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Example of Private Dr opinion that is probably (more than) adequate- Obesity/OSA (cross posting so more people see it)By brokensoldier244th
Okay guys and girls, gather round the fire. This is a bit of a read, but THIS is the best private doctor submitted opinion Ive come across while Ive been 'on the inside'. Most of the ones I see are a paragraph or two, wishy washing around about the condition, and the doctors opinion- with no WHY, other than "I'm the doctor, and I examined them and this is why I think so.....". That doesn't really cut it. Yes, I know that C and P docs don't do anything this extensive, either, most of the time, and I can't defend that either, but this particular condition that they are claiming is already thorny, and its 'by way of' another caused by an SC disability.
For those of you with OSA caused by obesity that have been shot down, do a word (CTRL-F) search for the word "intermediate" as in "intermediate condition". There is an interesting tidbit on that page RE obesity specifically, and this was how I claimed my OSA in 2014 when I appealed, minus the VA letter, since it hadn't been written yet. This was my doctors chain of thought on my OSA as well.
Read this, and give it some thought when you are constructing your claims, and writing your boilerplates for your doc to sign after examining you. I have no idea what this persons rating will be, or if they will prevail, but damn if this didn't stick out as what I would want to see, as a rater, if I was one. This resembles a few of my later claims that I filed for myself in its construction and layout, minus the calling myself a doctor. The overall layout and organization is on point, and will make it easy for whomever gets it.
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)
"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?
Some exams are just for the fun of it for VA. I am getting sooooooooooooooooooooo frustrated right now I can just scream!!!!!!!!!!!!!!!!!!!!!!!!!
Put in claim for anxiety and another claim for Ptsd (didnt know they rated under one) ONLY after speaking with VA psychologist the first time. He eventually recommended me to speak with VA Psychiatrist for medicines to help me. Now i am seeing both of them
I personally sent in my medical records with dates and hospital stay of stressor/ Buddy statements, etc. Went for exam with contractor. Spent 2 hours with him, he stated that he couldnt decide if I suffered from Ptsd with anxiety disorder and depression or more anxiety and depression. As I looked back at my sessions, I have been diagnosed with as Generalized Anxiety Disorder and Adjustment DO with depression from psychologist, but never PTSD. From VA Psychiatrist it states Insomnia, other trauma related anxiety, mood disorder, panic disorder, but AGAIN, never has written ptsd. First time ptsd was said to me was during the c&p exam by the VA contractor
BUT, I am assuming the doc for the Ptsd wasnt clear enough in his wording because after all these months claim went back to gather evidence for a medical opinion and/or 2nd ptsd exam. I had requested my C-file and C/P notes in February, I am told they are behind and it could be 3-6 months before I get them.
What on God's green earth could possibly be the hold up now?
rebabevets posted a question in VA Disability Compensation Benefits Claims Research Forum,I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently
Ddsr posted a question in VA Disability Compensation Benefits Claims Research Forum,The 5, 10, 20 year rules...
Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.
Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.
Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.
If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"
At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.
NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.
Example for 2020 using the same disability rating
1998 - Initially Service Connected @ 10%
RESULT: Service Connection Protected in 2008
RESULT: 10% Protected from reduction in 2018 (20 years)
2020 - Service Connection Increased @ 30%
RESULT: 30% is Protected from reduction in 2040 (20 years)
broncovet posted an answer to a question,While the BVA has some discretion here, often they "chop up claims". For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.
I hate that its that way. The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.
Ztmiller8 posted a question in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC,Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!
My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.
Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
Joey Ross posted an answer to a question,I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and nothing about stressor,
Picked ByJoey Ross,