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qwiksting

Claim At Bva ( Kinda Long)

Question

I am new to alot of the words used here on this message board, and I dont have that much experience in all this paper work. I was medically retired from the Army May 06. I currently have a rating of 80% on a couple of different problems. I filed a claim to the VA about having stomach problems that started when I was in Iraq. My medical records show that I was treated while in Iraq, and also from the VA starting Dec 05. In December of 05, I was given an upper GI showing their was a problem, put on meds for it. My primary ordered an endoscopy, but it was denied the first time (it was entered as routine). The next time I saw my Doc, He asked about the appt. and I told him I havent heard or got anything about it. He ordered it again, same results. I got concerned and tired of waiting , so I decided to file a claim (july 07), hoping a C&P would follow and I could find out what was going on with me(force them to schedul an endoscopy). Within a month of filing that , I got a notice I had an endoscopy appt. I went to it, and was told I had a hiatle hernia, gerd, and small ulcer. I think they also tested to see if it was cancerous, but that came back negative. I have been working with a wonderful DAV lady, she helped me file and get the paperwork together. The C&P I got was a joke. I was given another upper GI. I couldn't understand the examiner, she was from poland or russia?? Her accent and her words were hard to understand. I didnt think that was a big deal, I and my DAV lady felt very confident with all of the records and treatment. I waited for about 6 months and recieved the descision that I was denied. Was told that the problem had corrected itself based off of the last upper GI, and the examiners report.. Of course I NOD, and my DAV Lady helped with that. In Fact, she said I should request a RSO. I did, however, it seemed to be sent to the BVA. I have been waiting for something to happen. It seems like it has been forever on a case that was "a slam dunk" according to my DAV lady. Even my primary has it listed as a chronic problem. GERD. I even asked my primary, since the VA examiner said my problem corrected itself, why Am I still having problems, and why am I still on meds?? He sent me to a specialist, and he said the same thing after looking at my endoscopy. He agreed with my primary, Gerd, hernia, ulcer. Very Frustrated VET here.

My question is...I recieved a letter from the BVA, washington D.C. over the weekend that said my claim had been certified and that I have either 90 days or before because my case could be decided before the 90 days are up, which ever comes first to submit new evidence, get some one to represent me. I dont have anything new to submit, and didnt think I needed representation. Does anyone or has anyone had this happen? I would go to my DAV lady, but she is so busy and has done soo much already to help me.

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If you feel its ready write them back and tell them to go ahead with the info they have. May speed you up a little.

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Did the DAV rep suggest a reconsideration request?

"Was told that the problem had corrected itself based off of the last upper GI,"

Did the actual C & P results give a medical rationale for that?

I can not understand where they got that idea.

The DAV can still represent you at the BVA.

Did the SOC list and refer to ALL of the evidence you had sent to them?

Was the VA aware of the primary doctor's statements and the specialist's input?

Something is wrong here-

Since the DAV rep considered this a "slam dunk" she should actively be seeking a way to get a better decision before it goes to the BVA (which will add years to the claim).

After the NOD was filed- was a rebuttal prepared for the SOC? When was that?

I feel there is more evidence you could send to get closer to an acceptable RO decision.

I dont know what your med recs and C file would reveal but it sure looks to me as though they are ignoring the most important evidence.

The SOC is the clue to what they considered and then whatever they ignored.

Dont feel bad about asking the DAV rep to do more- she is well paid to do more for you.

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I am new to alot of the words used here on this message board, and I dont have that much experience in all this paper work. I was medically retired from the Army May 06. I currently have a rating of 80% on a couple of different problems. I filed a claim to the VA about having stomach problems that started when I was in Iraq. My medical records show that I was treated while in Iraq, and also from the VA starting Dec 05. In December of 05, I was given an upper GI showing their was a problem, put on meds for it. My primary ordered an endoscopy, but it was denied the first time (it was entered as routine). The next time I saw my Doc, He asked about the appt. and I told him I havent heard or got anything about it. He ordered it again, same results. I got concerned and tired of waiting , so I decided to file a claim (july 07), hoping a C&P would follow and I could find out what was going on with me(force them to schedul an endoscopy). Within a month of filing that , I got a notice I had an endoscopy appt. I went to it, and was told I had a hiatle hernia, gerd, and small ulcer. I think they also tested to see if it was cancerous, but that came back negative. I have been working with a wonderful DAV lady, she helped me file and get the paperwork together. The C&P I got was a joke. I was given another upper GI. I couldn't understand the examiner, she was from poland or russia?? Her accent and her words were hard to understand. I didnt think that was a big deal, I and my DAV lady felt very confident with all of the records and treatment. I waited for about 6 months and recieved the descision that I was denied. Was told that the problem had corrected itself based off of the last upper GI, and the examiners report.. Of course I NOD, and my DAV Lady helped with that. In Fact, she said I should request a RSO. I did, however, it seemed to be sent to the BVA. I have been waiting for something to happen. It seems like it has been forever on a case that was "a slam dunk" according to my DAV lady. Even my primary has it listed as a chronic problem. GERD. I even asked my primary, since the VA examiner said my problem corrected itself, why Am I still having problems, and why am I still on meds?? He sent me to a specialist, and he said the same thing after looking at my endoscopy. He agreed with my primary, Gerd, hernia, ulcer. Very Frustrated VET here.

My question is...I recieved a letter from the BVA, washington D.C. over the weekend that said my claim had been certified and that I have either 90 days or before because my case could be decided before the 90 days are up, which ever comes first to submit new evidence, get some one to represent me. I dont have anything new to submit, and didnt think I needed representation. Does anyone or has anyone had this happen? I would go to my DAV lady, but she is so busy and has done soo much already to help me.

sounds like you already have representation.

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May 2006, I was medically retired from the Army. I currently have a rating of 80% on a couple of different problems.

July 2007, I filed a VA Claim for stomach problems that started when I was in Iraq. My service medical records show that I was treated while in Iraq, and also [treated] by the VA starting December 2005. Dec. 05, I was given an Upper GI [by the VA] showing there was a stomach problem, and was put on meds.

Hopefully, you have a copy of your service medical records, your VA medical records and any other private treatment records. "Stomach problems", by itself does not indicate a specific compensatable diagnosis.

My primary [VA Dr.] ordered an Endoscopy, but it was denied the first time (it was entered as routine). The next time I saw my primary, he asked about the appt. and I told him I havent heard or got anything about it. He ordered it again, same results. I got concerned and tired of waiting, so I decided to file a claim July 07, hoping a C&P would follow and I could find out what was going on with me (force them to schedule an Endoscopy). Good thinking on your part!

Within a month of filing the claim, I got a notice I had an Endoscopy appt. I went to it, and was told I had a Hiatal Hernia, Gerd, and small Ulcer. I think they also tested to see if it was cancerous, but that came back negative.

This medical evidence (of a current disability) should have decided your claim. Do you have a copy of this evidence? "I was told such and such a thing" has no probabtive value --it is heresay.

I have been working with a wonderful DAV lady, she helped me file and get the paperwork together.

The C&P I got was a joke. I was given another upper GI. I couldn't understand the examiner, she was from poland or russia?? Her accent and her words were hard to understand. I didnt think that was a big deal, I and my DAV lady felt very confident with all of the records and treatment.

I waited for about 6 months and recieved the decision that I was Denied. Was told that the problem had corrected itself based off of the last upper GI, and the examiners report. Of course I NOD, and my DAV Lady helped with that. In Fact, she said I should request a RSO. I did, however, it seemed to be sent to the BVA.

RSO? Do you mean DRO (Decision Review Officer)? If, in fact, you filed a request, then your claim should not have been "certified" to the BVA. Your service officer should have communicated all of this to you. If you have evidence of your timely request for a DRO review, then you should submit that evidence to the BVA now, and get the claim sent back to the RO for a review.

I have been waiting for something to happen. It seems like it has been forever on a case that was "a slam dunk" according to my DAV lady. Even my primary has it listed as a chronic problem. GERD. I even asked my primary, since the VA examiner said my problem corrected itself, why Am I still having problems, and why am I still on meds?? He sent me to a specialist, and he said the same thing after looking at my endoscopy. He agreed with my primary, Gerd, Hernia, Ulcer. Very Frustrated VET here.

I do not know the difference between an Upper GI and an Endoscopy. I'm sure you know the difference, and if one or the other carries more probative weight in deciding a claim.

My question is... I recieved a letter from the BVA, washington D.C. over the weekend that said my claim had been certified and that I have either 90 days or before because my case could be decided before the 90 days are up, which ever comes first to submit new evidence, get some one to represent me. I dont have anything new to submit, and didnt think I needed representation. Does anyone or has anyone had this happen? I would go to my DAV lady, but she is so busy and has done soo much already to help me.

Like Berta said, did your VA Decision list the evidence that was relied upon to make the decision? If not, send that evidence ASAP. Also, I would question WHY your claim was certified to the BVA when you had requested a DRO review: was this request in writing??? ~~~Wings

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I apologize for not being more clear. Just when I think about this I get pissed off and irrate. I was treated and have the medical documentation from Iraq. Diagnosis was "Gerd". Meds_ prilozac. Its all they had in country, or at least at my FOB. My primary physician at the VA has noted on my records everytime I go in for an appt to him (every 6 to 8 months) that I have GERD. He is the one that called for an Upper GI (least invasive way to check for either GERD or Helicobacter infection) It was determined that I had reflux during the test. The test was on Dec 06. So I believe the "nexus" should have been tied to either my service record from Iraq, or within one year of Discharge from Active service Mar 05. After the test i was given an ongoing prescription of omeprazole. The primary doc then ordered an Endoscopy (where they go down your throat with a camera) That test was denied because the primary put it in as a routine test. (Ifound out later) I went back to him the again, and he didnt see my endoscopy results, so he ordered it again. Once again it was put in as a routine test. I continued on my meds, he noted it everytime I went, and eventually it was noted with my other probles as being chronic. July 07 I decided not to wait anymore for the VA, I filed a claim for GERD. Not long after that I got a letter in the mail telling me that I had an appt for an endoscopy. Result from the endoscopy revealed a hernia, Gerd with gastro ulcer. So I was assuming that was part of the C&P process, until 3 months later I got another letter saying I had a C&P and was scheduled for an Upper GI. I was dumbfounded because they just had the most invasive test you could do, and now they wanted to do an upper GI?? So I went to my appointments. Met with the examiner, couldn't really understand her questions and I am sure she didnt understand me. She was having difficulty choosing english words. So I felt ok about it, thinking they had all my records, (evidence I submitted plus the endoscopy) . About 4 months later I got the denial letter. She said I said things and that the GERd had "resolved" itself and that my discharge physical showed no signs of GERD. I never had a discharge physical. I was pissed. I took that to my DAV lady, with the endoscopy results. I pointed out that a hernia and ulcer were found along with GERD or reflux. She filed a NOD and filed another claim for the hernia and ulcer at the same time. She said she couldn't believe the response of the denial letter. Said my nod needed to be looked at along with my new claim by an DRO. She said it would be faster to get it all looked at at one time. So I have been waiting, until I got a letter stating my appeal was going to Washington. I called the VA and asked about the DRO thing, they told me they never got a response to some form??So that is where I am at now. Oh, I did call the State DAV and was brushed off about it. "Your appeal had to be certified by us, and then we sent it to Washington, it will take 1 to 2 years before you get a descision". So, thank you to your responses, it looks like I will be back in 1 to 2 years to let you know what happened.

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