Reduced Rating

[Rambo]

Hello and good day to you all.  I was recently scheduled by the VA to have a C&P on my back that I am already getting 40% on.  The appointment was set for January 4, 2017.  On Jan 3, 2017 the C&P DR called me and said she need to have an X-ray done before she can see me.  I could not get it done the day before so she told me to cancel my appoint one hour before and she will put in the order fro the X-ray.  I took the X-rays on Jan 5, 2017.  I received a call from AMVETS that the VA is reducing my rating from 70% to 0 because I did not show to my C&P.  I followed the instructions of the DR and today I receive a letter in the mail saying I owe the VA $7500.  What do I need to do to fight this, please let me know.  Thanks

[Buck52]

Take that letter down to the C&P Dr...ask her to call your R.O. & Try to straighten this out, the Dr can tell them what happen and request another C&P .

if the Dr won't help   file an NOD to be on the safe side!

keep all documents  you may need them later.  phone call is your only evidence  so you might ask the C&P Dr to confirm the phone call on Jan 3,2017

From now on Always go to your C&P even if Dr needed an X-Ray...then you can confirm that by showing up for your C&P  or if they cancel the C&P On that date then your there to say you showed up and it was canceled...but you need it in writing.

some of the VA Dr's don't have a lick of common sense  and that will get you in trouble.

Edited January 15, 2017 by Buck52

[broncovet]

This sounds like a "proposed reduction" letter.  If they never sent a proposed reduction letter, they violated protocol and this should be reveresed on appeal.  

If its a proposed reduction, then you have a right to a hearing, and you should ask for one.  Get you a grreat representatative, if you dont have one, and it sounds like you dont.  

Dont delay..ask for the hearing asap.  You have to ask for the hearing on a proposed reduction in 60 days.  

[Gastone]

Hindsight is 20/20, Avoid Verbal Orders, get it in WRITING! It's always easy to tell someone what they should have done, right.

With that said, you do have the VA C & P Dr's name, she wasn't a QTC Dr, right?

Is there any record in your MHV Treatment Notes regarding the Dr's Telephone contact? When & Who made the Xray appointment, the C & P Dr right?

Time to start gathering your Paper Trail to support your Verbal Orders.

Help me out with your SC numbers, your profile says 60, you say your were getting 40% for your back, AMVETS calls and says your 70%?? SC is being reduced to 0% SC. What exactly were your SC's and how long had you carried the Ratings?

Was this C & P the result of a VA Notice of SC Reduction?

Could you post a redacted copy of the VA letter stating you owe $7500? How many months of Comp does this cover?

What do your Rating Letters in your E-Ben account state? If you've already been reduced, appears you have, they should show your New Rating and possibly why.

This is definitely going to require a Face to Face with the Rating Dept Director, sooner rather than later. Contact your VSO RO HQ, talk to the MFIC and set up an appointment with the Rating Dept Director. The AMVETS Honcho, should have a direct line to the Rating Dept Director.

Semper Fi

[Buck52]

BRONCOVET  

He needs to file the NOD. (good for a year)..Asking for a DRO Hearing or how he wants to prove his case?..what he elects to do is on him.......once RO gets his NOD Then they respond with a letter of instructions letting him know what they decided to do   he then has 60 days from the date he gets that letter to respond. or he will probably be reduced back to 0%

[Gastone]

Buck & Bronc, I could be mistaken, sounds like he's already been reduced to 0%.

We certainly need more definitive information. He may have missed filing Deadlines also.

That Bill from the VA for $7500.00, ever heard of that, before a Reduction Decision is made?

If he's been 60 or 70% SC, we really don't know, his Comp with a Wife is in the $1500 per mos range. That would be (5) mos of Comp being Clawed Back, not good.

We're missing some critical info.

Semper Fi

[rhoe]

This does not remotely add up. 

If your review examination was scheduled in January, there is no possible way that the 60 days for a proposed reduction could have elapsed already, as that isn't the way time works. 

Filing an NOD as Buck suggests is entirely pointless, as you cannot disagree with a decision that has not happened yet (proposed reductions are not appealable, as a final decision has not been made). Do not waste your time or anyone else's with this.

I have no idea how you have a letter indicating an overpayment, as overpayments are not generated as a result of proposed reductions (or finalized ones). What does the letter say you owe the money for? 

Finally, even though it was apparently the doctor's fault for poorly communicating, it doesn't matter now. Call the hotline and request that your examination be rescheduled and state that you are willing to report. Do not tell the operator that you missed the appointment because you didn't know you had to attend or didn't recieve a notice to attend, as this does not legally demonstrate "good cause" for a missed appointment. Feel free to tell them that the doctor called you and indicated she needed the imaging results before the exam and stated she would schedule it for a different date - the imaging results in your VAMC records will support this statement.