Condition secondary to more than 1 service connected disabilities.

[mwillis71]

Hello,

I am service connected for sleep apnea, ptsd, anxiety and more. I have GERD which I believe is secondary to anxiety, ptsd and sleep apnea.  However, when applying for a secondary condition, you can only link it to 1 existing disability. My chances of getting it approved would be higher if I could link it all together. Is there a way to do that or should I file multiple claims for secondary to each disability? 

[flow1972]

I am also SC'd on PTSD (among other things).  I had a diagnosis of GERD in my record.  All I did was submit it as secondary to PTSD and included the diagnosis/treatment records supporting the level of impact to me along with a Medical Article I downloaded from the Mayo Clinic stating how it can be "worsened" or "caused" by Stress.  It was approved..no big deal. 

The thing to keep in mind is that the "medical opinion" you submit doesn't have to be about "you".  It can be something that is "Common Knowledge" in the medical community.  The P&T exam will be the medical opinion they use "about you".  If they decide something that goes against Commonly Accepted Medical Knowledge...then, you have the ability to fight that by getting a different opinion if you want..but most of the time you won't have to.

[Berta]

Great advice from all above-

you said:

" However, when applying for a secondary condition, you can only link it to 1 existing disability." 

That is the first time I ever heard of that-it is possible to raise as many theories of entitlement as possible. However it is best to claim first, the best one that can be proven, by medical evidence,  to the VA.( often ,but not always , this takes an IMO/IME.)

This article shows what I mean as to a new theory of entitlement which could cause a BVA remand ( far better  than a BVA denial

https://www.woodslawyers.com/bva-remanded-decisions-va-remand/

I saw a widow's claim a few days ago ( cant find it yet) whereby the widow raised 3 theories of entitlement to DIC.

The BVA granted one of her entitlement theories claim and rendered the other theories as moot because they did award the DIC.

This is a similar situation:

The widow below got a remand due to other theories of entitlement and a remand is far better from the BVA than a denial:( us widows can be very aggressive with their claims)

"A remand is further warranted to address all theories of entitlement advanced by the appellant.  In October 2019, the VA notified the appellant of the Blue Water Navy Vietnam Veterans Act of 2019 and advised her to submit a VA Form 20-0995, Decision Review Request: Supplemental Claim if the requirements were met.  October 23, 2019, Notification Letter.  The appellant submitted the Supplemental Claim Form on May 12, 2020. She did not check the box indicating she was withdrawing her claim from the legacy process.  During this appeal, the appellant argued that in-service herbicide exposure caused the Veteran’s lung cancer.  See May 18, 2010, Statement of the Case (SOC); see also April 17, 2013, Hearing Transcript.  Lung cancer is one of the diseases for which presumptive service connection based on herbicide exposure is available.  38 C.F.R. § 3.309(e).  The Board denied this theory of entitlement to service connection for cause of death as the evidence failed to confirm the Veteran’s actual presence on the landmass or inland waterways of Vietnam.  August 11, 2017, BVA Decision.  That portion of the August 2017 Board decision that denied service connection for cause of death was vacated and remanded by the JMPR.  

The appellant has submitted additional argument and contends that exposure to herbicides should be presumed based on service in the blue waters of Vietnam aboard the U.S.S. Kawishiwi.  The record indicates that the Veteran served aboard the U.S.S. Kawishiwi from January 1974 through March 1975; however, the proximity of this ship to the offshore waters of Vietnam is unclear based upon the evidence in the file.  A remand is necessary to determine whether the Veteran served in the blue waters of Vietnam and is entitled to presumptive service connection based on herbicide exposure."

https://www.va.gov/vetapp21/Files4/21021432.txt

At least one veteran ( Blue Water Navy) was approved for AO comp due to this ships log and his time frame on board the ship.

Source Facebook https://www.facebook.com/groups/273591375984513/

I am not a Facebook member but this info was open to the public.

[Berta]

PS, if you are obtaining an IMO/IME it is best to let the doctor know of any oher possible  theories of entitlement- but a good IMO/IME doctor would probably consider that anyhow- if they have lots of VA claim experience.

They also would seek (I hope) any compensable  issue you have that might fall under Section 1151, 38 USC. If so a formal claim should be filed with their IMO/IME on that aspet as well, in addition to the secondaries.

 

 

This is the sort of attention to your full medical record, that you will never get from a C & P examiner.

 

 

 

[broncovet]

I agree with Berta.  Its HOGWASH that one disorder can not cause multiple secondaries.  Pure hogwash.  Probably from a VSO.  Example:

Diabetes can lead to:

1.  heart problems.  

2. High blood pressure.

3.  Peripheral Neuropathy.  

4.  amputations.  

5. Obesity.  

   Pretty much everything else, too, healthwise.  sleep apnea, and many more.  

    If the VA denied you because you linked applied for SC scondary to diabetes after already be secondary for sleep apnena, then appeal.  One of those good law firms would be on that like white on rice.  

 

[broncovet]

What YOU DO need for secondary is a doctor statement that says your "condition applied for" is at least as likely as not due to (current sc condition).  THAT is what is required by VA laws.  

By the way, skip part of this.  No regulations require you parse out and understand primary, secondary, presumptives, or other sc methods.  Just apply, let VA figure it all out.  

My advice is stat on the form:

I want to apply for sleep apnea, both primary and secondary to my other secondary conditions, as a doctor shall so determine.  

You need not even use the term "secondary".  Just apply for SC.  

    I dont want VA to know I understand primary, secondary presumptive, 1151, etc.  I would rather my opponent underestimate me.  Go Bengals!!!!!!!

[flow1972]

23 minutes ago, broncovet said:

What YOU DO need for secondary is a doctor statement that says your "condition applied for" is at least as likely as not due to (current sc condition).  THAT is what is required by VA laws.  

I want to clarify this statement.  The way it's stated is absolutely not true.  Statements like this confused and frustrated me when I first started down the VA Road.  In order to grant, yes a doctor's opinion connecting the condition to an event or already existing condition is required.  However, it is not in any way required to have this before you file.  In most cases, the C&P is where this is opinion is created.  The only time this would be needed external to a C&P is if the C&P evaluator decides the nexis doesn't exist or isn't sufficient for whatever reason; and you now need to appeal that decision with an IMO (Independent Medical Opinion) or the VA is refusing to grant an exam for some reason.  If you have one already...great; but it is NOT required prior to filing.

When I applied for my PTSD, I was told things like "Only a VA Dr's diagnosis of PTSD will be accepted" and so forth when in fact, I was granted SC for PTSD without EVER seeing a VA Mental Health Professional to this day.  My diagnosis was made by my Private Mental Health Professional who completed a DBQ for me to submit with my claim.  That diagnosis was then "validated" by the VA's chosen C&P Evaluator when they did their 3 hour C&P Exam.  I was so freaked out that I'd done it wrong because of this type if information.

In my experience, don't over-complicate things when you don't need to.