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      How to get your questions answered. A few observations, and requests of all members. All folks who come here are volunteers who do this on their own time and their own dime.To avoid burning out our best contributors please follow these guidelinesf you are reading a post and it reminds you of a question you want to ask, start a new topic, if you place your question in someone thread it will be difficult to distinguish your question from the original poster, you will get better results posting a new topic with your question. 1. Before Posting please do a search and see if your question has already been answered. If you find the answer print it out and put it in a file to use as a reference file, I find this helpful myself. 2. If you can not find the answer and you do post a question, please print out those answers and refer to them to avoid duplicate questions. 3. Refer to the Frequently Asked Questions4. Duplicate questions will come up from time to time but the keeping them to the minimum will lighten the load on the regular volunteers.5. Respect folks privacy do not request their personal phone numbers for claims help, it is inappropriate and not why they are here.6. Keep the topics focused on veterans issues, in closing Search first Search ... Ask second.it may save a lot of time or at the very least enlighten you.
    • Listen Live Every Wed 5:30 PM CST to SVR Radio, Veterans Issues are discussed with various guests.

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    • A bit about Tbird and HadIt.com for those who've asked...

      The following is on my About page, but some have been asking how this all happened. So here is my little story. Tbird US Navy 1983 – 1990 E-6 HadIt.com the website domain registered Jan 20, 1997 the domain is registered and paid for through Jan 21, 2023 at which time I plan to register it for another 15 years Lord willing and the creek don't rise. I guess the best place to start is Jan 1991; I had gotten out of the navy Dec 1990. At my separation seminar, there was a DAV rep Jim Milton he told us to bring our medical records in and he would look through them for us and let us know if we should file a claim with the VA. Well, bless his heart, he opened my medical file, reads the first insert, looks me straight in the eye, and says you will be 50% for the rest of your life and he would file the claim for me. 50% was for surgery I had in the service. True to his word he met with me and talked with me for a long time filled out my paper work and urged me to file for PTSD. I would not file the PTSD claim, nor even discuss it. By Feb 1991 I had moved to the San Francisco bay area and was staying at a friends apartment and pretty much I was just a puddle. In desperation one night I called suicide hot line, I had no job, no idea about going to the VA. They talked with me for a long time and explained to me that I could go to the local VA hospital even if I did not have insurance. Now, I know what you are thinking if I was 50% why didn't I just go to the VA in the first place, two reasons 1, this was Feb 1991 and the 50% didn't come till May and 2, even if it had come through it is unlikely that I would have had the mental acuity at the time to put the two together. I relate this here because it is where so many of our brothers and sisters are coming from, perhaps where you started. Fuzzy and unsure, in pain and sometimes homeless they come to the VA hospital for help. And that is where I ended up. Up to the pysch ward I went, blah, blah, blah, a few days later I was released with a promise of a call from the out patient program, which I would soon be entering. Blah, blah, blah, after many missed communications, and no call backs I was at the Day Hospital everyday M-F. And this brothers and sisters is where I began to learn and formulate my plan for HadIt.com. Veterans, veterans everywhere…I spent a year in the day hospital and about another year at a sheltered workshop before I got back on my feet. So I just talked to veterans everyday waiting for appointments, waiting for prescriptions, waiting for a vet rep and I started to learn the system. While in the navy I was data analyst and had to learn a 5 volume manual and just about anything you were suppose to do was in that manual. So I figured there must be a manual on how to do a VA claim or at the very least regulations. So I found out about the Code of Federal Regulations, United States Code, Veterans Affairs Manuals and so on and so forth. Of course this was 1991/1992 I was living in a tiny studio apartment in a particularly bad neighborhood, working in a sheltered workshop making a nickel per envelope I stuffed throw in PTSD and you will see that it was a difficult task for me to get somewhere where they had copies of these, let alone that they would let me look at. And there was so much knowledge around me, it was like the gold rush in those days, I could just sit on a bench a veteran would sit down next to me a little conversation later I had another nugget, I made copious notes. Phone numbers to call, ask for this guy or that guy he'll give you the straight scoop and they'd slip me a piece of paper with a number on it. You want to read this regulation or that one and another slip of paper into my hand. I spent a lot of time on those benches watching the squirrels they gathered their nuts and I gathered mine :) So I'm thinking I could put a little handbook together print it out and hand it out at the VA. Or perhaps fliers. Still formulating, time goes by, 1994/1995 I am being treated for PTSD regularly and doing and feeling much better and I go to work for a company as a marketing systems analyst and I discover the internet. Well let me tell you that was perhaps one of the most significant life changing events I have ever experienced. And I might add finally a positive one :) It seemed only natural to me that surely there must be a website that contained all the knowledge I wanted, well as it turned out not so much, lots of stuff but I wanted to get straight to the claims information and there was a lot of stuff to wade through to get to it. So taking my lesson from the squirrels earlier I started to gather, gather, gather…and learn HTML and work as a marketing systems analyst and work my claim. 1996/1997 major PTSD cork blows and unemployed. Working my claim, working the website. 20 Jan 1997 register HadIt.com domain name right after getting off the phone with the VA and saying I've had it with this. As fate would have it the old DAV board goes down just as mine opens up and folks start to wander in. So HadIt.com has two main components the website which supports the discussion board with links, articles, research resources etc. The website starts to grow, I can't tell you how many times I had to switch servers for space and features. I continue on a downward trend and in 1998 ended up back home in St Louis living in my sisters basement in therapy and working it, I swear I would have swung a dead chicken around my head at midnight naked if I thought it would have helped. The website continued to do great during this time, I just stayed in the basement bought new software, new books, and learned how to make things work and I continued to use this knowledge to make HadIt.com better. My 100% finally came through from the VA and I had a friend who is an advocate who helped me thru my SSDI claim, he was literally at my side thru the entire process and that came through for me. My therapist and sister continued to try and get me to leave the basement, but to no avail. At some point in 1998 or 1999 I put a counter on the website and was shocked to discover how many visitors we were getting. Time goes by my sister gets married and I move from the basement to the upstairs, there is much celebration that Aunt T is living in the light again. More time goes by and I settle into my life in St Louis and spend more time on the site trying new things, finding more information. 2003 I buy my own home VA loan. For years now I have just considered HadIt.com my job and I get up every morning go to the office and work for several hours, take an afternoon break and see where the rest of day takes me. I have a place in the office to use the computer and a comfortable to place to read journals and articles and take notes. Blah, blah, blah so that is my story and HadIt.com's intertwined.
    • HadIt.com Pass It On Cards

      Hi I've updated our HadIt.com Pass It On Cards. They are in a PDF format you can print them out cut them there are 12 to a page. If you have found HadIt.com helpful and would like to pass it on to other veterans this is an easy way to do it.I hope you find them helpful, feel free to leave a few anywhere veterans gather, veterans centers, veterans hospitals, public libraries, be creative. Please make sure though, that if you want to leave some at any business you ask permission first.Here you go http://www.hadit.com...it_on_cards.pdf
    • VA Training and Fast Letter Forum Index

      VA Training and Fast Letter Forum Index The following is the index with links to the various Training and Fast Letters plus a few miscellaneous. These letters are not necessarily in the original formatting. I have tried to present them in an easy-to-read form instead of some forms as originally presented. Some of the paragraphs were WAAAAYYY too long. lol - HadIt.com Member fanaticbooks Something to be aware.... Some of these letters may be rescinded, outdated, or otherwise no longer viable. I have still included them because sometimes they provide additional insight or just plain more information than the newest version. Use them wisely. The oldest letters will display at the bottom with the latest letters displayed at the top, all in sequential numbers. Coding of the letters... FL = Fast Letter TL = Training Letter First two numbers = last two digits of year of origin Training Letter http://www.hadit.com/forums/index.php?/topic/40694-va-tl-00-07/ http://www.hadit.com/forums/index.php?/topic/40693-va-tl-00-06/ Fast Letter Number Title http://www.hadit.com/forums/index.php?/topic/44262-va-fl-11-15/ http://www.hadit.com/forums/index.php?/topic/44260-va-fl-11-13/ http://www.hadit.com/forums/index.php?/topic/44261-va-fl-11-11/ http://www.hadit.com/forums/index.php?/topic/44310-va-fl-11-09/ http://www.hadit.com/forums/index.php?/topic/42151-va-fl-11-03/ http://www.hadit.com/forums/index.php?/topic/40957-va-fl-10-49/ http://www.hadit.com/forums/index.php?/topic/40958-va-fl-10-46/ http://www.hadit.com/forums/index.php?/topic/40959-va-fl-10-45/ http://www.hadit.com/forums/index.php?/topic/40960-va-fl-10-42/ http://www.hadit.com/forums/index.php?/topic/40961-va-fl-10-39/ http://www.hadit.com/forums/index.php?/topic/40962-va-fl-10-35/ 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  • 0

Astonishing Ptsd -hbp Bva Decision!

Question

Posted · Report post

I think this is an astonishing and fairly recent decision because Dr. Boscarini's work is acknowledged in this decision- (as a treatise)

His work on PTSD has never been given much credence by VA-in the past -unfortunately-

And it is a good example of the way Relative Equipoise is supposed to work.

Citation Nr: 0521679

Decision Date: 08/10/05 Archive Date: 08/19/05

DOCKET NO. 93-23 884 ) DATE

)

)

On appeal from the

Department of Veterans Affairs Regional Office in Newark, New

Jersey

THE ISSUE

Entitlement to service connection for hypertension.

REPRESENTATION

Appellant represented by: New Jersey Department of

Military and Veterans' Affairs

ATTORNEY FOR THE BOARD

Ronald W. Scholz, Senior Counsel

INTRODUCTION

The veteran served on active duty from July 1968 to April

1970.

This matter comes before the Board of Veterans' Appeals

(Board) on appeal from a February 1992 rating decision by the

Department of Veterans Affairs (VA) Regional Office (RO) in

Newark, New Jersey which denied service connection for

hypertension.

The Board remanded the issue on appeal in October 1995,

November 1999, and September 2003. In its September 2003

Remand, the Board directed a VA examination to determine

whether the veteran's hypertension was caused or aggravated

by his service-connected PTSD.

FINDING OF FACT

The evidence of record is in equipoise with respect to the

question of whether the veteran's diagnosed hypertension is

secondary to his service-connected PTSD

CONCLUSION OF LAW

Hypertension is proximately due to the veteran's service-

connected PTSD. 38 U.S.C.A. § 1110, 5107 (West 2002); 38

C.F.R. § 3.102, 3.310 (2004).

REASONS AND BASES FOR FINDING AND CONCLUSION

In light of the favorable action taken herein, discussion of

whether VA duties pursuant to the Veterans Claims Assistance

Act of 2000 (VCAA) have been satisfied is not required. The

Board finds that no further notification or assistance is

necessary, and deciding the appeal at this time is not

prejudicial to the veteran.

Factual Background

The veteran has been service-connected for PTSD since May

1992.

Medical evidence of record reflects that the veteran has a

current diagnosis of hypertension.

Pursuant to a September 2003 Board Remand, the veteran

received a VA medical examination in April 2004. The

examining VA physician concluded there was no relationship

between the veteran's service-connected PTSD and his

hypertension and, further, that PTSD did not cause

hypertension or contribute to any exacerbations of

hypertension.

An April 2005 letter from Alfred M. Dipiero, D.O., noted that

the veteran had been under his care for hypertension, and

concluded that the hypertension resulted from the veteran's

service-connected PTSD.

Legal Criteria

.

Service connection may also be granted on a secondary basis

if a claimed disability is found to be proximately due to, or

is the result of, an established service-connected disease or

injury. Establishing service connection on a secondary basis

requires evidence sufficient to show: (1) that a current

disability exits, and (2) that the current disability was

either (a) caused by or (;) aggravated by a service-

connected disease or injury. 38 C.F.R. § 3.310(a) (2004);

See Allen v. Brown, 7 Vet. App. 439, 446 (1995).

The Secretary shall consider all information and lay and

medical evidence of record with respect to benefits under

laws administered by the Secretary. When there is an

approximate balance of positive and negative evidence

regarding any issue material to the determination of a

matter, the Secretary shall give the benefit of the doubt to

the claimant. 38 U.S.C.A. § 5107(B) (West 2002); 38 C.F.R.

§ 3.102 (2004).

Analysis

The evidence with respect to whether the veteran has a

current disability, hypertension, is not in dispute. The

record reflects that the veteran was first diagnosed with,

and treated for, hypertension, sometime in the 1970's.

In its September 2003 Remand, the Board directed that a VA

medical examination be conducted to determine whether the

veteran's service-connected PTSD caused or aggravated the

veteran's hypertension. Subsequently, two medical opinions

have been obtained and added to the file, both of which are

remarkably inadequate with respect to providing any rationale

for their diametrically opposed conclusions.

The first, a report of an April 2004 VA medical examination,

concluded that there is no relationship between the veteran's

service-connected PTSD and his hypertension. No rationale of

any kind, however, is provided for that conclusion.

The second, a letter from a private physician who has treated

the veteran for his hypertension for many years, concluded

that the veteran's hypertension resulted from his service-

connected PTSD. Again, no rationale of any kind is provided

for that conclusion.

Other than the two medical opinions discussed above, there is

no evidence of record with respect to the issue of secondary

service-connection for hypertension resulting from the

veteran's PTSD.

The Board finds that the evidence with respect to secondary

service-connection is in approximate balance, as there is no

sound basis for choosing one medical opinion over the other.

When there is an approximate balance of positive and negative

evidence regarding any issue material to the determination of

a matter, the benefit of the doubt shall be given to the

claimant and, accordingly, the claim must be granted.

In reaching this determination, the Board notes that the fact

that PTSD was recognized after hypertension was diagnosed is

not determinative, since the record is not lcear as to when

PTSD first existed. Furthermore, in reaching this

determiantion, the Board notes that the VA published

information in the Federal Register. The study did find a

statistically significant increased incidence of hypertension

and chronic heart disease among World War II veterans with

PTSD (odds ratio = 1.25 for hypertension and 1.19 for chronic

heart disease). The conclusion that PTSD may be associated

with cardiovascular disorders is also supported by a 1997

study finding that Vietnam veterans diagnosed with PTSD had a

significantly increased risk of circulatory disease many

years after service. (Boscarino JA. Diseases Among Men 20

Years After Exposure to Severe Stress: Implications for

Clinical Research and Medical Care. Psychosom Med 1997;

59:605-14.) 69 FR 60083-01. In view of the lack of reasoning

in each pertinent medical opinion, the favorable evidence at

least has some support in a document placed in the Federal

Register by VA.

ORDER

Entitlement to service connection for hypertension, secondary

to the veteran's service-connected PTSD, is granted.

____________________________________________

H.N. SCHWARTZ

Veterans Law Judge, Board of Veterans' Appeals

Department of Veterans Affairs

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