Backdated Diagnosis

[awgv001]

How does an individual go about obtaining a backdated diagnosis - I'll give an example -

Veteran is in service and reports secondary symptoms of a well known issue.

The veteran is not a doctor, and doesn't recognize that these symptoms reflect upon a much bigger issue.

They put in a claim for the secondary conditions, and are unchallenged for service connection, however, the causal injury/disease is ignored,undiscovered, or omitted for some reason or another. Everything points to the causal injury as being the "origin" of the secondary conditions.

A diagnosis for the causal injury/disease finally happens, years after the veteran exits service, and now it's up to the veteran to make corrections and attempt to repair their claims history.

There is information in regard to "causal relationships to SC'd secondaries and original injuries via ---- M21-1 III.iv.5.C.3.g.  Correlation Between Effective Date for Primary and Secondary SC Disabilities

Would it benefit the veteran to have an exam that reflects that the causal injury has a backdated diagnosis date, or something that shows that "the disease manifested on XXXX date, the day the injury etc. occurred" just to spell it out, creating a fairly damming case for EED's as well as proof of diagnosis, and cover all the "when's"?

 

[awgv001]

1 hour ago, broncovet said:

1.  You submitted new evidence under 38 cfr 3.156.

2.  You have a pending claim that VA never adjuticated.  Remember, prior to about 2012, an informal claim would suffice.  Now you have to fill in a form, but back then, an doctor visit can be construed as a claim for increase.  

      Have you applied and received benefits for TBI??  Have you been diagnosed with it (now)? 

@broncovet I submitted at least 1 of each of the Caluza elements back in 2015 when I filed a "New" claim for TBI so it doesn't quite fit the bill for your (#2) I suppose....not sure how its handled since it has been adjudicated once, however it is still open and in appeals now, but no matter, and it came back with them saying it was an "inconclusive diagnosis" at the last point of denial --- though we had done second level TBI evaluations as well as a separate statement from my neuro himself that says quote "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. This diagnosis and my treatments are in each of my clinical notes for your review."

Diagnosis, check, IMO, check.....I'm having a DBQ done on Tuesday for TBI with my PCP while my claim sits in appeals at the BVA.....

OH - I can see that how the doctor wrote that could confuse a rater since his verbiage was "symptoms related to TBI" --- they just said...well, that's not specifically TBI.

So the next doctor wrote - "I concur with the diagnosis of TBI caused by ...... he suffered on active duty." W/ subsequent chronic headaches as a consequence...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 he sustained on active duty."

So, if anything, I hope that the second doctor make it pretty bulletproof and straightforward.

Edited February 8, 2020 by awgv001

[vetquest]

You never know until you try.  I was rated at 0% at discharge, my rating went to 30%, 10%, 30% and ten years later to 50% all as to the date of discharge.  I also was rated for a disability with ten years of back pay another time.  The most important thing is that you keep an active case going.  What I mean is that you keep your case open by appealing the decision when you think that the VA is incorrect.  The VA has many ways to deny you a rating but as long as you do not give up you can prevail.  Sometimes the VA will claim the facts were determined as of the last C&P they sent you to.  If you quit there you are done, appeal for an EED.  On our side we have lawyers and the BVA and CVA.

Good luck.  A VA head staffer one time told me the VA does not award persistence.  He was right but that was before we had the option to use lawyers and the CVA.  Some things have changed for the better.