congress identify the chronic diseases which are entitled to the benefit of the presumption of service connection in various circumstances as diseases as recognized by this court in walker the chronic disease it issue in this case is a psychosis neither congress nor the secretary require a diagnosis of a specific diagnosis or the same diagnosis but only the symptoms or manifestations of that condition that chronic disease excuse me the interpretation relied upon by the veterans court erroneous li required that a diagnosis of a particular type of psychosis be the same as noted in service and note and following discharge from service this was a misinterpretation of the plain language of the secretary's regulation at thirty eight  that your view is this organic delusional syndrome is the same disease as bipolar disorder yes they correct it it is a psychosis each of those conditions are a psychosis each of the various diagnoses that are in the record for mr geils are all psychosis yes they have different diagnostic designations but they are as the statute requires and as the regulation requires a chronic disease they give you is that all psycho see if you come into i don't know how long the list is but that all of them  interchange of all in terms of being at the end of the day the same chronic disease they are in terms of triggering the presumptive provisions of three point three zero three b but what  is required is the same chronic disease not a differentiation as was relied upon by the veterans court for a crime it gives me a specific label or zero nine a list another one is either organic diseases of the nervous system tumors malignant or of the brain or spinal cord or peripheral nerves would we be having to say that because the single item there of their organic diseases of the nervous system is listed that all of those different designated problems tumors etc brain spinal cord peripheral nerves also would be a single disease i'm not quite sure i understand your let me yes let me let me take this i guess just following up on the chief question and maybe maybe the following helps or maybe it doesn't it seems to  me the argument that bipolar disorder and the organic problem are the same is easy either can be a factual one in which case i don't think it's really within our jurisdiction or it is a legal assertion about what it means to be listed on this list of three point three zero nine a and i take it as a legal assertion that you are saying that all psychosis are the same disease because they fall under the single heading so i wanted to test that proposition by looking at another item on the three dollars list that is also written in the plural for which it seems singularly implausible at least to me to think that the regulators meant all of the different problems falling under diseases of the nervous system would be viewed as the same disease as a matter of  secretary did in his regulation was copy from the nd from the congress's list at thirty eight us the lebanon one ok i i'm not sure i'm prepared to read with you about how the various conditions in the other identified conditions would be treated but i think that chronic disease that would be characterized as a psychosis without regard to whether or not there was a difference in labeling and that's particularly true in the context of this regulation because in this regulation it talks about it in terms of the matter how remote and so if you limited as the way that the veterans court limited it then you would be precluded if there was simply  a different diagnostic characterization of the psychosis post service versus the characterization that was made during services but also in this case the original  provisional diagnosis was one of psychosis generally not specifically and then the diagnosis was made of an atypical psychosis and then later on  that's correct your honor but let me just move a little away from that if we have if we end up agreeing hypothetically with the veterans court three point three zero three b where does that leave your other one hundred and one and three frankly in a quandary as to whether or not to put them in there since that's obvious but i felt like i needed to put them in there to demonstrate that if the st argument prevails then the harmless error position and took position are brief that these are best understood to be categories and not as mr carpenter characterizes that you know  diseases that are subject to you know if they're labeled differently in diagnoses that that has that has no effect i think the example that was given of organic diseases of the nervous system  and also you know psychosis is another example of a plural a plural category within three thousand three hundred and nine and i think it's very the the i think the force of this argument becomes very evident when one thinks about are lawyers and judges coming in and talking about diagnoses for mental health professionals as labels of psychosis and not as distinct chronic diseases within the category of based record about different you know lengthy mental health history different encounters with mental health providers and different diagnoses and the turn it into a question of a purely legal question but is it your view that all items listed on three point three zero nine are categories or only the ones listed in the plural i think that the eleven goes through the list  you can see things that perhaps look you know look more like a one off disease or or a specific thing but then there are also categories that are in the poor poor girl where you can imagine many different things falling under that a different diagnoses and i think it's also instructive you look at three hundred and thirty one stuff in the talks about you know manifestations of the same the same disease that every instance of something is not necessarily the same chronic disease that has there has to present in a way that indicates that this is the same thing and there i think we're talking about a category like psychosis or these you know organic diseases of the central nervous system as a another example what the inner have providers have import you happen to have any other example on the list today on organic diseases of the nervous system well let me appearances of tumors that's a category on here you know staying away from the subcategories of tropical diseases and and you know the others that are specific to the prisoners of war where there a i'm not aware of anything in the in the legislative history that that addresses that and i think both parties have recognized that psychosis is not provided with a definition by congress or in the rags to just sort sort of fill out with what that term means but i guess i think that the record the example is enough you have i think it's it's very dangerous and perhaps even arrogant to think that a diagnosis of bipolar disorder is necessarily the same as organic delusional syndrome or or possible schizophrenia or something else that these are different diseases a mental health providers diagnosis and that they can have different causes different manifestations and statistical manual d s m which is i guess pretty universally used to use the term diagnosis or disease in a way that might be informative here the zigzag use the different kinds of psycho just copy out what i'm about to say with the fact that i am a lay person and mental health issues but that i did do this research prior to this argument and so with that i can just say what i found about the d s category and it there it refers to this sort of different symptomatology isn't and and i'll use the word manifestation i can't remember the exact word that's used that fall into that that that broader category and you know in later d s m so i don't know if it's in there but i've seen that you know this bipolar can be can have psychotic features or not have psychotic features it can be a psychosis or it cannot be a did it use the word disease and did it use the word diagnosis and if so how did it use those two words in relation to each other that your honor i'm just i'm not comfortable going on the record with that right now by memory and i don't want to fill in something wrong you know i did this research to get a sense of what was going on in the mental health community on these sorts of diagnoses  multiple input so the diagnosis psychosis and also it's something that when you read the d s m you see that it can be attached to other diagnoses you can have something with psychosis so all of that i you and i would just also add i think again as i said earlier in my argument i think it's a dangerous place to to go i understand the need to to try and interpret the language in the regulations in the statues but i think there's enough there with the fact that it's plural that it's a general term that look at the mental health advisers are putting different diagnosis mental health providers are putting different diagnoses on things and if they are drawing the distinctions and a distinction in the eighty's is being drawn by different  so the answer to them is i think no i don't think we're in a position to know as a matter of medical diagnosis whether all psycho cs are chronic i think the record indicates from what i see that they're not at the mental health providers seem to you know that there's a there's acute there can be acute episode even the two thousand and two diagnosis of v a it talks about the nineteen eighty four episode as a break you know in a kind acute events are so i think that points to a as psychoses that are not chronic i think that that's evident in the record again and that's what i want because it isn't in the and i don't mean in my interpretation the records i mean in terms of medical professionals after time and i think that's enough for us on that point that it can be temporary and acute given strip was a magic matter medical signs that there's such a thing as a non chronic psychosis that supports the argument that fact fact that the acute organic delusional syndrome suffered by his client was not chronic if it was not chronic then he can't get access to three point three or three be period correct that's and as as your honor said i think that the the that distinction between acute and chronic is fatal to the claim also you know any finding and here again it's so easy in this case to start getting into fact weighing but that any just if there's a distinction supportable distinction which it does seem to be in the record between organic and delusional organic delusional syndrome and eighty four dollars and the bipolar diagnosis eighty five findings that puts in a hard line between these two diagnoses and eighty four and eighty five and then ultimately that is what this case turns on and it is why the board and the cast see decision  began that list with anemia included on that list is arthritis included in that list is cardiovascular  disease including hypertension the point i'm trying to make is that when congress articulated this list or set out this list it didn't make any type of categorical distinctions it made a broad statement that these the identified and described conditions constituted chronic diseases for the purposes alternately the secretary's regulation at three dollars a which identifies the diseases which are subject to presumptive service connection i'd like now to go to the language of the regulation at three three hundred and three b and in the st sentence it says with chronic of the same chronic disease at any later date however remote our service connected unless and clearly attributable to and enter current cause or causes in the sentence that not the sentence that follows but the rd sentence of the regulation says that for a showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease and a t and what the board did what the veterans court did and what the secretary is now trying to do in his argument is to create a categorical system which simply isn't supported by the plain language of the statute or the regulation we are talking about the disease entity and the disease as described by congress is psychosis now whether you consider that to be in the poor girl and then include others which i think is a reasonable inference the fact is is that there is a requirement are there scrutiny the only requirement is is that it is shown as such in service and the government's reliance and the board's reliance on the fact that there was a finding about a organic condition that was just one of about a half a dozen different diagnostic characterizations of what was noted as such in service which include the term psychosis and atypical psychosis and schizophrenia all three of those are sufficient to trigger the