Claim Requests

[Usaf9498]

I was at Khobar Towers in 1996 when it was bombed. I opened my claim August 8th. I checked today and the status is in evidence gathering. I claimed :

 

• PTSD (post traumatic stress disorder) (related to: PTSD - Combat) (New)
• Hearing Loss (related to: PTSD - Combat) (New)
• tinnitus (related to: PTSD - Combat) (New)
• sleep apnea (related to: PTSD - Combat) (New)

There is an open request for medical records backing up any claims. 

I am cpt therapy now for my PTSD. Do I need to upload all of that or will they already have access to that since it is being done at the VA?

I had a hearing test done at the VA a month ago and I have severe hearing loss in my right ear as well as bilateral tinnitus. They ordered a hearing aid for my right ear.  I didn't connect the dots at the time that she asked why I might have loss in only one ear. I realize now that it is likely from the concussion from the bomb detonation. My tinnitus started then, but I never saw a doctor for it. 

As far as sleap apnea goes, I was diagnosed with obstructive sleep apnea about 7 years ago and have used a CPAP every since. The doctors office that I was diagnosed at is no longer in business and I was a self pay patient and have always bought my own equipment. 

I had a second sleep study done 2 years ago for a new device and lo and behold, that doctor office is also out of business.  I don't know what I can send in for records of that besides a statement from my wife stating she slept with me and noticed my breathing stop and choking. 

As of now the only C&P that they have scheduled for me is a hearing C and P.  Seems odd that they have not ordered a sleep study nor a PTSD C&P. 

I did notice that there was something called a JSSR Coordinator Review that says now is no longer needed. 

Any advice on what to upload for the requests?

[kanewnut]

8 hours ago, Usaf9498 said:

Do I need to upload all of that or will they already have access to that since it is being done at the VA?

I would think they will have access to it. Did you tell them which VA?

8 hours ago, Usaf9498 said:

I don't know what I can send in for records of that besides a statement from my wife stating she slept with me and noticed my breathing stop and choking.

Your wife should write up a letter with a lot of detail about this. If you  can find any receipts, send copies of those.

[GeekySquid]

13 hours ago, Usaf9498 said:

realize now that it is likely from the concussion from the bomb detonation.

Do your STRs show that concussion?

Even if they don't put in a claim for TBI. A concussion is a form of a TBI.

Make sure they do an MRI. You definitely want that MRI report.

13 hours ago, Usaf9498 said:

Any advice on what to upload for the requests?

everything but do it in an organized way.

name your files appropriately,

like Hearing Test 1996, Hearing test 1999, Sleep Study at Blah blah 2006

Reference them in your statement in support of claim by that same name.

The VA will order up all your records and YOU need to order your C-File NOW. It will take 3 to 6 months to get. You will only have a year to file an appeal if appropriate. DON"T wait for your C-file as that eats into your year and the VA knows it.

13 hours ago, Usaf9498 said:

JSSR Coordinator Review

The JSSR is a joint services record system. It records all in service events like bombings, raids, etc. any significant event or harm that occurs gets recorded there and they also have access to all unit records not in their possession.

They are just looking to verify you were in a unit there at the Towers and were not at home on leave or some such thing like that.

13 hours ago, Usaf9498 said:

I had a hearing test done at the VA a month ago and I have severe hearing loss in my right ear as well as bilateral tinnitus. They ordered a hearing aid for my right ear.

Having a Hearing Aid is not enough to get an actual paying percent for Hearing Loss. Depending on your Purtone scores and Maryland CNC test you might get SC'd at 0% or if you are deaf as a post you might get a 10 or 20, higher is possible but I think you have to have your ears missing or some such ridiculous standard.

Tinnitus is almost a given for someone in a bomb blast with a concussion. 10% is the max.

now for some interesting possibilities for you to consider.

If you apply for TBI eval and get an MRI look for a statement in that report about an Empty Sella. It is a bony growth in the head that covers the pituitary gland, which is the Master Gland that controls everything in our bodies including our hormones.

IF you have ptsd and a hormone imbalance your anxiety, depression etc may not be controllable by typical medications and should be rated separately with your TBI.

it also affects your sex drive, weight, drive, and about a hundred other things that I am just not willing to type out. If you are rated for PTSD and are overweight your pituitary can be part of the problem. This goes for your SA also. The co-morbidity of these issues is documented but VA hates to pay for them. you may have to fight for them and fight hard.

Do you have severe headaches/migraines? if so put in a claim for them if they started after the bombing. If they got worse after the bombing put in for that too

do you have vision problems since the bombing? fuzzy vision occasionally? brings us back to the MRI.

With your Hearing Loss and Tinnitus, do you also suffer from dizziness? can you/do you walk in a straight line? do you have to control your gait to walk in a straight line? this is called cerebral gait or the drunk walk and is critical to getting the max award.

If you have that dizziness you may have vertigo. there are like 12 types of vertigo, one is related to ptsd, one to migraines, one to TBI, etc. you can have more than one type at the same time.

If you have vertigo and the HL and Tinnitus w/ the drunk gait, you should be rated a meniere's disease at 100% depending on how your conditions fit the 38 CFR listing for Vertigo/Meniere's.

For your SA, a recent change at VA makes it a requirement that your diagnosis say "you require a cpap to live" or similar words. It is in the DBQ. make sure you have that magic statement.

You are at least in your 40's based on the towers bombing. Do you have urinary problems? leaking? I am not being personal, it is called Voiding Dysfunction and happens to people as they age. It also happens to people with PTSD at a lot younger age. There is a DBQ for it, if it applies I suggest you read that DBQ and file.

Do you have ED? again not being personal, it can be a side effect of PTSD and or the TBI/Empty Sella. It is paid as SMC(k) about 110 bucks over and above your rating. Tell your PCP and file a claim.

If you file that claim they will ask you about voiding dysfunction, nocturia, etc. They will ask about "pads" Read the DBQ, part of it is the voiding dysfunction DBQ. read them both. read the CFRs. do this before your C&P exams. for all your C&P exams.

so there are some potentials based on YOUR health that you may or may not have considered.

 

 

 

[Usaf9498]

11 hours ago, GeekySquid said:

Reference them in your statement in support of claim by that same name.

The VA will order up all your records and YOU need to order your C-File NOW. It will take 3 to 6 months to get. You will only have a year to file an appeal if appropriate. DON"T wait for your C-file as that eats into your year and the VA knows it.

Statement in support of claim. Should I do the VA 21-4138 or just type the doc and sign it? ? I have a buddy statement from someone I served with and my mom, with her account of the bombing and calling the red cross and my first shirt asking on information on me because she knew I was stationed at Khobar. Should I ask them to redo them and put them on the 21-4138 as well? 

As far as the c-file goes, I will call and request a viewing today.

11 hours ago, GeekySquid said:

The JSSR is a joint services record system. It records all in service events like bombings, raids, etc. any significant event or harm that occurs gets recorded there and they also have access to all unit records not in their possession.

They are just looking to verify you were in a unit there at the Towers and were not at home on leave or some such thing like that.

So now that it says no longer needed I assume that they already verified it?

 

11 hours ago, GeekySquid said:

Tinnitus is almost a given for someone in a bomb blast with a concussion. 10% is the max.

Do your STRs show that concussion?

11 hours ago, GeekySquid said:

Do your STRs show that concussion?

Even if they don't put in a claim for TBI. A concussion is a form of a TBI.

Make sure they do an MRI. You definitely want that MRI report.

I might have mis-communicated this. I did not get a concussion, rather I meant that the concussion of the bomb, gave me tinnitus, and quite possibly the hearing loss. Should I request an MRI?

 

11 hours ago, GeekySquid said:

it also affects your sex drive, weight, drive, and about a hundred other things that I am just not willing to type out. If you are rated for PTSD and are overweight your pituitary can be part of the problem. This goes for your SA also. The co-morbidity of these issues is documented but VA hates to pay for them. you may have to fight for them and fight hard.

I am overweight and find it extremely hard to lose weight. For whatever reason, I can diet and work out like crazy but for whatever reason, I hold on to my weight. 

 

11 hours ago, GeekySquid said:

Do you have severe headaches/migraines? if so put in a claim for them if they started after the bombing. If they got worse after the bombing put in for that too

I do get headaches but I can't say that they are really frequent. The are different from a typical headache however in that they are stabbing pains in my scalp. I can feel them coming on and they just have to run their course. Nothing that I have ever taken has seemed to help them.

11 hours ago, GeekySquid said:

do you have vision problems since the bombing? fuzzy vision occasionally? brings us back to the MRI.

Vision problems. So 3 years ago, I had to go to an opthamologist because in my right eye, I had severe pain and redness, light sensitivity, extreme shooting headache etc. He diagnosed me with Rheumatoid Arthritis in my eye. However, he did no bloodwork or anything to confirm that. 

I just had this flare up again a month ago and he sounded less convinced that it is RA. 

11 hours ago, GeekySquid said:

With your Hearing Loss and Tinnitus, do you also suffer from dizziness? can you/do you walk in a straight line? do you have to control your gait to walk in a straight line? this is called cerebral gait or the drunk walk and is critical to getting the max award.

I do not have trouble walking a straight line. I do have dizzineess but it is reallly really infrequent. 

 

11 hours ago, GeekySquid said:

For your SA, a recent change at VA makes it a requirement that your diagnosis say "you require a cpap to live" or similar words. It is in the DBQ. make sure you have that magic statement.

I managed to somehow remember who did my sleep study yesterday and they agreed to send me the results so I should have them in 3 weeks give or take. That was a home sleep study done in 2012. So far, the VA has not asked me for a C&P for SA. My PC said that I could start getting my SA equipment from the VA but did not tell me how to go about it. I assume they will not just give me CPAP stuff without seeing a prescription which I no longer have. Should I ask for a sleep study?

 

11 hours ago, GeekySquid said:

You are at least in your 40's based on the towers bombing. Do you have urinary problems? leaking? I am not being personal, it is called Voiding Dysfunction and happens to people as they age. It also happens to people with PTSD at a lot younger age. There is a DBQ for it, if it applies I suggest you read that DBQ and file.

I have frequent and very fast urination. My buddy is always commenting on how quickly i pee. He always says i must have a bladder the size of a walnut. Until I got my sleep under control with my CPAP, I used to have accidents at night. 

 

11 hours ago, GeekySquid said:

Do you have ED? again not being personal, it can be a side effect of PTSD and or the TBI/Empty Sella. It is paid as SMC(k) about 110 bucks over and above your rating. Tell your PCP and file a claim.

I do not have ED per say but I will say that since I got on Escitalopram for anxiety, I have a hugely diminished sex drive. I can still do it, I just have lost a lot of my desire to. 

 

Holy cow, I had no idea any of this could be tied together if it indeed can be, or if any of it is related. I have a lot more homework to do for sure. 

GeekySquid thank you so much, and I mean that, for taking time out of your day to answer all of this. 

Edited August 29, 2019 by Usaf9498

[GeekySquid]

Atvl va right now on phone cannot really respond well.... definitely research TBI ....any blast sufficient to damage your vestibular system can also be a tbi. U need med eval to be sure..not a ln MD here just familiar with some of the possibilities .

I mentioned some of the possibilities simply because all of ua start where u r...knowimg squat about the VA and getting hosed by that lack of knowledge.

As u learn more u will have more questions

[GeekySquid]

9 hours ago, Usaf9498 said:

Should I do the VA 21-4138

if there is a prescribed form from the VA USE IT... ALWAYS USE IT. not using it has become a reason to immediately deny, which is part of the attempt to look like they are really cutting the backlog or blame it on vets not doing what they are supposed to do.

9 hours ago, Usaf9498 said:

Should I ask them to redo them and put them on the 21-4138 as well? 

yeah

9 hours ago, Usaf9498 said:

So now that it says no longer needed I assume that they already verified it?

no one actually knows. The status messages are so whacked they really cannot be relied on to mean anything. I have had a status message at 9 a.m and by 10 say it was no longer needed....don't sweat it.

9 hours ago, Usaf9498 said:

I did not get a concussion, rather I meant that the concussion of the bomb, gave me tinnitus, and quite possibly the hearing loss. Should I request an MRI?

As I sent in the short response, a bomb blast concussion wave strong enough to knock you down or damage you vestibular system is strong enough to cause a TBI. A 5 mph car crash can cause a TBI.

I am not a doctor but if you DON"T put in for a TBI evaluation there is a 100% chance you will not get rated for TBI.

9 hours ago, Usaf9498 said:

I am overweight and find it extremely hard to lose weight. For whatever reason, I can diet and work out like crazy but for whatever reason, I hold on to my weight. 

weight gain is normal for some people as they get older. The inability to lose that weight or control it can be a genetic/age combo. However, if your pituitary is not working properly no amount of dieting will ever control your weight.

Having an MRI, or an autopsy, are the only two ways to 100% know if you have Empty Sella Syndrome, i.e. a crushed sella. That said, your PCP can consult with an ENT and order a bunch of blood tests including for Adult Growth Hormone, and those results can indicate a problem with your pituitary.

If you have an empty sella that may be SC'd to the TBI from that blast. 

Further info: The pituitary has two functional areas for testing. The anterior and posterior. Different tests are done for function of each area. They are typically NOT done at the same time. you would need to give a quart of blood ...not that much but close, and they usually don't do that bit a draw at one time. My first set of tests drew 18 vials of blood.

9 hours ago, Usaf9498 said:

I do get headaches but I can't say that they are really frequent. The are different from a typical headache however in that they are stabbing pains in my scalp. I can feel them coming on and they just have to run their course. Nothing that I have ever taken has seemed to help them.

I would bet YOUR left nut you are having migraines. I would bet mine but I am attached to it and am not giving it up for anyone.

9 hours ago, Usaf9498 said:

So 3 years ago, I had to go to an opthamologist because in my right eye, I had severe pain and redness, light sensitivity, extreme shooting headache etc.

see above.. these are possible effects of migraines.

think back to the headaches. Does laying down in a dark room help at all? have you tried? for some sufferers even their hair moving hurts them, others it is blinding pain.

The VA uses the word prostrating to describe the event. It means needing to lay down...really needing to lay down. Get past any macho "i can tough it out" self image and analyze if you SHOULD have laid down when you had those blinding stabbing pains.

9 hours ago, Usaf9498 said:

do not have trouble walking a straight line. I do have dizzineess but it is reallly really infrequent. 

the cerebral gait is a requirement of meniere's it just means you drift when you walk. it does not have to happen all the time.

as to the dizziness, when you rollover in bed do you get a "swimming" sensation in your head? even with you eyes closed? if so that is an indication of Nystagmus, a requirement of Vertigo. watch these videos of nystagmus tests and eye movement recordings. Be aware Nystagmus is not only related to vertigo, but is a VA rating requirement for vertigo.

https://www.youtube.com/watch?v=phpe_RVGqcA

https://www.youtube.com/watch?v=FVHbIu_1lD4

9 hours ago, Usaf9498 said:

So far, the VA has not asked me for a C&P for SA. My PC said that I could start getting my SA equipment from the VA but did not tell me how to go about it.

you need your PCP to make a request to the VAMC CPAP clinic to accept the existing diagnosis and issue a cpap. if they agree they will schedule you a fitting.

If you put in a claim for SA and told the VA you had a sleep study at XXXX location, they should request that study from them. They can/may/will also force you to do yet another one in house.

if you do not get a C&P exam request in a month, call Peggy and and send an IRIS request asking what is up.

9 hours ago, Usaf9498 said:

I have frequent and very fast urination. My buddy is always commenting on how quickly i pee.

i am not going to ask why that conversation happens LOL. sorry couldn't resist.  I am two days older than dirt and the idea of discussing my pissing habits with a buddy would never occur to me. In fact telling my Dr I had problems was tough and it is still tough to discuss even here. Just an old guy thing I guess.

Frequency and stream strength are part of a voiding dysfunction diagnosis. too fast, too slow, too weak, too infrequent, too frequent are all possible variants. Different possible characteristics can be caused by voiding problems. discuss OAB with your PCP.

9 hours ago, Usaf9498 said:

Until I got my sleep under control with my CPAP, I used to have accidents at night. 

this is a touchy area to address, but not for the reason you might immediately think.

Do NOT ever ever ever ever ever, did i say ever?, tell your PCP or a C&P examiner that X condition or thing cured Y condition. never never never never never, did I say never?

If you have something that "cures" that problem, then you don't have a rateable problem. If you get rated for ED and viagra helps, fine. Get rated first and never tell them it is "cured".

It is not that you are lying, it is those words will be used against your claim as a reason to deny your claim. You still have the condition but sometimes , okay frequently it seems, that VA will just grab at any reason to make you climb another barrier.

9 hours ago, Usaf9498 said:

I do not have ED per say but I will say that since I got on Escitalopram for anxiety, I have a hugely diminished sex drive.

This would be a claim for Loss of Creative organ and the immediate cause is VA medication. File for SMC(k) for ED. There really is no test for it unless you say your balls were shot off or you developed peyronie's disease or another penile deformity. You just tell the C&P you are mostly limp and viagra doesn't really do it for ya.

Be aware of the connection to a low sex drive to Empty Sella if you have that condition.

9 hours ago, Usaf9498 said:

Holy cow, I had no idea any of this could be tied together if it indeed can be, or if any of it is related. I have a lot more homework to do for sure.

yes you do.

This is the typical problem for veterans. We are not issued a VA to Veteran dictionary.

We don't know that secondary conditions exist or 38 CFR says a butt load of stuff can be rateable conditions. We don't know about C-files, C&P Exams or that being 100% upfront and using human language can screw over our own claims.

We don't know that by "handling things" we are harming our own claims. We don't know that "dealing with it" means that we don't need help from the VA compensation.

To those of us raised to believe in being truthful, it can be a painful twist to realize that your words will be routinely used against you.

you must become your own best advocate.

I highly recommend, that if you can afford it, you invest in an online training course put out by the NVLSP

https://www.nvlsp.org/what-we-do/training

it is 150 and can be essential to learning how to deal with the VA.

I also suggest you check out the Veterans Law Blog by attorney Chris Attig who is featured here from time to time. He also has training material for sale and it is worth it.

If you cannot afford them that is understandable, but you must become your own best advocate and those two resources will help speed that process.

you will be dealing with this stuff for a long time to come, IMO the better informed you are the better your outcomes will be and sooner.

10 hours ago, Usaf9498 said:

thank you so much, and I mean that, for taking time out of your day to answer all of this. 

you are welcome. What I hope you do is learn what you can, keep asking questions, become a strong knowledgeable advocate and pay it forward by coming here and helping others with what you learned. Give back your time once you learn the ropes.  Give back your experiences to help others avoid pitfalls.

we all started at the beginning.. meaning behind the 8 ball. having knowledgeable people who have run the gauntlet and survived is the best resource and thanks anyone can hope for. We are all veterans or veterans spouses/kids here. all trying to do our best to survive the VA fun house.

[Usaf9498]

15 hours ago, GeekySquid said:

I would bet YOUR left nut you are having migraines. I would bet mine but I am attached to it and am not giving it up for anyone.

I kinda like mine too so I don't think I will take that bet!

 

15 hours ago, GeekySquid said:

ou need your PCP to make a request to the VAMC CPAP clinic to accept the existing diagnosis and issue a cpap. if they agree they will schedule you a fitting.

If you put in a claim for SA and told the VA you had a sleep study at XXXX location, they should request that study from them. They can/may/will also force you to do yet another one in house.

if you do not get a C&P exam request in a month, call Peggy and and send an IRIS request asking what is up.

I sent a message to my PCP through myhealthevet this morning asking her the procedure. Thank you for that advice. 

I had seen mention of Peggy before and looked it up this morning. Here in another 10 days, my claim will be ablut 30 days old. I will reach out at that point and see what is happening. 

My mom works with a gal whose husband is not 100% pandt. She told me in an email it took her 5 years to get a C&P for OSA and 3 years for PTSD. 

15 hours ago, GeekySquid said:

i am not going to ask why that conversation happens LOL. sorry couldn't resist.  I am two days older than dirt and the idea of discussing my pissing habits with a buddy would never occur to me. In fact telling my Dr I had problems was tough and it is still tough to discuss even here. Just an old guy thing I guess.

Ha! He is a beer drinking buddy of mine. Honestly the only buddy I have anymore. He always razzes me about it. 

 

15 hours ago, GeekySquid said:

you are welcome. What I hope you do is learn what you can, keep asking questions, become a strong knowledgeable advocate and pay it forward by coming here and helping others with what you learned. Give back your time once you learn the ropes.  Give back your experiences to help others avoid pitfalls.

That is exactly what I plan to do.