17 Burst results for "Dr Bash"

"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

14:50 min | 1 year ago

"dr bash" Discussed on Veterans Helping Veterans

"You right you will pick you up there so how you doing doc say life doing getting them doing good so couple of weeks ago i had a patient went to a higher level review and her patient heavy call in on i'm calling on the phone call and then the diario those doctrine line was asking questions and then he grabbed a week later earlier so that DRO higher review process with with experts on the line might be a good way to get the cases resolve you know that's good you hear a lot of good and bad about harlem and avenue for you know they knew that is the way that it worked out so you know we always have sometimes happened bill bill's been teaching teachers about the laws right bill bill until some of our opinion are putting laws in there so when you go to harlem review then you have something to talk about with the law so it right and and that's that's that's that's my doctor bashing teamed up because of my knowledge of what the ratings schedule requires the manual tells employees to do and and how to determine service connection how to evaluate a disability what i do for dr basch is to make sure he knows the criteria and how these things are interpreted then when his opinion and review reaches the decision review officer there's an outline of just exactly what the veteran want why he wants it what the medicine is it supports it and what the manual a new old regulation the court case law said for him to do so if they want to they can just run right down dr dr bashes opinions follow it degree and be done but if they want to check some look it up well there's the references you know i helped him find it you know that's a perfect that's pretty pretty hard living but remember now my my question is now the manual says ah that if you elect higher level review and then you submit additional evidence take it out of the higher level review and instead assign it as a supplemental plane so you to me that means you lose your place jason line now what i like about what dr bash did to engage in that phone call okay he is actually providing testimony that will give the d. r. o. additional evidence without it being kicked out that's a brilliant brilliant move dr bash sometimes i fall on these things you know a couple of questions about how i wrote my opinion look at those attribution or direct service connection and things like that and then he just wanted to decide so in this case you had already written an opinion that was part of the record and then it went into the review with the evidence hand up the word gracious and things like that there's suing the higher review perfectly excellent excellent by go well supporting important view TV neither law part is if you go there at the medicine review then it's not you can't review the medicine as much as you can legal parts of it so interesting you can't get you have a nicely prepared next let it feels it makes up process working with the team are bringing yes and of course i don't recall what i what i referred to as the difference between the practice of medicine and DA's a as adjudication medicine they're not exactly the same terms have different meanings to the adjudicators like raiders and decision review officers then they do to medical professionals and of course terms uh-huh change over time medical terminology evolves with time VA does from time to time amend the rating schedule bring the terms found NBA's rating schedule more in concert with current time -nology so but that that always lax there's always a lag between what the medical world is doing and what the adjudicators or using in the way of medical terms i mean i i remember ver i remember years ago when i was practicing as a representative they rating schedules do contain the term dementia pray cox okay now need i sell anybody that that term is no longer used half was that was a very old term for schizophrenia so and and sometimes a raider might read something and take a lay interpretation of what those words mean and failed to comprehend what the medical terminology is and what it occasion is case because remember decision review officers raiders they get some rudimentary courses on some medical terminologies is in medical and anatomical systems but they're not medically train and so VA doesn't emphasize that instead they teach raiders some basic course about here's some terminologies and here's some of the functionality but they're ordered to defer to the medical evidence not their own understanding so bill even u-turn surge out this thing called semitic pain syndrome you know something that they've gotten some reader told me about you know we have that law that law that talks about pain from unknown cause or those things kind of the same or they're talking about the same thing there or are they doing something different with those well back back in the day if they were if if the report said they condition was psychosomatic guy was the term used raiders would interpret data asthma lingering and understand it was a an acquired mental this winter i there there was a i i actually solicited the help of the department of veterans affairs chief of psychological services to intervene in a case i i i've done some business with him and and we had a working relationship and the case was before me where they they had the regional office had sent a case for his review he had opined and they denied based on his opinion gossip board of veterans appeals where i was representing the appeal and i looked at it and i said i i don't think they i understand what he's said so and so i called him up asking for an amendment myself and fortunately it was gracious enough to it they understand the terminology that he used they interpreted to mean that it it was a a defect that it was a personality defect and not a disability and the law that's not at all but what the words meant so his clarification word and the and the diagnosis was enough to demonstrate that the mental disorder actually began during active duty and before and so the case was guided by the board of veterans appeals field was example of of the words i recall POW and and trying to think of the exact term there was some time ago now but paris easy is he had paris suzy's of his hands and he was claiming frostbite okay and he's a korean war combat veterans about a stretch there is it you know but if you're a doctor wrote the exam paris is a hands history of frostbite okay well i know what that means okay he's got frost bit hands from korean war and that's leaving him with burning and numbness and tingling pain okay vance well raider denied it and i walked upstairs i asked the guy you know i ah i'm not sure i understand why they denied it he says well the doctor didn't say you had frostbite he said he had history frostbite about tennessee easiest he can have spots on and from anywhere oh is it oh i i understand you think paris means bob okay i'll be back in a little while so the examiner and i said i got a problem with them can you help me out and yeah we were all kind of friends back in those days and and it sure though what do you mean as well the reader doesn't understand your terminology not do you actually mean to say that he has residuals of frost price now manifesting in paris easiest thing etc yeah okay did you just know pat on here for me please put your next to it so we did walk it back upstairs as it here you go those aren't spots those are no logical logical symptoms okay anyone had grabbed it can get spots on oh okay oh i'll help you so that's that's a lost trying to get around right bill bill that will keep versus sandra talk about you can't diagnose the pain that you're experiencing that could be related to that then they can grant it it was kinda trying to get out early early in the court's jurisprudence court decided that pain in and of itself would would not be a rateable service collectible visibility guys that there had to be some underlying diagnosis explain the symptom of pain and of course the reverse that now and you know pain is a real manifestation itself and the man who has been revised to make make sure everybody understands that so we we shouldn't see that problem coming up i was gonna say we should coming up anymore but it depends on the training of the of the raider involved it kinda imagine now how enormous VA is the numbers you know thousands and thousands of employees over the country and trying to get this entire rafter of employees on the same page ages is extraordinarily challenging you know it's just it's just hard to get everybody to have a clear understanding particularly particularly in this environment where now the compensation service has been revising rules willy nilly a eh unbelievable pace i mean you you know it used to take months for rule change and and my golly i i remember member seeing in recent years multiple substantive rule changes per week trying to absorb all these changes all at once i from my experience i can sympathize with those employees for trying to the challenges of keeping up with all the rule changes ages nonetheless i was capable of producing decisions it well in excess of the required level and still you know take time to read the rule changes and review and look for rule changes you know on a daily basis regularly so you know i'm sympathetic but i i challenge the employees and say hey you gotta keep pace job you know kind of like kind of like if you wanna be marine you're gonna run three miles and twenty eight minutes or you're not are- okay yeah the rules for CPT coding had about five hundred new changes here for the doctors you know set yourself these rule changes are happening all the time different places sure i'm sure it's not unique to be.

"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

15:16 min | 1 year ago

"dr bash" Discussed on Veterans Helping Veterans

"In the navy. I recently discharge discharge recently In February it's hard to say I worked in the operating room Do a lot of manual work Constantly moving around Lifting patients pushing patient Living patient bad too soon you list that company lift your arms and put a lot of pressure on your neck you know so I mean can you ruptured disappearing. Let me see Nick Lowe time something like that. The neck might be twenty percent then each arm to be said for that ridicule apathy numbness tingling and maybe weakness in the leg. They could be ten or twenty percent for that sort of thing about bladder problems. Down below leak urine stool no thankfully so let's just Yeah yeah so I I saw the doctor thought the the Docs back in November twenty eighteen and they said I should go physical therapy and they gave me all these exercises and then nothing improved. I thought it was primarily issue with my left shoulder. I thought maybe I had T. O. S. or TSE. I ah having the numb numbness and tingling and is there anything like do. I need to go see a neurosurgeon. Like I'm just concerned at this. Appoint is it going to progressively get worse with aging or is this something got. I need to address quickly If I am having pain at the same time like I don't know where to go from here via the bad. Hey we can give you some m sad and you'll be okay. I I don't I don't feel it has the engine done scam They yeah they gave me an MRI of mine back so it's all so. It's always good to have neurosurgeon around neurologist to talk to you about these kind of symptoms jump through change. They say the sensory stuff is not as worse as the weakness muscle weakness. So it's still go the surgery center later and then That we have your contact. CAN IT turns out. The literature says that that the Just as oftentimes over seven years will have. The same result was without surgery that time period the district get resort on long soft tissue will start to heal and so things will get better as long time you know for that way for older if you have lots of things. We haven't fusion their survey Sunday then sometimes discs above below. That will go bad over time. So it's always kind of secondary complications down the road so I just trying to hold off on surgery until you really need it. You know the secondary supposed to chance of infection. Things could have been a lot. But if it's that's why it's good to have the surgery because he couldn't control case and see if it's emerging it's not emerge if any could probably tonight sometimes physical therapy make it worse because you know just not stable you a lot of emotion can kinda like it's Kinda like we're using the sprinkle in college. I is there anything I can do to prevent anything I can do at home. I'm or lifestyle changes so no lifting. Of course you know also big fan on tools to sleep because people you can get a Lotta complications so as a down pillow some people like that my pillow and that kind of thing can help. You might help with the pain a little bit. So You go to find out the most important make sure you have good even gene. Make sure you take your engineering radio neurologist neurosurgeon make sure that what you have. That's what you have then. Once you find out the engine is pretty. Pretty Benign thing. Second opinion is always good on that but I kind of use these things. There's something more a serious people get excited about the surgery of trumpet. You know. It's not the most stuff gets better with time. A lot of concern until you get over sixty seventy eight and start my search deployed so as that little car. Your seatbelt. Yeah it's a long time. If she were a seatbelt. Make sure you have a high back you know headrest on your car is your neck and fragile. Getting accident fall down or rear ended or something to do much worse off than you would right. I saw some of the the the the lifestyle modifications say it's like driving. Sec Don't ski anymore. don't fall down so and then no lifting of ways or like back or nothing nothing over my head so Dog May call all or neck brace Bay Mount use. You know periodically tells the main while when it got her own back. I kind of like I kind of like little little waterbed traction. What's it going to get to find out what's going on with you? Got Once you find out if something stable you know maybe the traction kinda helps 'cause can pull the Bonaparte and healthy disc reset reset itself so that kind of like that. The neckbrace is you know people like I have on my neck warm Really be much kind of does not very much Does remind people to kind of run into you being because he gets a brace on on but itself it in some people taking the weekend the net. 'cause that must week the Brezler so it's kind of dealer's choice not using that grace and you like it helps McCain go away like Jewison good use for your main doctor to find out how to the the sounds like this overtime you better for me to be the pre pretty good function. You don't have enemy injury policy. Thank you thank you Dr Rack thank you so much better. Bye Bye neck. Injury after three or five years on mine was out of fused about surgery. I've been pretty much neck. Pain free for three This is a little girl. Logic problems walking so when that goes about they've got yeah good question for you regarding sleep apnea Tom Topping or may for another time and so. I just told today that I have moderate severe. You're not severe but moderate sleep apnea And just hearing this news a little bit concerning Where do I go from here? And do I need to C. Path the sheen and what's doing in my brain so yeah so they don't want to this dangerous disease. I haven't myself as as you know I love my c-pap take naps afternoon. So go down low. And that's like trump before it and causes problems brands so we saw that old so you probably have to oxygenation anyway so but the valley it can be a problem so type it is a lot of cases he does work with the deals are just keep steady. Without they'll do teach that he would seek out and they're looking to see him Bursa. Solve your problems actionable. If you breathing well bring ways. So if that's the case then that would be useful. It's not the newest. Our quiet might valley operated. Wants to help somebody here. Shuki Do they do with the CPAP device or not Yeah I had I I had a normal I guess regular sleep study and then last night I had the CPAP and I like the nasal and the mask is is there one. That's more effective or generally. Well Yeah now depends on your precious precious with less than eight if you use the nasal nasal cushion ones says when the Christians are going into those and there's when it goes over your nose and that's when it goes over your nose enough so I've tried to put myself sometimes. Your nose plugged up for whatever reason you know you as you get you get rid of because I think it's just a source of bacterial growth and most times it's breathing room hearing myself at you that's personal preference and then get an extra piece of two. I take my treatment and put another six for two together. Get myself in a room hook it on a hook on the ceiling is your role round pick. Excuse me all the time. And then you know And there's a website called fat man. They have all kinds of different types of CPAP devices license. Contriving so don't don't keep very well device because all this war's last night but you used to take a scuba diver or airplane pilot quite apart a little mouse with boxes and they'll take it nap in the afternoon I'll put oh my c-pap on my blankets over my head just picking museums. Nice easy when you take a nap. So I love my despite injury so I can't get good air real well when I talk. It's hard to talk so I use the C-PAP at night or get big. Big Breasts of air helps alums. It's totally free battery. Power goes out and also camping. So that's a good thing. I think you traveling trouble. She's up so I use a trilogy If you can get your hands on trilogy uh boy that's a cat's meow. 'cause they're silent uh-huh and they they are batteries power. If you're a power goes out so you're covering over hold. Uh hold is that true is you know my I end up had about six seven years. Really that's cool Well have run electric but if the power goes out automatically you don't mess breath breath so it's a very heavy heavy joke and trump was bad me it. Oh I'd say inbound if things make more hello operated on battery battle Hot Update our. I believe they tell me Right now imagine. Have you probably imagine die for sleep apnea. Wasn't that well they both. Oh Yeah do you want him back back up. Yeah I'll sleep out of those dangerous people who had sleep apnea were generally only holder or maybe they had like six knacks or thick tongues or large tonsils. If always the case or is it sometimes. Yeah well you know. Historically it was it was kind of a mystery diagnosis. No people all these guys died in the sleep you know and now we we get more sophisticated with testing test about ten or twelve fifteen things and so we have a lot more than there's a whole science. The whole part of Medicine Sleep sleep specialty with testing and so on. So you know you get one more different kinds of chords necks long problems diaphragm ribs like just the way you would trump. But that's yeah I think Hateful having tendon strain of Seattle breathing. stage. And here's the thing craven shower or channel shower And this game ever. I mean nine trillion. I don't think I've noticed that the mud with regular c-pap gives you that extra up on little slurred air. I guess naturally get to worry. I know you really feel relaxed. Cracked your slaps to it. I'll be about talking. About Breast People Medicaid. They take depressing exercise. It's autismspeaks those depressant changes the hormones body. I think it's affected it changes the hormones and someone's body I I I think you know. Probably exactly the homeowner to go with the breathing somehow relaxes you met one team. Flap for them and yeah but now it's still safe path to drive racing. I Hey Luke. The doctor switched me. Overtake trilogy and I've loved it. So good.

"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

04:08 min | 1 year ago

"dr bash" Discussed on Veterans Helping Veterans

"To five three one seven five like six one bill kind of has access to people through me but we worked together as a team than bill could talk to people and we go yeah doc and and step he's sort sort of they sort of <hes> select which cases they want me to review well. That's good and it's good that we have a team out here but is working together and and <hes> helping hey open veterans <hes> and that's <hes> that's always from ford and cause a lay bad or you know a new veteran. I'm a lone star now. I don't see how they're going to do without some david. David and goliath alive d._a. Has a four thousand person team oh yeah but four thousand dollars whatever it is tro true and and they know every trick in the book and you have to know them get to dwell to dayo with with the yeah keeping your baggage pitcher because they'll scramble your brain they can say bill says don't don't give up because it's coming to quite sure relations right now but he said i'm sad to say it but i've seen a lot of them. Die hasn't always that's. That's a hard reality that that you have to have to listen to this business and they're trying to help them. He's at least now build. A spouse can carry on what the claim if they'll do it yeah yeah. That'd be a spouse. Yes not much consolation but it is better than nothing yes to. The client dodd with the bathroom was was a crime tame are not a a couple of my written article opinions and said this guy's gonna die like in two weeks for my medical judgment and they still have before unbelievable man oh well nobody wanted to diagnose. Uh-huh air wants to go ahead and but no one wants to die. That's that's something that to a medical standpoint. It's really nice because as we can you know the ratings raging and there's monetary things but it has a big impact on people's care because you diagnosis and get the right treatment the hospital and <hes> you know get better here can make a big difference in longevity. Oh absolutely da humble. He has saved lives. Yeah it's word tear on like you wouldn't believe and let to bank going to it and <hes> we know allowed math so they can rewrite fan well with that the him i guess we'll have john close out the show and we look forward to having when you guys back on this has been a real informed they show were sure and we really appreciate it yup. Thank you ashley. Okay.

david bill ford dodd john goliath four thousand dollars two weeks
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

05:40 min | 1 year ago

"dr bash" Discussed on Veterans Helping Veterans

"That's a question but i'd say it's quite popular one. Maybe let one guy go to the mets right. I don't think the dog is that a hundred percent evaluation kicks in at three. We don't you know for rating purposes three or less okay at this point one. It's sixty percent but if it's three or it's a hundred percent know how how how do they actually do the measurements for the them standing hardcastle labs and things like that that you know if you have a part of vacation or echoed and they want to actually measure your heart coach and they actual go rule for they the jacksonville. I don't see how the way going around that's yeah. They're taking it out attention. That's probably going to be jailed in court and they're gonna lose my fear. Probably we're going to be killed according to lose because the gold standard is the ejection fraction of what the cardiologists you actually term strength heart. Remember i said earlier there. There is medicine for treatment and care in the medical community and then there is v._a. Adjudication medicine <laughter> yeah okay some adjudication medicine for rating purposes up until this month ejection objection fractured less than thirty percent a hundred percent and injections horizon between thirty and fifty sixty percent. That's two and as so now they're taking that and then i met this <hes>. This is the manual change right. It's not a hundred now this. This is a regulatory change really the federal wig that's thirty eight c._f._r. For part for of course i <hes> from point one. Oh four is evaluation for cardiovascular disease and <hes> like i said that was just change this month and oh cool and they will bring worth individual register they have all of these discussions about how and why and what their reasoning is for the changes and <hes> basically saying yeah we'll all live stuff is nice you know but these studies indicate that message really thing that only count. I'm over simplifying here. Guys okay in other words. What i'm understanding is that they <hes> in debt in practice. Your don't care either way that it used to or don't carry anyway right. That's a clear understanding that this is the stove to patients date. Now <hes> the one point is this <hes> the provisions <hes> change this this month so all claims pending before the revision are entitled to be reviewed under either the a prior version or the newer version depending on which works better for the veteran so if i have if if i have a case before me and i see <hes> well. Let's say we have heart disease. The and we have a okay we have a mess of <hes> <hes> seven right but we have with jackie fraction of forty bucks now now the new method seven entitled the veterans thirty percent under the old rules the injection fraction of the sixty percent so he's entitled to get the sixty percent from the day of acclaim associated with that plane and because the change and rule provide less. It's benefit to him. It does not apply that and he he's fifty percent it the other way around that had oh let's say an injection fraction of sixty but his met where right now his met provides more than is a jackson practice so for the period from the data plane up to the change in the rule he will get sixty based on five minutes and then under the new rule it will become affected today's rule change and he retain the sixty under the new rules.

mets heart disease hardcastle jacksonville jackson hundred percent sixty percent thirty percent fifty sixty percent fifty percent five minutes
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

03:10 min | 1 year ago

"dr bash" Discussed on Veterans Helping Veterans

"Sailing cards disease <music> and of course sites do day exposure to her sides and <hes> he said till. I don't know what i do in for you on your heart. Oh no i'll remember seeing them iraq but there's so much stuff from iraq or too busy for dr though <hes> and i feel like i'm gonna have some repercussions over that because in green i will i will them over and no policy <hes> next time i go to my heart specialists by a twist. I'll have been a letter telling period. We'll he's a red one but <hes> absolutely <music> avenue literally gave them a letter from your doctor saying this is a disease but that's not the only alternative <hes> understand. I've mentioned this before in the past. There is the practice of medicine for treatment for care care and the practitioners and the physicians in the researchers develop a common language where words have specific meaning in that context in v._a. We have of what i referred to add v._a. Adjudication medicine couple couple of ads. It is for that because there are terms that v._a. Uses that aren't used in medicine or turns and medicines that are used in the way that <hes> create a conflict between what is understood between the medical side side of the house versus the adjudication side of the house right one example of that and dr bashing are going to talk further later in the exam porch but if you look at the current d._b._2. For spine and you look at the ratings schedule they contain the same language and under fifty to forty three diagnostic code of the spine they talk about intervertebral disc syndrome and the evaluation criteria is how many weeks the doctor has ordered. You two bedrooms okay two problems. Ah one is the medical world no user no longer uses the term intervertebral discs syndrome so doctors are naturally inclined to check the block. No secondly stations from this disease are not typically treated with weeks of bedrest anymore. <laughter> okay criteria established by v._a..

v._a iraq intervertebral disc
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

01:34 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"Or if it results in some malfunctioning specific nerve distribution, you can relate the nerve affected. So there's a lot of flexibility in the ratings schedule gets to now for other brain conditions and and to evaluate. Okay. But anoxia would be one term you'd certainly want to incorporate in on a Klein for. Not not TBI. I but. Pollen Dixon's like, slam them or what have you? Yeah. And and you know in in the more general term of brain injury as opposed to traumatic brain injury. That would be a reason for it and facing. As sprang lacing carbon monoxide poisoning. Yeah. Diving accident. There's came Mike O H Hoosier. Well, there were placed one on. Seizure, for example know, so fees season. They might up reading like an oxygen chemical, you know, back to your point. Really toxic chemicals brain into seizure state, and they could result doctor that one. Yeah. Yeah..

anoxia Klein
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

04:47 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"What I'm getting Matt is the im- the reaction their upper extremities that tears you right there. It could be. Some sort of brain issues true. And you would able to prove it down to a TBI. And they. Accepted that explanation. Uber's able to get them. Sure. Runs runs everything, you know. So we kinda had two cases Bill talked about one I talked about another. But the concept of saying the has little body little body inside it so depends on where the where the traumas are what part of the body doesn't work. So it's. My point being could chemicals have the same facts on the brain. Yeah. Talk with buying. They could have. Yes. Yep. Yep. Yeah. Classic toxin one talks. You talk about like radiations kind of obvious thing. People get radiation to the head neck and then affects the brain. They can get something very similar to TV Ike is brain only house. Bring only has so many ways to react you on and off good bottom level and things that affect the blood vessels or things that the Tricia and talks is across barriers can have similar kind of, you know, anoxia low oxygen too much radiation too, much chemotherapy can. Got can leave you very similar picture? Yes. That's that's the point. I was on the make this could be a new avenue for a lot of veterans. Daytime with exposures. Hit pay Bill. What is what is the, of course, schedule your that? Oh, there's there's a specific rating Parkinson ISM or Parkinson's disease. And of course, that is presumed to be associated exposure to herbicides. True. That might be something folks need to be aware of. So Bill could use some of these toxic exposures, get rid analogous. Brain trauma Trump. Not generally the manual makes it very clear that for rating purposes, traumatic brain injury being a. Physical disability resulting from any event of extra force causing injury to the brain. Now, the one one alternative diagnosis could be an oxymoron. If the individual suffers a loss of respiration and the brain suffers from the lack of oxygen that anoxia can reduce symptoms or two GB. Hi. In that circumstance. It's service related then they can't be evaluated. To a TV. I. Depending on the global presentation tensions. If it's. Yeah. Oh what you're saying? Is that normally you have to have some external blow, but there is sort of a footnote, but allows anoxia to be rated into the into the TV category. That's correct. Yes. If if it's to be a baby, I it has to be from external plotters. Six. But if it is from an Xia, you need to choose your ever in diagnostic code of diagnosis would provide the greatest compensation to that. You could read it similar to. Tv I or rats stroke, brain, hemorrhage and mental illness..

Bill TBI Matt Ike Tricia two GB
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

03:59 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"Choose additional the bass or our it's been a while today the fifth day of November. So you know on a Monday, it's a special day. They can you Assyria shows, but hopeful with Dr back and that Bill Krieger today, we're probably going to discuss the big one TBI. You know, that's very very serious injury business supper when they've been exposed explosive or head from. Alternative Dr batch. He didn't back, but. I'm good. I'm good talking about prototypical case that we have guy recently had a bunch of micro trauma. He was a controller for destroyer class. And yeah, no you have to have whole healthcare. Can't walk around. You this losses house, watches all cooking. So is is it's kind of a little bit secret. Like a secret. I usually people trying to question coming to this consciousness or I was bleeding on the brain is can or can't. Invisibly fan causes a lot of problems with the person never in concentration. So thinking about something about the ideas between how did. The teeth because we have a heart for that, you know, upset, but you also have the SEC kids out there like an art to level. There's a lot of little steps in between. So that's confused sector. How to read people and those intermediate steps, and so maybe Bill can help us little that stuff. Oh, sure. Let's. Congress congress convos savior generous benefit for the patients with traumatic brain injury. It was based on a lot on testimony by victims of TB I and their spouses who testified before congress has to the profound disability that they suffer and their severe needs. And I had the privilege of representing representing. But I had the privilege of actually deciding such a case for one of the individuals who actually testified before congress. And. That guy testified. Yeah. I'm not sure we're speaking of the same patient, but the one I had in mind, I. I was able to grant the maximum benefit in that case. There were certain activities of daily living that veteran could not perform independently because of TB on part of that was rather significant paramount of his hands inboard nation, lack of endurance. And so he needed help with some activities such as cooking and and dressing. He also had memory problems. And so he was reliant on GPS to get medical appointment or to find the grocery stores. Restore he wasn't capable of retaining that information. And. The board of veterans appeals had actually remand did that case for further development. And as soon as the case was brought to my attention..

Bill Krieger Congress SEC
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

06:20 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"You know, enacted legislation to improve appeals process and to help because if things continued as they were the appeals pending could not be judicata did within the victim lifespan of the veterans of the fields claims spent. Okay. So something had to be done. My fear is that the expeditious process. We'll be harmful to something that because if you've been licked a prompt review. Now, you're. You're basically inviting day to decide the case on the evidence at hand and most veterans in my experience don't have a good understanding what evidence is necessary to prevail on peel. They think they have a good case. They think they just needed to get it in the right hands to decide it their way. And I think that impression that somewhat naive. I think they don't understand that it requires significant medical evidence, then and that's that's probably the biggest issue facing. Our peels is getting the right medical evidence for the judicata do that you have chance. But if you take the ramp and go fast for fast decision, your brisk losing it because it's not been fully grown. Usually. I recall. One study. I recall. Be was analyzing remand appeals to find out. Why there were so many remains? And the result was that thirty percent. Nearly a third of all deals marine, man. Remand is because the regional office did not complete the development. Accordance with the rules already telling them what to do they were not completing the. So. If we who knows. We know that then then. Go ahead. Those is also there's nothing undercurrent of using a lot of nurse practitioners and persistence in those Devi Q and some of those different parts of the evaluation. So those people are not as well trained as the doctor definitely not as a specialist. And so they're not even gonna think about bringing up the issues that might be pertinent to the claim or the reading in those of I wish. Yeah. And and the instructions to those folks is generally stick to the script. You know, don't go off script. We're not asking you. If there's back is causing depression off. Okay. And the I think where we're most important is when we're trying to. Understand the condition and its potential for relationship the military service. I wanna hear more what I was getting in those medical opinions. I want a better in an now, it's not just a something rather superficial. I remember one case, for example, the. I was in this case and. The individual had after naval service working shipyard and had gotten compensation workers compensation for aspects related illness and VFW hall one time, why weren't you in the navy? Yeah. You're on fire with the did, you know and. The the. I o was basically predicated on the simple fact that he got a workers compensation plan, and I argued in that case eventually the court remanded them. Well, you know. Worker's compensation was presumptive. They did not analyze all pencil expose. It was simply a class action. And that's and so I wanna attorney who had been handling thousands of such claims, and they didn't analyze the holiday they presumed that it was due to the shipyard when they granted the workers comp they didn't they didn't ask about the navy. They didn't know about the knee. Okay. Point to it takes decades for specis relieve disease to develop in most cases, and so that would point to an earlier exposure as opposed to the shipyard and. Basic fluid all medical opinion, was basically now he got he got workers comp never mind. Oh, no. Better. Ability analogous cases, guys out of service or shoot is in a car accident breaks his back, you know, and veal then that the car accident was caused. But then if you go back and look at it, you might find once again Ray changes with arthritis to take decades for many years to form formula. Same kind of exactly right. Exactly. Right. Okay. So it was a car accident, you know, a couple of months ago, and they did the imaging at that time. And it shows very severely advanced genitive changes. Well, that doesn't happen. A couple of months. Right. I I would call them. Similar case fella had a Jeep accident is beyond me decade later had listening at the post office and got worker's comp at the post office and the opinion from the physician assistant the examiner..

VFW hall attorney Ray thirty percent
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

03:11 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"That is what good days, doc. That's it. Yep. We're still still doing cases where that reduction case recently Bill you wanna give them some details on that one. Because the same kind of teamwork that I say if I'm thinking of the proper case, I think this is the one where the V A, I think look to treatment records to reach a conclusion that a tumor brain tumor was in remission. And in fact, when you review the imaging it clearly demonstrated that it was not in remission. It was questioned but not in remission, and it was active and the poor veteran was facing a reduction from one hundred percent zero percent, which is wrong in and of itself, but that's a different argument. But the the proposal to reduce was incorrect. And again this proposal to reduce was a result of accepting evidence. That was incomplete and once Docker bash took a look at the records and and saw what the facts were medically. We were able to bring that to the attention of VA, and they they quite promptly reversed their position on that. Didn't that was like what less than two months? Yeah. It was pretty clear that concept that concept, you know, kids what was fifty nine days, and the concept is sometimes they'll match up my DBQ or my medical analysis with the clinical situation, and then we'll take that and seal compares bills knowledge of the liars and kind of Mel those two things together. Right bill. Yeah. My philosophy. When I was a Representative was always I want to make the raiders job as easy as possible. Because I'm going to give them the evidence. They need to make an accurate decision. And I'm going to point to the authorities. So they know where to look it up if they need to you know, if they're not familiar with this part of the rules or the ball. Here's where you can look it up, you know, so that so that I would always present a case in that way, you know, even back in the nineteen seventies. When I was way out in the field. All the way back then I would make a point of doing all that development work and getting all those documents getting all those treatment records witness statements putting it into as a complete package decades before the a came up with what they now call decision ready to claim. That's that's the way I was doing business decades ago. And if if everyone could do that, I truly believe we could help I truly believe that VA would be able to achieve its mission more accurately and faster with our help. And I think if every veteran every.

VA Bill raiders Mel Representative one hundred percent fifty nine days zero percent two months
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

05:26 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"But not Bill the Granville Sunai ratio. That's frenzy thing. You did with the analysis is reminds me how we do things with the brain with multiple sclerosis. You know, like we have patients that had lost their hearing or changing the vision, and we'd go, well, what does he writes scant short shows a little easier than the place for the head loss of vision or the hearing right kiss like that. Same thing. Like how houses hearing loss happen? Well, it helped me not brand. What is it? And you know, how? And how can we tell you know, what I found distressing many times? I would I would be getting medical opinions. And and in great numbers, these opinions are coming from physicians assistance, and they would just say, no. And I would just point to some literature and literature would say, you know, the most frequent cause of condition. A is. Though, I don't know age. Let's say, for example, I mean, well, okay. That doesn't tell me how you're able to determine whether this individual case. Is a result of being part of the minority of people who are affected versus the majority of people who are suffering with an age related condition. Your medical opinion has to explain to me why. This patient's experience is not in the minority. Man, the court may I I wasn't planning on bringing that up. So I didn't look it up early on in the court's jurisprudence in the court made that clear if for example, the opinions as thirty percent, you know, seventy percent of these conditions or age relate on guy. Mcchord found that. Well, okay. If if for example, the patient is. In that group. How do you know whether is in the seventy percent or the thirty percent. What what do you point to? And he was playing it. And I think that when the court ruled in the EVA's Rodriguez, it says, a rationale for the opinion, and why is the most important aspect of of a medical opinion. Then how we gauge the value that opinion is. Is is. Predicated on reasons being offered that's that's that'd be importing logic to use the nag. You know, the question of why why do you think he said putting Vietnam, and it's the same kind of logic. Because that's where the history went. And that's the way the logic goes for transportation pathway and the same thing in medicine. That's the way logic goes for the medical pathways or neurologic pathways or whatever it's the same kind of reasoning. Sure. Like like any analysis that you're attempting to do in life? Basically, you're saying, okay. Here's some evidence supporting one side, and here's some evidence for nine the other side. And let's see which one which way should we go. And why? Well, yeah. It's it's I just now recalled the case, you were just asking about it was hearing, and you and I over turned and opinion all they department head of a college of neurology. Because. You simply got his factual. He was he was jesting that this individuals problems with sinusitis and upper respiratory infection was affecting his hearing as an explanation for why his here was being different at different times in service records, and what I pointed out simply was that. No, that's exactly wrong. If if you haven't infection hearing loss is going to be flat. It's going to be across the board because all frequencies affected, by FEC Shen that impairs the ability of hearing. Whereas in this case this veterans hearing, not only was not flat. It was variable at various times and the times that he suffered with problems with hearing was not coincident with periods that he was having infection and the board of veterans appeals went with us and said, yeah, you're right. And what I done in that case, I I had seen peculiar findings things that are unusual regarding his hearing in his service records, and I looked at his MRI, and I did some reading on my own to say, okay. What what part of the brain is this and does it affect hearing. And I thought it probably was into his post earier. And and so that's when I got a hold of Dr bash, and and he pointed out. Yes. Yes. Absolutely. That is the area of the brain that affects hearing. So we were there. We were good. Happened. Really do..

Rodriguez Shen Dr bash department head Mcchord EVA Vietnam FEC seventy percent thirty percent
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

04:25 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"It just takes a lot of research. Yeah. Yeah. You gotta you gotta study the record. You gotta look for the little things you gotta take your time to compare that to all the little laws, and you gotta pay attention to what patients. Because all of that makes the whole thing. And. Can't be in. Hurry and do that. No, you can't. And there's a lot of things in a bathroom medical records. A lot of time to just overlooked or not. Accessible to the bathroom because when they used to send out these clients holders or. You know? Hell that I don't like copy one side of the medical records. Seen that. Yeah. Yeah. I bring. Here. Here morale. You'd bring the mind World War Two, and he's been denied for years and years and years, and I went looking through his service record. And I found stack of dental records with a rusty Osafo safel- in it that had never been. Well, I'm not surprised. Yeah. I'm pulled my family. What we needed to win that case? So is that the bathroom small, you know, long times, I say, well, we made this information that information when the bay setting on that information and better not be. That's about to. Yeah. That's that's that's very, that's that's. Veteran does no. What to look for? And you're you're right. It's really hard really hard. Got time, right? I've known my forty plus years. I've done some good that that study thing studying. Look through the record carefully and. Be sure that complete records here. That's a hard one one of my favorite alternatives. Particularly with the PTSD claims, you you get these decisions and from the region Loftus and they'd get the baby. And they say there's no proof of your stressor. I would do search and board of veterans appeals to see that there were five or seven other cases of PTSD that were granted by baby based on that same stressor. We're at work. We're out of town dot contact your next now. Got your back, Google ducking? Craig bashes creek basketball you to. And then my skiffs my schedule nine to five three eight one seven five six one nine to five eight one seven five six one scheduled him. Get back together next week too. That whole lot of go over maybe we can come back on. All right coming on. We do appreciate you guys have been wealthy people. You're getting ready to have the Matt. Will keep that. Right. All righty coming on your, thanks. Thanks rose. Well. Okay. Do you guys have even speed is Bj Bashar would be signing off on that?

PTSD Matt Craig Bj Bashar Google rose basketball
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

05:37 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"I drooled diagnosed that through smart enough haven't read enough haven't got him to the right person yet, y'all. All. Yeah. That's why I I see things in records and say, hey, doc. Hey, Dr best. My here. What we got just one example. I was looking for a record. And the definite was fine to prove that multiple sclerosis started in terrorists. He was totally committed. It was because the symptoms that he had at the sonically after service reminded him of the symptoms. He had inserted and so when he was finally diagnosed with them s which was a long time after. He was totally committed starting in service. Well. VA examined him two three times. And all the doctors were lining up and saying no there were no symptoms of MS present in service. So I took a look through his record. And I did some studying imaging, and it showed certain abnormalities in certain locations of the brain. So I just looked it up on the line. And I realized. Portion of the brain affects here. So I I look through his treatment records, and I see at one point in time the veteran complain that his hearing seemed odd. It sounds like my head is in a bucket. Right. Well, what explains that? Who knows they didn't know. But then I noticed that his hearing tests had Sukhois hearing tests service, and they were all over the map. So we. We suggested that these lesions on the brain are consistent with those in mess cases. They've been used to diagnose him in this case. So that's an has with lesions in this area this area of facts hearing and here are abnormalities of hearing in service records consistent with them. Four vexes appeals in that case decided to send it to a university and the department head and head of heroin in that university and came back and said, no, it's related to his sinus. Trouble. Well, I gotta home Dr bash and and when I started DACA Abacha's was look if it's if it's infection, then we would predict a cross Ford loss. Low medium high across the board are all going to go down during the infection. And then when it clears up, those frequencies will recover. In this case, it wasn't like that. In fact, his hearing was worse. After infection went away. And it wasn't across the board. It was at specific frequencies if you could fix your two hands. Playing plug. I know catching on the kids. Okay. And then put that on your hearing and see the frequencies going up and down at different frequencies, different years and different times. Now what explain? Other than relapsing remitting MS. That's a beckoning different functions at different times. In that recognizable pattern. So Dr bash. Agreed with me little oh Bill. Explained it to the BVI and be accepted, Dr bashes opinion. Over department headed many of major university. Now that new but Dr by is very thorough. He's. Yes. I am modes is statement. So what what that explanation? I don't see how like anything, but agree with. In that case, we have we have these in the brain, the brain stem. I think to some lesions in the. Brain. Oh, my back tomorrow. That would be. That'd be a real kicker 'cause the plays gonna brain that shows that affects hearing you right in the mid rain. So if we had probably did have good brand lesions, and I went through the whole explanation. So that's what you know. Really roll them over probably. Frequency losses picture on a brand that shows that accounts for. Yeah. Sometimes little things can really turn it over..

department head Dr Sukhois DACA Abacha VA BVI heroin two hands
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

03:50 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"You did bring up an interesting point there. Peripheral about identifying what's being playing. The man will attend here makes it very clear that these planes most the red sympathetically. So it's the civically survives. Somebody puts claim for head injury. Cautioned? They must accept that. As claim residuals of TV on. And conversely if a veteran claim things like combat injury assault and be accident. All. Any other injuries events that raise the issue at TV. If there was an injury to the head. Fis? He was in some kind of an accident or the salt combat injury that was traumatic to the head. Then whether the veteran does or doesn't specify claim for TB relevant VA is to construe that as a TV Ike lane. And then again, conversely, if they five the claim for the TB, I. The duty on VA is to identify any complications like were there idea or something where they're burn muscle. Injuries. Orthopedic injuries answer taste. In addition it to the brain injury. So it works both ways in favor of the veterans. We hope we can only hope that. Little be sympathetically, read and understood. Bill how to? Question. It was symptoms like headaches come with like to the come with dizziness memory loss. Those not much of a of a card for the raiders to maybe put those TI. Is there any kind of thing in manual tries to help them do that or. Integration. No only the section. I was just referring to you do find it. I'm gonna read off the numbers and making note, or you know, you can search on the website. Twenty one one. Three. Merel for. Number four. And. Who? And and that makes clear that if it wasn't injury to the head then accepted PB, I. And if they're claiming TV, I sure to explore the burns and injuries, and amputation and all the other things for all this Ebeling, chronic residuals of the ease vent, not just the head trauma. So the wolves are on our side. They Bill how does that work claims? So let's say, for example, before the TBS Kratz here came out, you know, veteran head hit injury. He was traded residuals in custody..

raiders Bill assault
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

05:08 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"Well, that's true. But there should be a wide measure that would. Take test of some sort. Maybe I don't know. Now, the brand. Raise the most complicated thing. We know you know, you can't understand exactly we're kinda looking out. But in the nerve psych testing rapid movement testing movement brain brain's game stuff. You can do. It doesn't there's nothing that tells exactly every case the black and white QB is so it's, you know, a lot of integrate digest this round like tastes. We're talking about. You know, they give them a diagnosis of Asia, which was one symptom. I was bigger more global TI problem later on down the road record worked it out. Give more correct diagnosis. Duck TBS situation have to do if you have a head injury back day back in the nineties. I didn't keep you have to basically residual test. Konate rates fatal by them. But today, you see a lot of it had Nick injure hit PBS and they have nerve Dame's ears. Not is what's link when those two. Historically medicines. Go about TV is for a long time. Congress relate populations trying to catch up, you know with all new engine now. So can kind of you know, a term that people recognize, and, you know, the brain has its own set of functions, and it has all these nerves that run out run different parts of by. So you know, one place that happens a lot is in the temporal bone ear seventh through that ear and oftentimes people have a fractured from temple bone. And it'll several tries ties those nurses, south nation. We dizziness business in Lhasa function. So it's a common thing grain skull and the brain trying to have dance going on. It's a skull gets hurt way. The rain is gonna respond skull fractures in a certain way for certain common place practice. Con concrete. It's not poor correctly crack replaced the brand has some sort of common things that happen to traumatize we image. We look for those common fractures start to look for the associated Nerva mature, the the brain trouble. One thing it's important members brain swells that were consul. Oftentimes patients will be sort of lucid brain has like max Levin days. So cases, go along, and you know, go home and sleep it off. And then we could train goes into that de Mistry's. So brain's really actually pretty dynamic. So you have to look at it with that in mind and also died goes to those, you know, separate functions. Well, that's the Brian had a tendency to three insides if it becomes injured or maybe not not for Latian, but perhaps bruised Brian gets bruised. I would have meant that someone that. Close to five inch Gannon. They're going up all the time. That concussion your head could bruise a man is there any way to help the brain was birth. Or is that cars trucks? Yeah. That's exactly right. You know, like keep stepping on a rock on your foot. You're going to get Cruz on your foot, and it's going up, Mike, Mike trauma. So bring bring the way it's gonna swell probably the brands that since a little box. So it's almost like an egg show or the Nagin side. So there's not much room when you're young for the brain to swell. So in young people when they get those micro Trump's bring swell, and then you don't get very good profusion like those talk about anoxia, and you can actually bring Justice based on swelling. When you're older, you go through life the drain starts to slowly. So I even had seen cases where older patients eighty nine year old to to the brain that suck up that extra space just kinda residual there now, and they're older, and they don't even have any symptoms because there's so much room inside to the bone. Bony vault. So it depends on yard. You have trouble. You have what type of trauma and a lot of factors. Vault. Bush, especially if you've ever had knows the pace of Huntington's disease. No, I haven't. Teaching. That's bad. Bring the..

Mike trauma temple bone Brian Asia Congress max Levin Nick Nerva de Mistry Trump Gannon Bush Nagin Huntington Cruz Latian eighty nine year five inch
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

04:08 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"Bring runs runs everything, you know. So kinda had two cases talked about one I talked about another. But the concept on saying over the Braehead little body little body inside it so depends on where the where the traumas, but what part of you doesn't work. So it's. My point being. Good chemicals, hab same affects on the brain. Yeah. Talk with buying. They could have. Yes. Yep. Yep. Yeah. Classic toxin one talks. We talk about like radiations kind of obvious thing people relationship head neck, and then that affects the brain. And it can get very similar to TV. I bring only bring only has so many ways to react, you know, on and off. Good bottom level and things that affect the blood vessels or things that wreck. The Tricia talks is across in various and have similar kind of knocks you low oxygen too, much radiation too, much chemotherapy can leave you very similar picture. Yes. That's that's the point. I was on the mate. This could be a new avenue for a lot of veterans. Daytime with exposures. Bill. What is what is the? Schedule your that. Oh, there's there's a specific rating for Parkinson ISM or Parkinson's disease. And of course, that is presumed to be associated exposure to herbicides true. That might be something. Folks needs to be aware of. So Bill could use some of these toxic exposures, get rid analogous. Brain trauma Trump. Not generally the manual makes it very clear that for rating purposes, traumatic brain injury being a. Physical disability resign. Resulting from any event of external force causing injury to the brain. Now, the one one alternative diagnosis could be an oxymoron, if the individuals suffers a loss of respiration and the brain suffers from the lack of oxygen that anoxia can reduce symptoms to TB. In that circumstance. It's service related then it can't be evaluated. To TV. I. Depending on the global presentation. If it's. Yeah. What you're saying? Is that normally you have to have some extra blowed footnote, but allows anoxia to be rated into the into the TV I category, basically. That's correct. Yes. If if it's to be a kidney, I it has to be from external. But if it is from an Axial. Xia you need to choose whichever. Diagnostic code of diagnosis would provide the greatest compensation to that. You could read it similar to. Tv I or reps a stroke, brain, hemorrhage and mental illness..

Bill Tricia
"dr bash" Discussed on Veterans Helping Veterans

Veterans Helping Veterans

03:49 min | 2 years ago

"dr bash" Discussed on Veterans Helping Veterans

"Can you a series of shows but hope with the doctor back and kick Bill Krieger today? Republican discuss the big one TBI. No, that's very very serious injury business supper they've been exposed explosions or head Trump. So turn it's over Dr bash. Hey didn't act by. I'm good. I'm good. I was talking about the prototypical case, we have guy recently. I had a bunch of micro traumas. He was a controller six inch guy for destroyer class where and you know, you have to have whole healthcare can't walk around disease. Just losses. House wife is cooking. Know, it's kind of a little bit secret like a secret to usually people try to pression with somebody conscious or bleeding on the brain. Alright skin or skin. Thinking invisibly causes a lot of problems with the person never concentration. So about something about the ideas between how did. The teeth because we have a Harper that you know, is upset the kids out there like an art to level. There's a lot of steps in between. That's confusing. How to read people and those intermediate steps, and so maybe Bill can help us little of that stuff. Oh, sure. Sure. Congress congress generous benefit for the patients with traumatic brain injury. It was based on testimony by victims of TB I and their spouses who testified before congress to profound disabilities that they suffer and their severe needs. And I had the privilege of representing representing. But I had the privilege of actually deciding such a case for one of the individuals who actually testified before congress. And. I guy testified. Yeah. I'm not sure we're speaking of the same patience. But the one I had in mind, I. I was able to grant the maximum benefit in that case. There were certain activities of daily living that veteran could not perform independently because of TB on part of that was rather significant paramount of his hands inboard nation back the door ins, and so he needed help with some activities such as cooking and and dressing. He also had memory problems. And so he was reliant on GPS to get medical appointment or to find the grocery stores. He wasn't capable of retaining that information. And uh. The board of veterans appeals had actually remand did that case for further development. And as soon as the case was brought to my attention..

Congress Bill Krieger Dr bash Trump Harper six inch