This eBook will teach you how to get C-Files (paper and electronic) from the VA Regional Office.
How to Get your VA C-File


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    • PTSD Denied NSC - Schizophrenia NSC
      You are most welcome. :o) Does he refuse psych treatment? Schizophrenia is a serious illness, but patients can often enjoy substantial improvement with treatment. With the NSC 50% rating for schizophrenia, he can receive free treatment at a VAMC or VA outpatient clinic.  When was he discharged? @THOMAS89031's point about continuity of symptoms is an important one. I've done several C&P exams with vets who were not diagnosed with schizophrenia in service but who began to manifest symptoms shortly after service. Schizophrenia usually starts with prodromal symptoms before progressing to the full-blown disorder, so if those symptoms can be identified as beginning during military service, and then continuity of symptoms can be demonstrated, then the veteran should be service-connected. (Of course, the ultimate decision is up to VBA or the BVA, as you know.) He might very well also suffer from PTSD, but it will help to see what the C&P examiner said about that. Yes, being wounded by an explosive booby trap is certainly a traumatic stressor. It sounds like they are not disputing that fact, but are instead saying that he is not displaying PTSD symptoms (or not many) currently.  You really need a psychiatrist or psychologist with experience conducting C&P exams, otherwise they won't know what kind of information VBA needs to determine service connection. Also, keep in mind that when a doctor completes a DBQ, he or she is declaring him or herself to be an expert witness, offering an expert witness opinion in a federal legal proceeding. Consequently, psychologists and psychiatrists who know what they are doing will devote sufficient time to conduct a thorough, evidence-based evaluation, and write a cogent report to support their diagnosis and opinion(s). So, you're talking at least 5, and as many as 10 hours for a good evaluation and report. At anywhere from $150 to $300 per hour (psychiatrists usually charge more), you're looking at $750 to $3000 for a well-written, persuasive report.  A potentially effective, but less expensive option is a "report critique", in which the psychologist or psychiatrist reviews all the relevant records, and then critiques the C&P exam report, pointing out deficiencies particularly with regard to following established VA guidance for C&P exams, and professional standards for such evaluations. Such a critique can support a request for reconsideration and a new C&P exam. If granted, the critique puts the new C&P examiner on notice that they better conduct a thorough, evidence-based evaluation consistent with VA guidance and relevant professional standards ... because you (and your experts) are watching.  Keep us posted!  All the Best, Mark  
    • Curious
      Hi Everyone! Would Like To Say Happy Memorial Day To My Fellow Comrades And All The Fallen Veterans For Paying The Ultimate Price Of Life! I Went On Ebennie Friday, May 27, 2016 And Seen Where My Claim Went To PDA. I Originally Filed For Three (3) Contentions: hysterectomy, bilateral foot condition and cervical radiculopathy. I received both C&P examinations on May 13, 2016 for hysterectomy and bilateral foot condition, but have not received one for the cervical radiculopathy. Have there ever been a situation where the rater may possibly rate the cervical radiculopathy along with the other two, if I have sufficient evidence in my records?
    • New VA Malpractice stats from reporter
      Its a crying shame these veterans died  from the substandard health care the VA  has give them. I know the VA will eventually kill me off. As my pcp just looks at my chart and I don't think she even reads it.  Example The last time I went in to see my PCP by Appointment  6 month check-up She was in a hurry  it was 2:00pm  she had a Meeting with the big wigs there at the Hospital at 3:00pm she said my vitals look ok do you have any questions? she never read my chats I watched her, I said yes mam I do have,  she said well let me look at you and she listen to my heart lungs  vowel sounds  ect,,ect,, took  maybe two minutes.. I went in for my exam at 2:00pm and it was over at 2:10 pm then I sit back in the chair by her desk at the computer, I was going tell her I had this chronic disabling pain in my right hip..she said well its probably arthritis you do have DJD, I'll send you to X-Ray.&  I wanted to tell her I been having a coughing spree for the last 2 months and wanted to get her to check that out too  then she said alright this ends your exam  just stop by the X-Ray dept on your way out  walk me to the door  like get the hell out of here I'm busy with a meeting at 3:00 ...I was there every bit of 5 minutes and never got a chance to ask he about my swollen Prostate and the problems its been causing me   I was going to let her know the med's she has me on for that don't seem to be working  but she had to go to that meeting with the big wigs  and it was at 3:00 pm according to the Tech that check my B.P. Vitals she did renew my meds.  guess that's a good deal. so needless to say it pissed me off  but what can be done about it...this is maybe nothing to worry to much about  but it could turn in to be worse or cost me my life at some point &time she use to be throual and check me out from hear to toe and talk with me explain things to me  and I really started to like her..but I'm in doubt now. What about the other veterans that are in worse shape than me...I tell ya the VA Kill us all if nothing is done about this VA substandard heath care. If I had the $$ or insurance I'd sure use private care..I hope to live a little longer. JMO .........Buck      
    • DRO hearing
      Berta the P&T was in fact my whole case I brought up to the DRO. I had the POA go over and asked them to approve the P&T and I would drop the bowel and bladder issues. They refused. So since they want to go that route then I am going to make them pay big time as in extra scheduling such as SMC. I gave them a chance to fix themselves but the DRO is dumb enough to refuse. Oh well the CUE will settle and fix everything because this should have been rated whenever they rated my legs during the De Novo Review back in Feb. They cannot pick and choose what and what not to rate when the evidence is overwhelming and I am not going to let them.
    • Miss Figured EED?
      Buck, we can not answer that question unless we had way more information.  The effective date is the later of the date the doc said you are disabled, or the date you applied.  Since I dont know when the doc said this vet was disabled, I can not answer.   However...I would treat this as a reduction, and appeal that reduction, since the reduction amounted, apparently, to a later effective date, even with the new disability.  
    • When can the VA reduce my rating "again" after reduction?
      Va can/does lower your rating at any time.  How long ago did they reduce you?  You may still be able to appeal.  You see, VA can NOT reduce 100% P and T Veterans, UNLESS they can show "actual improvement" under "ordinary conditions of life", that is, while working.  If you are not working, then you should appeal.  
    • New VA Malpractice stats from reporter
      I can say with some certainty its "not just" NY VA.  My VA also gives mostly substandard care, but there are some great parts about my VAMC.  For example, the audio department is superb.  Last week I  got hearing aids adjusted from the audiologist who did my 2002 exam.   This means she was there for 14 years.  I dont think she would have stayed that long unless the department was running at least somewhat right.  
    • New VA Malpractice stats from reporter
      This is the same reporter who called me last year, interested in NY VA malpractice issues. I was the only FTCA case here in NY that I had documentation on so I didn't want to let him use solely my story..it will be in my book anyhow.... http://www.nydailynews.com/news/national/legal-settlements-veterans-affairs-triple-article-1.2654179 His focus was solely on NY FTCA - VA cases and all I could do is give him some tips because these settlements are very well hidden by the VA. No one here responded as a NYer with a FTCA issue when he asked me to post his contact info here. He and another reporter found some large cases but they do not reveal how much  was paid out in 1151 when FTCA was not an option ( or the claimant or survivor filed both FTCA and 1151claims.) After a 1151 offset is recouped by VA for FTCA settlements ,then the subsequent SC payments under 1151 are not part of the whole picture...VA pays out more for malpractice then we know. There is no record (except what I have in my settlement papers of what their malpractice on my husband cost them. I added up a recent audit and it all ,in my case, is a staggering sum.) Interesting article and they did a good job in the article with the evidence they found. The rest of VA's secret malpractice cash pay outs is well hidden. And there are probably many malpractice claims that are never filed because the vet or their survivor never considered VA could have been grossly negligent in their VA health care.  
       
    • When can the VA reduce my rating "again" after reduction?
      Sorry to hear of your issues, as I too have Asthma bud. I am so tired of the VA coming after us. I just went thru this last month. I too am 100% P&T, yet the VA called me on 2/29 to come in for a Review on my 40% for Bladder issues. Well we drove over 300 miles round trip for a 10 min exam. Well what happened next, they continued my 40%, but then the Damn VA lowered my 30% for Scars down to 10%, even though I never had an Review Exam for my Scars and the Doc never asked me anything about it. Luckily it did not affect my 100% P&T. 

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SSGmajik

Va Incompetence

12 posts in this topic

I recently was denied for an increase for my spine injury. I am currently 40% for my thorocumbular because of my ROM especially only a 5 degree forward flexion and 50% total. I went to my C&P in July 08' and was measured for my cervical ROM not my Lumbar. I received NOD letter, but the big shock was they said my lumbar was showing signs of improvement and that I showed a 40 degree forward flexion. The 40 degree forward flexion was froma really old C&P and that is the only place I can think of that they got that measurement since I was not measured during this last C&P. That shows you how close they really do look at your medical evidence! I also was denied multiple things wrong with my spine and the medical evidence is there! The VA said the doctor does not say it's service connected! My whole spine injury is service connected and the past 4 MRI's since my injur has showed that it is degenerating and the EMG showed nerve damge and yet it was denied! Cleveland VA is the worst!!!!!!!!!!!!!!!!!!!!!!!

SSGmajik

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Does your C&P mention Wadell test or tests?? It would probably be towards the bottom of the C&P above the Diagnosis somewhere..

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No waddell test! I use a cane to walk because my pain and numbness down my right leg is so bad that I lose my balance or my leg just gives out and I fall. Should there have been a waddell test?

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No, the reason I asked was the VA can use the test during the C&P to imply a Veteran is "Malingering" and not grant an increase for that reason.. You would think that an X-ray/MRI or nerve conduction test would be enough to prove the problem is organic and not mental, but they use it.. I have seen them alot on increase for spine issue C&Ps, including mine..

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Well my congressman has got involved and my VA doctor wants to know what evidence they were looking at because what he wrote in my records contradicts what they are saying. All my MRI's and X-rays prove my case, but the VA always try's to find loop holes to not give you ratings. Thank you for your insight Tig.

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No problem, I have alot of SC spine related issues and just thought you might want to watch for that test on your C&Ps. It seems to be more and more considered out dated, often misused and doesn't signify malingering.. I would almost bet they used it during your exam, but maybe not... If you need any info on it let me know..

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TIG: I appreciate any help you can give here is the run down that I had on a earlier post......

I need some help! Here is a start to the problem I am having. I served from 02/1997 to 09/2005. I had my first surgery on my back in 12/2004 and then I was medically discharged in 09/2005 for my spine injury. I filed my initial claim in 12/2005 and received my first rating 06/2007, 10% for my neck and 10% for my lower back. I had two more surgeries in 06/2007 and 07/2007 and filed for an increase in 08/2007 and received a rating in 10/2007 (surprisingly quick)! I received an increase of 10% for my lumbar which brought now to 20% and my neck stayed at 10%. I then filed for another increase in 10/2007 stating that my condition deserved higher rating; I mean I could hardly move. I received an increase in 04/2008 for my lumbar, it was increased to 40%! I then filed for secondary conditions listed below in 04/2008. I thought they would rate the arthritis and most of the conditions listed below when I initially filed, but to no surprise they did not! I have done this all on my own and I have learned that I have been taking the long way around, but my vet rep was no help to me. He would not listen to what was wrong with saying just file for an increase and they will see the evidence, and obviously they did not! I am seeing a mental health doctor for my depression in dealing with my chronic pain and just everything else that I have to deal with in my back. I have been going to the VA regularly for my back at least 2-3 times a month for the past year. I am on Gabapentin, oxycodone, etolodac, and two medications for headaches and migraines that I can not remember the names. I recently filed for another increase for the conditions below and the VA denied all of them except that they deferred a rating for my scar from my microdiscectomy surgery. I have had 4 MRI’s (3 on my Lumbar and 1 on my cervical) and they all showed my condition getting worse. On the first MRI on my lumbar it showed bulging discs and some mild stenosis that was about it. Then the next showed it getting worse and worse as listed in the conditions listed below. The VA said that it is not getting worse. I had a C&P in 03/2008 for my increase that I got in 04/2008 and I was measured at 5 degree forward flexion. Then when I got my letter for this increase they said I had 40 degree forward flexion, but the thing was I never had a C&P for my lower back on this one! There were notes from 2007 that said I had 40 degree forward flexion, but that was 2007 and I had the latest measurements in 2008! That tells you how close they really look at the documentation! Please help I have more info if someone can help!

Here is some of the issues that I have…….

1.) Facet arthropathy (arthritis)

2.) Spinal Stenosis in my Cervical and Lumbar spine (Moderate to severe grade) spine

3.) Bulging discs in my Cervical and Lumbar spine

4.) Scoliosis

5.) Osteophytes and/or Bone-spurs in my Cervical and Lumbar spine (Moderate to severe grade) spine

6.) Scar from the microdiscectomy surgery approximately three inches in length. Two RFA (Radio Frequency Ablation) surgeries on my L3-L4, L4-L5, L5-S1.

7.) Spondylolisthesis in my Lumbar and Cervical (Moderate to severe grade) spine

8.) Migraines that occur at least one every seven days due to the chronic pain, medication and the difficulty to sleep.

9.) Degenerative Disc Disease (Moderate to severe grade) has developed in both my cervical and lumbar levels of spine.

10.) Nerve damage in my lower back caused chronic radiating pain down through my right leg and foot; as a result, the muscles in these locations have deteriorated somewhat. Occasionally, I get the same pain in my left leg.

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No, the reason I asked was the VA can use the test during the C&P to imply a Veteran is "Malingering" and not grant an increase for that reason.. You would think that an X-ray/MRI or nerve conduction test would be enough to prove the problem is organic and not mental, but they use it.. I have seen them alot on increase for spine issue C&Ps, including mine..

SSGmajik, man I know how you feel, I had my first real hands on C&P for my foot in 16 years. According to the VA whom rated me at zero 3 times prior. After receiving my c-file and I never even knew it and the same would apply with my old ratings. I still have the same broken foot condition but until Friday they had never laid a hand on me or seen me for my foot I just assume back then I was stuck with it and zero means zero, i should have filed back then but I know more over the last year than I ever knew over last 16 years total. I know they used my old record to reevaluate because I had never had a C&P till I filed for an increase for it last month, the weired thing is I had a C&P weeks later. So I think this is just another thing you can add to the list of things the VARO does to get over and draw out a claim. try to hang in there I know how it feels maybe this time will be different.

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Thanks for the encouragement Yoggie. I will not give up and I will fight for everything. Thanks to all hadit members for their help, it is much appreciated!

SSGmajik

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Hey SSGmajik,

All I can say is hang in there and hopefully one day at the Veterans court with a lawyer they will get it straight. If you can use a lawyer at the RO level I would. Here is my story to commiserate with you. Served in the Marines 91-95. Got out in 95 and was service connected for fractures of both feet 10% and 0%. Service connected for Asthma at 0% even though I used an abuteral inhaler, which is 10% min. They later in 2004 corrected that rating to 10% in 96 and 30% from 97 0n.

In 97 I started having problems with my back and legs. For the next three years my back and leg pain and symptoms became worse and worse. I had three MRI's and a disco-gram done. What came out was L-4 L-5 desiccated and severe degeneration and herniation to the right in the nerve root, L-3 L-4 severe degeneration and herniation to the left in the nerve root, L5 S1 moderate bulge pressing on the thecal sac. For the whole three years I just wanted to be fixed. I saw 4-6 neurosurgeons and orthopedic surgeons, neurologists, chiropractors, acupuncturists, holistic healers, yoga instructors, and massage therapists. No one wanted to touch me surgically. No fusions, no reconstruction no nothing. They said I had two many levels and too many different symptoms. So finally in 2000 a neurosurgeon at Yale said he would operate. Mind you the whole time I haven't gone after the VA yet.

He said he wanted fuse me at the top two levels. Then he changes his mind and does a hemi-laminectomy and discectomy at L3-4 and L4-5 and leaves L5-S1 alone. In the beginning it seemed like I got some relief. Must have been the six weeks in bed and the percs. Anyway once I went back to work things went right back to where I was prior to surgery except worse. The surgeon did another MRI and said well you are clear and have some scar tissue, nothing I can do.

So then I went after the VA. That was a long story but I got it connected directly and secondary to my feet. Initial rating back to July 2000 of 20% for lumbar strain. No intervertebral disc syndrome, no mention or MRIs or leg pain or anything else. I appealed of course. I couldn't do anything that I had done prior to 97. No physical activity without severe leg and back pain. So for the next three years I get denied again and then have a hearing and go to a DRO. In between I had another exam. Well sense I was taking Yoga I was able to bend to 70 degrees. I should have faked by I can't go back. So they take the bending into account and say I am better and actually rate 10% but we'll give you 20% for flare-ups. Said I had a mild back strain. I was diagnosed again with lumbar strain. No DDD no reference to MRI's, scar tissue, sharp shooting leg pain, no ref to the 10 plus dr’s that documented sciatica and positive straight leg raises, etc. Then it's on to the hearing and the DRO. She tells me that I got low balled for all my ratings. DAV is in there with me although I did most of the work on the case myself. I get my decision in Aug 2004 and it's denied again.

Something to keep in mind. In 2002 I lost it because I wasn't taking pain meds and got put on paxel, ativan, and buspar for anxiety and panic attacks do to the pain I had. In 2005 they service connected me secondary to the back 30%. So here I am secondary sc for mental at a higher rate than my primary aliment. They also secondary connected my high blood pressure at the same time for 0% of course. So I guess the mental and the blood pressure shows how mild my back was.

So it's on to the BVA. Well prior to the BVA I get Dr. Bash to write me an IME and he lines all my evidence up including tons of VA visits, MRI's, etc. and says change my diag code to intervertebral disc syndrome and rate 60%. The RO totally discredited his IME by saying we got but it doesn't hold enough weight. Yet they had no Dr dispute any of his findings.

So BVA here I come. I spend hours and hours reading cases on the BVA which rate people with conditions like yours and mine 50 and 60%. I figured even maybe a low ball of 40%. So as I am waiting for the year or two at the BVA I break down again and can't take the pain. I start seeing a pain center and get nerve blocks every couple of months for the next year and a half. I start on vicodan then move to precocet and finally your evil friend and mine oxycodone. While my case was down there I sent them all of this. Including the 15mg of oxycodone 4 times a day. The 4 or 5 panic attacks a day. A letter from my employer saying I missed 12 weeks out of eighteen months. Told them about the jobs I had been fired from. Had a letter from my Pain Dr. stating that the scar tissues at the two levels of surgery are entrapping the nerves. He also stated because they waited so long seven years it would be almost impossible to break it up. A letter from my chiropractor / physical therapists saying I had been seeing him three times a week for over a year and that I have severe orthopedic and neurologic deficit which was cited on four different full exams he had done on me over the year. A letter from a neurosurgeon stating I had severe DDD which was way out of proportion fro my age, that I had nerve entrapment at L4 including numbness. He also recommended getting a spinal stimulator but that I couldn’t be helped with surgery. The kicker was another letter from Dr. Bash stating again I should be 60% under intervertabral syndrome and the fact that no one had disputed his first letter and I have gotten worse. He also wrote this piece about entrapped scar tissue etc.

So I think I’m sitting pretty and here comes the letter one day. Guess what? No increase. Back stays at 20% based on orthopedic conditions to include the bending. Although they admitted DDD and spinal stenosis for the first time. Oh wait they threw in 10% for my neurological symptoms based on a 2002 VA doctor note. Almost all the evidence they pointed to was from prior 2000. Everything else they said was a just pain note. They even cut out the letter stating I missed 12 weeks in 18 months yet used a statement within it that said I had to stand up in meetings LOL. No mention of the two IMEs from Dr. Bash, no mention of any other doctors letters.

So here I sit at the court hopefully waiting to get a remand back to the appeal management center in Washington and get a correct rating. I honestly believe because I fought these guys myself they screwed me. When they denied me I wouldn’t have an NSO write them back I would and I would tell them exactly where they made a mistake. I was told by DAV stop sending stuff in because my C-file folder is too big and they wont look at it anymore. I dropped DAV after that. Sorry I went on for so long. Just wanted you to know my deal. I just had a spinal stimulator trail two weeks ago. I’m not sure if I want to move forward with the permanent solution yet. Until then I got bumped up to 30MG OXIs. Hopefully one day here at the court they will set me free.

Good luck in whatever way you move forward.

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DAV Marine,

Thank you for your story. It sounds like we are going through very similar difficulties both physical and mentally, I'm just a few steps behind. I plan on getting a lawyer and going after the VA as you know that obviously do not care if you even have the evidence to support your claim, they just don't care. I am going to take time and try to build up a complete and thorough case to support my claim. I'm not sure who your VARO is, but I know Cleveland is one of the worse ones. I had multiple Doctors and friends write letters on my condition on how it affects me personally and medically and they did not even care, probably never even read them. I hope you have better luck this time around. Take care and thank you for shareing your experience, it was very helpful.

SSGmajik

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Thanks SSGmajik,

It may sound stupid but it is very helpful for me to tell my story and talk with other chronic pain suffers. I'm trying live life and to deal with a family that includes a wife who can't understand, a 2yr old, a 3 yr old, and a 10yr old who shouldn't have to understand. I can't stop working yet because of the daycare issue. If my wife went to work I couldn't watch the kids and we couldn't pay for daycare. So I take the cocktail and somehow get to work each day. Anyway talking with you has helped me so thanks. I think your right on track with stepping back and getting your case all together. Just don't do what I did and try and shove it down their throat. Let the lawyer handle it and pay them some money. Sucks but it saves you sanity. I'm at the Hartford CT VARO by the way. My asthma is the only rating they have gotten correct yet. Take care.

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