Evidence and Links Used to Support VA Compensation Claims

Post your experiences dealing with the VA Disability Filing Process for GWS, issues with VA diagnoses, and so on.
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Your Gulf War Unit: USS La Salle (AGF-3)

Evidence and Links Used to Support VA Compensation Claims

Post by ichop » Thu Apr 04, 2013 11:23 pm

We need a central place to list the documents, justifications, links, etc, that we use in our Compensation & Pension (C&P) claims; with the idea that if it worked for one of us, maybe it will work for others! I am attempting to start such a list here.

I am two years into my Compensation & Pension (C&P) Claim, with a projected two additional years before my case/claim is completed (yes that's 2011 to 2014). I have been working hard to find ANYTHING that will help me justify my claims and thought I would create this forum to assist others (and myself).



So I am going to start with a discussion on Sleep Apnea for Gulf War Veterans. Please use that as an example for future posts.
Last edited by ichop on Thu Apr 04, 2013 11:38 pm, edited 1 time in total.
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Post by ichop » Thu Apr 04, 2013 11:30 pm

Here is some of the info I found on Sleep Apnea:

http://www.huffingtonpost.com/david-vol ... 82960.html
"Consider these statistics: According to the U.S. Department of Veterans Affairs (VA), one out of every five war veterans has been diagnosed with obstructive sleep apnea (OSA) -- compared with only five out of 100 civilians in the general population. And between 2008 and 2010, the number of veterans who received medical benefits related to sleep apnea grew by 61 percent, from 39,145 cases in 2008 to 63,118 cases in 2010"

"The results of the study are published in the October 2012 issue of Psychosomatic Medicine in the article "Obstructive Sleep Apnea, Post-Traumatic Stress Disorder, and Health in Immigrants." http://www.psychosomaticmedicine.org/content/74/8/824.abstract The research showed that:

Those who left Iraq after the war began and suffered from mental disorders such as post-traumatic stress disorder (PTSD) and depression and self-rated their physical health as worse than their actual health were 43 times more likely than pre-Gulf War immigrants to report OSA and later develop major chronic health issues, such as cardiovascular disease."
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Post by ichop » Thu Apr 04, 2013 11:37 pm

Condition: I was diagnosed with Prostate Cancer in 2008, at the age of 41 (with no family history) and believe it is a direct result of my deployment for 13 months to the Persian Gulf during Operations Desert Shield and Desert Storm. During this time, I was exposed to a variety of environmental and chemical hazards that carried potential health risks [referenced off the VA website: http://www.publichealth.va.gov/exposure ... osures.asp.

These exposures included:
Vaccinations: Including anthrax and botulinum toxoid
Oil Well Fires, Smoke and Petroleum: Oil or gas wells that caught on fire and burned
Pyridostigmine Bromide (PB): Round, white tablet used as pre-treatment drug to protect against nerve agent soman
Sand, Dust and Particulates: Tiny airborne matter that can cause respiratory and other health problems
Chemical & Biological Weapons (Khamisiyah, Iraq): Ammunitions storage depot containing warfare agents demolished by U.S. soldiers

Though currently there is limited research to correlate these with prostate cancer, I am seeing more and more cases of young men (35-45) being diagnosed with prostate cancer

“Yeah I have been really curious as to what studies show in percentage of younger males (40 - 45) with prostate cancer that were in theater to those that were not. I had my prostate and lymph nodes removed at 45 due to cancer. “
http://vets.yuku.com/topic/84081/PROSTA ... UE1-hl3a10

“ diagnosed with prostate cancer at age 44. My husband was in the first Gulf War and was diagnosed with prostate cancer at age 38, in 2008”

My personal belief is that there are MANY more undiagnosed cases out there. The reason for this is simple:

a) Currently, the “American Cancer Society Guidelines for the Early Detection of Cancer” states “Starting at age 50, men should talk to a doctor about the pros and cons of testing so they can decide if testing is the right choice for them”. Meaning most men will not test for prostate cancer till the age of 50 (or 55, even 60).
[ref: http://www.cancer.org/healthy/findcance ... -of-cancer]

b) The average age of those in theater for the Gulf War/Operation Desert Shield/Desert Storm was 28 [ref: pg 13. Gulf War and Health: Volume 6. Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress (2008), Committee on Gulf War and Health: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress, Board on Population Health and Public Health Practice, INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES, THE NATIONAL ACADEMIES PRESS, Washington, D.C., www.nap.edu]

c) Seeing as that war took place in 1991, 22 yrs ago, the average solder or sailor would be turning 50 this year (28+22=50). Therefore, most Gulf War Veterans have NEVER even tested for prostate cancer, so they would not even know if they have it. The only reason I caught it so early is I was trying to find out why I was so fatigued and had such bad IBS and was pulling quarterly blood work (I would never have known I had it otherwise).
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Post by ichop » Thu Apr 04, 2013 11:41 pm

Condition: Spastic colon/Irritable bowels cause me extreme and sever constant abdominal distress. Know that without this medication, I am unable to work as I these bouts are an instantaneous release of my bowels, causing diarrhea to run down my legs, without warning or time to reach a bathroom.

Also note that this is a VA presumptive chronic, unexplained symptom, and therefore related to Gulf War service without regard to cause.
“Functional gastrointestinal disorders, a group of conditions marked by chronic or recurrent symptoms related to any part of the gastrointestinal tract. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues. Examples include irritable bowel syndrome (IBS), functional dyspepsia, and functional abdominal pain syndrome”

REF: http://www.publichealth.va.gov/exposure ... llness.asp
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Pensions, Bonuses, and Veterans' Relief PART 4

Post by ichop » Fri Apr 05, 2013 12:04 am


You need to review Part 4 ( SCHEDULE FOR RATING DISABILITIES) of the Pensions, Bonuses, and Veterans' Relief law.
http://www.gpo.gov/fdsys/pkg/CFR-2008-t ... bpartB.pdf

Review each section you may think applies to you for a disability, and be sure to use the SAME VERBIAGE AS IS USED IN THE DESCRIPTION OF THE RATING!!

For example, if you have IRRITABLE BOWELS, the section that covers it is:

§4.114 Schedule of ratings—digestive system.
Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability war- rants such elevation.

7308 Postgastrectomy syndromes:

Severe; associated with nausea, sweating, circulatory disturbance after meals, diarrhea, hypoglycemic symptoms, and weight loss with malnutrition and anemia ..... 60 % Disability

Moderate; less frequent episodes of epigastric disorders with characteristic mild circulatory symptoms after meals but with diarrhea and weight loss ..... 40 % Disability

Mild; infrequent episodes of epigastric distress with characteristic mild circulatory symptoms or continuous mild manifestations ..... 20 % Disability


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Re: VFW: Gulf War Illness – A Practical Guide

Post by ichop » Fri Apr 05, 2013 12:20 am

This is just a great general reference written by the VFW...

http://www.91outcomes.com/2011/01/vfw-g ... guide.html

Approximately one in three 1991 Persian Gulf War veterans suffers from a multi-symptom illness. Follow these steps to seek treatment or VA compensation.

VFW: Gulf War Illness – A Practical Guide

Written by Kelly Von Lune, VFW Magazine, January 2011

(January 2011 – VFW) - VA confirmed in November 2008 that ailments reported by Persian Gulf War veterans are real. Of the some 700,000 service members sent to the Persian Gulf between August 1990 and July 1991, an estimated 250,000 endure “persistent, unexplained symptoms.”

The health conditions often are attributed to anti-nerve gas drugs given to troops and pesticides used during the war. Pyridostigmine bromide, which was administered to troops, had not been approved for nerve agent protection.

Also, service members were exposed to sarin, a toxic nerve agent, when coalition forces blew up an Iraqi missile arsenal after the war. [91outcomes Editor’s Note: Cyclosarin has been confirmed to also have been contained in the airborne post-explosion plume that drifted over an estimated 100,000 troops, and Mustard is also believed to have been present. Additionally, a myriad of Gulf War veterans have repeatedly testified before Congress that they had confirmed exposures to a host of other Iraqi chemical warfare agents, including Mustard gas, other vessicants. A book by CIA Analyst Patrick Eddington, “Gassed in the Gulf”, contained the most detailed accounting published to date of Gulf War chemical exposures.]

Yet the specific links still are not [fully] understood.

A review by the National Academy of Science’s Institute of Medicine concluded that [one] illness clearly caused by the Gulf War is post-traumatic stress disorder, present in 2% to 15% of Gulf War vets, depending on how it is diagnosed.

Dr. Michael Kilpatrick, director of strategic communications for the Military
Health System, told the American Forces Press Service in April 2010 that Gulf War veterans should seek care through VA rather than private doctors.

That way researchers can continue to track their data and search for causes of their symptoms.

In March 2010,VA announced that it would take a second look at disability claims related to Gulf War Illness, as well as train its medical staff to make sure not to tell vets that their symptoms are imaginary.

If you are a Gulf War veteran, what do you do?

Step 1: Know Presumptive Diseases

In September 2010, VA published new regulations stating that veterans who served in the Gulf War and have one or more of the following conditions are presumed to be service-connected. (Diseases marked with an * are newly approved.)

Brucellosis*: A bacterial disease with symptoms such as profuse sweating and joint and muscle pain.

Campylobacter jejuni*: A disease with symptoms such as abdominal pain, diarrhea and fever.

Chronic fatigue syndrome: A condition of prolonged and severe tiredness that is not relieved by rest and is not directly caused by other conditions.

Coxiella burnetii (Q fever)*: A bacterial disease with symptoms such as fever, severe headache and gastrointestinal problems such as nausea and diarrhea.

Fibromyalgia: A common condition [among Gulf War veterans] characterized by long-term, body-wide pain and tender points in joints, muscles, tendons and other soft tissues.

Irritable bowel syndrome: A common disorder [among Gulf War veterans] that affects the intestines (colon) and causes cramping, abdominal pain, bloating, gas, diarrhea and constipation.

Malaria*: An infectious disease caused by a parasite. Symptoms include chills, fever and sweats.

Mycobacterium tuberculosis*: An illness that primarily affects the lungs and causes symptoms such as chest pain, persistent cough,weight loss and fever.

Non-typhoid Salmonella*: A condition characterized by symptoms such as nausea, vomiting and diarrhea.

Shigella*: A condition characterized by symptoms such as fever, nausea, vomiting and diarrhea.

Visceral leishmaniasis*: A parasitic disease characterized by symptoms such as fever, weight loss, Removal of the spleen and liver, and anemia.

West Nile virus*: A disease spread by mosquitoes characterized by symptoms such as fever, headache, muscle pain or weakness, nausea and vomiting.

With the new rule, a veteran only needs to show service in Southwest Asia (also applies to Afghanistan), that he or she had one of the diseases within a certain time after service, and that he or she has a current disability as a result of that disease. However, seven of the diseases are subject to certain time limits.

Step 2: Get an Evaluation

Veterans who think they have been exposed to environmental hazards during military service and would like an evaluation should contact an environmental health coordinator at a regional VA medical center.

VA maintains a health registry evaluation program to track the health of veterans as described above. Gulf War (and Operation Iraqi Freedom) exposures may include pesticides, infectious diseases, chemical and biological warfare agents, oil well fires and depleted uranium.

A listing of coordinators is available online at www.publichealth.va.gov/exposures/eh_coordinators.asp. Information also is offered through the VA special health issues helpline at 1-800-749-8387.

The health registry evaluation is available free of charge to all eligible veterans. Veterans do not need to be enrolled in VA health care to be eligible.

The evaluation provides veterans with:

• A free specialized health evaluation.
• Answers to questions about environmental exposures.
• Information on health care and other VA benefits.
• Test results shared and maintained in VA medical records.

However, note that a Gulf War Registry examination is not a claim, nor is it required for VA health care benefits or disability compensation.

As of March 2010, 116,628 initial examinations had been performed,with 6,896 follow-up exams—a 5.9% follow-up rate.

[91outcomes Editor’s Note: The Gulf War Registry Exam may lead to treatment. After having a Gulf War Registry Exam and any follow-on medical care, veterans with unresolved chronic multi-symptom illness or continued undiagnosed symptoms can get exams from the VA’s War Related Illness and Injury Centers (WRIISC’s). See www.warrelatedillness.va.gov for more information on how to be evaluated at one of these three national veterans care facilities. ]

To receive the Gulf War Review VA newsletter via e-mail, sign up at www.easmailcall.aac.va.gov.

Step 3: File a Claim

Gulf War veterans seeking disability compensation for illnesses incurred in or aggravated by military service can use any of the following resources:

• Contact a veterans benefits counselor at the nearest VA regional office or health care facility at 1-800-827-1000.

• Submit claims online at http://vabenefits.vba.va.gov/vonapp.

• Call the VA Gulf War Information Helpline at 1-800-PGW-VETS (1-800-749-8387).

VA credits VFW for being “very helpful to Gulf War veterans.” To find a VFW service officer, go to www.vfw.org/Assistance/National-Veterans-Service.

As of September 2010, the basic VA compensation rate for veterans without dependents ranges from $123 to $2,673 per month, depending on disability.

Ongoing Research

VA approved $2.8 million in July 2010 to fund three new research projects to test or develop new treatments for Gulf War Illness:

• A five-year study will evaluate the impact of resistance exercise training in treating chronic musculoskeletal pain and associated symptoms in GulfWar veterans.
• A four-year study on an animal model of Gulf War illnesses will assess the effectiveness of therapies to enhance mood and memory.
• A two-year pilot study will include eight-week trials of “mindfulness based stress reduction,” compared with traditional care.

Search for “Gulf War Illness” on Clinicaltrials.gov to view recent studies, as well as those recruiting eligible veterans.



Gulf War Information Helpline: 1-800-749-8387
Gulf War Vets Website: www.va.gov/GulfWar
VA Benefits Information: 1-800-827-1000
Find a VA Medical Center: www.va.gov/directory


SOURCE: VFW Magazine, January 2011, http://digitaledition.qwinc.com/publication/?i=55687
Posted 14th January 2011 by Anthony Hardie
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va.gov Publications & Reports on Gulf War Veterans' Illnesse

Post by ichop » Fri Apr 05, 2013 12:29 am

VA's Environmental Health Program publishes the Gulf War Review newsletters, providing information especially for Veterans who served in Operations Desert Shield and Desert Storm.

http://www.publichealth.va.gov/exposure ... rchive.asp

Here are sample titles from the July 2010 Issue:
  • VA Seeks to Cover New Illnesses for Gulf War Veterans
    Gulf War Veterans’ Illnesses Task Force Releases Draft Report
    IOM Releases Report on Gulf War and Health
    Comprehensive Health Care for Women Veterans
    Free Gulf War Health Registry Evaluation
    Health Conditions Recognized for Presumptive Service-Connection
    Disability Compensation from VA
    VA Begins to Implement Task Force Recommendations — New Veterans Health Initiative on Gulf War
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IOM Reports on Gulf War and Health, Multiple Volumes

Post by ichop » Fri Apr 05, 2013 12:35 am

The Institute of Medicine of the National Academies (IOM) has released several volumes on Gulf War and Health issues.
http://www.iom.edu/Reports.aspx?series= ... earch=gulf
These include:
  • Volume 8. Health Effects of Serving in the Gulf War Released: April 9, 2010
    Volume 7. Long-term Consequences of Traumatic Brain Injury Released: December 3, 2008
    Volume 6. Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress Released: November 15, 2007
    Volume 5. Infectious Disease Released: November 3, 2006
    Volume 4. Health Effects of Serving in the Gulf War Released: September 12, 2006
    Volume 1. Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines Released: January 1, 2000
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SLEEP APNEA - National Gulf War Resource Center

Post by ichop » Fri Apr 05, 2013 12:45 am

Here is some good advice on Sleep Apnea from the National Gulf War Resource Center
http://www.ngwrc.org/index.php?option=c ... claims-faq

Claims Tip - Claims FAQ

If you have PTSD and Sleep Apnea you can file for Sleep Apnea secondary to your PTSD.

Please NOTE: If you are 100% or have IU do not reopen your claim.

You will need to get your doctors put it in your records by showing him this study and nicely asking him about it. You will need to do the same thing to the C&P exam to see what he will say. Remember BE NICE. Just ask him if he has seen it and with he thinks. Keep in mind doctors do not like to be told anything even by a nurse.

Fatigue is one of our biggest problems of PTSD and one had a full knowledge as to why. That was until some research at the Walter Reed Army Medical Center in Washington, D.C did their research study on the issue. Their research was completed published in late 2010. The researchers found out well over 50% of patients with PTSD also had sleep apnea. The final report that you will need for you claim and doctors can be downloaded at this hyper link:


You may be asking, “What good is it to me?”

That is easy, more and more veterans are getting diagnosed with sleep apnea and it is something a veteran who has served in the Iraqi area of operation any time from 1 August 1990 until a day yet to be set(so even today) cannot claim under section 3.317. This is because sleep apnea is a diagnosed illness and as the way the law was written it is ruled out as an undiagnosed illness.

If you have PTSD and Sleep Apnea you can now file for the sleep apnea as a secondary to your PTSD. If you tried to file it under the UI (Undiagnosed Illness) section you can now file for the sleep apnea again but as a secondary to the PTSD. If you have an appeal going with the sleep apnea under the UI section you need to add to the argument that the SA may also be caused by your PTSD and send in the research. You can give more than one argument for the same claim illness.

You will need to download the articles for yourself, your VSO, your doctors and the C&P examiner. Have your VSO file the claim. In many cases your VSO will want you to get your doctor to give a nexus of the PTSD and the sleep apnea first. This will help your claim. Show your doctor the two papers pointing out the highlighted parts and make sure to give a copy to your PTSD doctors too.

You will need to get your doctors put it in your records by showing him this study and nicely asking him about it. You will need to do the same thing to the C&P exam to see what he will say. Remember BE NICE. Just ask him if he has seen it and what he thinks. Keep in mind doctors do not like to be told anything even by a nurse.

If the examiner did not agree with the study, then your VSO will need to attack the C&P ASAP. Many of the examiners are PA’s and Nurse-P and are not as experienced as your doctor. The RO will go off the C&P only so get the C&P exam ASAP to see how it went.
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War Toxin Exposure

Post by ichop » Fri Apr 05, 2013 1:00 am

Here is another great resource for toxins.

NGWRC Guide to Today’s Toxic Wars
National Gulf War Resource Center, Inc
2611 SW 17th Street Topeka, KS 66604
Phone: 866-531-7183 Fax 785-235-6531


I. NGWRC Mission
a. Purpose
b. Mission
c. Core Values
II. Summary of Updated Material
III. History of the Gulf War Illness Act.
a. The “Persian Gulf War Veterans’ Act of 1994
b. The “Persian Gulf War Veterans’ Act of 1998
c. The “Persian Gulf War Veterans’ Act of 2001
d. The July Revisions to 38 C.F.R. § 3.317
IV. Description of Gulf War Illnesses
a. What caused GWI
b. What are the signs of GWI
c. Who can file for illnesses due to GWI
V. Researchers
a. Lea Steele
b. Dr. Robert Haley
VI. Lack of Data
VII.Gulf War Veterans Information System
a. Veterans
b. Civilians
c. Family
2 Qualifying Chronic Disabilities
3 Where to Get Help
4 Post-Traumatic Stress Disorder
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Post by ichop » Fri Apr 05, 2013 1:21 am

Another good link:
http://vets.yuku.com/topic/55794/Are-yo ... V5eqYIoAnA

Are you a veteran with IBS

Mar 23 11 10:04 AM

Do you have to wear different paints due to occasional involuntary bowel movements? Is it more often like complete loss of control? If so, then you may have impairment of sphincter control of the rectum and anus.

If you can get your doctor to agree that this has been caused and or is due to your IBS and will put it in your records, then you can file a claim for it. It is also a good thing if the doctor will write you a letter in support of your claim. If you are not using a VA doctor that will not be to hard, it will be some of the VA doctors that will be hard. The most important part is that it gets into your records by the doctor that the IBS has caused you to develop the impairment of sphincter control of the rectum and anus.

Get a copy of your records for the release of information department at your VA before you leave. They will mail the report to you. Once you get it, read it over to make sure the doctor did enter into the records everything as he said he would. Do not go off on him if he made a mistake, they do have a lot of veterans they see every day. Call him up or go and see him about it. Remind him what was said and point out the error in the record. Then get a new print out.

With a good print out, file a claim for impairment of sphincter control of the rectum and anus.

Using a 21-4138 you will file the claim as: “ I am filing a claim for impairment of sphincter control of the rectum and anus as secondary to my service connected irritable bowel syndrome.”

Then in detail write out just how bad it is.

The close with this:

R. at 16. For purposes of evaluating his claim under the presumption statute and regulation, Mr. Gutierrez, as well as his wife, father, and friend, are competent to testify because his alleged symptoms of Persian Gulf War illness are capable of lay observation. See Caluza, supra (holding that where determinative issue does not require medical expertise, lay evidence alone suffices); see also Layno v. Brown, 6 Vet.App. 465, 469-70 (1994) (lay evidence is competent to establish features or symptoms of injury or illness).

Here is the diagnostic code

7332 Rectum and anus, impairment of sphincter control:

Complete loss of sphincter control............................ 100

Extensive leakage and fairly frequent involuntary bowel movements...................................... 60

Occasional involuntary bowel movements, necessitating wearing of pad............................ 30

Constant slight, or occasional moderate leakage............... 10

Healed or slight, without leakage............................. 0
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Re: Evidence and Links Used to Support VA Compensation Claim

Post by sledgehammer » Sat Apr 20, 2013 8:03 am

U.S. Courts of Appreal for Vets. No - 03-0506 Bruce W. Pierce (Appellant) V. Anthony J. Principi (Sec. of V.A.) 8 Feb., 2005 . This was used to increase a V.A rating. It involved headaches , mem. problems and con. difficulties. Freq. and severity of headaches were a major factor. Vet. also kept a record of events .
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