C&P for increase to IU

[TLaff]

I am rated at 30% cervical, 40% Lumbar, 30% Migraines, 70% MH due to pain.

I requested IU and they scheduled me for C&P exams because im asking for increase is how they state it, however i went to my first exam for Cervical, Lumbar and Migraines and it was a very short exam no measuring device or anything of the sort. She did state she was checking to see if i have gotten worse. Just wondering if this is normal or was she suppose to provide a complete exam?? or is it their way of trying to reduce my percentages to keep me from obtaining IU?

To my advantage though i provided the C&P examiner hospital documents that two days prior i had a Lumbar Ablation (burning of nerves to reduce pain) with steroid injections, and just the day prior i had a Cat scan because my surgeon will meet with me discussing if one or two new fusions will be done on my Cervical at the end of March.

Any Thoughts??

[flores97]

Was the exam done at a VAMC,  or by a contractor like QTC? It's difficult to tell without seeing the exam notes,  but if the exam was done at a va facility you should be able to pull the exam records up on myhealthevet blue button after three days.  Good luck to you

[broncovet]

1.  To get TDIU, you need medical evidence stating that your service connected condition(s) prevent you from obtaining substantial gainful employment.  Do you have said evidence?  If so, your chances of TDIU are good if you are persistent enough to appeal and follow through if necessary.  

 

2.  Reductions.  Its a myth that VA will reduce you if you apply for an increase.  There are strict reduction criteria, and, unless you have a temporary rating or "actually improved under ordinary conditions of life" you are not likely to get reduced.  

However, if you did not have the requisite period(s) of service, then VA can reduce/quash your benefits regardless if you improved or not.  

[Gastone]

Have you filed for SSD? Did you receive an "Inferred IU Claim" notification with your last SC Award Letter?

Could you post a redacted copy of your last Award Letter and the C & P DBQ used for your 70% MH Rating?

Consider applying for VA Voc Rehab. If a VRC deems you ineligible for the VR Program due exclusively to your SC's, a VR Denial Letter could be the IU Evidence that get's you the Award.

It will all come down to your ability to do "Any Type" of sedentary work, that would provide earned income in excess of the VA SGI ($12,400 per yr under 65).

Semper Fi

[pwrslm]

On VA Fm 21-4138 you should make a statement about the C&P exam.Write down everything about the exam that you remember, what the examiner did, how he did it, and any questions/replies that you may have received or given.  Dont try to use big medical terminology to look smart, explain everything in simple, everyday language that anyone can understand.  This is a lay statement and is just as viable for evidence as the professional medical examiners. The VA cannot discount it without cause, and if you can document facts that support your statement, it is very hard for them to get around.

After you provide a description of what happened, provide a reason why you think the examiner did not give you a fair shake. For example, if you did not see any measuring device, and the DBQ called for one, detail the DBQ statements, and state clearly that you looked up what a goniometer looks like, and that he did not use one.  Do the same for any parts of the exam you feel he skipped or misrepresented, like testing reflexes and strength in both legs, did he palpate your spine looking for masses and tenderness , or that he made claims and statements on the examination report (DBQ) about something you never spoke of, or were examined for.  Use the exact words from the VA form as well as the C&P report whenever possible.

Last, ask for another C&P exam. The examiner provided a deficient exam and failed to provide you with a competent C&P report, as required by law.  If he made up stuff that didnt happen, or failed to account for facts that existed prior to the C&P exam in VA Medical records (CPRS and VISTA), or said he examined your CFile but omitted information about your hearing loss and tinnitus that was beneficial to your case, then you have a legitimate complaint against the examiner.

If you have a clear cut case against the examiner you could send him some well deserved luv via your state Guv (States AG or the examiners State licensing board) or the VAOIG. Making false statements deliberately in medical records is a felony.  If you have a black and white case to present, it needs to be reported.  The more Vets that do it the better off all vets are, the VA is required to do the job right and not just provide a fly by night BS artist for this job. I have seen 3 of these so far, and reported 2. Once my secondary claim is done, I am reporting the 3rd one.

Edited February 14, 2017 by pwrslm

[Guest L]

"Sidebar" - the Range of Motion measurements can be "Subjectively" observed by the "MD" - as you move about in the exam - in the place of some measurements, the baseline from the last time the measurements were taken, would be in your medical records.

ROM can be taken with a Goniometer, or by normal functional activities. 

[TLaff]

Ok i will try and send it again, real quick my effective date for 70% mental health and 30% migraines was Aug 9 2010. I had already a triple cirvical fusion in 2008 then another single added June 2015.

I had stopped working Nov or Dec of 2014 because of pain and i really did try and my income for 2014 was just over 1,000.00.

Here is the Award Letter for the MH.