How to get a diagnosis?

[Ranmic]

I need some help or your opinion please.  I have a few SC disabilities and have been considering filing a few secondary's in relation to them.  Example, one of the meds that I'm taking has a side effect of GERD, so talking to my VA doc about it I just said straight out that since I started taking it my GERD is off the hook.  She is sending me for a scope in Feb.  Not sure how that will turn out but I guess what I need to understand is how do I get a "diagnosis" and does it have to say that I have GERD now because of the VA meds I'm prescribed and taking in order to get my claim approved.  Next one is my hips in relation to my knees.  I have both knees SC and over time due to the constant shifting back and forth while standing to relieve my knees my hips are hurting.  I have told my VA doc about that one too and she wants to send me to therapy.  She said xrays show mild arthritis and that I'm awful young to have that (her words).  I did file a secondary for my hips in relation to my knees early this year and it got denied so recently (Oct) I filed for an HLR and I expect that one to get denied also honestly.  I guess I'm trying to figure out how to get them diagnosed and a link to my SC disabilities.  I complain to my VA doc, but I'm not sure if that is enough. Thanks for listening to my long rant.

[broncovet]

Take the following steps if you think an event in military service caused your illness/disorder(s):  

1.  Get your medical records and review them.  Dont guess what is in them.  Is there already a diagnosis?  Or, have you been prescribed meds which are only prescribed for your particular diagnosis?   Doctors (especially va) dont always say, "I diagnose you with Gerd".   Instead they often treat you for Gerd, and the next doc comes along and says, "I will continue with his Gerd treatment".    Yes, you need a diagnosis but you need a nexus exqually because you need both.  

2.  If you lack a nexus or diagnosis, ask another VA doc first.  "Doctor Smith, my old Doc, Dr. Jones,  was treating me for Gerd.  Do you agree and are gonna continue treating it?" 

      Contine with, " If so, please make a note of your confirmation of Gerd diagnosis in my file?"

       Then, of course, you do the same with your nexus.  Just ask. " Do you think my Gerd is related to (event in service)? " Again ask him to note that if he responds in the affirmative.  

3.  You need a backup plan if your records dont show a diagnosis and nexus.  You can seek treatment and ask the same questions again with another VA doc.  They are all different and another doc may provide a favorable diagnosis/nexus even if another doctor declined to give you a favorable diagnosis or nexus.   

4.  Lastly, to complete your Caluza elements for SC, if VA docs refuse to provide diagnosis and nexus, then a private doctor may.  This means a private IMO or private medical exam, including the caluza element documentation.  

     Its not unusual for VA docs, who are paid by VA, to "watch out for VA's interests" above your's, because they sign his paycheck and you dont.  So you have to seek an opinion from a private doctor YOU pay for.  

    As always:  You must have Caluza's or no SC.  If you do NOT have an event in service, your only option is to check to see if your disease is on the presumptive list.   A presumption list means if you have an illness on the list, and you served in the applicable country, then you should get SC.  Vietnam has many disorders presumptive because of agent orange, many other countries also have presumptives.  

    Remember, if a doctor fails to regard highly your interests, you dont have to continue seeing him/her.  You can seek another doctor within VA.  Lots of times the VA sends you to different doctors, anyway, even if you tried to keep the same doctor.  

 

Edited January 1, 2023 by broncovet

[Ranmic]

@broncovet Thank you very much for that explanation.  I really appreciate you taking time to respond.  Happy New Year.

[pacmanx1]

Quote

I have a few SC disabilities and have been considering filing a few secondaries in relation to them

Just keep in mind that for secondary issues you would not need the Caluza Elements, those are for trying to get direct service-connected issues service connected. For secondary issues you will/would need a nexus/statement that links/connects your new disability to an already service-connected disability or for medications to treat an already service-connected disability with a good/plausible medical rationale. Example: B condition is as least likely as not 50/50 caused by or the result of the veteran’s service-connected A.

While I do agree with Bronco, however go to the referrals and ask the specialists if your Acid Reflux (GERD) is caused by or made worst by your pain medications, the same for your hips, if the pain in your hips are the results of your service-connected knees, you will most likely need a nexus from either a Rheumatologist, Therapist or a Neurologist. There are times where there may be no in-service event, accident, illness or injury but you may very well have an already service-connected disability that could cause a new disability.

Secondary service-connected claim—file a claim for a new disability that’s linked to a service-connected disability you already have.

You can file a secondary claim to get more disability benefits for a new disability that’s linked to a service-connected disability you already have.

For example, you might file a secondary claim if you:

• Develop arthritis that’s caused by a service-connected knee injury you got while on active duty, or
• Develop heart disease that’s caused by the high blood pressure you were diagnosed with while on active duty and that we’d previously concluded was connected to your service

 

Types Of VA Disability Claims And When To File | Veterans Affairs

[broncovet]

pacman is correct:

   For secondary SC, you need only 2 Caluza's...diagnosis, and nexus to already sc condition.  Its not necessary to repeat the in service event for secondary SC, the in service event is already covered in the original sc. 

   Further, you dont need a nexus for presumptives, "as long as" your military service includes the required countries/dates of service. 

    Presumptives are explained here.  Note, the Pact Act presumptives may not be included, below, and you would have to search for those seperately.

https://www.hillandponton.com/agent-orange-presumptive-list-of-conditions/