Likelihood of Successful TDIU Claim??

[aggravating_coyote]

I know it's only a guess, but based on my application, I'm interested to know opinions on my chances of success.  Here are the particulars.

1. Very recently I'm 70% SC for mild neurocognitive disease.
2. I have not worked full-time since 2017, but have had 2 part-time jobs.
3. The following items were submitted as part of my application
   1. VA Request for Employment Information forms from both part-time employers documenting, cognitive and behavioral issues. 
   2. Warning letter documenting many behavioral issues from my last full-time employer
   3. HR letter document my behavioral issues as the reason for my contract non-renewal
   4. VA note from my neurologist documenting the SC disabilities making me unemployable with no expected improvement in my conditions

Wil  you offer a guess on my chances of getting permanent and total TDIU?

Thanks

[Berta]

Thanks for posting the whole opinion. It was done very well.

If you get SSDI award and it is solely for the neuro condition, make sure VA gets a copy of the award letter.

Amine is used on subs but I know of no negative affects it would have on sailors.

I found one case at the BVA based on amine use, but the case was denied.

Can you tell us some specific exposures you had ?

I have seen many exposure claims over the years and they often need to be narrowed down to specific chemicals.

I also saw a widow's claim that her husband was exposed to Benzene and other chemicals

In part:

"The appellant asserts that the Veteran’s multiple myeloma was caused by in-service exposure to benzene, ionizing radiation, and/or asbestos while serving on four nuclear submarines."

 

"In support of her claim that the Veteran was likely exposed to benzene during service, the appellant submitted a copy of a 2008 publication by the National Academy of Sciences’ (NAS) National Research Council (NRC) entitled Emergency and Continuous Exposure Guidance Levels for Selected Submarine Contaminants: Volume 2. The NRC publication notes that a submarine is an enclosed and isolated environment when submerged, and unlike a typical work environment, its crew is exposed to air contaminants 24 hours a day. According to the NRC publication, the ninety-day continuous exposure guidance level (CEGL) for benzene on Navy submarines at the time was 1 part per million (ppm). In the publication, the NRC recommended a ninety-day CEGL of .2 ppm, which, according to the appellant’s attorney, was ultimately adopted by the Navy based on 2007 findings by the Division of Cancer Epidemiology and Genetics at the National Institute of Health that benzene affects the progenitor cells that give rise to blood cells at concentrations below 1.0 ppm."

"The record includes medical opinions that are in favor of and against the claim. Upon review of the record, the Board finds the competent and probative evidence to at least be in equipoise. After resolving all doubt in the appellant’s favor, the Board finds that probative evidence demonstrates that it is at least as likely as not that the Veteran’s multiple myeloma, which ultimately resulted in his death, was related to his military service. Accordingly, service connection for the cause of the Veteran’s death is granted."

https://www.va.gov/vetapp20/files10/20067138.txt

While this is a different disability then what you have, the widow certainly proved that benzene exposure contributed to her spouse's death.

This shows what I mean-you have a strong IMO.INE but the VA wants specifity in what toxins you were exposed to, and I dont know if the  IMO/IME doctor bolstered his opinion with some medical treatises on that.

This is a BVA search feature I used :

https://www.index.va.gov/search/va/bva_search.jsp?QT=Navy++submarine&EW=organic+brain+disease&AT=s&ET=&RPP=10&DB=2021&DB=2020&DB=2019&DB=2018&DB=2017&DB=2016&DB=2015&DB=2014&DB=2013&DB=2012&DB=2011&DB=2010&DB=2009&DB=2008&DB=2007&DB=2006&DB=2005&DB=2004&DB=2003&DB=2002&DB=2001&DB=2000&DB=1999&DB=1998&DB=1997&DB=1996&DB=1995&DB=1994&DB=1993&DB=1992

It takes time to find similar cases to yours and those cases cannot be used as evidence, but 

exposure claims rest on the inservice proof of exposure.

Also vets have succeeded when they narrowed down their exposures to specific toxic agents and then often found substantial medical abstracts or treatises on the net to prove their disability was as likely as not,  from their MOS and service. as they had no other known etiology for the disability.

 

[aggravating_coyote]

Your comments are helping me process my case for submitting additional evidence supporting my case. I now wonder if I should include research studies supporting connections between submarine atmospheres and toxicity!

Here are my thoughts:

Evidence of submarine environments is lacking. But I found one or two studies indicating that sub environments are generally not detrimental. However, the studies tested a few of the possible exposures.

If I need to appeal, I will argue that many neurotoxic chemicals are neither monitored or cleaned by a boat's scrubbers or filters. An older Navy report on submarine atmospheres identified 125 potential toxic items, of which only 12 were studied.  LINK, page 127. Also, there is evidence that diesel particulate matter may be neurotoxic. LINK. I will also argue that there is no evidence supporting or refuting relationships between toxic submarine items and their effects on neurocognitive functioning.

I can not provide specific exposures as many toxic elements are not monitored. But, the VA received the following letter outlining my case.

Quote

Per my neurologist, neurotoxin exposures during a shipyard duty station and multiple submarine deployments caused my bipolar and Alzheimer's disease. 

 

Potential and know neurotoxins include, but are not limited to:

 

●       Welding fumes

●       Paint fumes

●       Diesel exhaust and particulates

●       Hydrogen gas

●       On-board fire

●       Radiation

●       Cleaning chemicals

●       Cooking smoke

●       Fumes from sanitary tank pressurization

●       Cigarette smoke

●       Amine

●       Increased carbon dioxide

 

 

A Fleet Balssoistic Missel (FBM) submarines utilize two crews, on-crews and off-crews,  with crew changes occurring approximately every 120 days. On-crew submariners endure about seventy days submerged.  Each strategic deterrent patrol yields 1,600 hours of exposure. 

Over eight patrols, I accumulated 13,500 hours of exposure.

Number of Patrols	Days Submerged	Hours Submerged
8	560	13,500

 

Submerged submarines utilize recirculated and "scrubbed" to assist with reducing Co2. It's impossible to determine the efficacy of the CO2 scrubbers during an on-crew patrol cycle.  Other airborne containments are reduced only through basic filtration, similar to what is seen in commercial buildings.

 

[Berta]

Yes, any good documented info like this will help-But it usually helps more if a IMOIME doctor can establish a nexus to it and quote from current medical links.

"Per my neurologist, neurotoxin exposures during a shipyard duty station and multiple submarine deployments caused my bipolar and Alzheimer's disease. "

Are you saying in addition to the neurocognitive disease. you have Alzheimer and Bi Polar?

I dont think the VA can service connect Alzheimer's-but they can service connect Bi Polar and dementia. Some one will correct me if I am wrong on Alzheimers.

I helped a bi polar vet friend of mine. He was in the Navy in 1960s and they didnt have a clue on Bipolar.Unfortunately he kept forgetting to do something I asked him to do-- get his military medical records, and a copy of his inservice personnel file (NAV201)with an SF 180 I gave to him.

He kept his claim going for years and it was denied so he appealed it to the BVA.

I was able to prove to his VA shrink that article 15 and a stay in the brig, long story was the first manifestation of his in service bi polar.

The Doc agreed with my summary of his SMRs , which he read, and also the 201 file , and prepared  brief MO/IME and he won almost 1/4 Million in retro due to "0" NSC for decades that became  100% P& T SC. 

Does your military medical file or NAV201  file reveal anything that would be a possible manifestation of your bi polar?

I have no idea if bipolar can be caused by major neurological problems.

Bi Polar is a MH issue, where as brain trauma and disease is a physical problem ( that could cause secondary MH problems.)

My husband had PTSD and organic brain trauma due to a stroke. The VA with some extensive tests ( after I had a battle with them) was able to not only send him to the right VA psyche,but those tests were able to separate his PTSD from the stroke brain trauma issue, and the testing results were instrumental in my being able to claim both issues , and they awarded on both because they were unable to legally combine the issues.

What Sub were you on?

 

 

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Edited May 21, 2021 by Berta

[Berta]

Here is a vet with dementia- service connected:

https://www.va.gov/vetapp09/files1/0909818.txt

The appeal was for a higher rating and it was granted but I dont know what his inservice nexus was.

Forgot to add, my husband with 100% PTSD also had dementia but that was part of the overall stroke rating.

[aggravating_coyote]

1 hour ago, Berta said:

1. Are you saying in addition to the neurocognitive disease. you have Alzheimer and Bi Polar?
2. Bi Polar is a MH issue, where as brain trauma and disease is a physical problem ( that could cause secondary MH problems.)
3. What Sub were you on?

1. I am not diagnosed with Alz.  I've been SC for depression for many years, but about 1 year ago, the psych MD changed it to bi-polar.  I have not submitted a bipolar claim. 
2. Yes, I've been advised to submit a claim for my MRI and PET diagnosed pathologies.
3. James Madison (G), Henry L. Stimson (B).

Thank you for continuing our conversation

[Berta]

There is also the fact that many sailors on shipyard duty have definitely been exposed to toxins.

https://www.king5.com/article/news/local/investigations/bremerton-shipyard-workers-exposed-to-dangerous-toxins-for-years/489773478

This article focuses on civilian shipyard workers, but I am sure sailors were exposed to cyanide etc as well.

Edited May 21, 2021 by Berta