 30 percent is not warranted for IBS unless there are severe symptoms demonstrated by diarrhea, OR alternating diarrhea AND constipation, with more or less constant abdominal distress.
i. In Paragraph 5, they already agree and state that I do have alternating diarrhea and constipation.
ii. Alternating diarrhea and constipation is the epitome definition of MORE OR LESS CONSTANT ABDOMINAL DISTRESS.
h. Paragraph 8 – Deals solely with the Hiatal Hernia/GERD evaluation
2. I feel like when they combined the two 7319 & 7346 codes which they often do, I understand that however I clearly meet the Irritable Colon Syndrome of 30% evaluation in paragraph 7. See below as well.
3. But when they combined both codes they make it seem like I have to have the other Hiatal Hernia/GERD symptoms as well to qualify for the 30% 7319 IBS Rating.
4. Wanted to get some advice before I figure out how to proceed.
7319 Irritable colon syndrome (spastic colitis, mucous colitis, etc.):
Severe; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress
Moderate; frequent episodes of bowel disturbance with abdominal distress
Mild; disturbances of bowel function with occasional episodes of abdominal distress
7346 Hernia hiatal:
Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health
Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health
With two or more of the symptoms for the 30 percent evaluation of less severity
Hoping to get some advice on where to start with a VA disability claim, I separated in 2017 and have filed several "intent to file" processes since separating but have let them all lapse as I've struggled so much with PTSD since getting out and have been in such a pit I'm only now trying to pull myself out of it and try and move forward with treatment and tying up all the loose ends I have.
Like a fool I spent so long suffering and not talking about my issues I've not only made them far worse but made any paths I have forward far more difficult, and was hoping that others that have had similar experiences can help me create a path forward somehow.
I originally joined the Air Force in 2001 and within my first year witnessed a fellow airman have a medical emergency during training and despite me and several others efforts to perform CPR we weren't able to save him. Thinking back I'm realizing I should have been more in tune with how it effected me, immediately after the incident I had lost all memory of the following two weeks, essentially a month after the incident I could remember the incident in every detail but the two weeks directly after were a complete blank spot in my memory just days after those two weeks passed. I couldn't remember people I had met or things that had happened, it's like I was teleported forward nd dumped there immediately after the incident. Over the years this started effecting me more and more and started to include other signs of trouble, I started having waking nightmares where I would sleepwalk and hallucinate the event unfolding all over again which still occurs almost nightly almost 20 years later.
The most debilitating aspect of it has become a slow descent into a deep fear and anxiety for death and medical events that causes daily panic attacks and daily uncontrollably unhinged sobbing, sometimes lasting as much as six hours a day. Starting ten years ago while I was still in the service I started seeing a private doctor and getting medication and treatment for PTSD and anxiety which I understand now incorrectly did everything I could to hide from the military. I spent the next seven years trying every medication under sun with sometimes three times per week therapy which has largely been unsuccessful with things getting especially worse since leaving the service three years ago.
Moronically I now realize, I kept everything from the military and pretended everything was fine, I pretended more than that, that I was thriving. It was only at the very end that I opened up to some about my struggles but honestly don't believe they ever made it into my military medical records, while my private medical records show diagnosis of PTSD, major anxiety disorder and depression along with a multitude of symptoms and other things effecting me like GERD and IBS (I take prescribed anti acid daily, as well as about half a bottle of tums daily and its still not uncommon for me to have to run to the bathroom several times in the night with bright orange lava coming out of my rear end), insomnia, hypertension, memory loss (it takes me probably an hour a day to find simple things such as my keys and wallet, and that's with systems being put in place to assist me with this) as well as the still nightly hallucinating waking nightmares and night sweats to the point where I need to keep towels next to the bed to wring myself off several times through the night.
With all of the struggles I've had I've lost three jobs in the past three years directly related and documented from the struggles I have had and still currently have and have decided to try and apply for VA disability for some of these issues if I have a path forward. The most important thing is probably the healthcare which I'm understanding without I have no hope. Being in and out of jobs and having healthcare come and go has made life the past three years impossible and while I filed an intent to file almost immediately after separating, that one lapsed, another I filed after has lapsed and now my third is lapsing December 28th with me only now just starting to try and gather my records and documents to support my claim.
After all of this I'm hoping to find advice as to if I have any path forward and what that may look like. With nothing but documented hearing loss and some foot issues while deployed ( I now have horrible bunions but that's a whole separate thing I'll worry about some other day), My military medical records are empty and its been longer than the year after separating that I'm realizing is the time I really should have done this.
Should I bother with any of it or have I waited to long to try and pull myself out of this pit?
Also is there any benefit to quickly getting it in before the 28th to make the window for the intent to file, even If I don't have everything together yet? Or should I just wait until I'm better prepared and file a new intent?
Also does someone know of a good resource explaining the difference between symptoms and secondary conditions? I cant quite wrap my mind around it, like GERD is a symptom on PTSD as well as a secondary condition, while insomnia is also a symptom but not usually a secondary condition.
Sorry so long and thanks for any advice anyone may have.
i was told to look into something called smc l. i dont know if i qualify or not.
i was given a 100% permanent and total rating in 2015. here are my ailments.
biploar disorder 70%
Asthma due to jet fuel exposure 60%
cystic acne due to jet fuel exposure 30%
carpal, allergies, tinnitus each at 10%
i also get ssdi 100% and they require me to use my sister to manage my finances.
my sister also basically serves as my caregiver. without her i dont believe i can function. she does everything for me from finances, to taking me to appts, to reminding me and sometimes helping me clean. and more.
would i be able to apply for smc-l and if so how would i go about doing it. i overheard a family member discussing it with my sister and mom the other day. and it sounds very helpful.
I served in the USAF from 1994-1998. Deployed to Bahrain, Turkey and Saudi, and was at Khobar Towers in 1995 when it was bombed. I am currently rated at 90% total. 70% PTSD from the bombing, 50% sleep apnea secondary to PTSD and 10% Tinnitus.
I have suffered from IBS for over 20 years. It was finally getting bad enough this spring that I went to the VA and talked to my primary care. She ordered a colonoscopy and referred me to the GI department. Colonoscopy came back relatively normal, with a few polyps removed and biopsied all coming back negative. They put me on fiber twice a day which has improved my issue a little. My GI nurse told me in a video conference yesterday that she was finally officially diagnosing me with IBS type D.
About the same time I was having the worst of the IBS issues this spring, I also started having severe joint pain. I was referred to rheumatology and was sent in for a CT scan, and gobs of blood work and x rays. They diagnosed me with Ankylosing Spondylitis. My bloodwork did show that I am HLA-b27 positive, but have no family history of AS or any type of auto immune diaseases. I am injecting myself in each leg once a month with 300mg Cosenyx. The injections help but they are talking about adding a pill to help get it under control 100%. It is really affecting my knees, my thumbs, and my ankles the most and I am afraid of it getting worse. I drive a truck for a living and I really need my joints to work to continue to provide for my family.
During the Xrays of everything, they found several masses in my lungs. They did a CT scan and said that they were likely not cancerous, but wanted to do follow up tests in a year to compare to make sure nothing was growing. I was a smoker for a few years so I cannot say that is from the sand but who knows?
For about the last 3 years, I have had a few bouts of irisitis/uveitis which my civilian opthamologist said was likely rheumatoid arthiritis. It is also a common side effect of my AS. I take a steroid eye drop when I have flares and when I catch it quick enough, knocks it out before it gets really bad. I have had one flare up since I have been going to the VA, and had them look at it and document it, and now get my prescription eye drops from the VA.
I know IBS is a Gulf War Presumptive. I am wondering if my AS would be condsidered GWP also? Would it be secondary to my IBS? Should it be a stand alone claim and the irisitis be secondary to AS? I am not the kind of guy that is trying to claim everything wrong with me is somehow a VA claim, but this stuff just has gotten the better of me and I can see no reason why I am having these issues.
As always, I appreciate all of the help!
I know there are NUMEROUS questions asked about the VA disability ratings, and even a disability calculator, but, my question is: my total combined disabilities are rated at 85%, so, it was rounded to 90%. I submitted a new claim for GERD, which I am expecting them to bring it from 10% up to 30%. For the disability calculation, will they work from the 90% and then factor in new claims or percentages or do they re-enter all my disabilities and so my rating could still remain at 90%?
rebabevets posted a question in VA Disability Compensation Benefits Claims Research Forum,I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently
Ddsr posted a question in VA Disability Compensation Benefits Claims Research Forum,The 5, 10, 20 year rules...
Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.
Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.
Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.
If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"
At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.
NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.
Example for 2020 using the same disability rating
1998 - Initially Service Connected @ 10%
RESULT: Service Connection Protected in 2008
RESULT: 10% Protected from reduction in 2018 (20 years)
2020 - Service Connection Increased @ 30%
RESULT: 30% is Protected from reduction in 2040 (20 years)
broncovet posted an answer to a question,While the BVA has some discretion here, often they "chop up claims". For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.
I hate that its that way. The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.
Ztmiller8 posted a question in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC,Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!
My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.
Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
Joey Ross posted an answer to a question,I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and nothing about stressor,
Picked ByJoey Ross,