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    • this wasn't a cue claim right  as some say they won lately just show evidence in the decision where VA say a CUE was committed  and its in all CUE claims decisions  I'VE seen which ant many this topic was for CUE claims correct this is not one. A lot of people win cues but cant post a decision where VA say IT was a CUE in the decision and to me its either lying or you just forgot like this vet lie for a purple heart and benefits you just don't know everybody who to trust. People will lie and so can I but what can I win with a lie paper work proves everything. jmho
    • SSD will often send a person for what they call a Second Opinion exam and what we call a C&P exam.  They are just as tricky as the VA.  The key phrase in a SSD claim  is "  claimant is totally disabled from all work for at least one year".    SSD only cares that you can't do any work and that you have enough quarters paying SSA to meet the requirements.    They are not concerned with service connection vs non service connection like the VA.  It is routine to have to hire a lawyer to win your SSD claim.  Some of us get lucky and get it the first time around but are in a minority.  If you can win a SSD claim based entirely on your military service then you should be able to get at least TDIU from the VA.
    • So, I woke up to encouraging news from e-benefits. It still says gathering dust, but it's asking for  two things from me: One is to update my Finacial institution immediately. We can only pay EFT or pre-paid Credit Card. The second was to update some form that deals with my dependants.  It looks like something is happening. I will post redacted copies when I get to my desktop later today. I also owe a copy of my Dr's nexus letter. I hope some of this helps other legitimate claim veterans.
    • This letter below grew out of a CUE claim I filed in 2001-2002? and I had forgotten....the VA denied it citing Neal V Derwinski-which had nothing to do with this specific issue.I dont remember  where the NOD is ,  because I had just started AMU and also was more concerned about a AO DMII claim my daughter insisted  that I file. When the VA got the AO DMII claim in 2003, they had to request info from the Regional Counsel Buffalo regarding the TORT claim . Even though they had my settlement papers as proof of the TORT,they checked with the RC,who ordered them to pay me, due to my 2001-2002 CUE claim he found in my C file. I only posted one page of the money they owed me. Up to that money, I had never received a DIC amount.The entire amount they owed me had been withheld since 1994.. Then in 2010 the VA owed me the entire offset amount,due to the 2003 AO DMII claim I had filed. The Office of General Counsel had to order them to send me  that payment because they,my RO, refused to pay me that too.....I didnt file CUE but could have. It was easier for me to call the General Counsel in DC to get that resolved. This was an unusual situation.If one receives a TORT amount as for wrongful death, as I did, but then successfully proves the VA caused the death of a veteran with AO malpracticed conditions ( IHD,DMII, HBP) the death is then directly service connected and the VA must refund the VA offset amount of the TORT.I negotiated the offset.Their payment for pain and suffering was much higher than the offset. I have yet to find any similar case at the BVA or CAVC. This was the first CUE award I had and it came from the Regional Counsel, Jeff Whiting,Buffalo NY, due to the CUE he saw in my C file.          Oct 17 2003 BUFFALO VARO     111 WEST HURON STREET
      BUFFALO NEW YORK 14202
      BERTA M SIMMONS   (redacted) In Reply Refer To:                                                                        (redacted)                                              "Dear Mrs. Simmons: We have received instruction from the Office of the Regional Counsel concerning the amount of
      offset of V A benefits due to the tort settlement you received. What Did We Decide? The total amount of $59,700.00 paid for economic loss to you should be offset. There should be no offset for the remaining portion of the settlement in the amount of   ( redacted) '-   allocated for pain and suffering of the decedent.     What Is Your Entitlement Amount And Payment Start I   Your monthly entitlement amount is shown below:     Total Award Amount Monthly Payment Start Reason For Change Amount Withheld Entitlement Date         Amount       $969.00 $969.00 $0.00 Nov 1, 1994 DIe granted   990.00 990.00 0.00 Dec 1, 1994 legislative increase 1,015.00 1,015.00 0.00 Dec 1, 1995 legislative increase 1,044.00 1,044.00 0.00 Dec 1, 1996 legislative increase 833.00 833.00 0.00 Jun 4,1997 Frances turns 18   850.00 850.00 0.00 Dec 1, 1997 legislative increase 861.00 861.00 0.00 Dec 1, 1998 legislative increase 881.00 881.00 0.00 Dec 1, 1999 legislative increase 911.00 911.00 0.00 Dee 1,2000 legislative increase 935.00 935.00 0.00 Dec 1,2001 legislative increase 948.00 948.00 0.00 Dec 1,2002 legislative increase The above table is for reference only. You have already had more than $59,700.00 recouped
      from your V A benefits. For computation purposes, we must return to your effective date for
      benefits, recoup the $59,700.00, and then pay you the remainder of what you are due." The next page shows the audit statement.They paid me 28 thousand but that was wrong. Instead of filing CUE I wrote to their Finance department.showing them how they had completely forgotten one year of DIC and one dependent ,before my daughter joined the military .They then paid me the 11 thousand more they owed me.                  





Cavtrooper088

C File Vs Medical Records

11 posts in this topic

I requested my C file from VA about two weeks ago. So far no reply, but I assume that is typical VA. Will the C file contain comments from my medical records, or should I request them from the VA hospital where I am being handled? I'm real curious to see what has been said about my various exams.

Cavtrooper088

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Your C File should contain all the records the VARO needs to rate your claim. That would include your Service Medical Records. However, it seems that they rarely have you treatment records or the records they have are inadequate.

Review the C File carefully and be prepared to fix the mistakes.

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Thanks Pete. How long does it usually take for VA to send the C file?

Cav

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********* Berta - this triple posted so I edited 2 of them out - carlie **********

You can request your VA medical records too-which are separate from the actual C file.

It is almost imperative these days for a vet to have copies of their C file, their SMRs, and the entire clinical medical record.

The results of C & P exams can be requested separately from the Records Access Officer where the exams took place.

This can be done by mail but I think many VAMCs have a form for this type of request in their Records Access department.

I feel C & P exam results should be attached directly to any denial and SOC based on the C & P.

Many vets dont know these results can be accessed and- (I had personal experience on this) the actual exam can be different from the way the VA has manipulated it in the SOC.To a claimant's detriment.

If the VA denies due to a C & P- the C & P exam has to be knocked down line by line with medical evidence and common sense.

I knocked down many past C & Ps without an IMO years ago-on older claims - and the BVA gave 2 more recent C & P exams on a newer claim very little weight and awarded this claim in April.It isnt easy but it can be done.

There is nothing better these days however then getting a real doctor to prepare an IMO with a full medical rationale.Most IMO doctors these days probably outweigh any credentials a C & P doc will have anyhow- and the C & P might not even be done by a "doc" , it could be prepared by someone with less experience in the field of the disability then you yourself have.

Use common sense.

2 C & P docs could not determine when some glucose tests were done on my husband.

They both stated they could not tell if the tests were done at fasting state or early in AM compared to later in day after meals.

I rebutted with common sense and medical evidence.

The tests were recorded in Military time- Early AM-at the VAMC and neither C & P doc could apparently read military time (very concerning for 2 medical professionals who work for the VA)

and failed to understand the tests were early AM tests.

Also I made the point that my husband had been on a feeding tube for weeks while hopitalized with paralyzed throat and was also paralyzed from chest down (CVA) so he could not eat anything anyhow and sur could not leave the VAMC and get to McDonalds for any food by early AM that would raise his glucose levels.

These tests revealed critical evidence that the VA tried hard to ignore or minimize.

Evidence of his undiagnosed diabetes.

Rebuttals to faulty C & Ps should be as brief as possible but to the point.

Raise every bit of evidence they did not medical consider and refer to specific medical records to prove your point.

You need all the info that VA has -to combat negative C & P exams.

Claims are denied in my opinion for 2 main reasons-

an improper VCAA letter was sent out or

the C & P was deficient in ways that were deliberately detrimental to the claimant-

( OK 3 reasons

VA employees are not taking the time to read our evidence- or dont have the fundamental knowledge of VA 101 and the ability to assess it properly)

It is the C & P exam that they use to justify most denials.

Edited by carlie

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Thanks Pete. How long does it usually take for VA to send the C file?

Cav

Cav,

It totally depends on the office you are working with.

I truly have seen some VA claimants wait even a year

to recieve a copy of their c-file.

Hopefully this will not be the case for you.

jmho,

carlie

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i called my varo to request my c-file from my award a year ago just the other day. this was the first time i have ever done this. i was told by the va-person to prepare a letter requesting them via freedom of information act (foia). i did and mailed it to varo. is this pretty standard? i wasn't told to submit a form. was this because i was awarded and not denied?

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