Very recent VARO claims approval

[Dustoff1970]

I am posting here for more reader exposure.  Very recently received initial VARO claim grant of 60% for GERD and 10% for Tinnitus.

I forgot to mention that a doctor's medical nexus opinion statement was not needed by me on these two very recent claims as my extensive long term VA medical records since 1985 for GERD, PTSD, Sleep issues, etc  and Army 1970 STRs provided plenty of strong positive evidence of my diagnosis and treatment/prescriptions for serious GERD and exposure in Nam for Tinnitus. 

Also my truthful statements and two separate QTC C&P examiners notes/DBQs were instrumental in grant of benefits on initial claim by VARO examiners.  I would have easily won this claim on appeal to the BVA if denied by the VARO raters (GERD secondary to PTSD just like my OSA Sleep Apnea due to PTSD).

Contrary to what some others say at other internet locations a vet does not always need the all important and helpful doctor's written letter nexus opinion if you have other positive medical and/or non medical evidence.  My PTSD and other claims (except one) were granted based primarily only upon medical records and other evidence and not a nexus opinion. If denied on initial claim then you can usually win on appeal. Not all vets including me can get a nexus statement from a doctor for many reasons.  If you can get one either for free or pay then by all means do so. 

Additionally both these claims were decided very quickly in only 20 days due to my well organized evidence package I presented with my claims and additional scanned or mailed to Intake center  several Statement of the Case forms with additional info.  Also C&P examiners sent in by email to VARO their DBQs/opinions within minutes of completing my exam.  This time everything worked perfectly.

Keep on truckin and see you at the rodeo.

P&T 100%  since 1998 and 50%  before that. I will soon make another to this great forum.

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

 

Edited May 2, 2022 by Dustoff 11

[JKWilliamsSr]

I don't think anyone here has ever disputed what you just stated. 

However, the majority of people that have been saying a nexus letter is needed is because of a VA denials, especially when it comes to secondary conditions.  I have had a number of denials from the VA with plenty of medical records after service to go with what was in my SMR's and yet I would still be denied based on a negative opinion from a VA C&P examiner.   That is just the direct service connection claims that should have been common sense.  Every secondary claim I ever filed on an already service connected disability was denied.   I had medical evidence to support that as well but would be denied because of a negative opinion from a C&P examiner. 

Would I have won at the BVA level?  I would like to believe I would but it would not have been easy because at the VA's disposal would be a negative opinion from their own examiner and I did not have any medical evidence to dispute it only medical records that show a diagnosis of the claimed condition.  As a lay person I am not qualified to provide a medical opinion.  I can report on my symptoms but no judge would take my "medical opinion" over a trained medical professional.  So to me it was prudent to get a nexus statement from an outside doctor and because of that I am 100% P&T and in getting that rating the BVA judge cited my outside medical nexus in granting service connection.

There are pros and cons to both.   Each person has to look at what they have in their file.  However, I will say this.  If you have a negative opinion from a C&P examiner the smart thing would be to get an outside opinion to counter it.

 

Edited May 2, 2022 by JKWilliamsSr

[Dustoff1970]

Yes I do encourage vets to get a doctors nexus opinion if they can but sometimes as I stated this is not possible as in my case many times so they and me are forced to go with what other medical and other evidence we have.  I have never discouraged anyone from not getting a nexus opinion statement or letter if they can.  Anyone who says otherwise is a liar and I am not referring to you.  8 our of 10 times I have been successful without a doctor's nexus statement on both initial claims and BVA, CAVC court appeals.

I despise other so called internet "experts" at other locations whose first and only advice out of their mean mouths  to a vet is simply the abrupt arrogant comment to "Get a doctor's nexus opinion" without also explaining that they may win the claim or appeal with other favorable/positive evidence if they cannot get the much sought after coveted doctor's statement. The liars are telling the vet he/she has no chance of winning a claim or appeal without the doctor's nexus opinion (not always true) and they do use the word doctor.  By saying the above quote is also a lazy and quick wrong reply to vets question.

As I patiently explained in another post the BVA often sides with the vet against a negative C&P examiner's opinion if the BVA and/or vet finds the examiners opinion to be defective or inadequate and this occurs sometimes even when the vet does not have a favorable doctor's opinion available to support his claim/appeal.  The vet can point out in his appeal be believes the examiner failed to discuss any of the positive evidence in vets favor or to adequately and fully explain the reason why the examiner arrived at his/her negative opinion and this sometimes results in a grant or remand of the appeal by BVA.

The BVA and courts have a long list of different types of deficiencies that occur in VA C&P examiner's negative opinions that I discovered in reading hundreds of appeals.   I am not about to list all these deficiencies due to my own many years of hard work and research.  Others will have to do their own work.  I am tired. Anyone who wants to argue with me over this clear comment will be on my ignore list super quick to join 3 others as I have no time for repeating this comment over and over.

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

Edited May 2, 2022 by Dustoff 11

[john999]

I have service-connected DMII and 6 secondary conditions.  I got a nexus report from a VA doctor back about 10 years ago for clots in my legs due to DMII.  Would I have gotten that without some kind of report from a doctor tying the two conditions together....I doubt it.  I got SC'ed for PN in all four limbs without a private nexus letter.  I was shocked by that. The VA diagnosed PN which is secondary to DMII.  The dispute we had was the actual rating.  The VA finally SC'ed me for heart disease and PN secondary to DIM11.  The hardest case I ever had was for depression/ptsd.  The VA connected me but at a very low rating.  It took years with all kinds of doctor's reports to get it to 70%.  If you are not schedular 100% for one condition it is so hard to get to actual 100% even if you have had 90% TDIU for 20 years.  I finally got actual 100% but VA still says I am unemployable.  IMO you really must have some medical evidence to tie secondary conditions to the primary SC condition.  You can show VA all the scientific medical reports you want and they just demand a nexus letter.  It stinks because many private doctors don't want to get involved with patient's VA problems.