supplemental claims sent in oct 3, 20 and all denied in 5 days or less

[datart]

I sent in the supplemental claim form with attached statement in support of claim and added evidence. It took only five days or less to deny my requests on several issues.  I don't think they looked at anything other than supplemental claim form and nothing else. I did not use a VSO although the american legion is listed as my VSO (i tried contacting them but never got any appointments, etc, they ignored me and same with DAV, and others too).  I did my original claims on my own, no help from anyone (I recently found you site searching about this).  I managed to get 60% disability.  I suffer from IBS and was told by the examiner I needed proof of a diagnosis.  I had a diagnosis from a specialist who has moved around and no longer has records for me as they were from over years ago. I found a record of being sent to him and being prescribed meds for IBS and then getting another drug as the first was causing issues.  I don't like drugs and so over the years i would get a prescription from a doc in the box when IBS was flared up. I had to this in July as I was stressed, upset as I lost a brother and nephew to covid in June.  I sent this in with my claim and proof that I still suffer daily and get meds when it is really bad, as i thought when in doubt the VA gives the vet the benefit of the doubt.  IBS then would benefit my claim of auto immune disease and other odd illnesses that all started in same time frame.  I guess they don't want that as I am a Gulf War vet and that mean gulf war illness and harder to deny associated illnesses like skin cancer, pre cancerous lesions, unexplained rashes, Reynolds syndrome, etc.  I served in guam, california, on board uss missouri.     It just seems odd they got my claim and decided in record time, is this common these days?  What can i do as I don't want to start over as that would mean losing that time and payments if given high enough ratings.  Some things i just asked to get service connected like my ankles but they said there is record of it but not an issue today.  VSO is that good route if there are any good ones that could help.  Of should i try the legal route with a lawyer?  any suggestions and experiences .  thank you

[GBArmy]

datart Welcome to Hadit brother. Here's the deal. To receive an approved disability claim you need the Caluza Triangle: a current diagnosis, an event or illness of the injury in-service, and a connection or nexus to the two. Doesn't sound like you meet the first and 3d. Current diagnosis. If you don't have a current doc, go get one and get a diagnosis and current prescription. Key word: current, not years ago. Not hard to do. Next ask the doc if your current symptoms are related to your in service time. Do you have any med records showing IBS symptoms while in service? If you had issues while in service, you need to prove it. Get your str's if you don't have them. The doc has to review your records and determine that your in service injury is the cause of your current problems i.e. "at least as likely as not" caused by your in service injury. Read up on what a nexus letter is so it is in a format that will work for the VA. Now understand you are up against a rock and a hard place: you already were denied twice, so your appeal has to be right on. I would suggest you consider getting a specialist who will opine the diagnosis and nexus and that will cost you some $, but if you don't it's going to be difficult to get past the history you have created. You can submit a new supplemental claim within a year and still keep your EED.

[broncovet]

I agree with GBArmy.  Get your records and check to see if you meet the Caluza triangle.  (aka Caluza elements). 

My advice is "not to do anything" until you get the envelope, dont rely upon ebenefits.  After you get the decision letter, its likely you will need to appeal it, but dont do that now, because you want to see their reasons for denial.  Then refute those reasons.  Example:

VA letter states:  "Your claim was denied because you dont have a diagnosis in service".  Your response:

Quote

Caluza vs Brown does NOT require an in service diagnosis, but an in service event or aggravation.  My in service event is located on page 14, of my medical in service records where "I was punched in the stomach" and had to go to sick bay. 

 

[Buck52]

Yes Sir I totally agree with GBArmy  he has some great advice.  use it.

[Tbird]

 

[Buck52]

Also if you have Myhealthevet...check your medical notes and see if you have anything related in them that is in your favor.

LOOK TO SEE WHAT THE VA DR'S have mention about all your medical related problems.

[datart]

On 10/19/2020 at 10:27 PM, datart said:

I sent in the supplemental claim form with attached statement in support of claim and added evidence. It took only five days or less to deny my requests on several issues.  I don't think they looked at anything other than supplemental claim form and nothing else. I did not use a VSO although the american legion is listed as my VSO (i tried contacting them but never got any appointments, etc, they ignored me and same with DAV, and others too).  I did my original claims on my own, no help from anyone (I recently found you site searching about this).  I managed to get 60% disability.  I suffer from IBS and was told by the examiner I needed proof of a diagnosis.  I had a diagnosis from a specialist who has moved around and no longer has records for me as they were from over years ago. I found a record of being sent to him and being prescribed meds for IBS and then getting another drug as the first was causing issues.  I don't like drugs and so over the years i would get a prescription from a doc in the box when IBS was flared up. I had to this in July as I was stressed, upset as I lost a brother and nephew to covid in June.  I sent this in with my claim and proof that I still suffer daily and get meds when it is really bad, as i thought when in doubt the VA gives the vet the benefit of the doubt.  IBS then would benefit my claim of auto immune disease and other odd illnesses that all started in same time frame.  I guess they don't want that as I am a Gulf War vet and that mean gulf war illness and harder to deny associated illnesses like skin cancer, pre cancerous lesions, unexplained rashes, Reynolds syndrome, etc.  I served in guam, california, on board uss missouri.     It just seems odd they got my claim and decided in record time, is this common these days?  What can i do as I don't want to start over as that would mean losing that time and payments if given high enough ratings.  Some things i just asked to get service connected like my ankles but they said there is record of it but not an issue today.  VSO is that good route if there are any good ones that could help.  Of should i try the legal route with a lawyer?  any suggestions and experiences .  thank you

 

18 hours ago, GBArmy said:

datart Welcome to Hadit brother. Here's the deal. To receive an approved disability claim you need the Caluza Triangle: a current diagnosis, an event or illness of the injury in-service, and a connection or nexus to the two. Doesn't sound like you meet the first and 3d. Current diagnosis. If you don't have a current doc, go get one and get a diagnosis and current prescription. Key word: current, not years ago. Not hard to do. Next ask the doc if your current symptoms are related to your in service time. Do you have any med records showing IBS symptoms while in service? If you had issues while in service, you need to prove it. Get your str's if you don't have them. The doc has to review your records and determine that your in service injury is the cause of your current problems i.e. "at least as likely as not" caused by your in service injury. Read up on what a nexus letter is so it is in a format that will work for the VA. Now understand you are up against a rock and a hard place: you already were denied twice, so your appeal has to be right on. I would suggest you consider getting a specialist who will opine the diagnosis and nexus and that will cost you some $, but if you don't it's going to be difficult to get past the history you have created. You can submit a new supplemental claim within a year and still keep your EED.

i got the denial letter yesterday.  I sent the paperwork and they got it on the 5th, on the 9th i was denied.  I never knew the va worked this fast.  i appreciate your suggestions and i guess i will have to go to a specialist and get a current diagnosis for ibs as it is a presumptive illness for gulf war vets.  my autoimmune disease is  undifferentiated connective tissue disease" (UCTD) because they could not determine what i have as i was tested for all kinds of diseases. I have rashes, other issues that all appeared in a cluster as Medically Unexplained Chronic Multisymptom Illnesses. Gulf War presumption applies to MUCMIs and infectious diseases as well as undiagnosed illnesses.  showing old medical records and history of being treated and giving meds, years ago and now show current diagnosis and treatments should be enough right.  i didn't think a nexus letter was needed and the benefit of doubt would go my way.  reading your response i guess if it is not chronic and something i have issues with currently, even if there is records of injuries of my ankles for example, then no service connection just a note saying in was in your records but sorry, no rating of even 0.  skin issues, i have sun damaged skin and have things burned, cut, etc, sometimes cancerous, mostly pre cancerous, that was denied.  i saw a case of a WW2 vet 40 years later got it service connection and awarded 30, and they gave him the benefit of the doubt.  

i can't get the legion to assist and i tried in the past.  other vets said you can't get anyone around here to assist who knows anything.  so, i am thinking maybe suck it up and try a lawyer.  does having a law firm submitting this help.