Listener Questions

Question 1: Claiming Diabetes

Listener: I have two questions actually for Dr. Bash. One question is, I want to do a claim for diabetes because I was diagnosed with it after one year of leaving the service. I feel that I had the symptoms while serving, like elevated blood sugars, but not to the point where they would be diagnosed as diabetes. I think I had adverse effects as a result of being pre-diabetic while serving, but I didn’t get diagnosed until after the one year of leaving service. I’ve also been diagnosed with sleep apnea, so I don’t know if there’s a nexus there that could link to that. How can I go about getting the diabetes rated as service-connected?

Question 2: Claiming GERD

Listener: The second question is about my separation physical. I claimed GERD, but it was denied by the VA. After one year of separation, I had a scope completed, and sure enough, the doctor said I have acid reflux, not GERD. With that being said, I don’t know if that could be secondary to something or how I would go about claiming that as well.

Dr. Bash: So, you had symptoms of GERD in service and claimed it, but the VA denied it. After a year, you had a scope that confirmed acid reflux. You need nexus opinions for both conditions. For GERD, ensure you get it checked every year because it can turn into Barrett’s esophagus and potentially throat cancer. We often see GERD symptoms present in service, but VA exams might deny it. I could write a nexus letter stating that your GERD symptoms were present in service and continued afterwards. For diabetes, if your symptoms were there, I can write a nexus letter about it starting in service and continuing afterwards.

Bill: It’s important to have continuous symptoms documented. Elevated blood sugar levels and treatment during your separation physical can support your claim. If we can show elevated blood sugar and treatment, Dr. Bash can opine that it represented the onset of diabetes. Diabetes is a chronic disease by VA standards, so subsequent manifestations are service-connected.

Additional Considerations

Listener: I served in the first Gulf War and noticed a decrease in vitality upon returning. Could there be a correlation with environmental concerns?

Dr. Bash: There are a few ways to address this. One is continuous symptoms from service. Another is exposure to toxins that can cause diabetes. Lastly, you might have a claim for lung diseases as well. Many soldiers were exposed to dust and aerosolized toxins, leading to lung disease, which decreases vitality.

Listener: I’ve experienced wheezing and difficulty breathing throughout my career. They had me do a pulmonary function test, but it was within normal ranges. However, there’s another test they didn’t administer.

Dr. Bash: There are specialized tests like diffusion tests and high-resolution CT scans that can detect lung disease. These might show positive results and help connect your condition to service.

Bill: If there’s no explanation for your symptoms, it could be an undiagnosed illness presumed to be service-connected for Gulf War veterans. We’ll need to explore this further.

Listener: Based on what I’ve shared, what are your typical rates or fees for addressing this so I can file a claim?

Dr. Bash: It depends on the thickness of the record and the number of claims. Call my scheduler, Skip, at 925-381-7561, and we can discuss the price and details.

Conclusion

Dr. Bash: The VA is processing claims quickly, so getting your claim done right the first time is important. Thank you for calling in.

Listener: Thank you, I’ll definitely be giving you a call.

Dr. Bash: My new phone-friendly website goes online tomorrow. Just Google “Dr. Bash Veterans Medical Opinion” and you’ll find me.

Bill: We use Disability Benefits Questionnaires (DBQs) to provide specific findings needed for rating decisions. These forms can be completed by your doctor and reduce the burden on VA exams.

Dr. Bash: DBQs are complicated and have many questions with legal implications. We ensure they are completed accurately and comprehensively to support your claim.

Bill: If a veteran claims head injury or concussion, VA must accept it as a TBI claim and explore all disabling chronic residuals of the event.

Dr. Bash: For historical claims, if you had a head injury before the TBI criteria came out, the symptoms you had during that period are important. Continuous symptoms can support your claim.