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Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities. Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Tuesday & Wednesday at 7AM Central.
Take control of your medical evidence related to your benefits and visit https://podcast.prestigeveteranmctx.info/veteran/ for more information and to connect directly with us!
Hey guys it's Leah B from Prestige Veteran Medical Consulting. I am a U. Army veteran, physician assistant, and former compensation and pension examiner. So welcome back to our channel where we break down VA benefits in clear actionable language. I'm Leah and today's episode tackles a topic that is easy for veterans to miss but often has a big impact and that's side effects from prescribed medications or just medications prescribed to treat your VA service connected disabilities and how they can qualify you for a secondary VA disability.
Leah Bucholz:If you're taking medications for a secondary for a service connected condition and that medication has caused a new medical issue, you might be eligible for added compensation. And here's what we're going to cover today. So what qualifies as a VA recognized medication side effect, examples of common secondary conditions from prescriptions, how to prove secondary service connection in many cases, medical literature that supports these types of cases, special monthly compensation, and uncommon side effects, common pitfalls that I see when I review medical records. So let's just dive right in. So what are VA recognized medication side effects?
Leah Bucholz:So under 38 CFR 3.31, the VA recognizes that disabilities resulting from treatment of a service connected condition including prescribed medications can be compensable and that means if a new condition is caused or aggravated by your treatment it may qualify as a secondary service connection. I see this super frequently. So real examples of medication side effects leading to claims. So some common examples include scenarios like ulcers or GI bleeding from long term NSAID use to manage back or joint pain. That's probably the most common one that I personally see.
Leah Bucholz:Diabetes hypertension or obesity from antipsychotics or other medications prescribed for PTSD or bipolar disorder sexual dysfunction resulting from things like SSRIs or other types of antidepressants liver damage caused by anticonvulsant medications, memory impairment due to prolonged use of sleep aids. Another big one that people don't think about is different types of medications to treat hypertension can actually cause or worsen tinnitus or tinnitus. These conditions can each be connected back to a service connected diagnosis if documented properly. So how can you prove secondary service connection? So a current medical diagnosis is always going to be important for what that new condition is.
Leah Bucholz:So evidence that your original condition is already service connected or is related to your service. So you need to have a nexus from a licensed provider stating that it is at least as likely as not that the secondary condition was caused or aggravated by the medication prescribed by a service connected disability. So do you have to get that from your doctor or from, somebody like me? No absolutely not. The VA will provide a no cost exam for you if there's enough evidence to warrant an exam being ordered and you will have a C and P exam and that examiner will provide an opinion.
Leah Bucholz:May not always be a favorable opinion but it might be if it's pretty straightforward. You can also ask your treating provider and they may be willing provide you an opinion even just a short statement saying that they believe your ulcers are related to your NSAID use or whatever. Supporting this with prescriptions medical notes and side effect warnings may help you support that case. So let's talk about some medical literature because I like to go over that quite quite often for you guys. So let's back this up with science.
Leah Bucholz:Citing scholarly articles from places like PubMed can help you bring some credibility to your complaint. So NSAIDs and GI bleeding so upper gastrointestinal bleeding associated with the use of non steroidal anti inflammatory drugs newer versus older agents published in 2,004 documents dose dependent GI bleeding risk. A case study non steroidal anti inflammatory drugs and gastrointestinal bleeding from the american journal of medicine is another one. Antipsychotics and metabolic syndrome. Antipsychotic induced metabolic syndrome a review from Pharmaco psychiatry in 2023 estimates that thirty seven to sixty three percent of users develop metabolic syndrome.
Leah Bucholz:National trends and metabolic risk of psychiatric inpatients during the atypical antipsychotic era and schizophrenia research published in 2022. Another article predictors of metabolic monitoring with second generation antipsychotic use in the veterans health administration bmc psychiatry in 2009 focused on veterans. Big one here is SSRIs and sexual dysfunction so sexual dysfunction associated with antidepressants from the journal of clinical psychiatry notes that up to sixty percent of SSRI users experience sexual side effects. Anti convulsants and liver toxicity The FDA and the American Epilepsy Society materials acknowledge that many of these medications like valproate related to hepatotoxicity that was a mouthful or liver toxicity right that's what we mean by hepatotoxicity and cognitive risks. So z drugs and cognitive decline so zolpidem and cognitive function a review sleep medicine reviews twenty eleven links this use with memory impairment.
Leah Bucholz:When you file your claim you want to definitely discuss this with an accredited vs with a vso or an accredited claims agent or an attorney if you need assistance. Va.gov also has really good help docs on how to file your claims. They try to make it pretty easy and user friendly for veterans which I think is great, the actual filing process. So you may want to include brief summaries or citations of your articles when you see your doctor and ask them to support your case. So also special monthly compensation so this is a big one, special monthly compensation and severe side effects.
Leah Bucholz:So some side effects may qualify you for SMC or TDIU so unemployability payments beyond the standard VA rating. SSRI induced impotence may qualify you for special monthly compensation K which is loss of use of a creative organ. So chronic liver or kidney damage from medications could qualify you from aid and attendance or SMCL. Medication caused unemployability may qualify for TDIU or total disability individual unemployability. If your side effects make it difficult or impossible to work or care for yourself you may explore these additional benefit routes.
Leah Bucholz:So what are some common pitfalls that I see when, I review cases? So failing to link your symptoms specifically to a medication, not including, you know any relevant records from your doctor, assuming that out of range lab results or conditions like ulcers are just part of aging, Document everything prescription progress notes, doctor observations, those PubMed articles can be helpful. Work with a vso or accredited rep especially for complex side effect scenarios. So medications can be life saving but they can also create new health problems. If you've been harmed by some of the medications you're using to treat your service connected disabilities don't just dismiss it and you may actually be eligible for these additional benefits, right?
Leah Bucholz:Additional secondary service connections or some of those special monthly compensations or whatnot. So I hope this was helpful to you guys. Please drop some comments. I've got some great videos on NSAIDs and GI disorders, also some sexual dysfunction videos for female sexual arousal disorder or erectile dysfunction. Please drop some comments and as always thank you for watching.
Leah Bucholz:Right see you.