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Testvet

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  • HadIt.com Elder

I called the 1 800 number today to ask why my mail from the VARO is still going to my old address and that since I was expecting an award letter in the next few weeks I would hate for it to be sent to the old address and have the new tenant throw it in the trash or something else like that. Thelma said nope we got your new address right here, so I asked her why is the mail still going to shadblow lane, she said it shouldn't that it showed I changed my address back in Nov. I asked her to look and see if there was any status on the C&P exams they did since Dec 28, She told me I didn;t have any open claims or appeals pending.

Needless to say I have a call in to my SO, if he don't call me today he will see me in the morning lol don;t ya just love em chicky boom...................

Edited by Testvet
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That is ridiculous-

What I do Mike is ask them what the VACOLs screen says and then what the COVERS screen says-

VACOLS is all pending appealed issues (after NOD is filed)

COVERS tells them where the c file physically is-

That COVERS screen info can be very interesting info to have-if your c file was sent to a VAMC in Jipips-ville and was still there-

when the C & P exam occurred without it being present----

it is then one way to challenge a poor C & P exam.

The only way to prove that is to email them via the VA query section to get a hard copy print out of the fact it is somewhere it should not be- for a C & P.

Happened to me recently-

Got the hard copy that the examining doc didnt have the c file-it remained here at the Bath VA-2 hours from the VARO--but the doc did admit they didnt have it in the SOC-still- you never know-

This is what I heard today at 800#- "all our PCS are down for a few hours----- but the status of your claim is same as it was-"

say what? if the PCS are down ,how would they know that?

Ridiculous.

I still wonder why I got two BVA decisions last year from Washington-

The AL was happy to hear one guy won but the DAV decision was denied-

I opened the decisions not knowing what they were-

and contacted the vet reps and sent them the decisions-

Our federal Gov in action- all screwed up--

Edited by Berta
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I think some of the people working the 800 line will tell you anything just to get you to hand up. I got lucky. A real nice lady helped me and gave me her direct number. I've never used it but I never know when I might need it. If you find someone helpful, do like I did ask for a direct #, all they can say is no.

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I have a question concerning c-files and C&P exams. During the preseperation program for VA benefeits I was scheduled for C&P exams while active duty. The doctors I saw had no clue who I was and had no information on hand, like my SMR or anyother treatment records. The C&P's were extremely inadequte and relied on my own knowledge of the conditions which I am embarrassed to admit was little. I have since educated myself on my conditions and how they affect me.

How can I best refute these initial C&P's?

Also one condition I have is extremely rare, my treating GI doctor has seen only one case in over 30 years, how can I get the VA to send me to a specialist vice using the family practice C&P Doctor to evaluate it?

When I called the 800# to inquire about this the phone rep stated that is was her job to review my case and deem if a specialist is required. Since they havent scheduled me for one I am assuming with her knowledge in the field of medicine she thought it was not neccessary.

I have been waiting for my C-file for quite some time, they claim because of pending appeals it will not be avialable for some time.

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  • HadIt.com Elder

I don't have a clue as to how the pre-seperation exams work, but I magine you refute them on the same basis you would a regular C&P exam, the fact that the C&P was inadequate due to not having your SMR available for the exam. They should have to re-schedule new exams with a doctor that has your C file with all your SMR's in it. That is my best guess on how to approach it, any one else hop in and help I was out for over 20 years before I filed a VA claim. I didn't need the stress of it, I had a job and health insurance, now that I need it, now look at the mess I am in lol

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  • HadIt.com Elder

I would argue that any claim that is denied without an exam, be it a C&P exam, IME or otherwise whereby the examineer writes in the report that he had all known records including an itemization of all records as inadaquate for VA purposes. You will however to win your claim produce a thourough report as described below. Get this report however you can.

The M-21 requires that a decision be based on the entire record. By getiing a doctor to write good detailed reports based on all the medical records including the doctors assesment of inservice occurance, aggrivation, chronicity inservice, post service continuance, and the current symptomology, limits the adjudicators ability to write incoherent, fictional denials. With such comprehensive medical workup, denials could be argued that the adjudicators opinion rebuts sound medical opinion which is prohibited by the M-21.

I found on my claim that adjudication took advantage of any slight flaw in the thouroughness of the medical reports to deny the claim. They do not ask for clarification, they do not reschedule exams. They just write BS denials whereby they blow smoke so you cannot even really determine what the weeknees in your claim was.

Also, remember that any doctor can write a good thourough report that can be submitted as medical evidence. I won my claim without ever having a C&P exam. I asked for a C&P exam for many years. Finally, they changed the law and required VA doctors for veterans who were treated ay VA hospitals to write nexus letters. I went to the hospital and asked them to write up a nexus letter. I took a copy of the VA directive requiring a doctor to write such a letter. Some hospitals tell you to take it to your primary doctor. Consider that some hospitals prohibit department heads from writing letters for veterans claims. Some actually encourage the heads of departments to get involved. I was able to find out the hospital policy by enquiring at the patient relations office of the hospital. Then I went straight to the department and the head of the department agreed to see me that same day. Luckily I brought a stack of records with me, including my SMR. The nexus letter was written so well that the adjudicators had to make up lies to deny the claim. I pointed out the lies to the DRO and he awarded the claim based soley on the nexus letter.

On a secondary condition which also qualified as awardable claim in and of itself the DRO scheduled a C&P exam. This C&P exam was with the head of the department at the hospital. His report was very thourough and also was a slam dunk for service connection. The secondary condition was also service connected both as a secondary condition and as having been aggravated by military service. Some hospitals require that only department heads can do C&P exams for the RO. The department heads write very good reports. That is why I would recommed that you take your records to the hospital and try to get a nexus letter written by the department head. Do not wait for the VA to schedule exams if it is in your power to get them some other way. Know the medical principals that are required to win and have the doctor specifically address these principals in his report. If the doctor does not take your side on the claim and write a favorable report then you will have a steep uphill battle. If he takes your side then things can be much easier.

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