Camp Lejeune Presumptive Condition

[pawmbi]

Hello just trying to get a better understanding of of the presumptive conditions.  When I researched va.gov at https://www.va.gov/disability/eligibility/hazardous-materials-exposure/camp-lejeune-water-contamination/

It give a list of presumptive conditions and what must be filed.  I filed the diagnosis for Renal Cancer (Kidney Cancer) and provided the dates of service April to September 1968.  I've attached the letter received from the VA.  It seems to me they are asking above and beyond what is required for a presumptive condition.  The 61 pages of medical documents submitted from the urologist very clear diagnoses as Renal Cancer and the doctor even rights in his notes this exact statement "...In my opinion this cancer is as likely as not, caused by exposure to agent orange or contamination in Camp Lejeune..."

So I am asking how to respond to the VA's request for what seems like more medical and scientific proof as well as a Nexus letter when this is suppose to be presumptive and all that should be shown is records supporting his time at Camp Lejeune and the diagnosis for any of the eight presumptive conditions and in this case Renal Cancer.  Any feedback would be appreciated.  

[broncovet]

The Camp LeJune presumptives is "very" new legislation, and it takes VA significant time to implement new laws.  

My advice is to definately comply with this letter.  Send them applicable evidence, and it would be great to even cite a doc opinion which was favorable to you, if you have such an opinion.  Dont ignore the letter assuming that your conditions are a presumptive under the new rules, which probably have not even been implemented yet.  

"Send them something" in compliance "even if" it could be/is redundandt and is info VA already should have.  (We often dont know exactly what evidence VA has in real time, unless we have VBMS access.  Vets dont get VBMS access, pretty much only VSO's and attorneys who have jumped through VA hoops to obtain said access have it, we do not)

Remember:  When VA requests information "and you fail to provide it", the VA considers your claim abandoned.  You dont want that!  It would likely result in frustrating long and unnecessary delays, and necessitate appeals.  

At a minimum, send them a letter (citing this letter, use the applicable code on the letter to reference it), telling them you are requesting a presumptive under the new camp Lejune presumptives, such as the Pact act.  

     Im not crazy about insisting these are presumptives...I dont like to burn down bridges I have not yet crossed, yet.  You see, we dont have a crystal ball to know what the rating specialist or judge is thinking.  He may be thinking presumptive, or, he may say, "phoey" on presumptives, and award benefits on the old fashioned Caluza elements in your file.   So, dont burn down the Caluza elements in favor of presumptives, because all of the presumptives have "gothcha's"..such as they only apply during specific periods of times, and you have to demonstrate you were stationed at camp Lejune for a period of time sufficient to meet the criteria.  

Let VA decide to rate you presumptive, secondary, primary, etc.  Dont overthink it, and dont tell some GS14 how to do his or her job, many are offended at that.  Its rarely a good idea to antagonize someone who is decision maker for your claim.  

While I have found that I often know more about a particular regulation than the vA employee Im am speaking to on the phone, I refrain from telling them that.  

     While it may make me feel good about "how much I know" or how smart I am, that feeling will be short lived when I get a denial from a decision maker angry at me that I could even suggest I know more than he does.  

     You get more flies with honey than vinegar, and many if not most of the employees I have spoken with have "less" knowledge and experience than I have.  (I filed a claim in 2002, and have answered thousands and thousands of Vets questions over nearly 2 decades.  So, even tho I may know more about it, I do not wave that flag in their face.). 

     Instead of attacking them, I might say stomething like:

     "You and I are thinking alike, as your position makes sense.  However, after I read 38 CFR 3.156b, noting its about "pending claims", it seems that the effective date should be the date I first applied.  "

      Instead of making the employee seem stupid, tell them they make sense, its that stupid regulation that makes no sense.  In other words, dont attack them.  

      I beleive it was former president Grover Cleveland who said, "you double up your fist at me, and I will double up mine".  

     Blame the computer, the regulations..etc.  Dont blame that employee, most of us dont like to be blamed for stuff.  

Edited August 16, 2022 by broncovet

[brokensoldier244th]

Camp lejeune had always been covered for exposure. PACT only lets you sue them, too. 

 

The letter says renal failure, the regulation says renal cancer. Point out that you have renal failure because of renal cancer. Not every VSR has the same level of experience with medal terminology and generally rather than get bogged down in medical Latin we'll ask you for more info if your dx doesn't match the regulation.

The raters take far more classes than we do regarding body systems and affecting conditions but they don't see it until after we do, unless the vsr is more experienced and had built up experience or internal contacts to ask about things like this, or has a medical dictionary and the rating scepter on their shortcuts list, or knows that they can look up prior appeals court clues. This isn't part of VSR training, it's stuff you pick up as you go.

 

The first year and a half of a VSR is class learning regulations, training, not screwing up, and about 6 months of actual claims work, and VA has hired a lot of vsrs in the last year.