BVA and SOC/Ramp narrative changes

[awgv001]

So, awaiting my hearing - filed in April 2019 - originally went through PEB/MEB - then filed my "first" claim in 2015

 

This is something that has been sitting in the back of my mind about my claim (4 contentions in appeal, TBI, back, bilateral neuropathy, etc.) that has me puzzled.

When my VSO and I sat down an looked over the paperwork for filing, I took note that my other issues on appeal are being claimed as secondary to tbi. I feel as if trying to SC on secondary may be in question, though the SC is not.

I'm wondering if this may hurt my claim or not because it wasn't until recently that I was SC'd for PTSD(after 3 years and several denials) (Claimed as MST/PTSD - however, there is also evidence of other personal assault(s)...)

I'm focused particularly on my Nexus statements, all of which are from VA Doc's, (and 3 Nexus' in particular) - the Nexus(s) im referring to for tbi does not include a rationale that speaks about the ptsd, but instead notes some other "significant" events leading to tbi.

I have a diagnosis for TBI, but on the last denial it stated that it wasn't a "conclusive" diagnosis.

...what are they talking about???

 

It says outright on the page(s).

First - the IME/IMO done by the VA specialist - an MD -

"Based on my initial evaluation, and his medical records, I am treating him for symptoms related to a traumatic brain injury resulting from trauma that occurred during his military service."

As if this quote wasn't enough, the next one says (my local VA doc, also an MD),

"I concur with the diagnosis of TBI caused by ..."This was confirmed on 2 separate visits to XXX" .... on active duty" - "It is my medical opinion that it is more likely than not that the current symptoms of TBI .... are a direct consequence of the injury(ies) he sustained on active duty."

 

I noted that the narrative also changed on the reasons and basis between the SOC and the Denial letter.

Ramp decision for denial ( Jan 2019 ) - "You were previously denied SC because the evidence at the time did not show an event, disease, or injury, nothing in STR's, and no current Diagnosis.

STR's show a consult from (Neuro 2012)  which you reported a syncope episode (Blackout) with no history of a head injury or trauma (WHAAATTT!?!? - Red flag here..when you combine with the details from lay evidence - it was witnessed my head struck first, this was also reported to this particular doctor (again 2012) but for some unknown reason, he failed to list it as such) I wish this record could be amended, but instead I'm just using other evidence so they just toss it out. - Ironically this was also noted as a favorable finding because when the good doctor quoted me, he did put in his report that I had an episode of syncope.

"In support of your claim you submitted a lay statement from X which indicates a personal knowledge or observation of etc etc. The lay evidence, however, was not found to be competent and sufficient in this case to establish a link, or to establish that such a link has been found by a medical professional. ----( Not anymore! )

I re-filed in 2017 but they basically threw it out again for "VA treatment records from x to x show that you were seen for symptoms that possibly were due to a TBI. However, CONCLUSIVE findings did not show a Dx of TBI" (To which I had submitted evidence stating otherwise)

SOC -

"RD dated...denies for no STR's with complaints, treatment, or diagnosis"...Here it says "You stated on your NOD the the injury occurred prior to your deployment....you also submitted a lay statement that you injured your head in XXX, however on XXX You told Dr. X - that you suffered a head injury during deployment. ---- If it happened on active duty, it happened during service right? What are they getting at here? Injuries that could have caused TBI occurred both BEFORE and DURING deployment, I feel like this is them trying to attack credibility.

"On XX your were treated for your vision symptoms by Dr. X - There YOU reported and Dr. X recorded that you denied a history of head trauma and head injury. Your STR's from 2012 list a history  of health problems and complaints that you had in service. Head trauma, brain injury, or falling is not listed. Dr. X statement, recording what you stated while receiving medical treatment for a different issue is contemporaneous to your military service and convincing evidence that you most likely did not incur a head injury or TBI in service. Service connection remains denied. -- (hold up, did they just Opine this via SOC? LOL, didn't know that was a thing)

The Nexus for my back injuries and the latter came from my PCP that opined that my back injury was DIRECTLY service connected. - What's your thoughts here on this with regard to what was mentioned above?

I don't know how the VA will eventually connect these contentions, and can only assume how this may pan out.

 

Anything else that could help me here in preparing for BVA that I'm missing?

[awgv001]

20 minutes ago, vetquest said:

Please do that, looking at secondary's.  If your TBI is SC than they will probably rate it to 2015 when you filed your claim.  The reference you referred to in the relation of primaries and secondary's would be hard to use to get your EED moved to earlier.  Not saying you should not try but I do not think they will go for it.  The VA likes to use the excuse that the evidence available at the time of decision was what was used to determine disability.  Meaning that even though you are now diagnosed with something different the VA does not have to look back and change a diagnosis.  I fought that battle once and was denied outright.

Well, I also filed for a medical record amendment - and if that is granted, it will provide the medical evidence with the appropriate date of when I had that exam!

This part is a work in progress still - but it is easier(exponentially faster) IMO to ensure that my records are more consistent. Plus they used the un-amended version both as negative evidence, and positive evidence, mainly because the doctor did not accurately reflect what I explained to him - so the whole time I was being evaluated by him, he remarked as if I had passed out, but that passing out alone didnt cause a head injury... (Guess what, my head hit the ground first, and thankfully (to much embarrassment) there were a ton of witnesses present.)

Edited January 22, 2020 by awgv001

[Buck52]

Never underestimate what a TBI can cause years down the road  and most VA Dr's are on to this,  & never over exaggerate your symptoms. 

Always be totally honest with all these Dr's  we have a member here with a Severe TBI and he is still doing claims  he is up to SMC t I think?

[blahsaysme2u]

2 minutes ago, Buck52 said:

Never underestimate what a TBI can cause years down the road 

i didnt have a severe TBI, but even a mTBI causes serious effects. i just recently discovered a disorder called aphantasia. this is "mind blindness" where i cant picture faces, objects etc. only black kaleidoscope of colors and "stars/fireworks" when i close my eyes. this is a know disorder for many years but just recently has been named and has very little research on it the subject. but i never had these symtoms growing up or while in the military, just after my IED injuries. and i only recently realized i had the symtoms, since the mind is great at adapting and filling in missing information, i never noticed a change until i heard about this and was asked to visualize in my mind the events that happened(PTSD couseling) and wondered why i couldnt see anything. 

if you are interested in this subject, look up http://sites.exeter.ac.uk/eyesmind/

there also maybe links to PTSD triggering this disorder(early studies show children with traumatic experiences are later diagnosed with this)

for what its worth!

[Buck52]

1 hour ago, blahsaysme2u said:

i didnt have a severe TBI, but even a mTBI causes serious effects. i just recently discovered a disorder called aphantasia. this is "mind blindness" where i cant picture faces, objects etc. only black kaleidoscope of colors and "stars/fireworks" when i close my eyes. this is a know disorder for many years but just recently has been named and has very little research on it the subject. but i never had these symtoms growing up or while in the military, just after my IED injuries. and i only recently realized i had the symtoms, since the mind is great at adapting and filling in missing information, i never noticed a change until i heard about this and was asked to visualize in my mind the events that happened(PTSD couseling) and wondered why i couldnt see anything. 

if you are interested in this subject, look up http://sites.exeter.ac.uk/eyesmind/

there also maybe links to PTSD triggering this disorder(early studies show children with traumatic experiences are later diagnosed with this)

for what its worth!

TBI's Are all new even for most Dr's , the last say 20 years or so or since the Gulf Wars Started up...most of us older Veterans if we had a head injury they called it shell Shocked or PTSD, war war I AND II And the Vietnam War...which I am a combat Veteran from that war.(Conflict) sorry.

TBI were never thought about then..so now that were in the 20.s they are doing more and more studies on the TBI  and they are still doing research.

  so I tell every Veteran I know or in contact with to never underestimate a TBI...when your head takes a sudden bolt   there's no telling what can happen in the future or late future  so its best the VA give the Veteran the benefit of the doubt, because we don't know what all a TBI can cause in the future its best they let TBI Veterans get their claims in and be ready for what might await this Veteran and his family.

[blahsaysme2u]

20 minutes ago, Buck52 said:

when your head takes a sudden bolt   there's no telling what can happen in the future or late future  so its best the VA give the Veteran the benefit of the doubt, because we don't know what all a TBI can cause in the future its best they let TBI Veterans get their claims in and be ready for what might await this Veteran and his family.

not to mention just the blast percussion(blast wave) is just as damaging. lots of data out there on just blast  exposure(like AT4s etc)... great advice Buck!

https://www.npr.org/sections/health-shots/2018/04/30/606142634/report-to-army-cites-concussion-risk-of-weapons-blast-to-the-shooter

https://www.cdc.gov/masstrauma/preparedness/primer.pdf

 

[awgv001]

On 1/22/2020 at 11:53 AM, Buck52 said:

if you suffer from a TBI you may have all kinds of Medical problems in the future.

  You may want to check out all the Symptoms a TBI can cause and see if you have any of those?...you be surprised at all these symptoms..if you have any of these symptoms=

So, on my original claim (going back to MEB/PEB) I was checked out for vision changes via ophthalmologist - Nothing unusual was reported for my eyes, then, migraines - examined by an off-base neuro, and such, but it was never diagnosed as TBI until after service.

The person evaluating my migraines recorded syncope, but didn't record a LOC, or that the syncope ended in the form of a fall.

PEB found me unfit at 10% for nerve damage to my left arm. Migraines don't get a rating for DoD (BUT TBI'S DO)

These were the only contentions on the original claim:

VA SC'd for 40% for my left arm nerve damage, migraines, and tinnitus, (0% for each --- pes planus, left wrist strain, and a scar)

Note -- My CO's report details that I missed 40 hours of work per week - He's not a doctor but shouldn't his input on this have like, a TON of weight in light of the circumstances?

THIS WAS NOT EVIDENCE LISTED OR REVIEWED FOR MY RATING DECISION ^^^^

Symptoms present at the time of MEB/PEB

• Headache/Migraines
• Vision changes & Photophobia
• Tinnitus

(LOC was not in here because it could only be verified by a witness to the incident - which I have, but only after separation.) You are not allowed to report your own LOC.

I didn't even fill out the items being claimed on sheet myself, as I had no understanding of what I was looking at, or what I could potentially claim. They pointed out every line I had to sign.

All of these filings that I have done and disagreed with (I'm now awaiting at the BVA level) and yet not a single one of them ever triggered a C&P exam, however I did get referred out to another neuro, and with all the other evidence in tow - hastily gave me both diagnosis and Nexus. The RO then kicked my claim back at me one more time after turning those in saying that it wasn't a "conclusive diagnosis"

--- The treating Neuro post-service wrote this statement, that they had as evidence at the time they made this decision - Here it is verbatim

"I AM TREATING HIM FOR SYMPTOMS RELATED TO A TBI RESULTING FROM TRAUMA THAT OCCURRED DURING HIS MILITARY SERVICE. THIS DIAGNOSIS AND MY TREATMENTS ARE IN EACH OF MY CLINICAL NOTES FOR YOUR REVIEW."

This has now been followed up by yet another doctor as evidence to take with me up to BVA, who stands with the first doctor saying

"HE HAS BEEN DIAGNOSED WITH TBI BY THE (city) VA TBI CLINIC" "I CONCUR WITH THE DIAGNOSIS CAUSED BY THE FALL....IT IS MY MEDICAL OPINION THAT IT IS MORE LIKELY THAN NOT THAT THE CURRENT SYMPTOMS OF TBI INCLUDING...(LIST OF 2ND'S)... ARE A DIRECT CONSEQUENCE OF THE INJURY HE SUSTAINED WHEN ON ACTIVE DUTY."

---

I'm trying to do all that I can to strengthen my claim, you guys are all I have when it comes to battle here...Any help outside of here has been next to worthless.

From the bottom of my heart, without you guys, I would most likely be homeless or dead.

Thank you for everything!

Edited January 31, 2020 by awgv001
Brain doing dumb things again.