PRESUMPTIVE SERVICE
CONNECTED DISABILITIES
Public Law 97-37 (Layman’s Terms)
by William Paul Skelton, Ill, MD F.A.C.P.
All ex-POWs should keep these and/or make copies. Whenever you open your claim,
take them with you and make sure the adjudication officer sees them and have
him read them! Make sure he knows all about them. Tell him your own story as it
relates to your problem.....
1. ARTHRITIS, TRAUMATIC
Also
known as articular trauma. This disorder looks and is treated just like
degenerative arthritis (arthritis associated with age) except it is caused by
severe damage to a single or few joints producing early onset arthritis. Since
it has a definite cause, it is called a secondary form of arthritis. This is an
extremely difficult diagnosis to make, but in general one has to prove that a
specific trauma occurred to a single or very few joints, and other changes
consistent with degenerative arthritis are not present throughout the rest of
the body at the same time. In short, these changes need to be localized.
2. AVITAMINOSIS
The
total lack of vitamins in the diet. This disorder is a fatal condition unless
it is supplemented with vitamins within a few weeks. Therefore, most
individuals suffer from hypovitaminosis, which is a relative deficiency or vitamins
in the diet. The specific type, intensity and duration of deprivation
determines the long-term effects.
3. BERIBERI
Caused
by a severe lack of vitamin BI (thiamine) in the diet. This produces changes in
the nerves (both in the brain and extremities) and the heart. Brain changes
could produce dementia or psychosis. Nervous changes are usually associated
with numbness and/or painful feet. Beriberi heart disease is an acute
condition, similar to congestive heart failure, except that the heart pumps more
blood than in normal congestive heart failure and it is associated with the
presence of an excessive amount of lactic acid in the body. It is unknown at
the current time whether this can produce a chronic state.
4.DYSENTERY, CHRONIC
A
disease characterized by frequent and watery stools, usually with blood and
mucus, and accompanied by rectal pain and abdominal, fever, and dehydration.
This is an infection in the colon and can be caused by a multitude of different
organisms, the most common of which is amoeba which can produce a mild or
severe dysentery and possibly he associated with a chronic irritable colon.
Bacillary dysentery is associated with the bacteria shigella, but will not
cause a chronic state. There are multiple other bacteria that can cause
dysentery which usually do not produce chronic states. Viral dysentery can also
present like amoebic or bacillary dysentery and will not produce a chronic
state.
5. FROSTBITE
The
actual freezing of tissue. This is graded on a continuum with one representing
mild to four representing mummification of the tissue. The extremities furthest
from the heart are usually affected, with primarily the nose, ears, fingertips,
and toes being involved. This usually produces long-term side effects such as
numbness, discoloration, excessive swelling, and pain in the affected area.
6. HELMINTHIASIS
Infection
with any type of worms that parasitize the human. Most infections usually
resolve spontaneously either with proper treatment or as the natural course of
the disease. Strongyloides is known to persist in a permanent state in humans
due to its ability to reinfect the host.
7. MALNUTRITION
Merely
means bad nutrition. The nutritional depletion may be either caloric. vitamin,
fatty acid, or mineral deficiency, or more likely a combination. Depending on
the type. intensity, and duration, it may yield permanent side effects or no
lasting side effects at all.
8.
PELLAGRA
Literally meaning rough skin in Italian, also known as black tongue in dogs. It is caused by a virtual lack of vitamin B3 (niacin) in the diet, producing the classical trio of diarrhea, dermatitis, and dementia. All are easily treated early on with no side effects. The dementia, if left untreated, may produce permanent mental deficits.
9.
ANY OTHER NUTRITIONAL DEFICIENCY
The
lack of protein and calories in the diet, generally produces no lasting side
effects. However, vitamin deficiencies other than the aforementioned B1
(beriberi) and B3 (pellagra) can have very disastrous effects on one’s
body. Also deficiencies of certain fatty acids and essential minerals in the
diet can have lasting and long term sequela.
10. PSYCHOSIS
A
generic term for any of the insanities. Generally, it is thought of as a mental
disorder causing gross disorganization of a person’s mental capacity and
his ability to recognize reality and communicate with others regarding the
demands of everyday life.
11.
PANIC DISORDER
Characterized
by discrete periods of apprehension or fear with at least four of the following
during an attack: shortness of breath, feelings or heart skipping, chest pain,
dizziness, sweating, fainting, trembling, fear of dying, or doing something
uncontrollable during an attack. These attacks need to occur at least three
times within a three week period, not associated with physical exertion or life
threatening situations. Also there needs to be an absence of severe physical or
other mental illness which could cause these symptoms.
12. GENERALIZED ANXIETY DISORDER
Characterized
by generalized persistent anxiety and with symptoms of at least three of the
following four categories: (1) Motor tension as characterized by shaking,
jumpiness, trembling and restlessness; (2) Autonomic hyperactivity. such as
sweating, cold or clammy hands, high or irregular heart rate, dry mouth, etc.;
(3) Apprehensive expectations, anxiety, worry, fear, anticipation of misfortune
to himself or others; (4) Tendency to insomnia, hyperattentiveness, irritable.
All these symptoms had to have lasted at least one month. Also, there needs to
be an absence of all other mental disorders and physical disorders which could
explain the symptoms.
13.
OBSESSIVE COMPULSIVE DISORDER
This
may be either obsessions or compulsions. Obsessions are recurrent persistent
ideas or impulses that are thoughts that invite consciousness and are
experienced as senseless or repugnant. Attempts are made to ignore or suppress
them. Compulsions are repetitive and seemingly purposeful behaviors that arc
performed in certain similar manners. The behavior is felt by the individual to
produce or prevent some future event. Generally, the individuals recognize the
senselessness of the behavior and do not derive pleasure from carrying it out,
although it often relieves tension. Also, the obsessive or compulsive
individuals are associated with a significant sense of distress in that it
interferes with social or role functioning.
14.
POST TRAUMATIC STRESS DISORDER
The
re-experiencing of a trauma of a past recognized stress or that can produce
symptoms of distress. This re-experiencing needs at least one of the following:
(I) Recurrent and intrusive recollection of the event; (2) Recurrent dreams;
(3) Sudden feelings that the trauma was occurring because of an association, an
environmental or ideational situation Also involved is reduced involvement with
the external world beginning after the trauma, revealed by at least one of the
following: (1) Hyperalertness or exaggerated startle response; (2) Sleep
disturbance; (3) Guilt about surviving when others have not; (4) Memory
impairment or trouble concentrating; (5) Avoidance of activities that arouse
recollection of the traumatic event; (6) Intensification of symptoms by
exposure to events that symbolize or resemble the traumatic event.
15. ATYPICAL ANXIETY DISORDER
This
is a category that is used for diagnosis when the affected individual appears
to have an anxiety disorder that does not meet the criteria for entry into any
of the other known anxiety disorders.
16. DEPRESSIVE NEUROSIS/DYSTHYMIC DISORDER
Characterized
by depressive periods in which the patient feels sad and/or down and has a loss
of interest in the usual activities that cause pleasure or involvement in usual
past times. These depressive periods are separated by periods of normal mood,
lasting a few days to a few weeks, but no more than a few months at a time.
During the depressive period, at least sleep or too much sleep, low energy or
chronic tiredness, loss of self esteem, decreased effectiveness or productivity
at work, social withdrawal, loss of interest in pleasurable activities,
excessive anger, inability to respond with apparent pleasure to praise or
reward, less active or talkative than usual, pessimistic attitude about the
future, tearful or crying thoughts about death or suicide. There are also no
psychotic features present.
17. PERIPHERAL NEUROPATHY
Literally Greek for the suffering of nerves outside of the brain and spinal cord. There are several different causes for peripheral neuropathy, and vitamin deficiency and possibly mineral deficiency are just two. Other causes to be considered are various toxins such as lead, copper, and mercury, a hereditary pre-disposition to neuropathy, deposition of amyloid or protein produced by one’s own body mounted in response to an infection, infections such as by leprosy, which is the most common form of neuropathy in the world, and multiple other less common causes.
18. IRRITABLE BOWEL SYNDROME
Irritable bowel syndrome (IBS) is a common disorder of
the intestines that leads to crampy pain, gassiness, bloating, and changes in
bowel habits. Some people with IBS have constipation (difficult or infrequent
bowel movements); still others have diarrhea ( frequent loose stools, often
with an urgent need to move the bowels); and some people experience both.
Sometimes the person with IBS has a crampy urge to move the bowels but cannot
do so. Through the years, IBS has been called by many names - colitis, mucous
colitis, spastic colon, spastic bowel, and functional bowel disease. Most of
these terms are inaccurate.
19.
PEPTIC ULCER DISEASE
A peptic ulcer is a sore or hole in the lining of the
stomach or duodenum (the first part of the small intestine). In addition to the
pain caused by the ulcer itself, peptic ulcers give rise to such complications
as hemorrhage from the erosion of a major blood vessel; perforation of the wall
of the stomach or intestine, with resultant peritonitis; or obstruction of the
gastrointestinal tract because of spasm or swelling in the area of the ulcer.
The direct cause of peptic ulcers is the destruction of the gastric or
intestinal mucosal lining by hydrochloric acid, an acid normally present in the
digestive juices of the stomach.
20. ISCHEMIC CARDIOMYOPATHY
A disorder caused by lack of oxygen to the tissues of
the heart, in which the muscles of the heart are affected and the heart cannot
pump properly. Ischemic cardiomyopathy is a cause of heart failure and is a
complication of ischemic heart diseases such as acute MI, angina, and unstable
angina.
Symptoms include: chest pain, experienced under the sternum, may radiate to the neck, jaw, back,
shoulder, arm, may feel tight, pressure, crushing, squeezing, may or may not be relieved by rest or nitroglycerin
sensation of feeling the heart beat (palpitations)
irregular or rapid pulse
shortness of breath, especially with activity, or shortness of breath
that occurs after lying down for a while
cough
fatigue, weakness, faintness
decreased alertness or concentration
decreased urine output
excessive urination at night
overall swelling
breathing difficulty when lying down
high blood pressure
Examination may reveal an irregular heartbeat, and heart and lung sounds may be abnormal. There may be other signs of heart failure. Decreased functioning and enlargement of the heart may show in these tests: coronary angiography, echocardiogram, chest X-ray, chest CT scan, MRI of chest. An ECG may show enlargement, old MI, ischemic changes, arrhythmias, or other abnormality. A biopsy of the heart may be needed to rule out other disorders. Lab tests may be used to rule out other disorders and to assess the condition of the heart.