IBS presumtive?

[SPO 21]

I have been recently diagnosed with IBS.  They have already verified through colonoscopy, blood-work, and stool sample that my issues are not cause by anything such as chron's or ulcerative colotis, so it is a functional condition with no definite explanation as to what started it.  I did deploy to Iraq 3 times from 2005-2007, for a total of about 22 months.  I'm not 100% if I can file this as a presumptive claim since I've been out for 11 years and the issues.  How would I go about submitting as presumptive?  As usual, everyone's help is greatly appreciated.

[shrekthetank1 720]

So you have done everything you need to do to show you have IBS.  You also meet the presumptive list to make this claim!  

There used to be when you filed and I think there still is a list of dualities when you open it and it will ask if it is a presumptive  disability.

I would go there asap and file and get the ball rolling!  I think there is still a year on the time you have to file, but each month that passes is a month you miss out on!  

[SPO 21]

Luckily I already submitted a Intent to file while I was waiting to get all my testing done.  As far as what I need from my doctor, will just a dbq suffice? and I guess in this case she doesn't need to do a nexus since its presumptive?  

[shrekthetank1 720]

You can get one, but you really only need to file and do your C&P exam as they will do one there anyways.  This will just be them checking what you say with the information you submitted.  I would not but it is up to you as it may speed it up!

[Guest]

Please keep in mind that IBS can be service connected as directly and secondary not just as presumptive.  It really depends on the evidence in your records and or any nexus and medical rationale.

[SPO 21]

Thanks guys,  I don't believe I have any significant information in my SMR to justify a direct service connection.  The symptoms I've been having have been going on for about 1-2 years now, so it started about 9-10 years after discharge from active duty.   I believe I would qualify a the 30% level since I have issues everyday, sometimes multiple times a day.

[shrekthetank1 720]

Do you have GERD also?  

[SPO 21]

No,  some how I've been lucky enough not to have to deal with GERD, at least so far.  Is there any specific way to word this claim in the application, and support statements to make sure they see its a gulf war presumptive so it doesn't get denied.  I've heard the VA likes to play games with these types of claims.

[shrekthetank1 720]

I believe inside the claim there will be a way to link it to the Gulf war.  I would also do it a couple of ways as to what matches what you are going through.  You will see this part then you go to put the condition in.  Like for my GERD I put down Gulf War with it and they have now removed this and made it secondary to my IBS.  

See what best fits when you are filling it out and then let them sort it out.  Mine was probably the shortest of all mine at about 3-4 months.

[SPO 21]

Can I also claim a secondary to a presumptive in the same claim, or do I have to wait until the presumptive claim is completed?  In this case internal Hemorrhoids found during the colonoscopy to diagnose the IBS.  The doc suggested the they were probably cause by the IBS symptoms and colonoscopy prep.

[shrekthetank1 720]

I think you can and should.  As this will preserve the EED and even if you need to appeal you will have the record.  

[GBArmy 1,436]

I agree 100% with Shrek; file now. Do you have any side affects from meds the VA is prescribing for IBS. If you take meds, look up their cautions on Google; if you do have some symptoms, include those as disabilities as well. It would be helpful if you talked to your doc and ask, hey doc, does this xxx drug cause my xyz issues or at least contribute to those conditions? If the doc says yes, then ask him to put it in your process/procedure notes. Add that to you claim as well as a medical issue/journal that says the same. 

[SPO 21]

I've already put in my intent to file, just waiting to get back to the doc for followup and get them to fill a dbq out.  as soon as thats done im planning on filing.

A nurse practitioner is acceptable for a DBQ, correct?

Edited March 18, 2020 by SPO

[SPO 21]

I'm not sure exactly how much it will help in this claim, but my VA primary care listed my IBS on my VA problem list.  Seems like I managed to find a good VA doc.

[GBArmy 1,436]

SPO To answer your previous question, yes a NP can do a dbq for you. (Didn't see your question, sorry.)

[SPO 21]

If I am going to submit VA medical evidence for a fully developed claim or decision ready claim for this issue, should I just include a copy of my blue button report from Myhealthevet?  That is the only way I know to easily get ahold of that info.

[GBArmy 1,436]

SPO I would certainly include a copy of the report. And be sure you save a hard copy for yourself. It so happens the VA "overlooks" evidence in our medical files, even when we call them out in a claim. If you submit, it has to be reviewed because you called it out in your documents. I'm not paranoid; it happens.

[SPO 21]

I have a few more questions specifically about filing this claim.  I have not received a copy of my c-file yet, should I wait until I get it so my private GI doc can review it before filling out the DBQ?  If I file now will it delay my c-file even more (already been 10 months)? Will my claim pretty much just end up sitting with no work being done anyway because (from what I have heard) most C&P exams are being postponed?

[GBArmy 1,436]

SPO Certainly not ALL C&P's aren't being postponed; I have a new one ate LHI next week. Possibly there are at the VAMC's though.

[SPO 21]

Is there anything specific I should as the Doc to put in the remarks section on this dbq?

[shrekthetank1 720]

Below is exactly what you should be putting into remarks.  Like For veterans with daily IBS episodes of diarrhea, constipation, or severe gas and bloating, this could be the most appropriate rating.  This is my issues as it always goes back and forth and it just sucks.  I know it will be weird talking about it, but you have to tell them how bad it is!  Also there are more issue which can be onset because of this like hemorrhoids and muscles not able to keep things closed.  Sadly this might not ends at just IBS.  

Under the 0% criteria, a veteran’s Irritable Bowel Syndrome must be considered mild. For VA, “mild” translates into “disturbances of bowel function with occasional episodes of abdominal distress.” The VA does not define “occasional episodes” so veterans and attorneys can argue what should be considered occasional for that veteran.

In order to qualify for the 10% criteria, the Irritable Bowel Syndrome must be considered moderate with “frequent episodes of bowel disturbance with abdominal distress.” Similar to “occasional episodes,” the VA does not define what it considers as “frequent episodes” of IBS. Bowel disturbance can be considered episodes of diarrhea or severe gas and bloating.

The highest rating for IBS is 30% and is characterized as severe with “diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress.” This is the highest rating you can get for IBS through the VA and veterans must show that their IBS causes them to be almost constantly in pain. For veterans with daily IBS episodes of diarrhea, constipation, or severe gas and bloating, this could be the most appropriate rating.

Edited April 1, 2020 by shrekthetank1