Mental Health And Nexus Letters

Navigating the VA claims process isn't for the faint of heart.  Air Force veteran and Dr. Prashant Sharma knows this all to well as a mental health provider and veteran.  Dr. Sharma breaks down DBQ's and nexus letters and how important they are in the mental health claim process.  The two major areas the VA looks at is occupational and social impairment and to what level they affect the veterans ability to work and integrate into society.  You don't want to miss this invaluable information on the mental health claims process!

Battle Buddy Podcast Guest Links:

https://open.spotify.com/show/7yQFDCTMu1QlvCIMl1x9E4

https://www.linkedin.com/in/prashant-sharma-a138903/

www.concisepsych.com

 
 

Transcript from Episode 78 with Prashant Sharma:


Keith McKeever 0:01

Hey, welcome back to another episode of battle buddy podcast. If you are struggling with mental health, you have gone through that claim process and maybe you've hit that brick wall, where you need a Nexus letter, you need some advice, you need those next steps, right? Whatever the case may be, you want to want to pay attention to this episode today. We've got a doctor on here, we're gonna talk a lot about mental health psychology, things like that nexus letters, DBQ, a lot of fancy VA claims stuff. So if that's something of interest to you, or something that can help you, you definitely want to pay attention today.

Welcome to the battle buddy podcast with Keith McKeever. All right. So welcome to the show. Dr. Prashant Sharma. I sit down currently,

Dr. Prashant Sharma 0:41

you did you did

Keith McKeever 0:44

this for messing things up.

Dr. Prashant Sharma 0:47

No, that was perfect.

Keith McKeever 0:49

Not only a doctor, but you're an Air Force veteran.

Dr. Prashant Sharma 0:52

That's right. Yeah. I was a flight surgeon in the Air Force many years ago. But yeah,

Keith McKeever 0:58

it's been many years for me to since I threw that uniform on, and I can hand it to you, it doesn't fit anymore. So let's just back up a little bit in, you know, what's, what's your story? Like? You know, why'd you get the military? Would you do you know, well, obviously, your flight surgeon, but you know, those kind of things to illustrate, for

Dr. Prashant Sharma 1:19

sure. Absolutely. Yeah. Thanks for having me on. I'm super excited for this. Yeah, so basically, you know, my brother was in the Marines. And, you know, I really wanted to join the military as well, and also wanted to go to medical school. And I was like, Alright, how do we combine these things, right, and have someone pay for med school as well. And, you know, when went through the air force on that, so it was great, you know, they did pay for school, and I went through and initially, I was activated as a flight surgeon, which is essentially doing primary care for aircrew and their families, things like that, you know, and aerospace medicine. And it was great. It was a lot of fun times, you know, went on a deployment as well, which was interesting, challenging, but good stuff. And came back and, you know, ended up getting out and went to psychiatry residency. So what happened was, when I was in the military, I was really gravitated towards the patients who had mental illness, you know, like depression, PTSD, anxiety, things like that. And that's when I knew I was like, Alright, I gotta get into this field.

So I ended up going to residency to specialize in that. And then once I was done with the residency, I practice regular psychiatry, but then I got into these Nexus letters and independent medical opinions and things like that, to help veterans, you know, kind of clarify their case and get their applications approved and started doing that. And so I do a combination of both these days as well. That's awesome. Because I know, most doctors, anybody goes to aren't going to have military experience, they're not gonna be able to kind of relate, or be able to put things in words the way they need to be put into words to describe. Absolutely. Because, you know, they're worse. Yeah. Understatement of the year, right.

Exactly. Yeah, no, no, that's exactly right. And, you know, there's certain words that the VA looks for, right. And, you know, it's, it's, it's very key, you know, to include those words. And then, like you said, with the veterans, too, it's like, you know, a lot what was your MOS or, you know, like little words like that, which we just know, you know, that

Keith McKeever 3:41

civilians aren't gonna know that. But, you know, so your medical jam, don't know that much about doctors. Okay. It's kind of what I pick up on TV shows like Chicago Med, but it seems like you definitely took a different path to it. You know, I know there's like residency and different stuff, obviously go to your like, college and pre med than med school, and then you go get a job, then residency, then, you know, like, there's different steps. So I guess in my mind, I was thought it was one of those things like you become a resident first, and then you get through that. So he didn't do that. So, so you end up in the air force doing it and then went to residency? Yeah, a different path. I mean, because it seems like it to me.

Dr. Prashant Sharma 4:18

Yeah, absolutely. No, you're right. So the military is kind of strange with that. So So you know, I did you know, pre med, you know, undergrad, med school. And then when I was activated, what they had me do was do a general medical internship, right? So for a year, it's like a crash course in medicine, right, that you're doing. And then you're a flight surgeon without a residency, which the military is the only place this happens nowadays, you know, that it's called, like a general practitioner. You know, that's

Keith McKeever 4:47

what I thought was really interesting. I'm like, wait, yeah, like, seems like there's a lot of hands on. Explain some doctors, some doctors in some ways.

Dr. Prashant Sharma 4:57

Exactly. Yeah. And that's why when I was like, alright, what am I going to do? What am I going to specialize in regular medicine or something else, you know,

Keith McKeever 5:05

oh provides a lot of I'm sure provide a lot of interesting experience, eventually going into site just, you know, a lot of background and different things that I guess they might not get.

Dr. Prashant Sharma 5:16

Oh, 100% I mean, you know, just doing like aeromedical, evac, you know, evacuations, you know, things like that. And, and just, I mean, as you know, like, just so much mental health, you know, related issues in the military. So it gave me a ton of experience and that even before going into residency for psychiatry, yeah,

Keith McKeever 5:37

absolutely. kind of different. I mean, anybody can suffer from PTSD or mental health issues, but as veterans we deal with it, like, maybe the reasons are different, or not making it better or worse or anything, it's just different cause of some of those things. Exactly. Vironment tempo, no combat stress or witnessing, you know, you know, horrific things that are just different, you know, but I guess you can make an argument for, you know, somebody's suffering with PTSD because of seeing people die in the streets is no different than somebody in a suit, you know, in, in a city somewhere here in United States seeing somebody died. Fair. Yeah. I guess we could look at it like that.

Dr. Prashant Sharma 6:19

But apps? Yeah, no, absolutely. It's it's Yeah. And you're right. It's very similar. I guess it just happens with more frequency to veterans because of the situations. Yeah. Oh, absolutely. And I

Keith McKeever 6:31

know, like, I'm sure it's a lot different now. You know, the military culture, I'm sure hasn't shifted much since we got out many years ago. Right. Exactly. But the operations tempo is different. You know, this is, you know, we're recording this in 2022. You know, the pulled out of Afghanistan last year? Yes, we have operators, you know, operating doing all kinds of crazy stuff that none of us will ever know, about and hundreds of countries across the globe. But, you know, Iraq and Afghanistan are over, you know, we don't have troops in those countries with deployment back to back to back to back anymore. Yeah, that's, that was a lot. You know, I know, I know, a lot of Vietnam veterans have a lot of issues from their one to one deployment for a year. You know, when I was in Iraq, a lot of army guys, I mean, they had taken it from 12 months to 1518. Wow. You know, it's like, we'd like one or two breaks in there to come home for like a week or two, you barely let your guard down. And you're right back in the sandbox. Oh, my gosh, you know, so it's like, how do you ever decompress from that?

Dr. Prashant Sharma 7:35

Exactly. Yeah, you know, and oh, go ahead. Yeah. So

Keith McKeever 7:40

you have no, you have no time to do so.

Dr. Prashant Sharma 7:42

Exactly. And that's where like the brain comes in, right? Because it's like, all right. So you're, you're you're deployed for all these long periods of time, right. And there's a part of the brain, right, which is our fight or flight Fight or Flight Center, the amygdala. And that ends up being on like, all the time for 12 months, 50 however long the deployment is right. And then you come back and you're like, You got to turn it off. You know, and how do you do that? It's it's, it's tough.

Keith McKeever 8:12

Well, I don't think it happens in a two week decompression period. Exactly. That's right. So I got back from both by deployments. Oh, congratulations, you're back, do this paperwork and process back to the unit, whatever, you know, a day or so. ago, take two weeks off, which for me, like, especially my first deployment, you know, I was I was stationed in Japan at Yokota Air Base, a hydro family. I was young single guy. Okay, go decompress. You have two weeks off. Yeah. You know what I did for two weeks, sit in my room, and drink and play video games. There you go wasn't exactly healthy things. Right. What else was I going to do? Exactly two weeks? Yeah, go travel somewhere what you want to be didn't want to leave? And so you know, I don't know what the answer is. But haven't people sit in their rooms for two weeks or go back to their family and try and reintegrate back into, you know, that now that husband or that wife has been home? Right, dealing with the kids and the dynamics of the family? Now you're just stepping back into it? Those rules don't work. It takes, you know, a lot of guys I've talked to it takes weeks months to cycle back into the rotation. I think those guys are right back out the door again.

Dr. Prashant Sharma 9:16

Yeah, yeah. Yeah. It's a great point. Like I don't and I don't know what the answer is to that. Besides like, increasing the amount of time in between, you know, I mean, I realized we're not in that situation now. But you know,

Keith McKeever 9:29

oh, yeah, really increase the time in between or, you know, get more people in the military. So that, yeah, people aren't exposed to that. Okay, you've done your time. Now, you got a couple years off. The Air Force is doing it now. I mean, I know you know, when I went in at least the Air Force at one point in time had correct me if I'm wrong, I think it was like buckets or something they called it. So like you will be eligible for mostly Air Force anyway, the rest of you are eligible to deploy in this particular time frame. So potentially, but then after that, you wouldn't be eligible until like, you know, four or five, six buckets later. So which can be like two or three years. That's right eligible for microfilm security forces. And one point in time we were gone six months and back six months. Wow. gone gone again. You know, I, I could just under eight months turn around. A couple of months later, they sent me down to Ecuador, not necess not another deployment. Okay, let's get that straight. On paper, it was a deployment. But then I came back from New York, APCs to Scott Air Force Base, and then boom, turn right around and get back to Iraq. Wow. You know, so that two year period is like Gone Home gone home. You know, like, that was just the tempo backend. For microfilm anyway.

Dr. Prashant Sharma 10:41

No, that's Yeah. And that's, and that's roughly I feel like, and you're right now that you said that I had forgotten about the buckets. That's right. We had buckets. And like I had a bucket of the several months. And you know, like, oh, okay, this is your vulnerable time, you know, when you could be deployed. So at least, you know, there's some you can expect it or not, you know, or not expect

Keith McKeever 11:03

that you could go in that timeframe. Somewhere, maybe, you know, people in other career fields that had to fight and claw for years, just to get on the list. You go someplace when they're talking about

Dr. Prashant Sharma 11:14

that's true. Yeah. Yeah. So

Keith McKeever 11:17

that's different across one branch, let alone different branches.

Dr. Prashant Sharma 11:22

Exactly. Yeah. And your tempo sounds like. So when I was deployed, I, I, you know, worked with a bomber unit, where they used to do six months back home, six months deployed, and they just, it was like, infinite, you know, and I was like, Oh, my God, like, how are you doing that? You know, but yeah, it sounds like that.

Keith McKeever 11:41

Just as much time to decompress. Yeah, well, actually, I mean, really, you get less I mean, you got like, you know, situations, you only got two to three months to try and decompress, and get more to a normal state. That's true. And you have to be like, Okay, you're about to get relieved to duty and go back to pre deployment training, and, you know, get all your qualifications and your shots and all those things that, you know, all the 50 million places, the Air Force may just, you know, get stamps or initials. I don't even have to check all the things they're supposed to check in all those places. But all those motions you had to go through, you know, you know, so by the time you get back to normal, you're ramping right back up to go again.

Dr. Prashant Sharma 12:17

Yeah, yeah. Yeah, that's, I guess both are like jarring, jarring in some levels. Right. I mean, it's just, yeah.

Keith McKeever 12:26

Yeah, that was good. That that was back in the day, hopefully, I really hope. I really don't know what the tempo is like, today. But yeah, I hope it's a lot different for the troops today.

Dr. Prashant Sharma 12:35

Yeah, good point.

Keith McKeever 12:37

But he's like, everybody has mental health, right? You know, we're all on a sliding scale of where we're at good or bad. So, you know, like, I got started to show off and people are having problems or, you know, looking to make a claim, things like that. There might be some things they're not familiar with, like a Nexus letter or a DBQ. Can you break down? what those are? For people?

Dr. Prashant Sharma 12:58

Absolutely. Yeah, it's a great question. And, you know, it's good to talk about it, because nobody tells us tells you, right? When you're gone. You know, you're just kind of, you know, you're just in the process. So basically, you know, what it is, is, you know, you have different types of disability claims, right. And, um, you know, if, if somebody had an issue in the military, let's just take, for example, you know, they had a leg fracture when they were in the military, and then they had pain that, you know, went on after they left the military, right? That's, that's really a good claim. It's an easy claim, you know, you can, you can easily make the claim and submit the documentation, you know, go to your regular doctor and, and let them know, you know, I'm having this pain. I had a fractured back when I was serving, and then you submit all the records, and there's a pretty reasonable chance that you're going to get that approved.

Keith McKeever 13:58

Because you went to the doctor when you read in the book, okay. Yeah, we took some X rays, it's broken. Here's your task. Here's your profile for six months, you know, you know, whatever, exact record of it, like what exactly how they treated it, what they did with the diagnosis was?

Dr. Prashant Sharma 14:14

That's right. That's it. Yeah. It's like, it's straightforward. Right. You know, it's like, alright, yeah, you know, you know, it's easy, right? But, you know, that's where, and, you know, that's where we have the difficulties if the case is different, right. So let's say we go with something else, right, like, let's say somebody was deployed and you know, they had to handle a lot of human remains, you know, so a lot of like, chaplains, chaplains, assistants, they have to handle human remains. Right. And after that, you know, they never got seen, but they were having a lot of symptoms, like they were hyper vigilant, you know, they're feeling pretty down. They're having a lot of anxiety, flashbacks, you know, nightmares, things like that. But they never told anybody, right they Just you know, it's like oh man, like, maybe they'll disqualify me if I tell them, you know if and they diagnosed me with something.

Keith McKeever 15:07

very real fear there that you're going. Yes. Yeah, so security forces. So I came back from my first deployment. And basically we're like, Oh, welcome back. If you want to talk to somebody, they're right to this door. Uh huh. And nobody got up. And why? Nobody got up, you know? Yeah, yeah. I'm not gonna, ya know, you're not gonna, you're not gonna be there. Nobody wanted to be that person to kind of show that weakness. Like, no, you just made it through a deployment. You just, you know, you just were in the middle of Iraq. And you did this, that and the other, you know?

Dr. Prashant Sharma 15:41

Yeah. Like,

Keith McKeever 15:42

you don't want to show that weakness. Like, you just, you just made it through that.

Dr. Prashant Sharma 15:46

The Yeah, and that's such a, like, when we think about it, that's, that's such a not a good way of doing it, right? Like just showing it in front of everybody and be like, Hey, if you need help walk through that door. And everybody's like, looking at everybody. It's like, nobody's gonna walk through that door, because nobody wants to show that in front of others. Like you're saying weakness. Yeah, you know, not that it is a weakness. But you know, it's personal. But there's

Keith McKeever 16:09

a perceived weakness, because, unfortunately, the military you have to be you have to be strong, you have to be there for your team, you have to be there for your battle buddies. Like you, you know, it takes everybody to pull off the mission. And you can't really show a sign of weakness. Yes, like, you know, because everything is it's all about the mission. But it has to be, you know, in order for the military to work and protect our country, it has to be willing machine like, they don't want to change that. That's, that that's the system. Right?

Dr. Prashant Sharma 16:39

Right. Exactly. Yeah, no, no, and you know, you know, then you're worried about, you know, I'm just gonna, it's gonna put stress on my teammates, you know, they're gonna have to do more if I if I do something. Yeah, it's infinite infinite kind of thought loop. You know, you can go into,

Keith McKeever 16:55

yeah, that's, that's a dark thing. But

Dr. Prashant Sharma 16:59

yes, yeah. Yeah. And so, you know, the, your original question about Nexus letter, so So you know, that person comes back, you know, they don't talk about it, then they get out of the military. And, you know, it's really affecting them. Right. It's, you know, the flashbacks, the nightmares, they're not sleeping, they're irritable, they're having problems with their spouse, they get, like, irritated with coworkers, they're lashing out, you know, the supervisors, like, man, what are you doing, you know, all of this stuff is happening, and they're like, oh, man, you know, it looks like I was really affected by that. I just didn't realize it, you know, and, and that's when they go to their VA doctor, and they start talking about it, like, Hey, listen, this is what I was going through, I didn't tell anybody. I'm telling you now. And this is what's happening. That's where a Nexus letter can come in, and really help the individual. So a Nexus what a Nexus really means is a link or a connection. So the goal of a Nexus letter is to connect whatever the veteran has as a diagnosis to something in military service. Now, it doesn't have to be that the military surface caused it directly, it just has to have happened during military service, right? It if it caused it, then that's an even stronger claim, like, you know, some stressful incident or fracture or whatever. But but but that's what a Nexus letter is. It establishes a connection between the diagnosis and military service.

Keith McKeever 18:31

Because without that connection, you're not going to get any any disability rating or anything. Exactly. That requires the diagnosis and the connection. That's right. Yeah, he's in there somewhere. But, you know, it all has to sink in. You have to prove that to the VA. To some random person sitting in an office. Yeah, exactly. Exactly. Your story on paper, you know?

Dr. Prashant Sharma 18:51

Yep. Yeah, exactly. And, you know, you can submit your personal statement, right, which says, like, Oh, this is what happened and everything, which is good. That is a part of the evidence, you know, and you can certainly submit a claim without a Nexus, but but the Nexus kind of adds weight to it, because it's also coming from an independent physician, right, somebody who's not a part of your treatment team, you know, they're not, they're not biased, you know, they're just they're independent, you know, so

Keith McKeever 19:20

it's a lot like a court case. Yeah, you know, it's like, oh, we arrested you for shoplifting. Right? But they're like, We don't have any evidence. We just did it. You know, versus like, oh, we have somebody in the store saw you we have video camera evidence, we found it on your person. Like you're just kind of building all those connections to be like, see all the evidence is here. Yes. Like the case is gonna get thrown out. If you get arrested for shoplifting and you have no evidence versus there's clear and obvious evidence here like yeah, we'll see you on video doing it. Best analogy I've got of like, you just want you want to be like the release and gather as much evidence as possible, like making a slam dunk case.

Dr. Prashant Sharma 20:03

Yeah, that's a that's a great comparison, actually, because it is kind of like you're a detective, right? You're just like going through and like, because, you know, when I'm reading a medical record, I'm like, I'm going through and I'm trying to find like, where, you know, everything is and to establish that, that connection. So yeah, 100% Absolutely.

Keith McKeever 20:25

Just like the timelines to like, Okay, does it does everything line up? You know, I mean, I've gone through the claims couple times, you know, and they always ask those questions in those processes with the doctors like, Okay, tell me when this started. Yeah, didn't didn't get worse. You know, what happened next, you know, kind of thanks, which I'll tell you what is really hard. I would my piece of advice to anybody getting out of the military is go file your claim immediately when you get out? Yeah, because when you file another claim, 10 years later, like I just did last year, and they started asking questions, and you're like, I, this particular year, what do you know, a month? It's been over 10 years? No, I don't remember exactly what mommy right there in there. I can't pinpoint it. You know, I mean, so when it's fresh in your mind, you can more accurately articulate the dates and the times and be more precise with things. Because after a while, exactly. You're out of your head.

Dr. Prashant Sharma 21:20

That's right. Yeah, no, I agree. 100%. And, like, so that's the best advice gets seen as soon as you're out. And if you're still in and you're listening to this, you know, at least talk about it at your separation physical, because at least at that point, you can get it on the record, and it's on the record while you're still in the military before you get out. You know, and, you know, I mean, you know, I guess they could disqualify you right before you get out. But I think that is the safest time, if you're really worried about getting disqualified, you know,

Keith McKeever 21:53

I mean, just go, really go to the doctor for anything that you have, like, I rolled my in my left ankle, like three or four times, now and I just go to the doctor, you know, painkillers, whatever. And stay off of it. I said, whatever. I never thought anything of it. When I got out and waiting for my initial claim, they start looking back through and they're like, Well, you went to the doctor four times for your ankle, does it bother you? And I'm like, I mean, every now and then I'll, you know, twist it, whatever. So I've had a zero rating on my left ankle for 11 years or so now. There you go, whatever it's been, you know, so the good news is like, that's covered, should something ever happen in the future, and he gets worse, or, you know, weakness, whatever. You know, that's just one of the things that got me never really thought about it was just like, hey, can you give me like a brace and some painkillers? A couple days and let the swelling go down? You know? Because for some reason, we have do PT in the field with potholes, you know, holes in it, you know, whatever. Right. Right. Yeah. It's always had the nicest facilities even in the Air Force. Yes. Marines. So anyway, yeah. So I was that, you know, so we got the Nexus letters, is his letters in the DBQ is just basically the outline of like, what each what they're looking for in each one of those, correct?

Dr. Prashant Sharma 23:09

That's right. Yeah. So that was the other part of your question. DBQ. So those are the Disability Benefits Questionnaires, which is like the VA Form, outlining the condition. It's very robotic as, as you would expect from the VA, it's like, a checkmark, you know, checkboxes and things like that. And, and so you know, the person doing the Nexus letter for you, you should be doing the DBQ. At least I do that and, and, you know, you go through and do it. The DBQ is easy. I think the Nexus letter is the one that carries the most weight, because it's like a narrative, you know, it very nicely should describe, like everything that's going on. But you're right, the DBQ is still important, because the VA looks for it. And they look for the buzzwords from the DBQ as well.

Keith McKeever 23:54

Exactly. You know, like, I know, when it comes to mental health, I don't remember the exact words but like, there are certain things that the certain rating levels, you've got, what the minimum was, what 10% 1030 5070 100 I believe it like 100% for PTSD, you almost have to be darn near having a caregiver and capable manage your own finances, personal hygiene, I think some some things like that in there. I've read through those before. One of just a few years I've ever read through any anything from the VA, you know, they'll put you to sleep Reagan too long. But apps kind of basically outlines what generally you'd expect in those ranges.

Dr. Prashant Sharma 24:34

Exactly. Yeah. No, no. And you described it perfectly. It's it's like a near having a caregiver for 100% It's like total social and occupational impairment, you know, like no ADLs, which is like, activities of daily living, like not just not able to do personal hygiene, and stuff like that. So yeah, you're right. And, you know, there's a whole range of course of percentages. There's

Keith McKeever 24:58

absolutely yeah, so that's important. For anybody going through any claim troops, you kind of read those because those are the ones I've read. I've definitely never pulled out the manual and started finding random things to read about. But it is interesting to kind of see what they're looking for. And some things will make any sense with this or getting technical with like, joints and movement, percentages and range. And that's true or No, no, any of that stuff. That's gonna be like reading a foreign language.

Dr. Prashant Sharma 25:25

But yeah, so that's true. Yeah. Unless you Google a bunch of stuff.

Keith McKeever 25:32

Got a fair a fair amount of googling. So you said you help people through the process? What exactly are you doing? Everybody?

Dr. Prashant Sharma 25:43

Sure. Yeah. So sorry, you cut out for a second. Could you repeat that? Yes.

Keith McKeever 25:47

So you're helping people with Nexus letters and stuff like that? Can you just maybe explain for everybody more of what you're doing? Oh, yeah.

Dr. Prashant Sharma 25:55

Absolutely. Yes. So basically, you know, I do you know, anybody that I partner with, I do both the Nexus letter and the DBQ, no matter what, because, you know, they're both really important. And so what I do is I write Nexus letters, for folks who have any type of mental health condition that either popped up during the military service or was worsened by military service. So you know, when we think about depression, so that's like major depressive disorder, adjustment disorder, anxiety, PTSD, insomnia, all that kind of stuff, right. And usually, you know, I'm helping the folks who have a gap, they don't have that connection, right. So the folks who have the connection, meaning they were seen in the military, for any of these mental health conditions, and they get out and they make the claim, it's pretty clear, it's easy, and there's no nexus needed. I'm there to fill in the gap where somebody might need a connection that nexus done. And, and so what I usually do is, you know, people email me, and then we do a phone consultation, we just talk about the case first, because I don't want to, you know, take anybody on and have them pay a fee if the if I can't help them, you know, what's the point of that? Right, you know? Yeah. So once I verify, like, okay, you know, it sounds like I can help you. Then we connect via email, we have a HIPAA compliant email, I have them send their records to me, I review the records, just to double check everything. And then we actually scheduled a video evaluation to do the formal evaluation, and then I write up the Nexus letter for them, basically. And, you know, not only one other thing is like secondary conditions. So a lot of folks Yeah, a lot of folks don't know. And it's not their fault. But you can get depression from chronic pain from an injury during military service. You can have irritable bowel syndrome that worsens because of anxiety, you know, people who might have be having a lot of bowel movements all the time, things like that. PTSD can be worsened by sleep apnea, you know, tons of secondary conditions to basically,

Keith McKeever 28:25

yeah, correct me if I'm wrong, there's other things in there, like GERD, you know, acid reflux and stuff like that, as another secondary to PTSD, have heard it like erectile dysfunction is another thing, although it's not apparently a actual rated claim. It's like a special thing. Anyways, different topic different day. But there's, there's quite a few different different things, I believe, is weight gain, like weight control, or things like that related to a secondary?

Dr. Prashant Sharma 28:55

Yes, yeah, it can. So usually, what I try to link that with is a medication that causes weight gain, that is being used for treating depression, right, or something, or PTSD, or whatever that the case may be. I have noticed that when we try to say weight gain was secondary to the mental illness itself. That is something that can be connected, but it's tough. The VA is really, you know, they really fight back on that one. But but you know, I try to gauge it case by case. Yeah,

Keith McKeever 29:26

I mean, you know, you could just be over stuffing your mouth, too. Have a tough one, for sure. So, so, you know, one of the things, you know that what I wanted to ask you about next, now that people have an idea of what you do, and the Nexus letters and all that stuff. I know when it comes to mental health, one of the things that you kind of have to articulate to the VA is one of two things. Maybe there's a third one you kind of like me, but occupational impairment and social impairment can you can break down like what those kind of look like.

Dr. Prashant Sharma 29:58

Absolutely, yeah, and And you bring up a like a fantastic point, because the more that you can verbalize this to your VA doctor or your regular doctor, the better it is, because then in the records, it's consistent, you know? Because it is, I mean, if this stuff is happening to you, it is happening to you whether it's in the record or not. Right. And so we're gonna

Keith McKeever 30:20

put an easy timeline together. Yeah, okay, cool. Everything just falls in line.

Dr. Prashant Sharma 30:25

Exactly. And they can see like, Oh, this guy has been consistent. You know, it's like, All right, yeah. He's always been saying this, right. And so, so yeah, so we can start with occupational which tends to be the big one. So how is the condition impacting your job, or difficulties in your job, right? So, and this can be a lot of different things, right. So maybe the PTSD is giving you such bad insomnia, that you go to work, and you're just like, in a brain fog the whole time, because you just didn't get any sleep last night, you know, and it's, it's something that recurs, you know, it happens pretty regularly. That's a big occupational impairment right there. Because, you know, in most jobs, you gotta be able to focus concentrate, you know, you got to take tasks from your supervisor, whatever, you know, all that kind of stuff. So that's a big thing. There's also irritability. I've noticed like irritability is a big thing, in in these conditions, like depression, anxiety, PTSD, where, you know, because it's almost like, you know, if you have a cup of reserve energy, if there's Person A who's completely without any mental illness, and completely healthy, they've got a full cup of reserve, but somebody who's struggling with like, severe PTSD, their reserve is like, 20%, right? So there's only so much that they can pour out of their cup. And then before they kind of get really annoyed or frustrated quickly. So irritability is a big one, where people might be lashing out at their co workers, you know, verbally kind of answering back to their supervisors. And then later on, they regret it, you know, they're like, oh, man, like, that's not me. That's not my personality. I've never been this way. It's happening to me. So that's another occupational impairment. So like things like over

Keith McKeever 32:20

and social too. Oh, yeah. Yeah, absolutely. You know, yeah, you know, that that person is, you know, that just grew up you all the time. Right? Do that. Okay, just be grumpy?

Dr. Prashant Sharma 32:30

Sure. It is possible. Yeah. Yeah, no, you're right. It could be a feature of personality. Right. And it could be a personality trait. But but you know, if you notice, it's, like, really different for that person, they could be struggling with a mood disorder, or PTSD or something like that. Yeah, absolutely.

Keith McKeever 32:47

There's a lot of things that could happen in the workplace. Absolutely. To me is, you know, it's, you really need to sit back and reflect on how you know, everything that's affecting you, and how does it affect you in the workplace?

Dr. Prashant Sharma 33:01

That's right. Exactly. And just even little things, right, if you if you're just like not focusing and concentrating as much as you used to, maybe it's anxiety, maybe your palms are sweaty all the time, you're looking over your shoulder, you know, you know, you're driving a forklift, and you always feel like everything's going to collapse, you know, the, the warehouse is going to collapse around you, whatever, right? Like, whatever setting you're in that you're imagining. And I'm just remembering examples from different folks I've seen, it's like, you know, these are, these are real things that happen and are rooted in things that you went through in the military potentially.

Keith McKeever 33:39

How about social impairment? Is there anything specific tends to be just in that category? Or?

Dr. Prashant Sharma 33:44

Yeah, and I think you mentioned it before, like that, you know, the irritability really goes into the social side, and I see that a ton in terms of that, getting easily annoyed with, like, your spouse, or your kids, you know, things like that, you know, being very depressed to the point of not being able to interact as much with family. So, you know, a lot of veterans will tell me, like, I just don't want to go anywhere, you know, I just don't want to leave the house. I I'd rather just sit in my room. And, you know, I don't want to do that. I'd really love to go out with my kids, you know, get ice cream, you know, go to the amusement park, whatever. But I just can't do it. I just feel like I can't leave. I'm anxious. I'm depressed. You know, I just can't get myself out of my room. So you know, things like that. Yeah, it's significant, though. For sure.

Keith McKeever 34:40

What would you say would be the most common things that you see? Between both

Dr. Prashant Sharma 34:45

of them? Yeah. Between social and occupational, social, occupational, you got it? Yeah, so I would say the most common thing in A social impairment is irritability. That has been extremely common. I think it's, it's an almost every letter, I feel like, you know, that I write. Right

Keith McKeever 35:13

most most of us I know. Okay. Got it sounds really bad. But I mean, it does, like, you know, everybody can be cool. But you know, I know a lot of guys who, you know, push the wrong way or the wrong race situation and they get they get pretty irritable, irate, angry, frustrated about things. So definitely see

Dr. Prashant Sharma 35:34

that. Absolutely. Yeah. And I think, you know, um, you know, and I think this would be interesting to study. But in veterans, I think it's because of the training itself, right, and what you have to go through where there's a lot of immediate reactions that happen in training, you know, and the things that we do in the military. It's very reactionary. So I think I think it's almost like conditioning that happens over time. Sometimes, you know,

Keith McKeever 35:58

well, I think sometimes. One thing I've noticed, because I would also throw myself in that boat sometimes is irritable. Sure, but like, just expectations, like showing up early to something, then you have people show up late and may not voice that, but I would definitely feel it on the inside. Like, why is this person showing up late Do they just not care what you know, this person is piece of shit, you know, like, what is going on, like, you just not care about your team, your mission, you get whatever you doing, you know, like, or just the just the rupee things that people would do. Like, even the military, you don't walk and talk on your, on your cell phone in uniform, you don't walk with your hands in your pocket, as a civilian, whatever, I can get past that one. But just like sure, people that were, you know, play on their phone unnecessarily or something like that, or they'll be doing things on their phone or a tablet when in a meeting. And I've been in meetings where it's like that, and I've been no to where I'm like, Hey, I'm gonna take you know, I'll just be like, Hey, I'm taking notes on my phone, just so you know, like, I'm actually using it to take notes. But I'm sure you could look next to you in a person is playing Angry Birds. Like, they're not paying attention. It's like, what are you doing here? Ya know, it's just like, it kind of just makes your blood curl a little bit like, yeah, you're missing for team. It's time to dive in, or meetings running starting late.

Dr. Prashant Sharma 37:23

You know, it's so interesting that you said that, because I can, I can think back to, as soon as I got out, I went to residency you know, and I was in first year where you have to walk around with the chief doctor, and the chief doctor teaches all the all the, you know, training doctors and things, right. And so there was a med student who was on his phone, like not taking notes, right, just like on his own stuff. And I, and I was like, it was inside as well. Like, I didn't say anything, but I was just like, man, like, exactly your response, like, Do you not care? Like, we're all here to take care of patients, and we have a common purpose? You know, do you not care about that? Like, you know, it's, it's? Yeah,

Keith McKeever 38:04

absolutely. To a lot of us systems, little things, you know, if not, 15 minutes early, you're late is that, you know, that's still to this day, after all these years, if I'm running late to something, oh, I hate running late. If I got to be somewhere with my wife, and my kids, let's say it's 5pm. And it's 30 minutes to get there, and I gotta drop my kids off. And my mom's I'll tell my wife to be ready at like, 415 15. So be like, okay, so I tell her 315 I'm lying to her because we absolutely need to leave by like, 345 to get kids, you know, somewhere for so we got plenty of time on the road. And then we're still 10 or 15 minutes early. Yeah, in my mind, I've got this timeline already built of like, this is what we need to be here. Here's all the timeline steps, the you know, the waypoints if you will, of like how we're going to get there. waypoints. Oh. Like, if we're like, two minutes past one of them, like I start freaking out on the side of like, Oh, we're so late now. I hate being late. It's like I've already built in like, 20 extra minutes to be there early. Sure. It's gonna be okay. But

Dr. Prashant Sharma 39:12

you gotta tactical map your waypoints. And everything

Keith McKeever 39:16

was on my secrets. I mean, she, he knows I do that to her from time to time. Sure. What time do I need to be ready? Okay, I'll tell you what time what happens. But yeah, anyway. Yeah,

Dr. Prashant Sharma 39:29

it's just, it's not it's just like, yeah, it's just like in the military, right. You know, the, you know, the Wing Commander will say we gotta meet for formation at 9am You know, and then the person below that will say, All right, we're gonna get there at 830 the person before that is like 730 You know, and then all of a sudden you're out there like 6am waiting

Keith McKeever 39:49

out there like not even go to sleep last night. Sorry. Well, I got two hours. Yeah, yeah. Yeah, it is what it is. I think there's things stick with This for a really long time. And yeah, it's normal. I think after so many years, you get over it a little bit more. I know, first couple years, I mean, some of the things that people run late or whatever, it's just really bothered me, ya know, like, look, you know what civilians just operate on a different frequency than we do? Exactly. Just have to be okay with it acceptable that not everybody's gonna see the world the way that you do. And once you kind of realize that, you know, it eases those a little bit, you just, you let it go, You know what I'm gonna do what I can do what makes me feel good, but I have no control of

Dr. Prashant Sharma 40:30

that person. So that's right. That's right. That's a good philosophy. Yeah,

Keith McKeever 40:34

absolutely. So your last thing, last thing I want to ask you here. Some people when it comes to mental health may have a problem to it. So if you've never gone to anybody, especially a mental health provider, but you've got their primary care provider versus say, how should they start that conversation with them of like, Hey, I'm struggling, because I know when I go to my doctor to VA, they'll just flat out ask if you had suicidal thoughts, if you had this, have you think some people lie? You know, or they just kind of stretch the truth or whatever. But how should somebody start verbalizing this stuff and start on the path to getting help and doing their paper trail for their eventual claim?

Dr. Prashant Sharma 41:13

Yeah, no, that's a fantastic question. And, yeah, so basically, you know, and it's tough, right? We, you know, just recognizing that systemically in the VA, it's really tough doing this, right? Because, and I'm not trying to, you know, obviously, there's understaffing in the VA, things like that. I know that, you know, it says, like a system issue. But, you know, it is tough, because, you know, I review a ton of VA records. And the biggest thing I see is that it's like variable, right? It's, some records are pretty good. And they describe things. And then in other records, it's one sentence for a visit that might have been 30 or 40 minutes, right, you know, and so like, oh, man, like, I wish, yeah, like, I really wish there was more information in this right. And I wonder what they talked about, right. Like, I wonder, you know, what happened? So, so recognizing that and saying, like, alright, it's, you know, recognizing the frustration that sometimes no matter what you do, it might not get in there. But that's only in one visit. Right? So what I that's why I tell people tell all your providers, right, which is difficult, I know, it's it's, it's difficult to do that it's difficult to

Keith McKeever 42:32

break broken record, bringing it up all the time again, you know, which makes I think some people make it makes them feel like, sounding like, you know, we've got all these problems. Let's, I guess you do. Know, but you like you're gonna grease the wheel, you know, you keep bringing it up over and over and over again. But that's the only way to make sure that it's in your records enough?

Dr. Prashant Sharma 42:53

That's right. Exactly, exactly. And that's the best way to describe it. It's, you know, and, and, and it helps you no matter what, right, like, let's say you talk about it three times, it gets in there once great. If you talk about it three times, it's in there three times. Fantastic. Right? That's, you know, that's really good. So what I usually tell folks is broach the topic and just say, Hey, Doc, you know, I wanted to talk to you about something that's, you know, it's tough for me to talk about, you know, and, and, you know, I've debated bringing it up or not, but I just wanted to, and I wanted to tell you, and that's, you know, you kind of bring it up that way and say this is what I've been dealing with, right? These, you know, I've noticed, you know, I've had trouble focusing and concentrating, and I'm always on edge, you know, I'm looking over my shoulder, you know, people look at me, and they're, they kind of, I feel like they're perceiving me as being odd. Because I'm doing these things, you know, whatever it is, right. And you start kind of talking through it. And, you know, I think most providers or doctors, hopefully, right, as they hear, like, how it's impacting you, there's more empathy there. Right. So not that they should, you know, obviously, they should have empathy no matter what. But sometimes when we just focus on the symptoms, like, Oh, I've had a tough time sleeping, or I'm irritable. And I say that it doesn't bring about as much response or empathy as if I talk about how it's impacting me, I guess. Right? And so, that's a good one. Yeah. And, and as you talk about that, then, you know, they really begin to understand like, alright, you know, this is really tough. And hopefully, they're gonna be documenting that and also helping, right and also being like, hey, like, maybe you want me to refer you to, you know, cognitive behavioral therapy, or do you want me to prescribe a medication? And that's good too, because that also does two things. The first thing is it helps you right? If you're struggling with a mental health issue, it helps you deal with it, process it, get treated for it. And the second thing It adds to that paper trail as well for the claim, because it shows that you're seeking out this treatment. And you've been tried on different things, you know, therapy, medication, things like that.

Keith McKeever 45:10

We mentioned empathy. And I think that's an interesting thing with doctors, because in all my years, I'm on my counting, right, Fifth Doctor. Ah, yeah, I can't wait for like a year, and then they're gone for whatever reason. Yeah. Yeah, but you know, every doctor I've had has, you know, I've liked certain things, about one versus the other. You know, my first doctor, she didn't have much empathy. She didn't have a lot of bedside manners. She was more of a to the point, point blank, like, you know, this is what you need to do, whatever. Not a real warm person. And you know, my second doctor, I kind of jokingly referred to him as like, a hippie guy was like, whatever, we'll do this, we'll do that, whatever. You know, he sent me some pills. For one thing was he was like, yeah, we'll just wait a year? Well, we'll test you know, we'll do some blood tests next year, see what happens. I'm gonna get pills two weeks later. And I call him up. And I'm like, what happened? And he's like, Yeah, you know, I had a change of heart after you left, and I decided we're going to try this. And I just wanted to share, you know, like, the pills are legitimately from it. This is contrary to what we just talked about, you know, right, that I had an older doctor, you know, he ended up retiring, but, you know, just just a totally different personality. And so,

Dr. Prashant Sharma 46:27

yeah,

Keith McKeever 46:28

it's gotta get to know your doctor, which you may not have a whole lot of time to do and build that comfort. You know, I probably have a better relationship with my current doctor than I do with any of the ones prior, just because of personality. I've seen her less than the rest of them. But like that bedside manner, that that, that connection, that ability to kind of freely talk.

Dr. Prashant Sharma 46:48

That yeah, no, that's a huge, I feel like, that's such a huge factor, right? Like it makes you more comfortable to if there is a positive good bedside manner, I feel like it makes you more comfortable to talk about things to

Keith McKeever 47:00

be trying to talk to your doctor about right. Sure. My opinion, I know there's a stigma around mental health. But I think that there's some things if you become your doctor, and try to talk about that. I would think it'd be a little more embarrassing. Absolutely. Problems down there as a guy or things that you might have caught from a partner or Yeah, urinating on your cell phone, like every day, or like, I mean, trying to make a joke out of it. But like, I would find it a little bit more embarrassing than talking about hey, like, I don't feel like I'm 100% up here. Need some help?

Dr. Prashant Sharma 47:32

Absolutely, absolutely. No, I agree with that. 100% there's way more embarrassing. Yeah, I can think of a few more. But you know, I was

Keith McKeever 47:42

planning ideas for people. Right, right.

Dr. Prashant Sharma 47:45

Yeah, exactly. And more. Yeah. And one thing I thought of, you know, just as you were talking, also, like another option, and I realized this is not an option for everybody, right. So this is very much situation dependent. But if you really feel like you're not getting traction at the VA, if you do have like another insurance, right, like, maybe it's through your job or something else, or through a partner, you know, go go to a doctor in that insurance plan, you know, go to somebody private, and tell them about it and develop a relationship and then request the records from there, you know, and get the help you need. And you know, that's another good

Keith McKeever 48:23

there's also the Vet Center, and I'm not super knowledgeable on the Vet Center, I do believe you'd have to have been a combat veteran of some sort, or survivor. military sexual trauma, I believe they may have some couples counseling or something. I don't know, somebody probably let me know for sure. But there's some other things there. Because it's kind of like in the VA system, but not kind of on the outside of it. You know, but so if you qualify for whatever, whatever the case, is there, I mean, it can be another way to get to see a counselor.

Dr. Prashant Sharma 48:50

That's a great idea. So yeah, for nonprofits.

Keith McKeever 48:53

I mean, there's some nonprofits out there to buy, you know, I know, one here, my area interviewed like a month ago, you know, for people here in our area that, you know, they realize that there's, it can take weeks to get into the VA, for your cat for counseling. So, for those people that are struggling, you know, they could call and go to a local doctor's office and get a couple of visits for free and get some of that stuff off their plate. You know, it was off your off their chest, you know, to try and curb that suicide rate. Wow. You know, so wonderful local nonprofit group, great people that run it, you know, they started under tragic circumstances, but they're just one of many nonprofits out there that are doing things like that, you know, maybe you don't want to go to the VA. Maybe you don't want you don't have another assurance. Maybe your nonprofit is the way to go. That's something that supports that.

Dr. Prashant Sharma 49:41

Yeah, that's incredible. I'm so glad they're doing that. Yeah, I hope more. Yeah, I have more organizations like that come up to to kind of fill in that gap. Exactly. Well, yeah.

Keith McKeever 49:52

Well, it's one thing as veterans we know how to get anything to the VA, right. Yeah, exactly. Yeah. Last night, you know, I was gonna ask you here, what was appeals? You know, how should somebody kind of handle that process? So, you know, you put in for it, you went through all the motions, because there's a lot of and you get denied, you know, an appeal, what kind of things should we be on the lookout for there?

Dr. Prashant Sharma 50:16

Yeah. So you know, that's the I think that's probably the toughest one of the toughest things is the appeals, right? Because it's so complicated. And so the the main thing with appeals, is you want to get more information, right, that would help your claim, right? So and there's a couple of options with this, right? You, you know, speaking on the, you know, doing it yourself is you want to get more information. So, maybe you want to go to the doctor's again, you want to talk about more things that are going on, that you might not have talked about before. You want to get more records, any other procedures you had done, if the if it was based on a procedure, things like that, you want to look at not only your own personal statement, but maybe a buddy statement, like maybe a buddy letter from somebody you served with. So let's say like, let's say for instance, you're going for obstructive sleep apnea, and you had a buddy who always used to, you know, complain about your snoring or something like that. And, and you know, right. Right. Exactly. And so, you bring that buddy, you know, you talk to them Be like, Hey, this is what I'm doing, would you be comfortable writing something like this up? You know, very simple, you know, and that would be a buddy letter that could add as evidence, right? You could add a spouse letter, right? You know, the spouse notice this happening since you were in the military. And it's and it's worsening, whatever. And you want to take that evidence as much as you can from collaterals and everything, and you want to add that for the appeal. Now, I will say like, and, you know, I think the hard part is getting everything right with the paperwork. And I do think that sometimes, and I don't have like an agency to recommend, but sometimes going through, like a law firm or agency can be helpful. You know, if it's really complicated, right, because if it gets really complex, it's hard to keep track of everything. And, you know, the VA has these experts weighing in and their legal advisors, and it's just you. So sometimes it's difficult, you know, to kind of balance that a

Keith McKeever 52:33

little out situations. Yeah, you're up against the wall.

Dr. Prashant Sharma 52:38

Yeah, exactly, exactly. And, you know, there are a lot of agencies that, um, that what they do is, they won't charge anything upfront, and, you know, you can go into it free, and, and then they just take a percentage of whatever you're compensated for in the future, you know, for a set amount of time for maybe two months, or three months or something. And, you know, what, you know, there are certain, you know, there are certain places like that, again, I'm not endorsing anyone, but, but sometimes when it's really complex, that might be a way to go. Because some of these cases, you know, I look at it, and I'm like, wow, like this is, I could not navigate this amount of paperwork, you know.

Keith McKeever 53:18

So yeah, I mean, some I think for some people, it should be pretty cut and dry. But I mean, I think there's basically three ways you can go about the claim or appeal or whatever, you can do it yourself, which I would never recommend. Or you can go to your county, state, whatever, veteran's service officer, maybe through an x ray, like AMVETS, or something like that, or DAV, I think doesn't do. Or you go to one of these law firms and say, hey, help me out. Your lawyers, whatever, I don't know, anything off top my head. But sure, you know, certainly, especially, you know, I don't know that I would recommend that for the first time or the second time. But if you've, if you had to try, like third or fourth time, yeah, you're probably in your third or fourth year battling this. Maybe it's worth considering coughing up some of that money that you get if you if your claim goes through, to force it through, you know,

Dr. Prashant Sharma 54:06

that's right. That's, uh, I liked that kind of stepwise method, you know, if it's been a few times, and it's like, Alright, maybe it's time to call in, you know, some good backup, you know, and, yeah, for sure. And I totally forgot to mention, you're right, the VSOs the VSOs a lot of VSOs are fantastic. And they can really help with the appeals.

Keith McKeever 54:26

Yeah, just running on my local VSOs the other day on Veterans Day, you know, nice, you know, had a hat on I don't always wear the hat. This is I'm a veteran, but you know, as Veterans Day, so you got to do it, right. You don't even listen to me say, Hey, man, how are you? Good. You get on claims. And I'm like, yeah, why? What's wrong with you? So, you know, the county and I'm like, Oh, you already got my guy over there. But the process goes good, man. I'm just looking out he goes, everybody I see today. I'm just making sure they're getting taken

Dr. Prashant Sharma 54:51

care of. Wow, he's got a cool you know, so that's really awesome group

Keith McKeever 54:55

of guys and gals over there from my local one. I've known a couple of them. Are there? They're good people. They work hard for you.

Dr. Prashant Sharma 55:04

That's amazing. No, that's really good to hear. Yeah,

Keith McKeever 55:06

it helps when it's an office full of veterans to, you know, like they they get it. So, yeah, there's there's definitely options out there. I would recommend people start with a VSO I would. I can't imagine any scenario where it makes any sense to try and do the paperwork yourself.

Dr. Prashant Sharma 55:21

Yeah. Yeah. Yeah, I agree. Yeah. Yeah. It's really it's like, it's difficult to comprehend. And there's, there's like, auxilary forms for things like, like, and they, and it's, they tell you, but it's like, buried in the fine print. So yeah, I agree.

Keith McKeever 55:41

It's all look the same. It's like all basic information at the top, and then the bottom looks the same, but it's a slightly different form, the title and form number, but everything else is basically the same things. You know, I know I've, I've looked at everything that I've ever gotten from Ivy. And so and I'm looking at Oh, my gosh, this is a lot of apparently redundant paperwork here. I don't even know what I'm looking at. But I'm like, hey, look, not trust you. I can see what you put in here. And the rest of this. I don't know what all this is, but you know, okay.

Dr. Prashant Sharma 56:10

Yeah, that's, that's a great. If you had to summarize like, you know, processes. bureaucratic red tape is at the VA. It's like redundancy. It's all redundancy.

Keith McKeever 56:22

Yep. Well, I think most of that student probably don't realize when you go in that, when you get out, and you want to do anything with the VA, you're probably in for a harder fight than you've probably had any other time in your life. You know, it is what it is. It's, it's a government agency. There's a lot of people a lot of processes, red tape oversight. And I get it, and there should be some of that, but it's frustrating. You know, especially exactly like, you know, like, like, Hey, I fit this, like I should have, like, I legitimately feel like I've got this problem or whatever it is how it's bothering me. And you just can't translate that to the government.

Dr. Prashant Sharma 56:57

Exactly. Exactly. And, you know, yeah, like, you're saying there shouldn't be like big roadblocks, you know, like, it's, it's, you know, and really the burden, like, sort of the burden of proof, you know, we say is, it just has to be, the condition has to be connected, and it should be as likely as not, that's the minimum standard, right, for claims is as likely as not. So it doesn't have to be highly likely. I mean, if it's great if it's highly likely, right, but so I wish that, you know, it was they would recognize that a bit more as like as likely as not as the minimum and take away some of these roadblocks. I guess, you know,

Keith McKeever 57:37

absolutely. I couldn't agree more so. But it's the system. And now, I mean, a lot more people are more educated on how that system is and how it works. And, and I really appreciate you coming on here and kind of sharing and breaking some of that down. Because I know it, especially if somebody hasn't been through it. It looks like this huge mountain that you have to climb in front of you. And you've got the right people in your corner. You can do this.

Dr. Prashant Sharma 58:02

Absolutely, absolutely. Glad to do it. You know, it was great, great conversation. Thanks for having me on as well. I feel like we talked about a lot of important topics. And it was fun.

Keith McKeever 58:16

To listen to this one a second or third time just to get all their ducks in a row figure out what they need to do. But hey, that's what that's what it takes. That's what it takes, right? Sure. Yeah, go go out there and put in your claims, get what's owed to you. And, you know, if you've got these problems and issues from your time and service, you know, and it's truly legitimately connected to it, then, you know, go out there and fight for your rights compensation on that. Exactly. agree with you put your mind and body you know, through the wringer for it.

Dr. Prashant Sharma 58:46

So, yes, you deserve it. Absolutely. So

Keith McKeever 58:49

I appreciate you Doc coming on here and talking to us and share.

Dr. Prashant Sharma 58:53

Anytime, Keith. Thanks again for having me on. It was awesome.

Keith McKeever 58:59

All right. There you have it, folks. Hope you enjoyed that. Once again, you go check out my website battle buddy. podcast.net. Like I always say, if there's a resource that's not on there that you think should be reached out, let me know. And if you've been struggling with anything, you feel like you're at the end of your rope. If you've been lying. Remember the suicide hotline number is 980 press one or you can text 838255

Transcribed by https://otter.ai

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