Senior Chief Petty Officer
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pwrslm last won the day on October 27 2015

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About pwrslm

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  1. 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.
  2. 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.
  3. 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.
  4. Hi TNegland, I would talk to legal council before doing anything on this issue. Key issue on this is that if you dont have a lawyer to press your case, you dont have a case.
  5. I think the VA must provide the reason and basis for them to ignore a lay statement by a Vet for disability claims. The absence of a reason and basis is a guarantee that a denial will be returned for them to provide the missing information on appeal. Same goes for the claim that they ignore IMO/IME, if they do not have a sufficient reason with a valid basis they cannot return a denial without the appeals judge returning the case and requiring them to provide the missing info. If they apply the missing info, its got to be valid, not arbitrary and biased.
  6. The VA also said my back was not so bad. I ended up getting an IMO for $250 from a specialist in Orlando for my service connection. He said I needed surgery. They also sent me to a young neurologist who said I needed surgery. Thanks to the VA dragging its feet, I ended up with permanent nerve damage, to slow to act. The Choice program has to be approved by the VA Dr. If they cannot see you in 30 days, you can ask them to give you choice authorization. The neurology department never gets you in that fast. Its like 7 to 11 weeks to get an appointment, so you should be within your rights to make them give you the choice option. From that point, you can get on the healthnet website and find a good spine surgeon, and get an opinion from them if you need surgery. They in turn must request authorization from healthnet, and you can get free surgery at the best hospitals in town that way. If the Choice people dont ask you who you want to go to, tell them, there is a list on the web site based on your zip code. The orthopedic surgeon in downtown Orlando is the only one in town that accepts healthnet, and comes with good recommendations. Link to healthnet: go to find a provider link in top left side of front page to find (surgeon-orthopedic of the spine)
  7. Peripheral Neuropathy is based on the nerve affected and how badly it affects the leg. Without knowing what nerves your diagnosis ID's as involved, I cant say anything beyond that. This link shows the breakdown of the disability by nerve and symptom;
  8. How long have you been 90% disabled by the VA? Do you have a Veteran Service Officer to help? If you have been SC for something related to Viet Nam boot on the ground in the past for 20+ years, they cannot take it back now. Sounds like you have had SC for conditions, but the link to boots on the ground might not have been made. Having medals from service IN country, along with buddy statements, should carry the day for you. Sounds like your rating representative is hard core and half educated. A VSO should help you apply to get copies of pay records and the 201 file as well. Pay records should show combat pay and the 201 would have the TDY records. You can request them yourself but it does not sound like you are versed in dealing with these things so the VSO might be a big help. If you got the notice that they want to reduce your rating, you must notify them within 30 days that you want a hearing. Dont hesitate, because if the whole mess is based on an error made by a Jr.rating processor, they might just drop the whole thing. Dont want to lose disability for a dumb clerical error. If you request the hearing, you get a chance to show that the rating is right, and a senior rater will review it before they make a hearing date. If you put in a claim and they denied it, you need to get the denial letter and if possible, post the reason and basis here so people can help you. There is a ton of experience here and the folks are so happy to get you on the right track. I have seen so many denials turned around based on what was learned here at Be sure to white out any names and personally identifiable info before you put anything here, and then keep up to date with the post for help.
  9. Send her a black rose with a small card that says "Paid for by my VA Benefits" and then ignore her. Unless you get information that she is trying to cause you a problem, you probably dont need a lawyer. If she is calling up SS and the VA and all the other points of contact about your disability, then you might think about it if she is lying. This would be defamation of your character if she is telling stories about you that are not true, in an attempt to cause you harm. Then you would want a lawyer.
  10. I take it this was a recent change in EBenefits. You need to give them a little time, that web site is only a general indication of what they are doing, not a reliable source of facts right off the bat, its slow! Grats though, sounds like something got done, just dont know what...try calling the 800 number. Peggy might be able to tell you what happened.
  11. Do you have any documents that show you filed a claim 4 years ago? You dont have to accept that they cheated you out of 4 years of benefits because of their mistake. Gather the facts, document the claim. Medical records, forms, everything you can. Was this all a verbal contact that you had? Did the VBA give you any documentation that your claim existed? These will all go to prove your case, if you filed, they can not just say "OOPs", it does not count. Appeal the decision, if you have enough facts to document your claim from 4 years ago, its a CUE. The VBA does not get a do over button like that. Your dealing with a situation where you are in poverty at this point. Your hardship has been approved, you should get a decision within 90 days or less. How is the eviction moving along? If you get the order to vacate, you will have only a short time to find a place to go and move. If you anticipate that this will happen, start packing at least 2 weeks ahead of time so you dont have to do the fire sale routine. You know this is a possibility so get ready. The VA can help if you are with in 15 days of becoming homeless, they get hundreds of millions of $$ to help veterans facing homelessness. Get to the VHA, your primary care team has a social worker, you should be able to walk in and see that person, or get him/her on the phone ASAP. This is one of the things they are trained to deal with. If you have a family and are about to get tossed from your home, they can move mountains and get you a place to live under HUD-VASH. Keep posting here. A lot of ppl can help, but only if you keep us engaged.
  12. Falsification of medical records is a felony. The law expects a higher level of competence from the medical specialists who represent themselves as qualified to conduct a C&P examination. Certainly, the VA does not accept every person trained in any medical field to be a specialists, you must meet specific guidelines, and have specific knowledge of the examination process to perform the exam. If the C&P for states that you must measure the ROM using a specific tool, then you must do so, or note that you did not. If you say you used it, and didnt, that is falsification of a medical record. Same thing goes if the examiner states that he/she reviewed your record, and they fail to note specific information that details facts about a condition that you have, and the examiner goes on to deny that the condition even existed. Making the statement that he/she reviewed a medical record means that the examiner must take into account the entire record when considering what to enter into the C&P examination report (which is a medical record). For example, I had 9 exams by MD's who were PCP's and Specialists/surgeons, and reports by Neurology and Radiology experts that I not only had Spinal Stenosis, but that the peripheral nerves to my legs were affected, and that the left leg had been substantially affected for years. The C&P report didn't even acknowledge that either one of my legs had any problem. They sent me to a 2nd exam after I pointed out that the 9 exams from far more qualified experts existed, and the second examiner did the same thing. (They must have been trained by the same guy?) In the end, a Sr Claims Processor indicated that both of these examiners failed to do their jobs. I am waiting for my complaint to be acted on by the IG, what these 2 examiners did was a crime and the IG is supposed to deal with federal employee's and contractors who do this sort of thing. No word yet. In the end, your best bet in your own claim is to shell out a few bucks and get an IMO on your condition. Most MD's will help you out, but dont expect them to lie for you. If its in your current medical record, and in your Active Duty medical record then it should be fairly basic for them to assess if the two conditions are related, and if there is any question about it, what percentage of probability that relation would be based on his/her professional experience. That is what you need to win a claim 90% of the time.
  13. The Ebenefits site is just a general assessment of the case. Don't think its a good idea to take that too seriously. The best shot is to call the 800 number, do that if it does not show any change in status after maybe 60 days. The C&P is situational. You dont always have to have an Exam, but normally you do. Also, if you do not have your address correct on their file, they can schedule the C&P and you wont even know that it was supposed to happen. Keep your address up to date on the EBenefits web site. Just because it is correct at every other VA agency in the world has no bearing on the VBA, your address will be exactly what it shows in your EBenefits account, be sure to update as needed. C&P exams that are scheduled w/VHA will also show on your Health E-Vet account as well. If the addy at the EB site is not the same, it will just show up and you will not get the notification because the notification will be sent to the EB addy, not your VHA addy.
  14. What is your peripheral neuropathy caused by? Lumbar, DMII?