George Patton

I have been with the VBA maybe 1-2-3-4 years and am still learning / discovering new things. However, there is this push to get raters out of formalized training too soon in order to make VBA appear to be diligently working on disability and compensation claims. Some of them are going to make awful and “costly” mistakes and, in some cases, unforgivable mistakes. They will miss an item or two, which for some veterans can mean receiving proper health care or not, paying rent or living in a shelter, purchasing food or obtaining it in other ways, etc. In other instances, the raters will want to grant an issue, however those damn time constraints may prevent them. I see this new generation made up of young and old, energetic people coming into the ranks of VBA with fresh ideas, open minds, and an understanding of justice as fairness. However, the organization does not embrace these employees, mentor them, or offer much guidance. They ask many questions, yet receive few honest and legitimate answers. Soon they will grow tired of trying to do the right thing, delaying a claim until it is fully developed, and examining every single medical record in that four volume GWOT claim and actually calling the veteran whether than defer his or her claim by instructing a VSR to DTA a specific issue—further delaying the claims process. There numbers are small, and there influence minuscule. To most, they go unnoticed, or when perceived are brushed away. “They having put in enough time.” Why are you asking me ‘all’ these questions”? “Sorry, I don’t have time right now.” “If the vet does not mention it, do not go looking for it.” “Yes, he is an in-country Vietnam vet, however he only claimed PTSD, he did not tell us he had been diagnosed with diabetes, and so pretend you did not come across it in his VA medical records.” There are people within VBA that have been rating claims for 30 years. They can review a new claim, a reopened claim, or a claim for increase and discover the smallest things that were missed in a DTA letter, prior decision, or SMR’s. “She was diagnosed with diabetes before …, so we can actually grant s/c one year retroactively from the date of claim.” Some of these geniuses can quote the rating guide forward and backward and recite VBA fast letters word for word. It is unfortunately that these people are not made available to the new employees coming into the agency. There are people out there that show up to grant, grant, grant—and in some instances stay beyond their eight hours. And, as you all know, there are those employees who show up to collect their check and exit, and maybe reluctantly rate a few cases, while ignoring any evidence that may hold up the claim. “We cannot always prepare the VBA for our new employees, but we can prepare our new workers for the VBA.” Someone, long ago, said something similar to this. George

This letter means nothing to me. If you do not have a confirmed stressor, you will not be service connected. In most cases, the physician is repeating what the patient has said. Has the examiner reviewed your SMR's? What medals do you have? If no medals, does your SMRS show you were exposed to a traumatic event while in the service? What is severe anxiety and in what way does the mental illness limit you socially and occupationally? Are you employed, if so, do you get along with your co=workers? Do you have any friends that you spend time with? Are there any s/i or h/i delusions or hallucinations? How many panic attacks per week / month? The physician can give as many opinions as he or she wants, but we are going to examine the entire c-folder to determine if there was a stressor. It is always best to have a physician examine all the evidence and then write a letter. George

I don't know, sorry.

When the c-folder is in RTR status, it can either be with the VSR, on the RVSR digit table, or at the RVSR's station. If the c-file is at the rater's station, it depends on other claims in which he must complete. Generally, the agency does not want the claim at the station longer than 30 days; however, it can always be handed to another rater to rate and the 30 days begin anew. Sometimes a manager may stop the rater and assigned the individual to another crisis assignment: EP 190, EP 600, or GWOT claims. Additionally, it depends on how the rater perceives the case. If it is relatively easy, more likely it will be done fairly soon. Thus, assuming the rater has performed a final RD, the c-folder goes to Post for promulgation. Once there, it can be entered immediately or lay around for one or two months. George

ED is noncompensable--0% unless the penis is deformed. In any event, you are service connected for ED and SMC K is an automatic. I do not know how a rater could have missed that, unless he/she is not apt at entering SMC codes in RBA 2000 and some are not.

VA Ousts Managers for Claims Deception A friend sent me an e-mail concerning the above article and my reply follows: No, I had not seen that report, but I was aware of the situation in New York. Management apprised its workers of the New York problem several weeks ago and have indicated that they do not want it to happen at this office. They gave amnesty to employees that had mail at their stations too long. Regional Offices (RO's) receive a tremendous amount of mail and it is supposed to be processed within 7 days. However, rarely are RO's ethically able to meet that standard. RO's are understaffed and employees are under great pressure to earn their assigned credits / points. It is not difficult for me to imagine that when mail begins to pile up that some of it is "lost," "misplaced," or destroyed. No employee wants to be placed on a performance improvement plan--PIP, because if he/she continues to under performed that individual can be fired, reassigned, demoted, etc. The New York RO is probably similar to many RO's around the country; that is, you have managers setting arbitrary performance standards and goals without relevant stakeholders' input. I am always amazed when I attend a meeting and management wants something done, without first consulting pertinent actors to determine if such a thing is possible. It does not surprise me that there were managers instructing employees to mislabel documents. There are various methods that the VA employs to suggest that it is meeting certain bench marks. For example, if a particular RO had 10, 000 claims pending and it wanted to present an image that it was doing its best to reduce the caseload, it could work on the available EP 190 (widows seeking compensation) and postpone EP 110 (veterans' initial claim). EP 190 can be done relatively fast, while some EP 110 may take hours or days to complete. There is a huge problem when an employee cannot go to his/her coach (manager) and explain that a certain claim required extra effort and his/her assigned quota should be waived for that day. My coach has indicated on numerous occasions that he/she does not want to hear it. The VA, or at least my RO, treats claims as if they are all similar--when in fact, they are not. Some veterans have military medical records that occupy 3-4 volumes and require a significant amount of time to review. However, with the time constraints in place, maybe one of those volumes wil be properly reviewed and the others--well, ignored or glanced over. The New York situation is so upsetting because, to a certain degree, it confirms what some veterans have maintained for quite some time: namely, that they have submitted claims and the VA incidentally or purposely lost it. The date of receipt is so important because it establishes the effective date of an award if compensation is granted. For instance, one RO receives a claim February 2008; however, it does not date stamp it until May 2008. In that typical VA scenario the veteran will lose a considerable amount of compensation. I know of a veteran that submitted his/her claim in three different ways: USPS mail, hand carried, and faxed. He/she did not perform all three actions in a single day, but several weeks apart. As far as I know, only one method worked, which mean, in this true example, there was a 33% probability that his/her claim would be received. I spoke with some workers and almost everyone may be inclined to ignore evidence--mail. If a rater has just completed a decision and someone in Triage brings him/her mail while the decision letter is done, that evidence may reverse his/her entire decision or worse the person may have to defer the claim in order to request a medical opinion. Raters at my office receive no credit for deferrals. Thus, that mail may be placed in the rear of the c-folder, which I have come across. Additionally, some of the responsibility must also be placed with the citizenry. Yes, we "support" our troops with bumper stickers, yellow ribbons, and enjoy our annual day off from work. However, I am not sure many of them will support the troops by agreeing to a slightly higher tax increase or even allow veterans to be relieved, to some degree-- of taxes, healthcare and education expenses. The VA is under funded and understaffed and many of us know this already. There are numerous problems with the VA: 1) not diagnosing PTSD; 2) shredding mail; 3) ignoring issues claimed by a veteran; 4) inadequate healthcare for veterans. I have read many reports where a veteran should have received compensation for a military related disability; however, the physician thought otherwise. What's striking is the lack of interest and concern our government, VSO's, and even some veterans have shown concerning veteran issues. At the very minimum, the Director of New York RO should have been demoted. In any event, the VA reacts extremely slow. Agent Orange took 20 years to recognize (but saved billions of dollars) and I am quit sure there are other disabilities related to exposure. Gulf War Syndrome took 15 years to acknowledge. Haas (blue water veterans, mainly sailors) have already been told that they were not exposed to Agent Orange as their ship were not in-country in Vietnam. I wonder how some of those barrels of herbicides made it to VN: Cargo planes, yes; ships, more likely than not. George Patton

I have been seeing a new physchiatrist for about several months. On my first visit I explained that I would need a letter from him to submit to the VA in support of my claim. He seemed very reluctant; I later learned that he also rotates at the VA medical center. Well, very recently, I asked him if he reviewed my medical records and if he was willing to provide a medical opinion on my behalf. In three to four months he has not reviewed them and informed me that he does not know if that is his proper role, so he will need to check with his boss for an answer. He asked what exactly I wanted him to do. I responded, review my private medical records and service treatment records and provide a medical opinion as to whether or not my disability is related to service. Moreover, I said he did not have to say it is certain--that he could state, it is my medical opinion, after reviewing private records and military records, that his mental disability is at least as likely as not related to servioce. Nevertheless, the physician seemed uncomfortable. Thus, I will obtain an IMO and seek another psychiatrist. I was not trying to lead / guide him in anyway. I told him to examine the evidence and offer a medical opinion based on them. For whatever reason he does not appear willing to do it, although I do have some ideas.

If you have been diagnosed with PTSD, depression, and anxiety--you will only be compensated for one mental disability. The most dominant disability will be be evaluated. For instance, in the above scenario, if PTSD is the major illness--the diagnosis will be PTSD to include depression and anxiety, or PTSD with symptoms of depression and anxiety.

If you have submitted sufficient medical evidence showing that your depression is aggravated by tinnitus, I suspect that you could receive compensation for it. However, I am reluctant to say that the VA would award an evaluation greater than 10 percent, although a 30 percent evaluation may be possible.

Claims are returned for a variety of reasons: failure to properly DTA an issue, ambigous medical opinion, missing documents, etc. I am not sure if you are able to receive complete and accurate information concerning the status of your claim from the 800 number. It really depends on what system the VA emloyee is viewing and whether the notes found there are clear.

A pit sniper in 3 main. I was a MM in 2 main machinery room when I was in the service. I served aboard another air craft carrier. Last to leave and first to return. Sometimes, 6 and 6 whle underway. Anyway, anyone familiar with machinery rooms know that the noise one is continously exposed to can cause serious damage. With what you have described, I would think you have an at least as likely than not chance of receiving sc.

If there is sufficient evidence of record, medical records that show treatment / diagnosis during service, and qualified IMO provides a nexus that the current disability is related to service, then a VA exam may not be warranted. However, the C&P is strictly structured to comform with the rating schedule. If the person providing the opinion is qualified and provides enough information--the claim can be evaluated without a VA exam. However, this is rare. Therefore, even when a case can be completed based on an IMO, raters are so accustomed to requesting exams that they may not know it.

The VA will have no problem with you marking out any information that you wish to keep private. That is totally your choice. However, I would reframe from sending treatment records that are not pertinent to your claim. For the most part, the VA only need to see a confirmed diagnosis with an official letter head, a date, and the signature of the clinician. I see veterans submitting numerous records--all of which are not relevant to their claim. Rarely, are private treatment records thorough to allow the VA to make a decision based on them.

I am also a grown man and I also cried during my mental examination. I really did not wamt to talk about certain issues, but the physician persisted. Anyway, before I walked into his office--I could tell that he had made up his mind about me. Certain questions that are mandatory during a mental exam were never asked during the session. I soon discovered that this physician is a chronic denial. I am in the process of gathering adequate information to be reconsidered for my mental disability.