Asthma as a presumptive CMI?

Asthma as a presumptive CMI?

kd668
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Joined: 26 Jun 2017, 14:00

05 Sep 2017, 13:06 #1

I've been carefully reading through the self-help guide. On pages 26 and 27, it talks about diagnosed CMI's. 

Page 26 states that sub-paragraph (B)(1-3) is NOT limited to CFS, FM, or functional gastro disorders.  Any diagnosis you have which meets the 'signs and symptoms' criteria, and which is also chronic, multi-symptom, and medically unexplained, can be used to file a claim under CFR 38, 3.317(a)(2)(i)(B).

Page 27 states "now you need to prove that the diagnosis meets a subset of the criteria, which are the same whether the condition is diagnosed or not."

Page 16 states "It does not matter whether the CMI is one of the diagnoses named in 3.317(a)(2)(i)(B), a diagnosis not specifically named but which meets the criteria found in FL 10-26."

As I see it, asthma falls under the subset of criteria (respiratory system) and is multi-symptom...shortness of breath, chest tightness, chronic coughing. It is chronic, officially diagnosed 7 years ago.

Has anyone successfully filed asthma under the diagnosed CMI rules? 

PGWVET, this is what the guide is stating, correct?  I should be able to file this under diagnosed CMI from what I'm understanding.
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Bighighway
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Joined: 26 May 2016, 08:12

05 Sep 2017, 17:44 #2

kd668 wrote: I've been carefully reading through the self-help guide. On pages 26 and 27, it talks about diagnosed CMI's. 

Page 26 states that sub-paragraph (B)(1-3) is NOT limited to CFS, FM, or functional gastro disorders.  Any diagnosis you have which meets the 'signs and symptoms' criteria, and which is also chronic, multi-symptom, and medically unexplained, can be used to file a claim under CFR 38, 3.317(a)(2)(i)(B).

Page 27 states "now you need to prove that the diagnosis meets a subset of the criteria, which are the same whether the condition is diagnosed or not."

Page 16 states "It does not matter whether the CMI is one of the diagnoses named in 3.317(a)(2)(i)(B), a diagnosis not specifically named but which meets the criteria found in FL 10-26."

As I see it, asthma falls under the subset of criteria (respiratory system) and is multi-symptom...shortness of breath, chest tightness, chronic coughing. It is chronic, officially diagnosed 7 years ago.

Has anyone successfully filed asthma under the diagnosed CMI rules? 

PGWVET, this is what the guide is stating, correct?  I should be able to file this under diagnosed CMI from what I'm understanding.
I claimed shortness of breath and got denied by the RO. Appealed to the BVA and got awarded 30 percent. The judge said that the RO failed to address the PFT results, so yes you can get it.
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kd668
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Joined: 26 Jun 2017, 14:00

05 Sep 2017, 18:02 #3

Bighighway, did you claim shortness of breath as an undiagnosed illness?  Or were you diagnosed with asthma?  
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Cruiser
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Joined: 27 Nov 2003, 23:33

05 Sep 2017, 19:57 #4

Asthma is not a medically unexplained condition and would not qualify for presumptive service connection under 38 CFR 3.317.

Cruiser
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pgwvet
h3
h3
Joined: 08 Jun 2008, 00:42

05 Sep 2017, 21:35 #5

kd668 wrote: I've been carefully reading through the self-help guide. On pages 26 and 27, it talks about diagnosed CMI's. 

Page 26 states that sub-paragraph (B)(1-3) is NOT limited to CFS, FM, or functional gastro disorders.  Any diagnosis you have which meets the 'signs and symptoms' criteria, and which is also chronic, multi-symptom, and medically unexplained, can be used to file a claim under CFR 38, 3.317(a)(2)(i)(B).

Page 27 states "now you need to prove that the diagnosis meets a subset of the criteria, which are the same whether the condition is diagnosed or not."

Page 16 states "It does not matter whether the CMI is one of the diagnoses named in 3.317(a)(2)(i)(B), a diagnosis not specifically named but which meets the criteria found in FL 10-26."

As I see it, asthma falls under the subset of criteria (respiratory system) and is multi-symptom...shortness of breath, chest tightness, chronic coughing. It is chronic, officially diagnosed 7 years ago.

Has anyone successfully filed asthma under the diagnosed CMI rules? 

PGWVET, this is what the guide is stating, correct?  I should be able to file this under diagnosed CMI from what I'm understanding.
Asthma is NOT a diagnosed medically unexplained chronic multi-symptom illness that you can file for under 3.317.
James A. Bunker
Executive Director
National Gulf War Resource Center
1725 SW Gage Blvd.
2nd Floor #200
Topeka, KS 66604
Gulf War Illness Guide
http://kansasvets.org
Like us on Facebook
http://www.facebook.com/ngwrc
HTTP://WWW.NGWRC.ORG
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pgwvet
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h3
Joined: 08 Jun 2008, 00:42

05 Sep 2017, 21:39 #6

kd668 wrote: Bighighway, did you claim shortness of breath as an undiagnosed illness?  Or were you diagnosed with asthma?  
This a diagnosis of asthma, even trying to claim the symptoms of "shortness of breath" as due to your service in the gulf will be denied. It is because you will have a diagnosed illness of asthma.  The first rule is if the VBA can run a lab test and find a cause to they symptom, you cannot claim the symptom. I made it clear in the guide.
James A. Bunker
Executive Director
National Gulf War Resource Center
1725 SW Gage Blvd.
2nd Floor #200
Topeka, KS 66604
Gulf War Illness Guide
http://kansasvets.org
Like us on Facebook
http://www.facebook.com/ngwrc
HTTP://WWW.NGWRC.ORG
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kd668
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Joined: 26 Jun 2017, 14:00

06 Sep 2017, 00:23 #7

Yes, I understand that pgwvet.

I'm asking how he filed, because he eventually got approved for shortness of breath at 30%.  It seems like if it was serious enough to warrant 30%, how was it not diagnosed as asthma?
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Bighighway
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Joined: 26 May 2016, 08:12

06 Sep 2017, 03:54 #8

kd668 wrote: Bighighway, did you claim shortness of breath as an undiagnosed illness?  Or were you diagnosed with asthma?  
Yes undiagnosed, 8866-6602 never been diagnosed with nothing however, the judge told them 3 options was available with my PFT results.
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Bighighway
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Joined: 26 May 2016, 08:12

06 Sep 2017, 04:49 #9

Bighighway wrote:
kd668 wrote: Bighighway, did you claim shortness of breath as an undiagnosed illness?  Or were you diagnosed with asthma?  
Yes undiagnosed, 8866-6602 never been diagnosed with nothing however, the judge told them 3 options was available with my PFT results.
I hate to disagree with PGWVET however, I have to this time because it happened to me. My Pulmonary Function Test (PFT) FEV-1 was 59. Run all the test you need that 59 will not change. What will change is the diagnosis, FEV-1 between 56-70; 6600 Bronchitis Chronic, 6601 Bronchictasis, 6602 Asthma, 6603 Emphysema, 6604 COPD. They all have the same criteria and treated basically the same! Hence the 8866-6602 which could have been any one of the above.
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pgwvet
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h3
Joined: 08 Jun 2008, 00:42

06 Sep 2017, 17:45 #10

Bighighway wrote:
Bighighway wrote:
kd668 wrote: Bighighway, did you claim shortness of breath as an undiagnosed illness?  Or were you diagnosed with asthma?  
Yes undiagnosed, 8866-6602 never been diagnosed with nothing however, the judge told them 3 options was available with my PFT results.
I hate to disagree with PGWVET however, I have to this time because it happened to me. My Pulmonary Function Test (PFT)  FEV-1 was 59. Run all the test you need that 59 will not change. What will change is the diagnosis, FEV-1 between 56-70; 6600 Bronchitis Chronic, 6601 Bronchictasis, 6602 Asthma, 6603 Emphysema, 6604 COPD. They all have the same criteria and treated basically the same! Hence the 8866-6602 which could have been any one of the above.
The 8866 is for the undiagnosed part of the claim 6602 is what is is rated under.  The M21-1 explains how to rate a undiagnose illness claim, that is how your shortness of breath is done. 
There is also ways to get some diagnosed illness due to exposures rated too. I will not cover those ways. it is not easy and to many look for outs that should not. 

There is a way to get asthma as well as other things,  but there are some but IF'S you have to fill first. That is why it is a case by case only.
James A. Bunker
Executive Director
National Gulf War Resource Center
1725 SW Gage Blvd.
2nd Floor #200
Topeka, KS 66604
Gulf War Illness Guide
http://kansasvets.org
Like us on Facebook
http://www.facebook.com/ngwrc
HTTP://WWW.NGWRC.ORG
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Cruiser
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Joined: 27 Nov 2003, 23:33

07 Sep 2017, 03:36 #11

Bighighway wrote: I hate to disagree with PGWVET however, I have to this time
While you are free to disagree with anyone that you wish, the fact is that he is right and you are wrong.  Asthma is a diagnosed condition that would not be a Gulf War presumptive condition under 38 CFR 3.317.  For background info, I was a member of the select VA Gulf War team that implemented the undiagnosed illness presumptions in 1995.

Cruiser
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Bighighway
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Joined: 26 May 2016, 08:12

07 Sep 2017, 06:10 #12

Cruiser wrote:
Bighighway wrote: I hate to disagree with PGWVET however, I have to this time
While you are free to disagree with anyone that you wish, the fact is that he is right and you are wrong.  Asthma is a diagnosed condition that would not be a Gulf War presumptive condition under 38 CFR 3.317.  For background info, I was a member of the select VA Gulf War team that implemented the undiagnosed illness presumptions in 1995.

Cruiser
Please see post number 8, I have never been diagnosed with asthma. I filed an undiagnosed illness IAW 38 CFR 3.317, respiratory disorder is among that list. I don't have no fancy letters at the end of my name. All I know is that I was having trouble breathing. Went to my PCP which set up a consult for a PFT. Got the results and issued or prescribed an inhaler. I waited 4 years to see a BVA judge that said the rater/regional office failed to address my lay statements and the fact that my PFT results where 59 which falls in the 30 percent rating of any 6600 condition, take a pick! Again, I filed for shortness of breath and let the professionals figure it out. Just as if someone filed for a mental disorder without naming one, or name one and is diagnosed with a different one and then determined it was due to service. Should he or she be denied, the court has said, NO. If you look at my code sheet or list of disabilities on Ebenefit it list 30 percent, 8866-6602 so please tell me what am I getting paid for monthly?
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kd668
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Joined: 26 Jun 2017, 14:00

07 Sep 2017, 16:47 #13

So basically, two people could have the exact same respiratory condition. One happens to see a private doc first, gets diagnosed with asthma, files a claim and gets denied. The other files a claim first, gets approved, and gets rated for asthma. It's absurd!   

So, we're screwed if we see private doctors for anything that may fit into the "undiagnosed" category, but we're screwed if we DON'T see a private doctor and get diagnosed with CFS, IBS, or FM before hand.

This gets my blood boiling. Too many sick vets (far more ill than I!) are not getting what they deserve or they're getting the runaround for years. The law needs updating! 

Pgwvet or Cruiser, do you think writing our congressmen would help?  How do we get this changed? I know you've been working on that, pgwvet, but could we all write letters?  Would it make a difference?
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KC135A
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Joined: 03 May 2016, 16:46

08 Sep 2017, 02:27 #14

I claimed my respiratory  (chronic coughing) as an unexplained multisymptom condition.  The pulmonologist the VA had sent me to said it was "like asthma but not " but used the code for asthma in her records. At the C&P the PA put it down as asthma. Lo and behold it was approved on appeal for asthma (100% due to the steroid treatment required to control it). In truth it is unexplained chronic inflammation of the bronchial passages in conjunction with inflammation of other organs including the skin rash conditions . So, no it is not presumptive, but if the cause is unknown it should be awarded even if it 'diagnosed' as asthma. In fact there is a an example of exactly this condition mimicking asthma  in one of the training letters or VA regs I quoted in my appeal. The other thing to point out is that even 'diagnosed' conditions are often just doctors being taught to always place a diagnosis on a condition. I think this is addressed in M21 or TL 10-10, can't recall right now. Anyway it is in the VA's own directions to raters.

So if the BVA would get their standards together it should not be such a fight for PGW vets. The same thing happened with my kidney condition. I was able to show that it was an insidious onset that only showed up as big issue several years after I got back. They denied it first time through, but with quoting their own regs and law it was approved at 60% based on presumed exposures including insect repellant, oil smoke, PG pills and other things they stated could have caused it. A guy I was flying with over there died of the same condition five years after we got back and his widow successfully sued for full benefits, which I also pointed out in my appeal.

The bottom line is that the raters and DROs are not well versed in GWI claims, and you have to proactively point out how they MUST rule under the law or under appeal where they screwed up. Otherwise you are setting yourself up for a long appeal process and years of stress when it get to the point you can not work. Ironically my original C&P doc was later assigned as my primary care. When I told him how badly he had screwed up my case he said " well we all know everyone wins if you keep appealing".  I asked him why that could be if the law is the law, and if he believed GWI was real. He said sure but the "jury is still out".  Very telling I thought. I fired him and moved to another VA for care despite the drive.

Hope this helps. 
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KC135A
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Joined: 03 May 2016, 16:46

08 Sep 2017, 02:39 #15

kd668 wrote: So basically, two people could have the exact same respiratory condition. One happens to see a private doc first, gets diagnosed with asthma, files a claim and gets denied. The other files a claim first, gets approved, and gets rated for asthma. It's absurd!   

So, we're screwed if we see private doctors for anything that may fit into the "undiagnosed" category, but we're screwed if we DON'T see a private doctor and get diagnosed with CFS, IBS, or FM before hand.

This gets my blood boiling. Too many sick vets (far more ill than I!) are not getting what they deserve or they're getting the runaround for years. The law needs updating! 

Pgwvet or Cruiser, do you think writing our congressmen would help?  How do we get this changed? I know you've been working on that, pgwvet, but could we all write letters?  Would it make a difference?
In my experience Congressmen don't want to or can't really get into the appeal process. All the laws are in place, all the regs are in place...just up to the vet to know them better than the raters seem to. I know when I sat down with the DRO armed with a pile folders and regs and was ready to read them to him on a claim by claim basis he agreed that his people had not reviewed the regs properly saying they don't get that many GW claims. He agreed to use 10-10 and M21 which they obviously did thank God.
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KC135A
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Joined: 03 May 2016, 16:46

08 Sep 2017, 02:55 #16

pgwvet wrote:
kd668 wrote: I've been carefully reading through the self-help guide. On pages 26 and 27, it talks about diagnosed CMI's. 

Page 26 states that sub-paragraph (B)(1-3) is NOT limited to CFS, FM, or functional gastro disorders.  Any diagnosis you have which meets the 'signs and symptoms' criteria, and which is also chronic, multi-symptom, and medically unexplained, can be used to file a claim under CFR 38, 3.317(a)(2)(i)(B).

Page 27 states "now you need to prove that the diagnosis meets a subset of the criteria, which are the same whether the condition is diagnosed or not."

Page 16 states "It does not matter whether the CMI is one of the diagnoses named in 3.317(a)(2)(i)(B), a diagnosis not specifically named but which meets the criteria found in FL 10-26."

As I see it, asthma falls under the subset of criteria (respiratory system) and is multi-symptom...shortness of breath, chest tightness, chronic coughing. It is chronic, officially diagnosed 7 years ago.

Has anyone successfully filed asthma under the diagnosed CMI rules? 

PGWVET, this is what the guide is stating, correct?  I should be able to file this under diagnosed CMI from what I'm understanding.
Asthma is NOT a diagnosed medically unexplained chronic multi-symptom illness that you can file for under 3.317.
“It appears that claims have been routinely denied as ‘diagnosed’ conditions, when in actuality the ‘diagnoses’ were just labels for unexplained symptoms that were part of a larger pattern of disability….” 38 CFR 5.2.4.

So 'asthma' certainly can fall under medically unexplained and part of the  overall pattern of disabilities. I am at a 100% rating for what is called asthma in the rating yet was indeed considered part of my GWI.  As I pointed out in my appeal "... an undiagnosed Gulf War related condition and therefore should be considered presumptive and more likely than not a medically unexplained chronic multi symptom related illness as part of a cluster of undiagnosed illnesses as per CFR 38, 3.317 (a) (2) (i) (B) and subject to 38 US Code 5107." I had to point out that it was not technically asthma yet it was rated as asthma related to Gulf War exposures.

 What the raters or whomever fail to consider it seems is the overall pattern of illnesses which make up GWI for many of us.  
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KC135A
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Joined: 03 May 2016, 16:46

08 Sep 2017, 03:10 #17

pgwvet wrote:
Bighighway wrote:
Bighighway wrote:

Yes undiagnosed, 8866-6602 never been diagnosed with nothing however, the judge told them 3 options was available with my PFT results.
I hate to disagree with PGWVET however, I have to this time because it happened to me. My Pulmonary Function Test (PFT)  FEV-1 was 59. Run all the test you need that 59 will not change. What will change is the diagnosis, FEV-1 between 56-70; 6600 Bronchitis Chronic, 6601 Bronchictasis, 6602 Asthma, 6603 Emphysema, 6604 COPD. They all have the same criteria and treated basically the same! Hence the 8866-6602 which could have been any one of the above.
The 8866 is for the undiagnosed part of the claim 6602 is what is is rated under.  The M21-1 explains how to rate a undiagnose illness claim, that is how your shortness of breath is done. 
There is also ways to get some diagnosed illness due to exposures rated too. I will not cover those ways. it is not easy and to many look for outs that should not. 

There is a way to get asthma as well as other things,  but there are some but IF'S you have to fill first. That is why it is a case by case only.
Also the Kansas study does point out that many of us have developed sensitivity to chemicals, smoke and other agents which present as asthma at times. 
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Bighighway
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Joined: 26 May 2016, 08:12

08 Sep 2017, 13:25 #18

KC135A wrote:
pgwvet wrote:
Bighighway wrote:

I hate to disagree with PGWVET however, I have to this time because it happened to me. My Pulmonary Function Test (PFT)  FEV-1 was 59. Run all the test you need that 59 will not change. What will change is the diagnosis, FEV-1 between 56-70; 6600 Bronchitis Chronic, 6601 Bronchictasis, 6602 Asthma, 6603 Emphysema, 6604 COPD. They all have the same criteria and treated basically the same! Hence the 8866-6602 which could have been any one of the above.
The 8866 is for the undiagnosed part of the claim 6602 is what is is rated under.  The M21-1 explains how to rate a undiagnose illness claim, that is how your shortness of breath is done. 
There is also ways to get some diagnosed illness due to exposures rated too. I will not cover those ways. it is not easy and to many look for outs that should not. 

There is a way to get asthma as well as other things,  but there are some but IF'S you have to fill first. That is why it is a case by case only.
Also the Kansas study does point out that many of us have developed sensitivity to chemicals, smoke and other agents which present as asthma at times. 
Thank you KC135A, again PGWVET has done some great work for veterans at the NGWRC. Cruiser has done a great job here. Both have tons of experience but that doesn't make them all knowing God's. You can't piss on my feet and then tell me it's raining. We should focus on working together for change and improvements.

Veteran puts in a claim for skin or prostate cancer. RO confirms the diagnosis, confirms vet served in Vietnam with boots on the ground. Results, presumptive conditions and claim granted.

Veteran puts in a claim for IBS, stomach cramps, using the restroom to much or not enough, bloating, or excessive gas. RO confirms vet served in the Persian Gulf with boots on the ground. Results, presumptive conditions and claim denied.
But I have read here over and over the VA or raters don't look to deny. Someone please defend or spin why over 80 percent of gulf war claims are denied and in Waco it's over 90 percent. Denied when they are presumptive conditions and case law that state no nexus is needed!
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pgwvet
h3
h3
Joined: 08 Jun 2008, 00:42

08 Sep 2017, 14:02 #19

Bighighway wrote:
KC135A wrote:
pgwvet wrote:

The 8866 is for the undiagnosed part of the claim 6602 is what is is rated under.  The M21-1 explains how to rate a undiagnose illness claim, that is how your shortness of breath is done. 
There is also ways to get some diagnosed illness due to exposures rated too. I will not cover those ways. it is not easy and to many look for outs that should not. 

There is a way to get asthma as well as other things,  but there are some but IF'S you have to fill first. That is why it is a case by case only.
Also the Kansas study does point out that many of us have developed sensitivity to chemicals, smoke and other agents which present as asthma at times. 
Thank you KC135A, again PGWVET has done some great work for veterans at the NGWRC. Cruiser has done a great job here. Both have tons of experience but that doesn't make them all knowing God's. You can't piss on my feet and then tell me it's raining. We should focus on working together for change and improvements.

Veteran puts in a claim for skin or prostate cancer. RO confirms the diagnosis, confirms vet served in Vietnam with boots on the ground. Results, presumptive conditions and claim granted.

Veteran puts in a claim for IBS, stomach cramps, using the restroom to much or not enough, bloating, or excessive gas. RO confirms vet served in the Persian Gulf with boots on the ground. Results, presumptive conditions and claim denied.
But I have read here over and over the VA or raters don't look to deny. Someone please defend or spin why over 80 percent of gulf war claims are denied and in Waco it's over 90 percent. Denied when they are presumptive conditions and case law that state no nexus is needed!
You would not like what I would tell you on why 80% are denied from all of my years of working claims on this issue and also helping veterans and their VSO. Cruiser and I both have addressed it in different posts over the years.

Just like some on this post is wrong on their thinking, overreaching is a problem.
As for not taking you statement in a claim, yes that is a CUE. courts have ruled on it for years.
in many of the diagnosed cases the VA did not apply 38 USC 1154(b) that only real combat veterans can use.  Example is a guy with a CIB.

Take care.
James A. Bunker
Executive Director
National Gulf War Resource Center
1725 SW Gage Blvd.
2nd Floor #200
Topeka, KS 66604
Gulf War Illness Guide
http://kansasvets.org
Like us on Facebook
http://www.facebook.com/ngwrc
HTTP://WWW.NGWRC.ORG
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KC135A
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Joined: 03 May 2016, 16:46

08 Sep 2017, 15:40 #20

Bighighway wrote:
KC135A wrote:
pgwvet wrote:

The 8866 is for the undiagnosed part of the claim 6602 is what is is rated under.  The M21-1 explains how to rate a undiagnose illness claim, that is how your shortness of breath is done. 
There is also ways to get some diagnosed illness due to exposures rated too. I will not cover those ways. it is not easy and to many look for outs that should not. 

There is a way to get asthma as well as other things,  but there are some but IF'S you have to fill first. That is why it is a case by case only.
Also the Kansas study does point out that many of us have developed sensitivity to chemicals, smoke and other agents which present as asthma at times. 
Thank you KC135A, again PGWVET has done some great work for veterans at the NGWRC. Cruiser has done a great job here. Both have tons of experience but that doesn't make them all knowing God's. You can't piss on my feet and then tell me it's raining. We should focus on working together for change and improvements.

Veteran puts in a claim for skin or prostate cancer. RO confirms the diagnosis, confirms vet served in Vietnam with boots on the ground. Results, presumptive conditions and claim granted.

Veteran puts in a claim for IBS, stomach cramps, using the restroom to much or not enough, bloating, or excessive gas. RO confirms vet served in the Persian Gulf with boots on the ground. Results, presumptive conditions and claim denied.
But I have read here over and over the VA or raters don't look to deny. Someone please defend or spin why over 80 percent of gulf war claims are denied and in Waco it's over 90 percent. Denied when they are presumptive conditions and case law that state no nexus is needed!
I want to stress that I am no expert in any claims or appeals other than my own. But in the end by not sitting back and let them dictate how they wanted to to rule as my VSO was scared to "make them mad" by pointing out the regs to them it worked. I also made sure I had DXs and DBQs for IBS, CFS and FB. WRIISC really helped out as did a VA researcher I contacted in terms of convincing VA docs this stuff is real.

As for raters looking to deny claims, all I know is that in my case in the original claim on the respiratory issues the guy went out of his way to ignore Mayo and other records that stated my chronic coughing was idiopathic and assigned a DX of pneumonitis  which was only mentioned once in 20 years. The same on many other issues I have. So perhaps it is not the reason 80% are denied, but given so many are claims are finally approved on appeal rather than originally is mystifying. Perhaps most claims such as mine were not completed properly to start with, perhaps as PGWVet has hinted at that some guys 'over reach' or in English try to scam the system? 

All I know is that when I got very serious about the appeal process and got by stuff in order things finally worked out. Funny enough now that I have the ratings for GWI issues my care at the VA has been outstanding. A total 180.

Good luck.
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Bighighway
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Joined: 26 May 2016, 08:12

08 Sep 2017, 16:31 #21

KC135A wrote: I claimed my respiratory  (chronic coughing) as an unexplained multisymptom condition.  The pulmonologist the VA had sent me to said it was "like asthma but not " but used the code for asthma in her records. At the C&P the PA put it down as asthma. Lo and behold it was approved on appeal for asthma (100% due to the steroid treatment required to control it). In truth it is unexplained chronic inflammation of the bronchial passages in conjunction with inflammation of other organs including the skin rash conditions . So, no it is not presumptive, but if the cause is unknown it should be awarded even if it 'diagnosed' as asthma. In fact there is a an example of exactly this condition mimicking asthma  in one of the training letters or VA regs I quoted in my appeal. The other thing to point out is that even 'diagnosed' conditions are often just doctors being taught to always place a diagnosis on a condition. I think this is addressed in M21 or TL 10-10, can't recall right now. Anyway it is in the VA's own directions to raters.

So if the BVA would get their standards together it should not be such a fight for PGW vets. The same thing happened with my kidney condition. I was able to show that it was an insidious onset that only showed up as big issue several years after I got back. They denied it first time through, but with quoting their own regs and law it was approved at 60% based on presumed exposures including insect repellant, oil smoke, PG pills and other things they stated could have caused it. A guy I was flying with over there died of the same condition five years after we got back and his widow successfully sued for full benefits, which I also pointed out in my appeal.

The bottom line is that the raters and DROs are not well versed in GWI claims, and you have to proactively point out how they MUST rule under the law or under appeal where they screwed up. Otherwise you are setting yourself up for a long appeal process and years of stress when it get to the point you can not work. Ironically my original C&P doc was later assigned as my primary care. When I told him how badly he had screwed up my case he said " well we all know everyone wins if you keep appealing".  I asked him why that could be if the law is the law, and if he believed GWI was real. He said sure but the "jury is still out".  Very telling I thought. I fired him and moved to another VA for care despite the drive.

Hope this helps. 
Thank you, just trying to point that the system is broken. I have been told VA Training Letter 10-01 & 10-03 have been replaced by M21-1. Nowhere in the latter does it explain the facts in both training letters that came out in 2010. So, if a rater wasn't in that position until recently those facts are lost. As far as scammers, 1 in 4 Gulf War Veterans was exposed or suffer from the deployment. That number would be close to 200,000. Then look at the claims granted and denied, the numbers don't add up. So the question should be who's doing the scamming? The government that said and continue to say, Agent Orange doesn't exist or Gulf War Syndrome but gives it another name. The DOD, that said at first maybe 5000, 20,000, 50,000 and now the number is 250,000 but it's all low level exposure. If a lie was told about how many, how can I depend on the exposure level. When my fellow veterans are still suffering and being denied benefits they fought for in the sand. Sorry, to get on my soap box, and I apologize if I offended anyone. Just tired Boss, Dog Tired!!!!
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Cruiser
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Joined: 27 Nov 2003, 23:33

08 Sep 2017, 18:25 #22

Bighighway wrote:


Someone please defend or spin why over 80 percent of gulf war claims are denied and in Waco it's over 90 percent. Denied when they are presumptive conditions and case law that state no nexus is needed!
Your answer can be found in this thread.  People use 38 CFR 3.317 to attempt to obtain service connection for everything under the sun.  Asthma is not an undiagnosed illness nor is it a medically unexplained illness and simply does not qualify for service connection on this basis; however, that doesn't stop people from submitting the claims and then complaining afterward about how VA denied their claim.

Cruiser
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KC135A
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Joined: 03 May 2016, 16:46

09 Sep 2017, 00:15 #23

Cruiser wrote:
Bighighway wrote:


Someone please defend or spin why over 80 percent of gulf war claims are denied and in Waco it's over 90 percent. Denied when they are presumptive conditions and case law that state no nexus is needed!
Your answer can be found in this thread.  People use 38 CFR 3.317 to attempt to obtain service connection for everything under the sun.  Asthma is not an undiagnosed illness nor is it a medically unexplained illness and simply does not qualify for service connection on this basis; however, that doesn't stop people from submitting the claims and then complaining afterward about how VA denied their claim.

Cruiser
Where in this thread has anyone CLAIMED asthma?????? 

 I understand you get defensive and all, but you need to actually read what is posted perhaps.
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KC135A
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Joined: 03 May 2016, 16:46

09 Sep 2017, 00:22 #24

Bighighway wrote:
KC135A wrote: I claimed my respiratory  (chronic coughing) as an unexplained multisymptom condition.  The pulmonologist the VA had sent me to said it was "like asthma but not " but used the code for asthma in her records. At the C&P the PA put it down as asthma. Lo and behold it was approved on appeal for asthma (100% due to the steroid treatment required to control it). In truth it is unexplained chronic inflammation of the bronchial passages in conjunction with inflammation of other organs including the skin rash conditions . So, no it is not presumptive, but if the cause is unknown it should be awarded even if it 'diagnosed' as asthma. In fact there is a an example of exactly this condition mimicking asthma  in one of the training letters or VA regs I quoted in my appeal. The other thing to point out is that even 'diagnosed' conditions are often just doctors being taught to always place a diagnosis on a condition. I think this is addressed in M21 or TL 10-10, can't recall right now. Anyway it is in the VA's own directions to raters.

So if the BVA would get their standards together it should not be such a fight for PGW vets. The same thing happened with my kidney condition. I was able to show that it was an insidious onset that only showed up as big issue several years after I got back. They denied it first time through, but with quoting their own regs and law it was approved at 60% based on presumed exposures including insect repellant, oil smoke, PG pills and other things they stated could have caused it. A guy I was flying with over there died of the same condition five years after we got back and his widow successfully sued for full benefits, which I also pointed out in my appeal.

The bottom line is that the raters and DROs are not well versed in GWI claims, and you have to proactively point out how they MUST rule under the law or under appeal where they screwed up. Otherwise you are setting yourself up for a long appeal process and years of stress when it get to the point you can not work. Ironically my original C&P doc was later assigned as my primary care. When I told him how badly he had screwed up my case he said " well we all know everyone wins if you keep appealing".  I asked him why that could be if the law is the law, and if he believed GWI was real. He said sure but the "jury is still out".  Very telling I thought. I fired him and moved to another VA for care despite the drive.

Hope this helps. 
Thank you, just trying to point that the system is broken. I have been told VA Training Letter 10-01 & 10-03 have been replaced by M21-1. Nowhere in the latter does it explain the facts in both training letters that came out in 2010. So, if a rater wasn't in that position until recently those facts are lost. As far as scammers, 1 in 4 Gulf War Veterans was exposed or suffer from the deployment. That number would be close to 200,000. Then look at the claims granted and denied, the numbers don't add up. So the question should be who's doing the scamming? The government that said and continue to say, Agent Orange doesn't exist or Gulf War Syndrome but gives it another name. The DOD, that said at first maybe 5000, 20,000, 50,000 and now the number is 250,000 but it's all low level exposure. If a lie was told about how many, how can I depend on the exposure level. When my fellow veterans are still suffering and being denied benefits they fought for in the sand. Sorry, to get on my soap box, and I apologize if I offended anyone. Just tired Boss, Dog Tired!!!!
I agree 100%. The VA still has docs and others who don't buy into what is a devastating condition for many of us, and gets worse as we age. 

WRIISC just sent out a study participation request to GWI vets asking us to give information on how our docs deal with and accept our reality. Clearly, there is still a huge problem within the VA concerning both the treatment and comp sides concerning GWI. As you pointed out the history of these sort of war related issues is not exactly stellar.  
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kd668
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Joined: 26 Jun 2017, 14:00

09 Sep 2017, 01:37 #25

Yes, I asked the question about asthma.  After studying the laws and the self help guide, it looked to me like CFS, FM and IBS were not the only CMI's that can be claimed under that rule. It clearly says CMI's 'SUCH AS' CFS, FM, and IBS, which leads me to believe that other conditions could also be CMI's. (Has anyone ever claimed one besides those three?)

Logically, if gastrointestinal signs or symptoms can lead to a diagnosable illness such as IBS, why couldn't respiratory signs or symptoms lead to a diagnosable illness such as asthma. To me, asthma seems just as "medically unexplained" as IBS or functional constipation. But, clearly it's a moot point. I would just need to have my pulmonologist write a nexus letter.

The undiagnosed illness claims are problematic and declined at a 90% rate according to the Veteran Affairs Committee hearing that I just watched.  Undiagnosed illness claims just don't work and it's hurting veterans. They talked about a single case definition. That might come to pass in March. Hopefully, it would help.
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Cruiser
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Joined: 27 Nov 2003, 23:33

09 Sep 2017, 03:57 #26

KC135A wrote: Where in this thread has anyone CLAIMED asthma?????? 

 I understand you get defensive and all, but you need to actually read what is posted perhaps.
Where in my post did I say that anyone in this thread had claimed asthma?  The question was about claiming asthma and my answer was based on my personal experience working about a thousand Gulf War claims, many of which included claims exactly like what is being asked about in this thread.

I think that perhaps you are the one who needs to read what is posted, or perhaps you did read it and just didn't understand it.  If so, I apologize for suggesting that you didn't read it.

As for me getting defensive, that seems to be a common response from more than a few in this forum when they get an honest and truthful answer that they just don't like.  I can't do anything about that.

Cruiser
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AAlarcon61
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Joined: 25 Aug 2014, 04:58

15 Sep 2017, 01:48 #27

Cruiser wrote: Asthma is not a medically unexplained condition and would not qualify for presumptive service connection under 38 CFR 3.317.

Cruiser
What if you were Dx with Asthma shortly after returning from the Gulf War and way before Presumptive conditions were in play?
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Cruiser
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Joined: 27 Nov 2003, 23:33

15 Sep 2017, 04:07 #28

AAlarcon61 wrote:

What if you were Dx with Asthma shortly after returning from the Gulf War and way before Presumptive conditions were in play?
I don't understand your question.  Asthma is not a presumptive disability under any law or regulation including the presumptions granted under 38 CFR 3.317.  If there was no evidence of asthma in service either before or after 3.317 was enacted it would be no different in that service connection would not be warranted.

Cruiser
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AAlarcon61
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Joined: 25 Aug 2014, 04:58

15 Sep 2017, 05:44 #29

Cruiser wrote:
AAlarcon61 wrote:

What if you were Dx with Asthma shortly after returning from the Gulf War and way before Presumptive conditions were in play?
I don't understand your question.  Asthma is not a presumptive disability under any law or regulation including the presumptions granted under 38 CFR 3.317.  If there was no evidence of asthma in service either before or after 3.317 was enacted it would be no different in that service connection would not be warranted.

Cruiser
Thanks for the reply. I guess I didn't provide sufficient information. When I returned from the GW in '91, I returned very ill with plenty of breathing issues. I was Dx w/asthma in '92. I have been treated for it ever since. There is nothing in my medical records prior to serving in the Gulf and plenty appointment and treatment records post GW. I don't know the exact date of when Presumptive conditions were being considered but I am sure it was after' 92. Maybe I understand the regs incorrectly but once you are Dx service connection is denied. Am I correct? I returned ill from my service in SE Asia.
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BROVET
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Joined: 17 Apr 2006, 19:42

15 Sep 2017, 13:14 #30

KC135A wrote:
Cruiser wrote:
Bighighway wrote:


Someone please defend or spin why over 80 percent of gulf war claims are denied and in Waco it's over 90 percent. Denied when they are presumptive conditions and case law that state no nexus is needed!
Your answer can be found in this thread.  People use 38 CFR 3.317 to attempt to obtain service connection for everything under the sun.  Asthma is not an undiagnosed illness nor is it a medically unexplained illness and simply does not qualify for service connection on this basis; however, that doesn't stop people from submitting the claims and then complaining afterward about how VA denied their claim.

Cruiser
Where in this thread has anyone CLAIMED asthma?????? 

 I understand you get defensive and all, but you need to actually read what is posted perhaps.
Did you read the OP's opening question?


"Has anyone successfully filed asthma under the diagnosed CMI rules? "
 

   
      
      A Co. 2nd/2nd
      1st Infantry
      11/66-11/67     
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Bighighway
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Joined: 26 May 2016, 08:12

15 Sep 2017, 22:55 #31

BROVET wrote:
KC135A wrote:
Cruiser wrote:

Your answer can be found in this thread.  People use 38 CFR 3.317 to attempt to obtain service connection for everything under the sun.  Asthma is not an undiagnosed illness nor is it a medically unexplained illness and simply does not qualify for service connection on this basis; however, that doesn't stop people from submitting the claims and then complaining afterward about how VA denied their claim.

Cruiser
Where in this thread has anyone CLAIMED asthma?????? 

 I understand you get defensive and all, but you need to actually read what is posted perhaps.
Did you read the OP's opening question?


"Has anyone successfully filed asthma under the diagnosed CMI rules? "
Yes read it, please define successfully. At some or one time a veteran believed he suffered a injury or illness while in the service of this nation. His or her main goal, a grant of compensation. I can't tell the OP how to win for asthma as a CMI. However, as a undiagnosed illness filed as shortness of breathe I was awarded my claim under diagnostic code 8866-6602 which is asthma. That being said, it could have been 8866-6603 or 8866-6604 because the criteria is the same based on the PFT results. Regardless of how you got the award, the goal is to get it.
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pgwvet
h3
h3
Joined: 08 Jun 2008, 00:42

20 Sep 2017, 15:07 #32

AAlarcon61 wrote:
Cruiser wrote:
AAlarcon61 wrote:

What if you were Dx with Asthma shortly after returning from the Gulf War and way before Presumptive conditions were in play?
I don't understand your question.  Asthma is not a presumptive disability under any law or regulation including the presumptions granted under 38 CFR 3.317.  If there was no evidence of asthma in service either before or after 3.317 was enacted it would be no different in that service connection would not be warranted.

Cruiser
Thanks for the reply. I guess I didn't provide sufficient information. When I returned from the GW in '91, I returned very ill with plenty of breathing issues. I was Dx w/asthma in '92. I have been treated for it ever since. There is nothing in my medical records prior to serving in the Gulf and plenty appointment and treatment records post GW. I don't know the exact date of when Presumptive conditions were being considered but I am sure it was after' 92. Maybe I understand the regs incorrectly but once you are Dx service connection is denied. Am I correct? I returned ill from my service in SE Asia.
This example is in the Gulf War examiner training guide. A web base video on TMS for the examiners. I took the course to help on making it better. Veterans in your example was used to give a connection due to the exposure of the PM in the war.  (sand, smoke, ext). Smoking is looked at as well as the onset (close to leaving the area)  of the symptoms. A high percentage of USMC that did the fighting did report symptoms in the gulf compared to their counterparts that staid back near the port. To do this you HAVE to show the proof in your records when it started. The doctors you went to. The treatment. You will need to turn in the records. You will need to list all VA medical centers you went to and the dates.


As I posted, there is a way; but it is only a case by case way as outlined in 8-98.  Asthma is a diagnosed illness and does not fall under the 38 CFR 3.317 in any form.
If anyone wants to keep calling Asthma a CMI do so, there are two types so it would be the one Congress stated cannot be granted under the law.
"Chronic multisymptom illnesses of partially understood etiology and pathophysiology  will not be considered medically unexplained."
Stop trying to read into the law that is not their.

Also it is not that 1/4 are sick it is some think that 1/4 are, remember that may deployed in other engagements and are service connected that way.  Some are SC with other issues so the symptoms are covered there.

Cruiser and I both have see any reasons to say there have been a lot of thing filed wrong.  Both by the Vet/VSO and the VARO inferring the claim.
James A. Bunker
Executive Director
National Gulf War Resource Center
1725 SW Gage Blvd.
2nd Floor #200
Topeka, KS 66604
Gulf War Illness Guide
http://kansasvets.org
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HTTP://WWW.NGWRC.ORG
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AAlarcon61
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Joined: 25 Aug 2014, 04:58

21 Sep 2017, 00:21 #33

pgwvet wrote:
AAlarcon61 wrote:
Cruiser wrote:

I don't understand your question.  Asthma is not a presumptive disability under any law or regulation including the presumptions granted under 38 CFR 3.317.  If there was no evidence of asthma in service either before or after 3.317 was enacted it would be no different in that service connection would not be warranted.

Cruiser
Thanks for the reply. I guess I didn't provide sufficient information. When I returned from the GW in '91, I returned very ill with plenty of breathing issues. I was Dx w/asthma in '92. I have been treated for it ever since. There is nothing in my medical records prior to serving in the Gulf and plenty appointment and treatment records post GW. I don't know the exact date of when Presumptive conditions were being considered but I am sure it was after' 92. Maybe I understand the regs incorrectly but once you are Dx service connection is denied. Am I correct? I returned ill from my service in SE Asia.
This example is in the Gulf War examiner training guide. A web base video on TMS for the examiners. I took the course to help on making it better. Veterans in your example was used to give a connection due to the exposure of the PM in the war.  (sand, smoke, ext). Smoking is looked at as well as the onset (close to leaving the area)  of the symptoms. A high percentage of USMC that did the fighting did report symptoms in the gulf compared to their counterparts that staid back near the port. To do this you HAVE to show the proof in your records when it started. The doctors you went to. The treatment. You will need to turn in the records. You will need to list all VA medical centers you went to and the dates.


As I posted, there is a way; but it is only a case by case way as outlined in 8-98.  Asthma is a diagnosed illness and does not fall under the 38 CFR 3.317 in any form.
If anyone wants to keep calling Asthma a CMI do so, there are two types so it would be the one Congress stated cannot be granted under the law.
"Chronic multisymptom illnesses of partially understood etiology and pathophysiology  will not be considered medically unexplained."
Stop trying to read into the law that is not their.

Also it is not that 1/4 are sick it is some think that 1/4 are, remember that may deployed in other engagements and are service connected that way.  Some are SC with other issues so the symptoms are covered there.

Cruiser and I both have see any reasons to say there have been a lot of thing filed wrong.  Both by the Vet/VSO and the VARO inferring the claim.
Thank you Sir for the information. There appears to be a dim light at the end of the long dark tunnel.
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