Senior Chief Petty Officer
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pwrslm last won the day on February 19

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About pwrslm

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  1. File a complaint with the Dr's state (licensing board). The fact that he claimed he denied everyone can be validated by his record. The fact that he said he reviewed your evidence should be verified in the DBQ. Your evidence should have been in your records and when he stated he reviewed them, he should have given you a competent recommendation... I am assuming that there were indisputable facts in your VISTA/CPRS history that he identified. When he states that he reviewed those records, and fails to account for what they contain, then provides a negative report, the man is guilty of a crime. He can also lose his license. (Falsification of medical records is a felony. When you falsify medical records, knowingly and unlawfully for the purpose of (fill in the blank), you may be charged in court for felony. The potential penalty for this is usually a maximum of five years in prison, or a $250,000 fine. ) Report the guy to the IG as well, the IG is responsible for investigating crimes committed by Federal Employee's.
  2. Great letter Berta!
  3. If you note pain during the exam, or in your current medical records then they must give you the minimum (paying) rating for the condition.
  4. Spine is rated on either movement or bed rest. (They dont prescribe bed rest anymore from what I see.) Forward flexion is the primary reason they give increases, but they also use extension, left to right etc in the regulations...but I have not seen that yet. If you can bend no more than 45 degree forward, you will max out at 20%. Under 30 degree bend=40%. Just pain with any flexion issue past 45 degrees is 10%. Exception to this is – If there is an abnormal spine contour (like scoliosis), or if you have muscle spasms, or if you guard your spine movements enough that you walk abnormally, then the condition is rated 20%. Link is a detailed breakdown of the spine rating system. They told me I had a strain also, turned out that it was a disc herniating out of the front of the spine, less pain misdiagnosed in 1979, 1980, 1982 and 1983 before my ETS. They also said I was born with scoliosis, so I lived with the pain for over 30 years. Then a Spine Surgeon told me he saw my story before, the slipped disk caused scoliosis, and over the last 3 decades, it got much worse. 4 Level spine fusion and service connected now. Back in the early 80s there was not such thing as an MRI, and it was common that herniated disks were misdiagnosed because they dont show up on xrays. Suggest you find a good spine specialists, let him/her give you a good exam, and ask for an opinion about why you have been in pain so long. Take your records.
  5. On VA Fm 21-4138 you should make a statement about the C&P exam.Write down everything about the exam that you remember, what the examiner did, how he did it, and any questions/replies that you may have received or given. Dont try to use big medical terminology to look smart, explain everything in simple, everyday language that anyone can understand. This is a lay statement and is just as viable for evidence as the professional medical examiners. The VA cannot discount it without cause, and if you can document facts that support your statement, it is very hard for them to get around. After you provide a description of what happened, provide a reason why you think the examiner did not give you a fair shake. For example, if you did not see any measuring device, and the DBQ called for one, detail the DBQ statements, and state clearly that you looked up what a goniometer looks like, and that he did not use one. Do the same for any parts of the exam you feel he skipped or misrepresented, like testing reflexes and strength in both legs, did he palpate your spine looking for masses and tenderness , or that he made claims and statements on the examination report (DBQ) about something you never spoke of, or were examined for. Use the exact words from the VA form as well as the C&P report whenever possible. Last, ask for another C&P exam. The examiner provided a deficient exam and failed to provide you with a competent C&P report, as required by law. If he made up stuff that didnt happen, or failed to account for facts that existed prior to the C&P exam in VA Medical records (CPRS and VISTA), or said he examined your CFile but omitted information about your hearing loss and tinnitus that was beneficial to your case, then you have a legitimate complaint against the examiner. If you have a clear cut case against the examiner you could send him some well deserved luv via your state Guv (States AG or the examiners State licensing board) or the VAOIG. Making false statements deliberately in medical records is a felony. If you have a black and white case to present, it needs to be reported. The more Vets that do it the better off all vets are, the VA is required to do the job right and not just provide a fly by night BS artist for this job. I have seen 3 of these so far, and reported 2. Once my secondary claim is done, I am reporting the 3rd one.
  6. Look at the reason and basis that they gave to deny tinnitus and hearing loss. If there is nothing in your entrance exam suggesting hearing loss or tinnitus, then it is supposed to be presumed SC. Dont tell them anything you dont need to; this is like court, they have to discover everything that they use to deny your claim. You have a presumption of good health as indicated in your entrance exam, and if these conditions are suggested, the RO must show that the conditions did not get worse during your enlistment, or that they only progressed naturally as the disease or disability does to everyone else who was not enlisted. The VA has a very high hoop to jump through to prove that hearing loss and tinnitus was not affected by your service to this country, and its a disgrace that they still keep trying to deny care and/or compensation to any Vet affected by something this fundamental. I have been thinking about filing for tinnitus as well, its like a 24-7 companion that follows me around from the 2/83rd FA Battalion.
  7. It sounds like the did an initial (de novo) review of the case and they probably found errors. Correcting the error would be the correct action for them in the review. Did you get an updated Statement of the Case (SoC) after you got the change in rating your toe? I think they should have sent one.
  8. I had gone to a VSO before I put in my claim. He told me to submit it myself on EBenefits. I think that was his total and complete involvement in the deal. Once I called him with a question, all I could do was to leave a message. About a month later he called back. From what I could tell by my own experience, learn the ropes because this is all about YOUR future. Not to disrespect them all, but there are some very lazy VSOs out there that can cause more harm than help for a veteran. There are plenty of resources to get help from and its not that hard.
  9. If the records gave a diagnosis, then it should be given the weight of an opinion, short any question about SC seeing how it was w/in 1 year of discharge. The minimum rating they can give you is 0%, and if you didn't get that, you should have based on the statement you made that they said it wasn't debilitating. You also have to look at the condition, and the ratings. If it is listed with a disability percentage, they have to have a reason and basis to deny it, this is the key to the diagnosis. If the urologist gave you a diagnosis that required a rating above 0%, then it is a valid CUE. If they gave you 0% and made other errors, and the 0% rating was valid based on the diagnosis in your records (from the urologist), then there is no CUE. It has to be significant enough to have made a difference in the rating they gave or denied you. Unless you can show that the mistake happened in 02, in your original claim, then your effective date would be the newer claim date.
  10. If they didnt give a reason and basis for not accepting the Urologists diagnosis, and if it was in fact in your C File or should have been, then it should be a valid CUE. They can not randomly pick and chose what MD that want, if they have opposing opinions, they must give the reason why they chose 1 over the other.
  11. I put in a claim to add 2 secondary conditions and an increase on my spine rating on 19 Jan 2017 and on 27 Jan 2017 it has gone to prep for Decision. Is this a record? I had the DBQ's done on this when I turned in the claim. Initially they put in that this would be finished between Jul 2017 to Jan 2018. Getting the DBQ's completed cuts months from the process. Status of Your Claim PREPARATION FOR DECISION Submitted: 01/19/2017 (Compensation) Estimated Completion: 03/16/2017 - 05/03/2017 Current Status: Preparation for Decision
  12. The equvalent of the DRO review will always be done after you elect traditional appeal anyway. They will do the same no matter before you get the SOC, which is done by a Sr. rating member. If they find the error that you are appealing valid, they can correct it on the spot and approve your claim. A few cases might benefit from a face to face, but the majority it is nothing more than spinning your wheels. Selecting the DRO is not doing much more than adding months or a year + before you get in the appeal line.
  13. It means you need to call the 800 number (Peggy) and ask what they need. They want something from your VAMC it looks like...a C&P exam? If it is something that you can do to get it, great, otherwise its a poke to get the thing updated.
  14. Updated policy-VHA Directive 1134 dated 28 Nov 2016; 4. POLICY Except when specifically prohibited, it is VHA policy that providers, when requested, must assist patients in completion of VA and non-VA medical forms and provide medical statements with respect to the patient’s medical condition and functionality. ... 5. RESPONSIBILIITES... c. VA Medical Facility Director. The VA medical facility Director is responsible for: (1) Establishing and implementing a written facility policy addressing the following: (a) Completion of VA Medical Forms by VA Medical Facility Health Care Providers. VA health care providers are responsible for completing VA medical forms, in either electronic or paper formats, to support the delivery of patient care. A patient or their personal representative (see definition for personal representative) may request that VA health care providers complete the medical forms on the patient’s behalf. Examples of VA medical forms completed upon patient or beneficiary request include, but are not limited to: 1. Application for clothing allowance form, 2. Aid and Attendance (A&A) pension forms, 3. Housebound pension forms, 4. Survivors pension forms, 5. Vocational rehabilitation forms, 6. Disability Benefits Questionnaires (DBQ), and 7. Veterans Benefits Administration (VBA) life insurance forms. The part "must assist patients" is a solid. It forces the VHA to complete DBQ's for Fully Developed Claims when we request it.
  15. Look at your record. Why did they send you to all the conservative treatments? If that shows its caused by your SC back issue, then it should be a done deal. Check with the ROI, ask for all of the referrals that the PCP or spec's put in sending you to conservative treatment also.