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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    • "Blue Screen of Death" at VAOIG
      Again.  This time: WASHINGTON — A Senate investigation of poor health care at a Veterans Affairs Medical Center in Tomah, Wis., found systemic failures in a VA inspector general’s review of the facility that raise questions about the internal watchdog’s ability to ensure adequate health care for veterans nationwide. The probe by the Senate Homeland Security and Governmental Affairs Committee found the inspector general’s office, which is charged with independently investigating VA complaints, discounted key evidence and witness testimony, needlessly narrowed its inquiry and has no standard for determining wrongdoing. One of the biggest failures identified by Senate investigators was the inspector general’s decision not to release its investigation report, which concluded two providers at the facility had been prescribing alarming levels of narcotics. The facility's chief of staff at the time was David Houlihan, a physician veterans had nick-named “candy man” because he doled out so many pills. STORY FROM TOURISM AUSTRALIA Take a 360 trip to meet Australia's wildlife Releasing the report would have forced VA officials to publicly address the issue and ensured follow up by the inspector general to make sure the VA took action. Instead, the inspector general’s office briefed local VA officials and closed the case. A 35-year-old Marine Corps veteran, Jason Simcakoski, died five months later from “mixed drug toxicity” at Tomah days after Houlihan signed off on adding another opiate to the 14 drugs he was already prescribed. The 350-page Senate committee report obtained by USA TODAY also chronicles instances where other agencies could have done more to fix problems at the Tomah VA Medical Center, including the local police, the FBI, DEA, and the VA itself, but it singles out the inspector general. “Perhaps the greatest failure to identify and prevent the tragedies at the Tomah VAMC was the VA Office of Inspector General’s two-year health care inspection of the facility,” the report concludes, adding that despite the dangerous drug prescriptions, the IG did not identify any wrongdoing. After news reports chronicled Simcakoski’s death last year, VA officials conducted another investigation with very different results and ousted Houlihan, a nurse practitioner, and the medical center’s director. “In just three months, the VA investigated and substantiated a majority of the allegations that the VA OIG could not substantiate after several years,” the committee report notes. Sen. Ron Johnson, R-Wis., chairman of the committee, which is holding a hearing on the findings in Tomah on Tuesday, told USA TODAY the failures were "systemic" and indicative of a troubling pattern. "The reasons the problems were allowed to fester for so many years is because in the inspector general's office, for whatever reason, for years, the inspector general lacked the independence and had lost the sense of what its true mission was, which is being the transparent watchdog of VA system," he said. The conclusions echo other recent findings about the office tasked under federal law to be an independent watchdog exposing problems at the VA and making recommendations for improvement. The Office of Special Counsel, a federal agency that reviews whistleblower reports of wrongdoing, issued blistering critiques in recent months of the office’s investigations in Illinois, Louisiana, and Texas, which it said were incomplete and overly narrow. USA TODAY also has reported that the VA inspector general failed to release the findings of 140 health care investigations and sat on the results of more than 70 wait-time probes for months. While a new inspector general, Michael Missal, took over the office last month andpromised comprehensive investigations and greater transparency, the lead investigators on health care remain in place, including John Daigh, the physician who made the decision to keep the Tomah report secret. Assistant Inspector General for Healthcare Inspections John Daigh. (Photo: MANDEL NGAN, AFP/Getty Images) A spokesman for the Office of Inspector General, Mike Nacincik, said Friday that IG officials had not finished reviewing the Senate report and so could not comment on the findings. But he said that at the time, Daigh felt it was appropriate not to release the Tomah report when it was finished in 2014 because the investigation did not substantiate wrongdoing. “The OIG has learned important lessons from the Tomah VA Medical Center health care inspections,” Nacincik said. Daigh’s office opened its Tomah investigation in 2011 after receiving complaints that Houlihan and a nurse practitioner, Deborah Frasher, were prescribing “massive doses of opiates to veterans with post traumatic stress disorder” and employees feared retaliation if they raised concerns. The complaints also said some patients kept getting early refills, suggesting they were abusing or selling their medications. Little progress was made on the case until February 2012, when Alan Mallinger, a physician in the inspector general’s Washington, D.C., office, was put in charge. It was his first case as lead investigator, the Senate committee found. Over the next two years, he and his team conducted dozens of interviews, pored through more than 225,000 emails and analyzed opioid prescription rates at hospitals and clinics across the Great Lakes region. But they didn’t look into whether Houlihan and Frasher were prescribing opiates in dangerous combinations with other drugs – something the VA later concluded was rampant. One of the inspector general’s employees who reviewed charts from patients of Houlihan and Frasher actually noted during the investigation “A LOT of polypharmacy – patients on both uppers and downers, would really love to have a pharmacist look at some of these combos.” But that didn’t happen because it was outside the scope of the investigation. “The allegation that we had was that he was using opioids to treat PTSD, and that was the allegation we looked at,” Mallinger told Senate investigators. They did have independent experts listen to audio of interviews with former Tomah pharmacists who recounted dangerous amounts of narcotics prescribed at the facility and said Houlihan would get hostile if they didn’t fill them. The experts told Mallinger’s team they were alarmed by what they heard. One said the facility could be in danger of losing its DEA license. But Mallinger said his team did not have those experts review prescription data and could not independently corroborate the concerns with evidence and so discounted them. “It was not valuable in terms of supporting allegations,” he told Senate investigators. In the end, the IG didn’t have a standard for deciding when to substantiate allegations and instead decided ad hoc by committee. Their report, released after intense media scrutiny last year, concluded Houlihan and Frasher were among the highest prescribers of opiates in a multistate region, raising "potentially serious concerns." But those conclusions “do not constitute proof of wrongdoing,” the report concluded. The IG investigation team had intended all along to publish a public report on the findings, but Daigh decided instead to brief local VA officials and close it privately. “I do not publish reports that repeat salacious allegations that I can’t support,” he told Senate investigators. “So to write a report with all sorts of accusations that I can’t support and throw that into a small community destroys the community and destroys the VA.” After the report was released last year, a separate VA clinical review found Houlihan had failed to meet standards of care in 92% of cases and Frasher failed in 80%, according to a VA report provided to the Senate committee. Houlihan and Frasher could not be reached for comment. Houlihan's lawyer did not respond to a message seeking comment. Houlihan defended his record in an interview with WKOW in March. "I am a good doctor, I do care very much for my patients," he said. "There is a need for good care, great care for our veterans and I think my record really has shown that I've done that." Nacincik, the spokesman for the new inspector general, Missal, said he is reviewing the office’s operations “with an eye towards making enhancements.” “We believe that our actions will enhance OIG investigations and increase the confidence that veterans, veterans service organizations, Congress and the American public have in the work of the OIG,” Nacincik said.
    • Mental Health C&P
      jlduty, I know I'm only one of a million Vets getting the shaft, but knowing that sure doesn't make me feel any less penned in and segregated from the herd.  Learned this weekend that I now have one less person to talk to, he thinks I talk too much, rambling on, and so forth.  At what age does a son stop seeking his Father's approval? Or is that something that you either have or don't have? I can recall only 2 C&P exams that I felt good about, and they were the 2 that got me bumped up in the past year or so.
    • Sleep Apnea Claim
      Yeah, SA is pretty much a half or nothing, or all or nothing kinda deal.  Which is one of the main reasons the VA probably resists it so much. I think SA or OSA with out Cpap should be 30%, with = 50% and O2 added in should be 70-100%, or  something like that.   Semper Fi
    • Question about NOD wait time after applying.
      Buck; im sorry but inhale to disagree with you regarding 'if the DRO says he will get back to you in 60 days that's not good'. Several factors play out in a DRO hearing. Not all DRO's are the same. My case in point. I had a 'stand in' DRO. WACO told me after speaking to my DAV rep that they are back logged regarding getting a decision. Some hearings go well and they are decided right away. I know for a fact after my hearing my case basically went and sat on a desk awaiting a DRO to review it.  My DAV rep spoke to the DRO who held my hearing and they indicated they are looking at 6-12 months for a decision. i know many years ago you had a quick turn around but not the case for all.    Wayne; unfortunatley you have to go through the process Lima most of us that had a lousy rater. My rater never looked at the evidence. He took this one examiner's two sentence note stating my injuries were not S/C. That foot never even looked at me. This was a medical opinion!  I have the evidence and I have more evidence as well. I got a lot of advice on this site. I chose an informal hearing BTW.   YOU WILL HAVE TO LEARN PATIENCE WITH THIS PROCESS!!! i know you know you should have been rated and most of us are or have been in the same boat   I've been waiting since the day I filed back in November 2014  I did inquire after one year like I stated in my earlier response to you   best of luck!  
    • Sleep Apnea Claim
      There is nothing between 50 and 100%.  You can get: Persistent day-time hypersomnolence ................................... 30   Travis  
    • Footnote One Nehmer (A0)
      38 CFR 3.307 (a)(2) is thrown out the window. They treated me for malaria, but just like described in all medical journals, when a victim is already infected, they "will have a reaction to chloroquine". The VA is denying every reason for me being hospitalized for a month. i told them before I was even admitted as an inpatient that I was eaten alive by misquotes because I had no net the first night or two in the Delta. A month for a chloroquine reaction? Really? Who would believe that? An entire month? A few hours, even a day, but a month? No what! sorry Berta, but it is still just a cover up, hiding the facts, and denying a large retro pay. That is all it has ever been.  Whem my claim was denied, they said Agent Orange "DID NO DAMAGE", and there was "THERE IS NO CAUSAL RELATIONSHIP YET ESTABLISHED///stop there. "Yet established". My claim was denied because they knew in 1968 that the diseases in the Delta were rampant, to the point it was affecting military operations. So, in my denial they did not list a single presumptive condition that is now law. Not one. Nothing was coded.  Time to lawyer up it seems. The VA is wrong, and every last cent I have will be spent proving it, it looks like. Time for the media!
    • Question about NOD wait time after applying.
      II will add this  if your homeless and have or show good reason you need your claim adjudicated  for hardship  they are suppose to speed up/ Expedite   your claim within 30 days.  other than that  they will take there time... The process of changing over to the digitized world is what is slowing down all the claims now...hopefully next year the change over will be done.
    • Question about NOD wait time after applying.
      Wayne Usually after you send in your NOD Request  DRO Hearing  it depends on how many  hearings is ahead of you?...I was let known about my Hearing in 2 months  when an where and time it would be after I sent in my NOD requesting the DRO Hearing.  but it just depends on how busy they are...my last claim  Waco RO sent my claim to Salt Lake City to have a decision made...this was last Jan/Feb 2016 The only explanation I can give  is the rater that read what your C&P examiner wrote down  ''skip your evidence'' he must not have read it?, ...what was their reason for denying your claim the first time? Anyway this is why we Have the DRO Hearings  its better to get your claim decided at the RO Level than wait in line at the BVA.  So the DRO can sort through all this and read your evidence you have now & Listen to you. and its your chance to tell him what you had at your C&P Exam ''clear evidence was right in front of him/her'' why was I denied?? you mention/ show a DRO that and I'll guarantee you will walk out of there knowing that your going to win your claim or increase or what ever....evidence is the whole key to winning your claim. Usually if a DRO Says I'll let ya know in 60 days  after your hearing this is not a good sign  because there unsure of a decision...and it could take a year or two or three. if you don't hear from them in 60 days after your hearing  I'd bug the hell out of them. until I got results.  you can say you did your part now do your part and make a decision on my claim  so that other veterans can get there claims adjudicated as well. Thank you Sir. Its just that some raters & C&P Examiners choose not to read it. I ask a DRO at my hearing one time after the Hearing was over  I ask him why in the hell didn't the C&P Doc read all my evidence?  and by him not reading it obviously I was denied...I ask him what will happen to that examiner? will he get fired? he said probably not...I said well what about all the lies he stated at my exam  will those documents go into my C-FILE ? HE SAID UNFORTUNATELY Yes they will but will never be used against you in any claim you file as this has been adjudicated  once adjudicated they can't go back.

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KennyJ

Dependency Claim? Why It Takes So Long

6 posts in this topic

Maybe in a sort of way I can see why it takes so long for a claim to go through the system with all the evidence gathering and waiting delays. But a dependency claim? They have the marriage license and SSNs so why should this take 2 up to 4 months for this simple type of claim. it should be just a matter of checking records a week at the least . Wow everything in this system is ridiculous.

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All of my stuff was sent in with my original claim. Now I know it does not mean anything until you hit 30 percent. However, you would think it would be kept and made part of the record but no...... I had to resend all information in again. My has been pending since Feb 2004. Iris inquiries provide "claim for dependcy has been received. We are currently working the issuse. I have been married for 35 years to same gal so I don't know what in the hell they could be doing.

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There is no excuse its just not right and I am sure that you have been told don't sweat it you will get all your money.

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I filed my dependant paperwork with my original claim. When I got to the 30% mark I had to do it again. It was explained it to me that my dependant situation could change (divorce, child birth, etc.). As we all know that the length of time it takes for a claim to go from start to finish, things could change.

The good news is that the process only took me a couple of weeks to get corrected. Terry Sturgis

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Generally, dependency issues are resolved with the Post-Determination Team at the regional offices. The dependency issues are worked together with the promuligation of the decsion from the rating activities and the actual C-file is needed to do this. So if a veteran has numerous issues pending at once and their C-file is bouncing from one team to another trying to get the other claims resolved, then it may take longer to get any dependents added to an award. For example, if a veteran has one claim that just finished with an award and was promuligated by the Post-Determination Team, but has an appeal pending, then more than likely before the dependents are added the C-file will go back to the Appeals Team to resolve the issue(s) on appeal first before any dependents may be added. Having said that, in the senario I just mentioned, sometimes the dependents are added before the C-file is sent back to the Appeals Team. Alot of it just depends on the individual claim and how complex the matters are. Sometimes the Post-Determination Teams do miss the dependency issues altogther, especially if a veteran had a 10% rating and then received an increase to say 50%.

Vike 17

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Vike - what you said makes me understand why mine is still pending (since 2004) I have two appeals and two seperate issues in the fire so I guess it will be a while before they complete the dependent claim. Oh well I got nuthing but time on my hands. Thanks for the info

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