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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    • 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. 
    • Should I file a claim now or wait?
      I agree with the others definitively file that ITF/FDC ASAP, when you file it that gives you your starting date to this claim and whats good about it  you have a year to submit the claim   and maybe have time to get yor C-FILE if you need it. Filing an ITF don't mean your filing your claim right then for what your claiming   it just means your going to file a claim within a year. Remember filing an ITF (Intent to file) you have a year to submit it as a claim, actually the VA is giving you the time to get all your evidence together before submitting the claim. if you have an appeal at the BVA  this will not effect that claim.  so file it buddy. jmo ...................Buck
    • C&P Examiner Pushed Me...FORCED
      You can always say this to the examiner, ''Do you mind if my wife/friend sets in during the exam''. My wife has always set in with me at all my exams. & I have had 4...so for. and it does help  keeps them for lying & If you call the VA you need to ask for he right person   the C&P Director for Request or Rescheduled another C&P  & Tell him/her your story as to what happen at your C&P jmo ................Buck    
    • Should I file a claim now or wait?
      Thanks Gastone, I have not started the claim on E-ben yet.  I'm still getting all my evidence in order.  I never filed on E-ben before I assume you can do a FDC on there just like filing at VSO.  
    • PTSD Denied NSC - Schizophrenia NSC
      Hi Mark, Thank you so much for responding.   He does not have a current treating psychiatrist.   Following a 1978 suicide attempt and subsequent hospitalization at a psych ward for 30 days - the psych ward doctor issued a diagnosis of schizophrenia - paranoid type.  After some bizarre behavior by my brother in years that followed, he was an outpatient treatment at county mental health center on and off and attending physician wrote diagnosis in 1983 of " schizophreniform episode with depressive symptoms" .  This medical evidence was submitted with his original claim in 1982 and his request to re-open claim in 2015.  He was not treated for any mental illness while in service / Vietnam.   At his recent C&P exam (last month) the attending VA examiner diagnosed him as still being schizophrenic and they issued a 50% rating -- but the rating indicates NSC. I will request a copy of his C&P exam from last month immediately -- thank you for pointing me to the form.  I have contacted several psychiatrists in the area to examine him and complete a "DBQ" to show nexus to his Vietnam trauma and they won't even return my calls.   My personal opinion as his sibling (I'm a former banker - certainly not a doctor) is that immediately upon return from Vietnam he had PTSD (burning his uniform, anti-social, startled behavior, etc) and this evolved into schizophrenia, culminating with a suicide attempt. Symptoms are still there -- just under the surface - because I take care of everything for him down to covering his rent shortage, co-signing for his apartment, buying his clothes and (meager) furnishings, etc.      
    • Question about NOD wait time after applying.
      Pack a lunch. DRO Reviews anywhere 12 - 18 months, DRO Hearings 2+ yrs, mine took 4.25 yrs in 2014. Check your RO's, most recent, Monday Morning Report. Unless it's changed, the MMR will show the "Total Appeals" pending for your RO. It doesn't list the DRO's separately from the BVA's. Gives you some idea of what your into. Call any of the VSO's that have an office at your RO, try to get the MFIC or a Sr Service Rep on the line. Find out how many DRO's are on your RO's Staff. He should be able to find out exactly how many pending DRO Hearings have been handled in 2016. From there you can do the math. Keep in mind, you MUST submit the "New & Material Evidence," Mandated by the VA Reg for a DRO Review or Hearing.  Early receipt of your N&M Evidence, could trigger the VA Automatic Review of your Denial by a Sr Rater or actual DRO. You "could?" get an award or a Continued Denial, much sooner than the actual DRO Hearing.  FAILURE to submit the N & M Evidence, will guarantee you an Administrative Denial. At the 4 yr mark, I filed an Official Request for an "Informal DRO Evidence Conference." Never got the conference, but within 3 months I received the VA notification that my DRO Hearing was on deck for 6/28/14. I chose to go "Informal," no recording transcription. Hearing lasted 35 min, DRO told me he was awarding everything. I was out of the RO by 930am. VSO Rep had a copy of the DRO Award by 3:30 same day. Retro hit mid July, VA Award Letter, like Aug 1. It's not unusual for the DRO's Decision, to take up to a yr after a Regular (not informal) DRO Hearing. Semper Fi
    • Question about NOD wait time after applying.
      The best way to figure out where you stand with your NOD is to follow the VA Monday reports. Look up your Waco RO and click on the TA tab all the on the right side. It will tell you how many appeals your RO has waiting. Follow the reports for a month and you will get a general number of how many NODs the RO is completing. Even this is not a guarantee or totally accurate. Example: My brother in law in Connecticut had his DRO review done in 28 days. A friend of mine out of the Tampa St Pete RO has been waiting 2 1/2 years. The VA says the average is 377 days. I figure 12 to 18 months is the average. I am out of the NY RO. I figure two years for DRO review and then tag on another three years if it goes to the BVA judge. Good luck with your appeal!
    • PTSD Denied NSC - Schizophrenia NSC
      What diagnosis does his current treating psychiatrist list? How about mental health treatment in the past--did they diagnose schizophrenia? PTSD?  When did he first manifest symptoms of schizophrenia? When did he first receive treatment for schizophrenia? Sorry to ask so many questions, but that information will help me and others to give you more specific advice.  I agree with @Berta - you have a right to receive a copy of the C&P exam reports from VBA after the Rating Decision. Use VA FORM 3288 and either mail or fax it to the VBA Centralized Intake Center. If you mail it, do so in a way that gives you proof that it was received, e.g., U.S. Postal Service Signature Confirmation. If you fax the form, you will receive a fax receipt from the VBA centralized intake center. I attached a copy of VA FORM 3288 with some tips for how to fill it out. You can complete the form by printing it and then filling it out with a pen, or you can type your answers into the form, and then print it. Be sure to sign and date the form in ink. VA FORM 3288 is online at: http://www.va.gov/vaforms/va/pdf/VA3288.pdf All the Best, Mark VA3288-Request-for-Records-use-for-C-file_Requests.pdf
    • Question about NOD wait time after applying.
      When you file a NOD how long does it generally take on the average to hear back from a DRO?. I filed a NOD form last week with Waco, TX. Regional Office and also asked for a DRO Hearing right up front to get that part out of the way without further delays asking me what kind of DRO I wanted...  Never done a NOD before so any input on average time frame of initial response is helpful.  Just curious. Wayne.

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Charleese

Disability Rating For Cervical Spine

Question

Hi all,

My husband's BVA decision states residuals of a herniated cervical disc and discectomy are the result of service connected residuals of a left tibia fracture. It also states under ORDER that Entitlement to service connection for residuals of a cervical disc herniation and discectomy as secondary to srvice-connected residuals of a left tibia fracture is granted. They sent it back to RO to be rated.

? What %age do you think RO will give him for this.

My husband current rating is 60% and he has applied for TDIU and was denied by RO.

However, BVA states in their decision: "With respect to the Veteran's claim for TDIU,, the claim is inextricably intertwined with the grant of service connection for a cervical spine disability discussed above. After implkementing the Board's grant of service connection, the RO should readjudicate the claim for TDIU. The Board notes that the Veteran's residuals of a left tibia fracture, left knee recurrent subluxation, and left knee tender scar are disabilities of a common etiology, and therefore meet the schedular criteria for a grant of TDIU under 38 C.F.R. Section 4.16(a)."

? Do you think RO will now grant him TDIU PT. 3 doctors have given IMO's stating that he is unemployable because of these injuries.

Thanks in advance for your replies.

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7 answers to this question

They most likely (Or SHould) rate his neck as Traumatic Arthritis under the 4.71. Thee is a diagnostic code for Cervical Fusion. What levels did he have fused. It also applies another rating if he has radiculopathy issues in his shoulders, arms.

The ratings are based on his range of motion. Since he has been examined, you can compare his actual ROM from the exam to the listed ROM parameters in the title 38 cfr 4.71a.

I think this is enough to put him over the IU hump. especially if he has neuroligical invilvement.

J

Edited by jbasser

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Fusion and plating was done at the C3-C4 level His BVA decision states: "On July 30, 2008 the Veteran fell injuring his neck while getting out of a car. Over a three week period, he experienced progressive quadripaersis and in August 2008 was admitted to a private hospital and diagnosed with a severe cervical disc herniation. A cervical discectomy was performed nd the Veteran demonstrated improved leg, aqrm aand hand function. The most recent records from the Veteran's private physician included a December 2009 MRI report showing numerous central disc protrusions along the cervical spine with central canal narrowing. Therfore, the record establishes the presence of a current cervical spine disability."

The only ROM that was done was done on his service connected left knee in June of 2010 boy his othropedic doctor and he states: The patient, on examination, has old well-healed scars over the left knee. Range of motion of the knee is about 10 degrees to about 80 degrees. He has good alignment. Both knees have crepitus. The right knee has more crepitus and pain on the medial side. Varus knee deformity on the right is noted. Sensory examination is intact. Reflexes are trace bilaterally. Dorsalis pedis pulse is 2+. What this means I do not know. He goes on to state that the patient had x-rays taken today in the office, standing films, show severe patellofemoral arthritis and milder femorotibial arthritis. He has also patellofemoral arthritis on the right knee and primarily medial joint arthritis on the right knee. Impression: The patient's pain is more severe in the left knee than the right.At the present time, the patient is unemployable since ambulation for any long periods of time bothers him and he cannot stand for a long period of time, anything longer than 20 minutes of the timeand also, when he sits in one position for a while, his legs start to cramp up and bother him as well as pain in the lower back, so he has got to get up and move.

He's in chronic pain from the hurting of both of his shoulders. He put claim in for them but they had not acted on it as of yet.

Also when you say: "I think this is enough to put him over the IU hump. especially if he has neuroligical involvement

WHAT RATING %AGE DO YOU THINK THAT RO WILL GIVE HIM WHICH WOULD MAKE HIM OVER IU HUMP.

Please all, continue to answer these questions.

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I MEANT HIS RANGE OF MOTION FOR THE CERVICAL SPINE IN COMPARISON TO THE CRITERIA LISTED BELOW?

General Rating Formula for Diseases and Injuries of the Spine

(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes):

With or without symptoms such as pain (whther or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease

Unfavorable ankylosis of the entire spine 100

Unfavorable ankylosis of the entire thoracolumbar spine 50

Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine 40

Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine 30

Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis 20

Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height 10

Note (1):Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.

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When I went through my C&P the Doctor had me go through all these bending motions, and I did not do very well. He also noted that I had a problem dressing with just a chair. But, the funny thing is that he said he was not scheduled to examine my back. Was he checking for something else?

Papa

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I have an injury to that effected my left foot and ankle and has caused stress fractures in my Tibia, the injury occured from a parachute jump that did not land so well :unsure:. Well I also have cervical spine damage. I did not get a percentage for it when I started my first claim in 2005 because I had never complained about the injury while I was in the Army. So VA gave me 0% but gave me 10% for the acquired flat foot which was caused by damage to the ankle. I just figured what ever back pain I was having was do to me not being able to stand correctly or walk normally. I was told after my first C&P exam in 2005 that I definatley had damaged my spine. I was told that I would have to prove that the injury not only occured while in the Army, but that it was caused by a particular event and not just an added complication of the ankle. I do know that it seems no matter what the problem is the more you get treated for it and the more documentation you have for your treatments the better chance you have of getting considered for compensation. Paper trails seem to be the name of the game.

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I have an injury to that effected my left foot and ankle and has caused stress fractures in my Tibia, the injury occured from a parachute jump that did not land so well :unsure:. Well I also have cervical spine damage. I did not get a percentage for it when I started my first claim in 2005 because I had never complained about the injury while I was in the Army. So VA gave me 0% but gave me 10% for the acquired flat foot which was caused by damage to the ankle. I just figured what ever back pain I was having was do to me not being able to stand correctly or walk normally. I was told after my first C&P exam in 2005 that I definatley had damaged my spine. I was told that I would have to prove that the injury not only occured while in the Army, but that it was caused by a particular event and not just an added complication of the ankle. I do know that it seems no matter what the problem is the more you get treated for it and the more documentation you have for your treatments the better chance you have of getting considered for compensation. Paper trails seem to be the name of the game.

Stu, you may be looking at secondary conditions from an abnormal gait.

In order to prove this, one would need to put it together to make it feasable. First, one should gather all medical information. go seek an IMO and have the Doc to review the entire history, Xrays, Etc.

The Doc can write an opiion and a nexus to your secondaries and put them into a medical prespective.

There is one Doc who is really good at this that I am aware of.

Dr Craig Bash. He is a Neuro Radiologist and he can put it together for you. The only negative I have seen is that he is a little pricey, but I have witnessed his work for 12 years and he is effective at all VA levels.

J

Edited by jbasser

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Had my C&P done yesterday for my physical stuff. The doctor agreed with everything I had claimed and even said that he could see that things were pretty messed up for me. He had some x-rays done on my spine. It turns out along with the herniated disc I also have some arthritis on my lower spine. So I do not know how all this will work out. I got my mental health c&p exam done and my GAF score was 50. My PTSD was said to be more likely than not caused by my service in Iraq. I am currently 20% and I have suffered through five long years of crap so it will be nice to have some breething room.

Stu, you may be looking at secondary conditions from an abnormal gait.

In order to prove this, one would need to put it together to make it feasable. First, one should gather all medical information. go seek an IMO and have the Doc to review the entire history, Xrays, Etc.

The Doc can write an opiion and a nexus to your secondaries and put them into a medical prespective.

There is one Doc who is really good at this that I am aware of.

Dr Craig Bash. He is a Neuro Radiologist and he can put it together for you. The only negative I have seen is that he is a little pricey, but I have witnessed his work for 12 years and he is effective at all VA levels.

J

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