Veterans' Advocate Jim Strickland answers questions from VA Watchdog dot Org readers.

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by Jim Strickland

NOTE:  Letters in my Q&A columns are reprinted just as they come to me. Spelling and grammar are left as is and only small corrections are made to improve readability, ensure anonymity or delete expletives that may offend some readers. This is not legal advice. You should always seek the advice of an attorney who is qualified in Veterans' law before you make any decisions about your own benefits.

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Jim;

I am writing to ask a question about a problem that I've had recently. Currently I am rated at 40% service connected, 10% being in nerve damage in both feet, and 20% for my knee where I tore my A.C.L.. I have not had surgery on my A.C.L. yet I am pending surgery for June of this year. Due to my knee I endure a severe amount of instability and recently went to step in my bathtub to take a shower, it was dry, but when I put all my weight on my bad knee it buckled and I hit my head ear first on the wall and additionally hurt my wrist. I followed up to the V.A. a couple days afterwards where they gave noted some redness inside of my ear, gave me some ear drops, and did an -x-ray on my wrist with no follow ups. That was about 3 months ago and still today I'm having pain and strange noises just in that one ear.

Also, I've been going to a chiropractor because of the lack of balance I shift all my weight to my opposing knee that my hips and back are all of out alignment. My good knee now hurts just as much as the one I initially injured. I'm in so much pain all caused by an injury with an exponent on the end that I have such great trouble getting and staying asleep, waking up with nightmares that my knee is being burned just due to it hurting. Is all of this what is considered non-service connected? Thank you.

Reply;

Conditions caused by existing service connected conditions may sometimes be service connected. It's usually hard to get that ruling though.

In your case, the fall in the shower produced very minor results. The first thing you would have to prove is that somehow that fall resulted in a disabling condition. A little redness in your ear and a slight pain in the wrist will be viewed as episodic and transitory and will not rise to the level of a disabling condition.

If your back and the opposing knee are bothering you as much as you say, you should be seeing an orthopedic surgeon to have that documented. In my experience the testimony of a chiropractor isn't much help. Only a qualified orthopedic doctor will be able to state that your back, hip and 2nd knee problems are a result of or connected to the original knee condition.

To claim that the knee is causing you to have a mental health issue will also require some development and history. You should report those symptoms to your primary care doctor and seek a referral to a mental health clinic. Then, when you've established for the record how severe your mental health problems are, you may have a case.

I'd have to guess that you won't see compensation from any of these complaints. A torn ACL is a fairly common problem and I can't say that I've ever known the injury to produce as many other health injuries as you claim it has. Without a lot of expert medical testimony to support all these claims, I don't believe that VBA will award you any further benefits.

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Jim;

I am currently rated at 40% from injuries I sustained while on active duty in the US Navy. The injuries are two fractured cervical bones and a herniated cervical disk (combined rating is 20% for those.) At the time I broke my neck my blood pressure also shot up to and stayed and about 188/122 (rated at 10%.) and recently after reading my C-File I was rated 10% for two lumbar herniated disks that I complained about for about 20 years without initiating a claim. All of the above injuries were related to an incident with a conference table that 4 of us were moving down a flight of stairs. The two sailors at the bottom of the table lost their footing and the table crushed on top of them and two of us at the top went over the top of the table and over the railing. I felt as if my life was in jepardy (as well as the other guys that were moving the table with me) once I tried to hold the table back from crushing my fellow sailors and I saw the table overtake them as they went under the table I along with the other fellow sailor that was on the topside with me, fell over the railing like I did. The worst part of it was that we were never reunited to see what happened to each other. I was in the hospital for a while and after that I was instructed to stay home "off Base" for bedrest except for numberous ortho, nerology, and psychiotrist appointments. since it was a training base for sonar, people came and went frequently and I'm not sure of their names in order to request information about their status. The base has since been closed so that didn't help either.

I was in charge of a 8 person work party and only allotted 4 people for this job and in hind site there should have been six on this detail or the legs of the table should have been removed.. I was unconscious from the time I went over the rail and awoken by medical staff that came to take us to the VA hospital in San Diego. After I was awoken I blacked out again and awoke in the hospital with IVs and monitoring devices. I was seen by a psychiatrist and was prescribed Elivil for insomnia, depression, anxiety, and I found out later it was a common medicine for PTSD sufferers at that time. I was discharged with a re3-p honorable discharge (not sure what that means) About 5 years after my discharge I was becoming more recluse and needed more alone time. Prior to that I was a very social person entertaining people on our speedboat and going out frequently, attending college, and playing cards with friends. I recall telling a friend that I felt empty and without emotion for family members that died, I no longer enjoyed get togethers. He recommended that I attend church and I felt more like a leper than a parishioner. My feelings over time worsened and I began feeling uncomfortable around family and spent a lot of time on the computer which I had enjoyed since computers first came out in the early 80's. I had seen the evolution of the Internet go from black and white text on the BBS system to a fast evolving Internet much like it is today. In fact in 1994 I began an Internet company that sold ink products and branched out to providing access to the Internet as an Internet service provider. Our company grew rapidly and it was a very lucrative business and I was shielded from contact of the public by my employees.

As my PTSD progressed I felt people were stealing from me and that was substantiated a couple times. In 2005 we were down to one employee from eight. I was forced to interact with customers at that point and I was approached by a customer that happened to be a veteran service representative. He told me by looking/listening to me I should be evaluated for PTSD. He said he worked with a lot of veterans with the same issues as I had. He seemed more of a crazy person than a veteran service officer. After that encounter I was told by a Vietnam vet that he saw a need for me to seek help from a psychiatrist that has dealt with patients with PTSD. After that I took a couple free PTSD tests on the internet that evaluated the likely hood of a person to be afflicted with PTSD. The results were similar and were both above a 70% likely hood I suffered from PTSD. At home I began feeling angry when my younger children used the stairs to launch the Tonka trucks down so they crashed sounding very much like my incident with the conference table down the stairs. I was constantly asking if everyone was ok thinking they had fell down the stairs with the trucks. Before I was seen and prescribed medication for my PTSD symptoms I had become a heavy drinker and smoked pot to get a couple hours of sleep per night. I was in my early thirties when I began to drink/smoke pot to numb the feelings I was having.

Since my first evaluation for PTSD all the psychiatrists came to the same conclusion (Severe PTSD.) I have seen three civilian, one VA, and one state psychiatrists, and one licensed social worker LSW. The results of my first VA claim for PTSD was denied and they admitted I had severe PTSD but claimed the accident with the conference table and my many serious injuries didn't cause it and the fact that the medication Elivil was used to treat a great deal of the symptoms of PTSD. I am being represented by the American Legion now and I am a member of that organization.

The local American Legion rep really botched my first request for service compensation for PTSD by writing that the cause of my PTSD was because of the "big guns" making a loud noise which I think he had me mixed up with another veteran or just forgot what I had told him happened. This American Legion rep in Toledo Ohio had me sign a blank sheet and told me he would write the notice of disagreement for me the next day and forward it to the rating board. Since I had never been in a war theater it was an easy denial for my PTSD. At that point I contacted the regional VSO in Cleveland to assist me and wrote my own accounts of what had happened since the last VSO I had worked with completely misrepresented my case. My claim is now being assesed by a DRO in Cleveland. Since my VA PTSD denial I have been awarded SSDI by the SSA. The DRO has requested my SSA file that was handled very professionally by a law firm named Binder and Binder. They were very methodical and compiled all of my PTSD assessments. I am hopeful that the DRO will find the SSA information complete and that it will be helpful in my VA claim for PTSD. I haven't worked since September of 2005, I am going through a divorce with my wife of 17 years. She gave up on me since I was no longer fulfilling her needs and the needs of our children. I was so fearful about going to a father daughter dance and I think that was one of the final straws that broke the camels back. I had caught her cheating on me and was suspicious of other infidelities. At that point I had also given up on our marriage. My DRO has requested the paperwork that the SSA used in determining my 100% unplayability rating. Do you think that will help me with my VA service connection for PTSD? Considering they have already acknowledged that I do have severe PTSD but they deny a service connection. It seems odd to me that I was given medication by the base psychiatrist to treat the symptoms of PTSD right after the tragedy but then they deny any service connection.

Reply;

That code, RE-3P means you aren't eligible to reenlist without a waiver due to, "Physical disability (includes discharge and transfer to TDRL). Obesity. Motion sickness. Disqualified for officer candidate training."

I don't understand your history. I'm not a physician nor a mental health expert but you tell me you sustained an injury on the job. That isn't at all unusual. You were hospitalized and awoke to begin seeing a psychiatrist? That is unusual.

You don't relate that you had major surgery or any particular complications from the hospitalization. Surgery is often a treatment for the injuries you describe so I'm a bit surprised that you don't mention that.

Personally, I can't recall anything close to what you've related to me being labeled as PTSD by the VA or SSA for that matter. You had what sounds like a minor accident, nobody was killed or seriously injured according to what you know and your own injuries required some bed rest and a few follow-up appointments.

The medication Elavil was approved by FDA in 1961 for the treatment of depression. Use of Elavil in the treatment of PTSD wouldn't be particularly unusual but it wasn't then and isn't now thought of as a primary treatment for PTSD.

The term PTSD wasn't used until the mid to late 1970's and became formal only in 1980 in the DSM-IV.

You report that after discharge and for many years you had a highly successful career and life that only began to deteriorate many years later. You don't elaborate on it and there is no mention of any mental health treatment for many years after your discharge.

I can't guess what the SSA used as a decision point to award your SSDI benefits. However, the SSDI system is markedly different than the VA system. To be seen as disabled and service connected by the VA requires an event or a "stressor" that not only occurred in service but rises to a level the VA believes would cause PTSD. That usually involves direct combat with a fear of loss of life, the observance of death in close proximity to you or a major trauma directly to you. PTSD may also arise from duty in a hospital burn unit or on a detail such as sorting out body parts and belongings of deceased soldiers.

The SSDI system requires that it be determined that you are unable to work, period. The origin of the disability doesn't carry nearly as much weight to SSDI as it does to the VA. If it has been determined that your current physical or mental health status is such that you are reasonably unable to seek or maintain gainful employment, the SSDI benefit will be awarded.

While the VA will take the SSDI award under consideration just as they do any evidence, it is in no way binding upon VA to make any award based on the SSDI determination.

Unless I've missed something, my guess is that VA will again deny you a service connected PTSD benefit.

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TOPICS: veterans, veterans' benefits, VA, Department of Veterans' Affairs, Jim Strickland, Veterans' Advocate,