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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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    • Full Knee Replacement
      First, if you  have newer x-rays from outside the VA, get them and the reports into your VA med file. The distance from the VA hospital initially is not as important as the distance to a local VA outpatient clinic. But, once you convince the clinic PCP then outside care (consult in VA speak) can be authorized, since the VAMC is farther away than 40 miles. 
    • Dro Review Processing Time
      I sent in an NOD requesting DRO review about two months ago.  Nothing appeared on ebenefits so I sent an ISIS message.   Took them 2 weeks to reply  (ignore their note that days reply would be sent in 5 workdays)   Return meggage said NOD was received but ebenefits is a little behind   Message said a letter was sent to me asking if I wanted DRO review.  Msg said ignore letter because I already asked for DRO in NOD. Here's  the killer.  Average time for DRO review    631 days
    • Code Sheet
      After reading my code sheet I saw I have one of those. I'm rated on my ankle as 5020-5271. It's also static.  To me the code sheet eases the Veterans MNF. I know what my codes are and I know that my contentions are either static or non-static.  This shoulf not be a secret to is at it is vital information. Nor should this be a huge issue to get. 
    • Auto Adaptive Reimbursement
      I'd try to get something in writing concerning changes/refusals, than, "run the flag up the pole" any way that I thought would help. Automatic transmissions are more or less standard these days, so I'd not be surprised about that.  Bureaucratic screw ups in budgets are not a valid reason for failing to provide benefits required by title 38. Looking at things from a different perspective, some vehicle options are often listed as options,even though they are really "standard". A/C and automatic transmissions are just two. Another possible go-around is that different trim levels of the same vehicle have different options as "standard". You could possibly buy a base version, and add options at extra cost, or an up trim version with the "options" already included as "standard". It may be that the VA is looking at what the "normal" buyer options are, and trying to avoid paying for them.  
    • CUE? Not using SMR?
      Yes, if they notice the CUE they can adjust on their own.  I just had the EED adjusted on my initial claims for asthma and left ankle, the rater looked at my entire record while processing my unadjudicated claim for diabetes.  He immediately file a cue and adjusted the EED.  I didn't have to do anything for the EED/CUE. However, my ED was actually a CU they started them in 98 vs. 97.  
    • C&P Exam Results, WTH is going on, Please Help!!!
      Agree with killemall. You got this Navy04, we can't wait for you to come back here and say DONE!    
    • Code Sheet
      Thanks Asknod My problem is finding out the code for the disability.?? PTSD Code has it at 9411&9435 Code for Unspecific Depresssive Disorder VA Notes from  PCP  has PTSD  As : SCT47505003  My Sleep Apnea Notes has the code as SCT 73430006, Some of these I get confused with Insurance Codes  for Insurance Purposes. Jbasser & Jerrel Cook had a blog talk radio show on these rating codes Last year some times Maybe I'll recheck the Archives Shows. I tried to look up the code for OSA but never found it. just the SCT #73430006..?  And I have a Boo-Coo List of NSC disability's/contentions.  with the SCT# at the end of them
    • Auto Adaptive Reimbursement
      Update. My friend talked to the head of prosthetics in Tucson(kristine) and she informed him that the VA will not cover some items like power options,automatic transmissions and a few others.(I can't remember the list of things he told me).These were all covered by the VA previously.
    • NOD / DRO or TARP?
      All, Thank you for the response's. Due to me posting all of my documents intermittently, there seems to be some confusion with the timeline and issues. I will attempt to run thru this chronologically and repost all documents including my 2015 decision which I had not previously posted and answer all questions. March 2009- Filed original Claim for the following issues and received results October 2009 (see 2009 - Rating Sheet below) I do not have the entire decision packet: TBI - 10 % SC Residuals, gallbladder removal - 0% SC Back Condition - declined SC Psoriasis - declined SC PTSD - declined SC / Stressor conceded as combat action badge. October 2010 - Filed NOD / DRO for PTSD March - 2011 - Appeal decision received. I never stated that PTSD was due to MST. The paragraph on page 2 of 2011Appeal decision below is just the last part of 10 pages that I cut out covering rules and US code that they sent in the letter. The actual decision starts at the bottom of that page. Results: PTSD declined - I did not submit any new evidence. Diagnosed as "adjustment disorder with mixed anxiety and depressed mood". Blamed on me worrying about my husband returning to Iraq, even though he had just returned??? October 2014  - Initiated following claims: (I had transferred to the North Texas VA and had finally began receiving treatment after being fed up with OKC VA. I live in southern Oklahoma, so its a drive for me to go to either one) PTSD - Re-open Claim. TBI - Request for increase. May 2015 -  I reported for C&P exams at the Dallas VA clinic for PTSD and TBI. I'm not sure if this is relevant, but I received a call while my husband and I were driving there stating that the TBI examiner had to leave early and they would have to re-schedule that exam. I protested because it is a 3 hour drive. They called me back 10 minutes later stating that he would conduct the exam. He seemed pissed the whole time. His notes stated that No TBI residuals were present.  This is also the exam where the PTSD screener stated "However, it should be pointed out that most of the symptoms the veteran described during today's MH examination certainly those common to a PTSD diagnosis- she also described during her 7/8/09 Initial PTSD examination, in Oklahoma City, three years PRIOR to her son's illness."  ( see 2015 C&P exam notes below) June 2015 - Latest decision received. Results (see 2015 - decision part 1 &2 below): TBI - Decreased to 0% SC PTSD - 50% SC May 2016 - Wondering what my best next COA should be? Would like to get PTSD effective date back to 2009 and get TBI increased to at least percentage it was before. I have about 50 days to file my NOD. Q&A: Berta: What did the C & P doc diagnose you with? 2009 - TBI (SC) and adjustment disorder with mixed anxiety and depressed mood (not SC) 2015 - No TBI residuals and PTSD w/ major depressive disorder.   Berta: Have you googled the doctor who did the C & P? I do not know the Doctor's name from 2009. But I have found several articles referring to a Dr. Gail Poyner who was conducting PTSD exams at OKC VA at the time. She was fired from the VA in 2010 for applying test to Veterans to see if they were malingering or faking. Her research paper can be found here: http://link.springer.com/article/10.1007%2Fs12207-010-9076-x?LI=true I would like to have my C-File to see if she conducted the evaluation.   Gastone: What did you claim as the PTSD Stressors in your 09 app for PTSD? Combat Action Badge   Gastone: The 1st Denial, discussed "No Evidence of Personal Assault," MST? No MST ever claimed. The paragraph that covers PTSD due to MST was just the last paragraph of 10 pages of regulations that they sent with the decision. Actual decision starts at the bottom of that page.   Gastone: Did you know anything about the DRO Process Requirement, for the N & M Evidence? I did. My fault I didn't send any. I was fed up with OKC VA and assumed they would send me for a new C&P exam. Stupid on my part.   Gastone: Did you ever get a copy of your 09 PTSD C & P DBQ? No, I did not. Blue button records do not go back that far. I have requested a copy of my C-File. EBenefits states that I will get it between NOV 2017 and NOV 2018.   Gastone:  Do you currently have a VA MH Psychiatrist/Psychologist that treats you on a regular basis? I was being seen at Bohnam, TX VA. After they kept switching Dr's a few times, I now just get my meds re-filled thru my family physician. My husband is active duty, so we are on tri-care prime remote. I also qualify for VA choice, but have not used it.   Gastone: Have they given you an official PTSD DX? I have a PTSD diagnosis and receive 50% SC in 2015.   Berta: Did they have the incident reports? I faxed in two incident reports. They do not show on the evidence list, but stressor was conceded with CAB.   Flores97: Email congressman for C-File. Thank You for the advice. I emailed my congressman today and reiterated the time crunch I am under.     2011 - Appeal decision.pdf 2015 - C&P exam Notes.pdf 2015 - decision part 1.pdf 2015 - decision part 2.pdf 2009 - Rating Sheet.pdf
    • Full Knee Replacement
      I just came back from the Ortho doctor in town he said I need a full knee replacement for my service connected injury after looking at past 11 years of x-rays from the VA and what he just took today. The Marine Corps. somehow don't keep x-rays after a certain period of time. The VA says they will not do one until I'm 60 years old, all they wanted to do was give me injections for the pain. What I have now is a Torn ACL and I'm running bone on bone, and my knee cap is just about gone so here is the question. I already receive 20% for my left knee, due to the past 3 surgery's. So after having the knee replacement what will I be looking at? for an increase? Does the VA have to pay for this since I live 178 miles from the Nearest VA hospital? because they are still telling me if you were injured on active duty you must go to the VA hospital even through the VA says They will not do a knee replacement until I'm 60? I already talked to two Veterans in town at the Vet center and they had the same problem but they paid for it out of their own pocket for the surgery then filed for an increase award. So far they are still waiting for the VA to answer them back. any ideals on the best route to take? I hate to get this done out in a local hospital then fine out the VA will not pay and give me an increase for the full knee replacement. Thank for any information on this subject.

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aggie54

Preparation For Notification

26 posts in this topic

Well, Finally went to Notification Stage after 18 months, I've been waiting a long time for this, now I just hope they do me justice and give me what I rate, Nothing More! Does anyone have an idea how long it will take before I actually get something in the mail or a post on ebenifits?

A big thanks to everyone all on this site for all your help and expertise on all subjects....

Aggie54

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CHECK YOUR LETTER GENERATOR AND SEE IF YOU HAVE ANYTHING IN THERE.

reddiTT

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Reddit:

That be under VA letters?

Thanks

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They sent mine to Notification and then back to review of evidence, 3 days later my claim was closed,

and saw my letter for 100% P&T on the VA letters. So don't get upset if they send it back to review of

evidence.

Good Luck,

NJ

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Thanks for the info NJ, I've been back to review of evidence twice already, so it wouldn't surprise me if it happens again, at this point I'm not even crossing my fingures anymore. It will get here when it gets here.

Thanks fir the reoly.

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Oops sorry NJ, I meant, Thanks for the reply, sorry blind from left eye and sometimes I make mistakes. LOL.

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Sounds like me aggie after reading online for a few hours..

Coot

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you'll be ok aggie54 just hang in there....

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Ok, I need some help here. I was in Notification Stage this morning, then went to Review of Evidence again, but I looked at Ebenefits and they put me at 90% but didn't dot the P or T. Then I went to VA letters and it says.This letter certifies that Domingo Aguilar is receiving service-connected disability compensation from the Department of Veterans Affairs. Gross Benefit Amount $1661.00. This is for a single person, but I'm married, then it says Effective Date March 1,2012. I was under the impression that I would be back dated from the day after I retired which was Sept 1, 2010. My question is, will they retro pay from the day after I retired or what? As for the dependant problem I can send them my marriage certificate not a problem. Why would they give me a 90% and send me back to Review of Evidence? And what will happen with my Unemployablity since I am already receiving my social security, plus I haven't seen anything as for the SMC since I lost my left eye sight while in the Military, is this the reason they sent it back to Review of Evidence to correct these unanswer questions. I know this seems like alot of questions, please forgive me but I'm just confuse about it all.

Thanks, and any information will be greatly appreicated.

Agiie.

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Thanks Coot

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aggie,

Not sure about Ebenefits, but I am sure that you are entitled to back pay to the day after discharge from active duty, and once they receive your marraige certificate, you will be entitled to the married rate back to the day after discharge or the day of marraige, whichever came second. Your SSD doesnt affect service connection so you can collect both! If they rate you at 90% and you arent or cant work, I would ask for a medical opinion stating that you cant work due to your disabilites so you can get IU at 100%.

donna

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Thanks Donna for your reply, I provided my marriage documents to the VA Rep while I was doing my retirement physical while Acap processing, no biggy I will provide them again. I was granted my Social Security Benefits in 2011 due to my Service Connected Disabilities.Donna, I got injured while on active duty on July 2007 and was keep off work until Aug 31, 2010 when I retired. I have not worked since 2007, when I got injured I was keep on a Permanant profile unable to work as a Recruiter due to being blind from my left eye, the military didn't want me to drive a government vehicle because I was to much of a liability so I was sent home for 3 years until I retired.

Donna,I hoping to get paid my retro pay because I am very close to losing my home due to not being able to work and earn a living. I do have a doctors report that states that I am disable and unable to work due to my other service connected disabilities, these documents have already been provided to the VA, once again I don't have a problem submitting them again.

Thank you so very much Donna for the information.

God Bless.

Edited by aggie54

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aggie, are you positive your effected date is 3-1-2012.?..This doesn't make sense! When did you file this claim?

Also, a vet has to be 30% or more to be eligible for Dependent Benefits. So, you been at 20% until this claim was awarded for 90% which means you reached your 30% or over, so now your Dependents pay will begin on the effected Date of this claim.

Please recheck the effective date for this! The reason is, the ED (effective Date) should start either the date you file this claim or in your case, the date you retired, maybe.

Coot

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Coot, I looking at it right now, and it says Effective Date March 1,2012. Combined Evaluation 90%, Gross Benefit Amount $1661.00, Net Amount Paid $1661.00. I don't know whats going on Coot. Ebenefits is showing Claim filed date of 7/25/2010 under Reveiew of Evidence and then it's also showing Special Correspondence, date of 7/12/2011 showing under Claim Received. Under Benefits Explorer it shows 90% Military Disability Rating and 90% VA Disability Rating. Permanant and Total is uncheck. Yes, I have been 20% since 1992 for injuries while in the Marine Corps. Coot that's all Ebenefits is showing, I truly don't understand what is going on with my case. Oh , I found my copy of the form 21-686c that I provided the VA with. No worries I'll send it again. I retired on 9/1/2010.

Thanks Coot.

Aggie

Edited by aggie54

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Well, Finally went to Notification Stage after 18 months, I've been waiting a long time for this, now I just hope they do me justice and give me what I rate, Nothing More! Does anyone have an idea how long it will take before I actually get something in the mail or a post on ebenifits?

A big thanks to everyone all on this site for all your help and expertise on all subjects....

Aggie54

I am an E-5 in the Navy, and I am active duty. Just submitted my NMA and dictations. Have appointment with Doc on April 1st, so he can type up the Dictations in medical terms. How long does the process take from here, I hear that the Navy and VA work together now and that the process is alot quicker, is that true? Please help with this matter, I am so stressed and trying to learn everything I can. Antonio

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​7-25-2010 should be your ED. Can you remember if that's the date you filed for THIS claim. The 3-1-12 ED is totally ridiculous.

Since you already turned in the 21-686c then I would wait till they ask you for it. Maybe they won't and just use the one they have. But the only problem there is, if you do wait till they ask for it, it'll just make it longer to receive the Dep. pay.

Coot

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The date Ebenefits first showed was 5/28/2010. QTC on 6/25/2010 with a closed date of 2/2/2011. But they have it showing as Claim date of 7/25/2010. I really don't understand these people. Seems to me like they have their dates all screwed up. Hopefully, they will notice it and fix it. I will take your advice and keep the form until I speak with them about it.

Thanks Coot for being so concern in helping me.

Aggie.

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Not a problem at all aggie! Thats what were all here for, each other.

Yea, they have it all screwed up on your dates. For instance, they mentioned later the claim date was 7-25-10, well then how is it you had your C&P (QTC) a month before you filed your claim..lol..Do yourself a favor, don't give to much trust what they put in ebenefits.

Since the claim has been adjudicated, I would just wait till you hear something from VA. Hope it works out good for ya!

Coot

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Thanks Coot.

God Bless.

Aggie

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Thank you for your service, Aggie. Sorry for your sacrifice. Blessings to you for a happier future.

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Thank you AFButch for your comment, Greatly appreicated, I know justice will be served as I served my Country almost all my life. I know the VA has a hard job to do and their only human, and like all of us sometimes we have to correct our mistakes by going back and fourth until we get it right. Right? I'm sure they will take a closer look and make the right decision.

Edited by aggie54

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I am an E-5 in the Navy, and I am active duty. Just submitted my NMA and dictations. Have appointment with Doc on April 1st, so he can type up the Dictations in medical terms. How long does the process take from here, I hear that the Navy and VA work together now and that the process is alot quicker, is that true? Please help with this matter, I am so stressed and trying to learn everything I can. Antonio

Kiefer82, this aggie54 did anyone get back too you on the questions that you have on the process with the VA? if not, send me a message and I will try to give you as much info as I can. Have you started a New Topic`

If not start one so you can get all the members involved and try to help you.

Good Luck..

Aggie...

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Aggie54,

Thank you so much for answering back. I created a new post, and asked questions, and no one has helped. I figured since I am active, and spent a few tours in Afghanistan, people would want to help. I am new to the site, and it is kind of hard to navigate. I have been so stressed about the whole situation. I am stationed in one state and my family lives in another state and having my health issues, and not knowing the process. I have Crohn;s disease, just had testicular surgery, two knee surgeries, seeing doc for PTSD, and been batteling MRSA for two years, that I was infected with at Walter Reed Medical Center. Once I do the Dictation with the Doc on April 1st, what happens after that, and what is the time frame. Please help me with this matter.

USN

E-5

Edited by kiefer82

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I received White envelope today but posted in wrong place. Please see under introduce yourself. Sorry, not feeling well tonight.

Thanks

Aggie

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Please be careful about putting personal information(your name,ss,ect) as this could get into wrong hands-You might want to delete your name-thanks

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