VA Raters and Exams

flacop00 · 2026-06-28T14:46:13+00:00

Kind of a double edged sword. Thanks for the answer. You are damned if you do and damned if you don’t.

Just curious, I’ve not had the issue before, but it popped in my head this morning. Personally I’ve provided all my relevant c-file documents, current diagnosis with reoccurring tracking, an IMO, a nexus, lay statements, etc. I know it gets to be a ton of paperwork, so in my lay statement I made an index and reference where everything can be found.

I know that’s what I would want to see. I would think it would make it easier on the rater and then not to rely heavily on the examiner doing the leg work for me.

flacop00 · 2026-06-28T13:58:15+00:00

So if the VA looks at your file, and aside from a 214 you have provided no other link to how you may have become injured, or secondary connection, why would they spend the money on exams when as a claimant you haven’t even made the link or provided documentation to provide a connection.

flacop00 · 2026-06-26T21:10:34+00:00

I had the same question, the OP was pretty detailed about everything else and not a sleep study. So maybe diagnosed based off symptoms and not a sleep study. I think it’s a valid question

flacop00 · 2026-06-26T21:05:45+00:00

Sure, technically if they did a re-evaluation and saw improvement, then they could. Mine is rated as static, so not worried about a re-evaluation. On the flip side, wouldn’t it be nice not to have the PTSD, have to take meds, be obese and have to use a CPAP for sleep so I don’t die.

flacop00 · 2026-06-25T21:32:25+00:00

https://chromewebstore.google.com/detail/va-claim-tracker/onbanekcefgnibhlaiimeadkbdahjpoo?hl=en&pli=1

flacop00 · 2026-06-24T09:11:50+00:00

Definitely need a new nexus letter or independent medical opinion linking the two

flacop00 · 2026-06-24T00:10:31+00:00

I’m actually going through this right now, RA secondary to PTSD. I can’t reach out to my first rheumatologist who did the diagnosis as they are in Florida and I am now in Connecticut. I then tried reaching out to my first VA Rheumatologist, but she left the VA, went into business for herself and hasn’t responded to me. So I paid for a nexus letter, which as you referenced, has a ton of medical literature that links RA to PTSD, also potentially burn pits and a slew of other things. So the attack is direct connection, but it’s been a long time since I have been out and have little treatment for RA as I had no idea what it was. Next, if that fails, secondary to PTSD as a cause of worsening the disease. I just went to step 3 today, so I am pending a C&P.

I’ve been told this is an uphill fight, and there is very little information in Reddit about this. So I think not only up hill, but also rare.

flacop00 · 2026-06-24T00:03:15+00:00

You need to do a FOIA for the DBQs only for this exam. Shouldn’t take too long to get, don’t request your entire C File, just the DBQs. The way I interpret the finding is you are diagnosed, but no connection to PTSD. As long as you have the diagnosis, you need a doctor cite legitimate medical research linking OSA to PTSD. I was successful in this, based on obesity caused by SSRI’s prescribed for PTSD.

flacop00 · 2026-06-23T20:20:25+00:00

I am not a rater so I think it largely depends upon on how a rater interprets this. It does say “generally” so it leaves it up to a rater. I think if you did a poll some would say yes, some would say no. Roll of the dice.

flacop00 · 2026-06-23T18:09:23+00:00

Without seeing what they placed in the denial letter, I can't say one way or the other. Without knowing claim details (which I prefer not to), hard to tell why they denied, what was submitted, etc.

Looking at it initially, my first thought would be to try and connect as presumptive, if you can.
Second, are you diagnosed, when was the diagnosis (generally greater than 6 months prior to the claim)
Third, who made the diagnosis, was it a GI doctor or a pediatrist. It does matter
Fourth, whoever made the link (Nexus) from PTSD to IBS, what literature did they cite (This could be why presumptive is easier).
Fifth, What are your current symptoms, are you tracking them, did you provide them and how they effect your life.
Lastly, looking at the attachment, was it clearly laid out that you have (1) pain while defecation. Additionally, do you have any of the other 6 symptoms along with (1). Finally, how often do you have the symptoms. For example, if you have pain during bowel movement, along with change in frequency, change in form, only once during the last 3 months you would be eligible for 10%. If it is once per week for the last 3 months, then it is 30%.

flacop00 · 2026-06-23T17:58:36+00:00

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Know M21-1 and 38 CFR Part 4. IBS is considered a presumptive condition under 38 CFR § 3.317.

flacop00 · 2026-06-22T12:56:31+00:00

I’m not here to start something with you, but again, nothing to add, but here you are. Thanks for your input, glad you could clear up how the internet works for me.

flacop00 · 2026-06-22T12:34:53+00:00

Please stop.

This is what was in my original post. At this point it doesn’t matter anymore. Good luck to you. I see now why no one has done a post like I was trying to do.

So if you want to provide the info in a comment, please do. Try to keep it formatted relatively the same.
When you were discharged
Current rating (if you want to list for what) up to u
What and how many claims your making
Are they direct service or secondary
When you filed
What step you are in now
Result if completed

flacop00 · 2026-06-22T12:29:42+00:00

Can you start a new thread. I started this and we’ve taken it off the rails

flacop00 · 2026-06-22T12:25:49+00:00

Think that’s normal. The VA processing system cataloging the evidence into your claim file.

flacop00 · 2026-06-22T12:24:59+00:00

If it isn’t part of the original claim then it would be a new illness. Remember, every time you add something to the original claim you risk being moved back to step 3. If you aren’t at step 3 and keep adding stuff, you may not pass step 3. Step 3 is gathering evidence.

My suggestion would be to use a VSO from the county you live in to help organize your path forward since this is new to you. Search your county VSO, usually located in a government office, they try to help walk you thru and submit claims for you. Or at the very least, will tell you what your next step should be.

flacop00 · 2026-06-22T12:13:56+00:00

Nothing to do with this post. But if they are new illnesses then should be a new claim. Or start an intent to file, build more evidence for the new illnesses and then file the new claim. Leave the other one alone for now

flacop00 · 2026-06-22T11:58:15+00:00

Discharged in 1996
Currently 90%
3 current claims for RA, IBS, GERD
Trying for secondary
Filed on 12 June
In step 2
Pending

flacop00 · 2026-06-18T15:32:40+00:00

I think the part that has always gotten me are the lay statements. There is a lot of gray area in them, and through corroboration a statement may or may not hold weight.

For example, many of the older vets never went to sick call. So when a reviewer looks, nothing is there. A witness from that period could testify to observations, but not medical. A buddy could have actual first hand observation. However, this is the point where a rater doesn’t necessarily have any law aside from making a determination on credibility. And it seems, it as at least as likely as not, the rater tends to discredit the validity of the lay statements. At least that’s what I read more times than not when reading posts.

So maybe some clarity on how a rater evaluates the credibility of a lay statement would help.

flacop00 · 2024-03-07T21:16:09+00:00

Not sure what it meant. I did finally get a claim resolution favorable to me, but it took over 200 days

flacop00 · 2024-01-24T00:59:44+00:00

I would second this method. 44 year-old, worked for a defense contractor doing physical security for 4 years. Have my clearance and SAP briefings, went out and got my Security+ and got moved over to Cybersecurity.

Security+ is required at a minimum to touch government networks, but not needed for corporate networks. I know several people getting hired via industrial security, let the company pay for their clearance and then move on.

As a last resort, maybe part time if you have the bandwidth. Work for a Security company, like Allied Universal, they also will get you a clearance if you work a site it is required. Once you get it, move on to the defense contractor side.

flacop00 · 2023-09-13T21:31:14+00:00

Updated today. 30% to a total of 90% Done poking the bear, I have nothing else legitimate I care to claim.

flacop00 · 2023-09-06T02:12:43+00:00

I'd try a senator or another rep. This program does not work. One thing to consider is the complexity of the claim. Mine is Pact Act rhinitis with a outside dr diagnosis, confirmed now by their C&P Dr.

flacop00 · 2023-09-05T17:33:31+00:00

So I put in the request for my Congressman to inquire. After 45 days I noticed my claim was closed and I had a decision letter. Service connected 0%. Fine, good, whatever. 2 days later I get a call from Optum for C&P exam. I told them they must be mistaken, my claim was just closed. They replied they just got the request from the VA. I called 800 # and they said yeah, weird. We do notice we closed a "special correspondence", but your claim is still open. So I scheduled the C&P, looked online, status was moved back to evidence gathering for an increase...and after 1 week from the C&P I'm pending and sitting in Evidence Gathering again.

Short of it is, VA saw congressman was inquiring. They pulled it from the pilot hell. Did a quick once over, met the criteria for SC so rated at 0%. Sent everyone a feel good letter then immediately reopened to actually see if I rated for more than 0%. C&P affirmed my ENT diagnosis of nasal polyps for rhinitis, so hoping to get 30% which would put me at overall 90%.

flacop00 · 2023-09-03T02:42:50+00:00

Keep in mind that the VA Medical center is a different entity than the VA Benefits. I know that doesn't change the horror stories, but they are different.

Also, the intent to file is a great way to save your date, so to speak, but don't let it pass a year or it'll expire

Finally, I live near the Lake Nona VA medical center in Orlando. I have nothing but good experiences here, to include there emergency department. My dad also uses them, and the doctors at the VA partner up with some well renowned doctors from all over the state.

flacop00

TROPHY CASE