Need advise on manic depression reactive, anxiety and headaches claim

[usmcrm65]

I filed my first VA claim back in November for Manic depression, anxiety, headaches, tbi, thoromcolumbar (back pain), ridiculopathy (sciata), tinnitis, and hearing loss.  I received a total service connected rating of 40% for the back pain, sciatica, tinnitis and hearing loss but the depression, anxiety, headaches and tbi were all given "not service connected."  I have a diagnosis and receive treatment from VA doctor and medication for the depression, anxiety and headaches but VA did not order a C&P exam for those conditions.  My formal Decision letter states that the evidence doesn't support service connection but I don't know what they used as evidence.  How do I go about requesting my service records and also can I request a C&P exam for the mental stuff and DBQ?  Not sure what to do from here but my issues stem from a physical assault by a sergeant.  I reported the assault and the sergeant was reassigned from my unit but that was 30 years ago, not sure if it's in my records but it should be.  Any guidance on this would be appreciated.

Edited March 3, 2020 by usmcrm65

[Vync]

Here's how to request your service records: https://www.va.gov/records/get-military-service-records/
 

Your personnel file can also be downloaded via the Blue Button feature on my health VA.gov depending on when you got out. I got out in 1995 and my personnel file was available. My father retired in 1990, but his was not available. 

 

You can also contact your VAMC's Release of Information Office and request your service treatment records plus and VA treatment records.

The decision letter should explain why they denied each condition. The VA first tries to verify if it occurred or was treated in service. If they don't find anything, then they will next check any treatment records for the first year after you got out. If they don't find anything there either, then they will deny.

If you kept in touch with some of your military buddies, they might be able to write you a buddy letter. It needs to be objective and describe what they saw.

 

The decision letter should explain why they denied each condition. Keep in mind the VA often wrongfully denies claims even if you had sufficient evidence.

 

[broncovet]

THIS is the criteria VA is required to use for SC:

1.  Current diagnosis

2.  In service event or aggravation

3.  Nexus or doctor's opinion that your current diagnosis is at least as likely as not due to the in service event or aggravation.  

     If you dont have a documented "in service event" then the doctor can not opine that a non existant event caused your current diagnosis, so no c and p will be ordered.  

     However, I smell a rat.  38 cfr 103 requires the VA give a written decision on your claim.  You did not indcate that they were denied with a decision.  This means your claim is "still open".   I would ask for the status of your claim for "depression, anxiety, headaches".   

     Now, you still need documentation of the above.  But buddy letters may suffice.  For example, one of your buddies "may" have been present when you had a tbi and was present at this trauma where you got hit on the head some way.  This may suffice for documentation of an in service event, if you are not able to get it elsewhere.  

    Are you currently going to treatment for these conditions?  

[usmcrm65]

14 hours ago, broncovet said:

THIS is the criteria VA is required to use for SC:

1.  Current diagnosis

2.  In service event or aggravation

3.  Nexus or doctor's opinion that your current diagnosis is at least as likely as not due to the in service event or aggravation.  

     If you dont have a documented "in service event" then the doctor can not opine that a non existant event caused your current diagnosis, so no c and p will be ordered.  

     However, I smell a rat.  38 cfr 103 requires the VA give a written decision on your claim.  You did not indcate that they were denied with a decision.  This means your claim is "still open".   I would ask for the status of your claim for "depression, anxiety, headaches".   

     Now, you still need documentation of the above.  But buddy letters may suffice.  For example, one of your buddies "may" have been present when you had a tbi and was present at this trauma where you got hit on the head some way.  This may suffice for documentation of an in service event, if you are not able to get it elsewhere.  

    Are you currently going to treatment for these conditions?  

I am getting treatment for these conditions from the VA.  They denied service connection though.  I don't know what's in my personnel records but I was assaulted by a sergeant and the assault was reported, but I have no idea what is in my service records.  The decision sounds like they were not able to verify the assault from my records but I don't know for sure.

[awgv001]

43 minutes ago, usmcrm65 said:

I am getting treatment for these conditions from the VA.  They denied service connection though.  I don't know what's in my personnel records but I was assaulted by a sergeant and the assault was reported, but I have no idea what is in my service records.  The decision sounds like they were not able to verify the assault from my records but I don't know for sure.

Devil Dog,

Get (copies of) that report, (See information on obtaining C-Files, or take a trip to your Regional Office(VARO) to view and make copies in person, it's worth the trip.) bring it to your (VA) care providers, and request their impression on your chronic illnesses and how they relate to the event you shared with us. They should be able to link the stressors of your assault(s) and the complications you face from it. Good on you for getting treatment, it may not only help you medically, and will also contribute to factors in your claims.

I'm in a similar boat, with diagnosis for TBI (NSC...yet, pending BVA hearing). I have been referred to Neurology for the 3rd time, this time armed with a TBI DBQ which will potentially save me from a C&P/Remand (adds at least 18+ months to claim potentially) once my claim lands in the BVA judge's hands. You can request the same (from Neuro). To clarify, they showed in their decision of my claims (from a DRO mind you) that despite a (chronic) diagnosis, witness statements, and a valid and competent Nexus, they still had not issued a C&P exam (hence why I'm pursuing to have a complete DBQ filled out), and included their own opinion to deny my claims. I encourage you to get in touch with buddies you served with if possible, and have them jot down a reflection of the events they witnessed, if any. Perhaps they noticed behavioral changes after a certain point of time, and conduct remarks in your SRB also contribute for evidentiary purposes too.

We have to do our due diligence, and with significant attention to detail.

Edited March 4, 2020 by awgv001

[usmcrm65]

12 minutes ago, awgv001 said:

Devil Dog,

Get (copies of) that report, (See information on obtaining C-Files, or take a trip to your Regional Office(VARO) to view and make copies in person, it's worth the trip.) bring it to your (VA) care providers, and request their impression on your chronic illnesses and how they relate to the event you shared with us. They should be able to link the stressors of your assault(s) and the complications you face from it. Good on you for getting treatment, it may not only help you medically, and will also contribute to factors in your claims.

I'm in a similar boat, with diagnosis for TBI (NSC...yet, pending BVA hearing). I have been referred to Neurology for the 3rd time, this time armed with a TBI DBQ which will potentially save me from a C&P/Remand (adds at least 18+ months to claim potentially) once my claim lands in the BVA judge's hands. You can request the same (from Neuro). To clarify, they showed in their decision of my claims (from a DRO mind you) that despite a (chronic) diagnosis, witness statements, and a valid and competent Nexus, they still had not issued a C&P exam (hence why I'm pursuing to have a complete DBQ filled out), and included their own opinion to deny my claims. I encourage you to get in touch with buddies you served with if possible, and have them jot down a reflection of the events they witnessed, if any. Perhaps they noticed behavioral changes after a certain point of time, and conduct remarks in your SRB also contribute for evidentiary purposes too.

We have to do our due diligence, and with significant attention to detail.

Thanks for replying!  Unfortunately I have been out of service for 30 years and have long since lost contact with anyone who could give a buddy statement.  The assault has had a major impact on me over the years and I shared that with my treating doctor.  She said there should be a record of the assault in my personnel files since it was reported and the sergeant was reassigned.  I"m going to request a copy of my records and see if I can find anything.  Other than that, I don't know how I would be able to prove it happened.  I feel like it's a lost cause.  I have the decision and am copying the results for the various denials below:

 

Is there any way to get service connection in my case?  How do I get them to give me a C&P Exam or DBQ for manic depression anxiety, and TBI?  Can I request it?

[awgv001]

37 minutes ago, usmcrm65 said:

Thanks for replying!  Unfortunately I have been out of service for 30 years and have long since lost contact with anyone who could give a buddy statement.  The assault has had a major impact on me over the years and I shared that with my treating doctor.  She said there should be a record of the assault in my personnel files since it was reported and the sergeant was reassigned.  I"m going to request a copy of my records and see if I can find anything.  Other than that, I don't know how I would be able to prove it happened.  I feel like it's a lost cause.  I have the decision and am copying the results for the various denials below:

Is there any way to get service connection in my case?  How do I get them to give me a C&P Exam or DBQ for manic depression anxiety, and TBI?  Can I request it?

I don't have much time right now, but I will get back to you on the denial points unless one of the elders tackle it.

I did catch a glimpse of one thing while "skimming" - they said you don't have a diagnosis for headaches - for which since you are trying for TBI, you'll probably have to see a Neuro to get that checked out further (it's a common secondary of tbi)

Somehow or another the VA's Duty to Assist is triggered in various ways, albeit that human error can happen at any point along our claim's journeys. I don't know anything about requesting a C&P, however, you can get a DBQ for the related contentions in the link below, match up the dbq to your issues with the closest body part/function - take them to the appropriate doctor, your PCP should be able to guide you in the right direction in getting those completed, and you may need referrals. Things like TBI and PTSD require specialists, and for PTSD in particular it HAS TO BE a VA Dr. to diagnose you for it. They do not accept private care diagnosis for that in regard to claim benefits. Your testimony, along with the record of the event should be enough to satisfy the requirements of the "event" in service. There may also be copies of any statements you gave during/around this timeframe - those will be very useful too, or if you kept a journal of some sort (I jotted things on a notepad in my shirt pocket from time to time). Don't just DBQ though, get a Nexus to link it all together to your ailments!

https://www.benefits.va.gov/compensation/dbq_disabilityexams.asp

Edited March 4, 2020 by awgv001