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    • I am rated at 70%.  It is my understanding once you reach 50% you can get treated free for non service connected problems at the VA in the US.  Under the FMP you cannot.  You get treated free only for service connected problems.   Could someone please explain the logic of such a policy?  I live in Thailand and medical care is much cheaper here.  I would think it would be to their benefit to have everything treated under FMP as well.   Thanks.
    • Contacted Glenn Johnson at FMP by phone and he approved the PM procedure.  Could have flown to the US and had it done under Medicare or VA, but thought I would give it a shot.  If by some reason they don't pay it will be a much more bitter pill to swallow knowing I could have gotten this done for little or no cost in the US.  The only reason I did not have it done in the US is because they said they would pay. Had the procedure done by a government hospital in Bangkok at half to a third of what it would have cost at a private hospital in Bangkok.  Everything went well.  I had to pay out of pocket.  Could have used Bangkok Hospital who would have billed FMP direct and no out of pocket, but would have been 2 to 3 times more expensive.  The government doctor was trained in the US and worked in both private and government hospitals.  She stated that if I had the procedure done at the private hospital she worked it would cost 2 to 3 times. Sent the bill for reimbursement in March by registered mail.  After 4 months of no news sent email to check status.  The response was they had no record of having received.  There was another bill I had sent by registered mail also in March.  Same response.  No record of my claim.  They requested I send again, so sent by email.  Received email confirmations, so know they have in house.  I have tried sending claims by email, regular mail, and fax.  All have their own problems.  Doctor I used in Bangkok said so much of what he was mailing to VA on behalf of his patients was getting lost.  Started sending by fax and that seemed to work.  Still waiting on reimbursement.  If they do not pay, it will be an expensive lesson.       
    • Better yet, put it in an excel spread sheet so you can copy and paste. I've got about 20 fields per record, but most are cut and copy grouped together, but all the fields are nice to have. My first time with a baby 470 page one took about a week and a half getting used to it and all. But now, I have a learning curve, and can cut and copy locations, addresses, phone numbers, quicker now. A good bit of records are fluff bs, but sometimes, there will be a lot of condensed records together so the excel ss helps you keep tabs of things without falling asleep. I can find anything, and have mine also printed out with every other page numbered. It really helps using the relational database design (based on page number, but it would take about 4 or 5 fields, with versions, to make a real record identifier for the VA, if they were smart, lol. I'm going to do the same thing for my MyHeatheVet records. And then you can group them according to your claims at the bottom because claims is a field in your db records. If you have Win 7 Pro OS, get Office 2010 business for the best bang for buck if you can find it on ebay/amazon (it's not easy for a good price.) imo.
    • I think most of you are looking at a totally optimistic point of view, which is unreasonable imo. As a pragmatic individual, I would think the VA is doing that so ANY MD they have, in the field or not, would overrule the Nurse, and cause an inordinate delay (one year plus, all at the Vet's expense.) The 'any' VA MD is probably getting pummeled in claims by expert doctors with more expertise now. So they delay, but eventually if the Vet does not die in the meantime, he will win. You guys are all experts and I'm just a sluggo, but I thought claims were always based on who is the most expert: the expert hired or a shifty lower wage VA M.D. from East Indies. All I know now is my NP who is an excellent HCP Dr., his opinions are not a deal breaker by no means now. But if his observations are used by an M.D., then wow, it means a whole lot more and it is a deal breaker! 1. The VA cannot supply equivalent M.D.'s to private M.D.'s. 2. All the VA can do is delay. 3. What in the world do you think will happen when 75 million claims hit the fan? You talk about decades of delays! Then the VA can pick each Nurse IMO off by any VA M.D. at their own sweet time. It will be virtual dead-still progress in claims. It is already... ymmv.
    • Thank you, Everyone for the great advice. So I will probably have to go through the VA DBQ when they schedule my C&P exam. Berta,  I was not able to file for the temporary 100% Comp. I have never filed for PTSD before so I was not service connected for PTSD even though I have been DX by the VA with having PTSD. I think I will be fine going through the VA, I am trying to do a FDC and though that I might need DBQ for that. Thanks, Bill

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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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