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How to Get your VA C-File

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      There are some Great VSO's out there that will do any thing they possibly can do for the veteran to help win his/her claim, and there some that just milk the system.  A veteran needs to wise up and learn the system himself and work his own claim if he don't get a good VSO & not help or be of any help ...when that happens its time to Fire the VSO. Choose another if he wishes  but the important part here is learn how the system works  & educate himself to the VA.  In cases of some vets they have to rely on a VSO for help   if they don't have a computer or know how to use one or live in a remote area. if its going to be by snail mail  then the VA should send the veteran all the information he needs and have the vet to send in a FOIA and then let the VA Request all the records and medical they need to adjuicate the claim. beings they do send out a NOD form  in case the vet is denied, with the information as what to do with the NOD. Veterans need to keep ALL copies VA sends them no matter what. Until the veteran is denied andfiles an appeal and don't know diddly about the VA system  then its time to DROP THE VSO and find a good experienced VA  Attorney.   I wonder what would happen if a veteran wrote the VA   letter and stating'' please help adjuicate my claim, I do understand the VA has an Obligations to ASSIST THE VETERAN in the claims process  my VSO does nothing to help and I am lost as what &how to persure my compensation claim
    • Hypertension(high Blood Pressure)
      I just received my rating...hypertension rated 0%.  I have BP which hoovers around 140/ no 100 or more Diastolic.  I am taking medication now due to doctor's recommendation which brought it down to 130/80s.  To receive higher rating, does the readings have to be 100+ WITH medication?  I am thinking with med increase as the time goes it probably will never go higher...unless I am close to heaven.
    • Just got my C&P letter, what to expect?
      Did you ever get a copy of your service medical record? The way they do it now, its digital and pretty quick to access that info. No prep needed for a C&P exam.  Just show up.  Its good to understand the rating process, and what the C&P examiner should be doing at the exam, but not required.  I went through the DBQ forms that they have on the VA Web Site for my conditions so that I would understand what was going on and why.  You can find the DBQ's here. They want to check out what is in your claim for the most part.  They are not there to treat you as a patient.  If you have records to show them, to back up your claim for service connection, you can take them, but the examiner is not required to look, some do, some dont.  Wear something comfortable, that wont interfere with the examination, I wore some gym shorts and a T shirt. Gluck.
      Mitch I have been around the VA block since 1981. There are some Great VSOs but are the ones who are always overwhelmed and probably burn out very fast. I happened to gop throught this whole post Broncovet had stated: "Posted October 7, 2015 · Report post According to the BVA chairmans report, State VSO's have the worst record (of wins for the Veteran) of all.  Attorneys have the best record." I filed a 43 page complaint with the VA OIG on my state's so called VSOs.  Of the 4 I mentioned with evidence, only one kept their job but was demoted. They also continually felt my AO DMII claim had no basis whatsoever.And they lied about the substance of a DRO review one of them showed up at. I was absolutely delighted to contact the state  Dept of Vets affairs attorney (who know of the complaint with the OIG) to tell him I not only won that case (the most important one I ever filed) but I also won a 3 part CUE they didnt think would succeed. I also sued the former DAV Rep I had  in Federal court.There was no monetary gain because I just wanted to show him and the DAV lawyer how  piss poor his representation was. His lawyer called me aside after I deposed this rep  and told me to become a lawyer. They were shocked that  I had won a FTCA case and the DAV ignored the significance of that for my 1151 DIC issue. I am sure you will do a very good job at repping vets and their survivors.So don't take our comments personally.... But after I got rid of using VSO or vet reps, I did much better with getting my claims resolved. I don't get it. I had the same training they had from NVLSP but never went to the seminar. I didn't need to go to the seminar, I have purchased the annual VBM from NVLSP since 1991 . The VBMs I donated to my state reps ,when I first though they were really on the ball, went unread by them and were unaccessible to any veteran who might want to peruse them at their office on the grounds of a VAMC. More and more vets are handling their claims themselves with the help of hadit and the internet. I have seen countless remands from the BVA whereby their representation did NOTHING to get the case resolved sooner and at a RO level. Even my VCAA letter was illegal but my state reps did not care .The state Director suddenly was replaced after I sent the OIG a letter he had sent to me. saying it was legal.Even the BVA agreed it was not. I just hope that because of my efforts ,neither the State of NY nor the DAV here in NY ever treated widows,after all that,  like shit again.            
      My experience with VSO's was very negative.  First encounter, I gave the guy the POA, when I left he pretty much told me to submit it on my own.  Needed to check up on status, took him 5 weeks to call back.  I quit trying.  Went from the local county guy to the state guy, he was just as helpless.  I proceeded to ID the CUE in my decision, and in 4 months I was finished, and I won. had a big part to play in that. VSO's might help some Vets that are not capable of dealing with the administration, but the quality of service that I got sucked.  I would not refer anyone to let a VSO go solo on a claim for disability.  It's too important to get it right the first time, if they dont, you are left holding the bag for years. VSO's have a direct line of communication with the RO.  When they refuse to give the same accord to Vets who file thier own claims, they shut us out.  I should have as much, if not more access, than the guy that has my POA, to communicate directly with the individual who is processing and making decisions on my claim.  The system should be restructured from the ground up.The rating personnel should be present at the local VAMC where they can speak face to face with the Vets, so they can get the job done right the first time.
      I find this post sad and disturbing considering that I am a (new) County VSO who focuses on our issues as veterans.
    • Guidance request on C&P exam - PTSD, hearing loss, and tinnitus
      I think I managed to answer my own question ,in a way....apparently a GAF can change over time. I just went to the BVA and notice GAF scores had changed in a few older decisions regarding PTSD. over time ..when VA depended on GAF a lot. I forgot too that my husband's went from 34 to 26. But I don't think it can be challenged ,however ,if the veteran is deceased and only one GAF score had been determined prior to their death and the decision was not appealed.    
    • Guidance request on C&P exam - PTSD, hearing loss, and tinnitus
      Mark, have you ever seen a high GAF score successfully challenged? Although VA does not depend on GAF anymore, it was a controlling factor in many of their past PTSD decisions.    
    • Guidance request on C&P exam - PTSD, hearing loss, and tinnitus
      Mark, have you ever seen a high GAF score successfully challenged? Although VA does not depend on GAF anymore, it was a controlling factor in many of their past PTSD decisions.    
    • New here - Knee pain?
      What treatment option did the doctor suggest?

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Guest Berta

Astonishing Ptsd -hbp Bva Decision!

1 post in this topic

I think this is an astonishing and fairly recent decision because Dr. Boscarini's work is acknowledged in this decision- (as a treatise)

His work on PTSD has never been given much credence by VA-in the past -unfortunately-

And it is a good example of the way Relative Equipoise is supposed to work.

Citation Nr: 0521679

Decision Date: 08/10/05 Archive Date: 08/19/05

DOCKET NO. 93-23 884 ) DATE



On appeal from the

Department of Veterans Affairs Regional Office in Newark, New



Entitlement to service connection for hypertension.


Appellant represented by: New Jersey Department of

Military and Veterans' Affairs


Ronald W. Scholz, Senior Counsel


The veteran served on active duty from July 1968 to April


This matter comes before the Board of Veterans' Appeals

(Board) on appeal from a February 1992 rating decision by the

Department of Veterans Affairs (VA) Regional Office (RO) in

Newark, New Jersey which denied service connection for


The Board remanded the issue on appeal in October 1995,

November 1999, and September 2003. In its September 2003

Remand, the Board directed a VA examination to determine

whether the veteran's hypertension was caused or aggravated

by his service-connected PTSD.


The evidence of record is in equipoise with respect to the

question of whether the veteran's diagnosed hypertension is

secondary to his service-connected PTSD


Hypertension is proximately due to the veteran's service-

connected PTSD. 38 U.S.C.A. § 1110, 5107 (West 2002); 38

C.F.R. § 3.102, 3.310 (2004).


In light of the favorable action taken herein, discussion of

whether VA duties pursuant to the Veterans Claims Assistance

Act of 2000 (VCAA) have been satisfied is not required. The

Board finds that no further notification or assistance is

necessary, and deciding the appeal at this time is not

prejudicial to the veteran.

Factual Background

The veteran has been service-connected for PTSD since May


Medical evidence of record reflects that the veteran has a

current diagnosis of hypertension.

Pursuant to a September 2003 Board Remand, the veteran

received a VA medical examination in April 2004. The

examining VA physician concluded there was no relationship

between the veteran's service-connected PTSD and his

hypertension and, further, that PTSD did not cause

hypertension or contribute to any exacerbations of


An April 2005 letter from Alfred M. Dipiero, D.O., noted that

the veteran had been under his care for hypertension, and

concluded that the hypertension resulted from the veteran's

service-connected PTSD.

Legal Criteria


Service connection may also be granted on a secondary basis

if a claimed disability is found to be proximately due to, or

is the result of, an established service-connected disease or

injury. Establishing service connection on a secondary basis

requires evidence sufficient to show: (1) that a current

disability exits, and (2) that the current disability was

either (a) caused by or (;) aggravated by a service-

connected disease or injury. 38 C.F.R. § 3.310(a) (2004);

See Allen v. Brown, 7 Vet. App. 439, 446 (1995).

The Secretary shall consider all information and lay and

medical evidence of record with respect to benefits under

laws administered by the Secretary. When there is an

approximate balance of positive and negative evidence

regarding any issue material to the determination of a

matter, the Secretary shall give the benefit of the doubt to

the claimant. 38 U.S.C.A. § 5107(B) (West 2002); 38 C.F.R.

§ 3.102 (2004).


The evidence with respect to whether the veteran has a

current disability, hypertension, is not in dispute. The

record reflects that the veteran was first diagnosed with,

and treated for, hypertension, sometime in the 1970's.

In its September 2003 Remand, the Board directed that a VA

medical examination be conducted to determine whether the

veteran's service-connected PTSD caused or aggravated the

veteran's hypertension. Subsequently, two medical opinions

have been obtained and added to the file, both of which are

remarkably inadequate with respect to providing any rationale

for their diametrically opposed conclusions.

The first, a report of an April 2004 VA medical examination,

concluded that there is no relationship between the veteran's

service-connected PTSD and his hypertension. No rationale of

any kind, however, is provided for that conclusion.

The second, a letter from a private physician who has treated

the veteran for his hypertension for many years, concluded

that the veteran's hypertension resulted from his service-

connected PTSD. Again, no rationale of any kind is provided

for that conclusion.

Other than the two medical opinions discussed above, there is

no evidence of record with respect to the issue of secondary

service-connection for hypertension resulting from the

veteran's PTSD.

The Board finds that the evidence with respect to secondary

service-connection is in approximate balance, as there is no

sound basis for choosing one medical opinion over the other.

When there is an approximate balance of positive and negative

evidence regarding any issue material to the determination of

a matter, the benefit of the doubt shall be given to the

claimant and, accordingly, the claim must be granted.

In reaching this determination, the Board notes that the fact

that PTSD was recognized after hypertension was diagnosed is

not determinative, since the record is not lcear as to when

PTSD first existed. Furthermore, in reaching this

determiantion, the Board notes that the VA published

information in the Federal Register. The study did find a

statistically significant increased incidence of hypertension

and chronic heart disease among World War II veterans with

PTSD (odds ratio = 1.25 for hypertension and 1.19 for chronic

heart disease). The conclusion that PTSD may be associated

with cardiovascular disorders is also supported by a 1997

study finding that Vietnam veterans diagnosed with PTSD had a

significantly increased risk of circulatory disease many

years after service. (Boscarino JA. Diseases Among Men 20

Years After Exposure to Severe Stress: Implications for

Clinical Research and Medical Care. Psychosom Med 1997;

59:605-14.) 69 FR 60083-01. In view of the lack of reasoning

in each pertinent medical opinion, the favorable evidence at

least has some support in a document placed in the Federal

Register by VA.


Entitlement to service connection for hypertension, secondary

to the veteran's service-connected PTSD, is granted.



Veterans Law Judge, Board of Veterans' Appeals

Department of Veterans Affairs

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