Something Odd With Claim - Missing Records?

[cd928]

Hey all.  My claim seems to be going oddly and I was hoping to get some advice. 

I put together a fully developed claim for my conditions.  I had tons of medical records, nexus letters, DBQs, buddy statements,  and more.  I decided to file the claim on the eBenefits website.   When I went to upload the evidence, I uploaded my entire claim as a single PDF file (about 70 pages).  When you upload evidence, they make you choose a category.  I choose "correspondence" as the most general category for this file.  In retrospect, I think this may have really screwed things up (more on this later).  

So two days (!!) after I submit the claim, I got a call from the VA medical center to schedule my C&P exams. I was disappointed because I hoped they would decide without needing the exams.   In the back of my mind though,  I'm thinking, how in the world could they have already reviewed all those records in that time and decided that I need exams.  

I went to the C&P exams and it was immediately apparent that the examiners did not have access to the records that I submitted.  Fortunately, I brought all the records with me and tried to show the examiners as many as possible.  

At this point, I'm really concerned that the VA is not using the documents I uploaded in consideration of my claim.  I went on the website and verified that I can actually see the file I uploaded.  I found the document to be there and I can download it fine.   I called the 1-800 number and asked about the document.  After some looking around, the guy said "well I can see the document, but I don't know if the rater will use it".   Not very encouraging.   

It's now just two days after my C&P exams, and eBenefits says my claim is preparing for decision with an estimated completion date of this week!  If that's true, that means the claim would have been decided in less than 3 weeks.   I'm really thinking that the rater somehow can't see or missed my records and thinks I submitted a FDC with no evidence.  Probably really quick to process those...as an automatic denial.    

Not sure what I should do here.  Maybe Fax them the records?  Any suggestions are welcome and appreciated.

 

Thank you! 

[Henrici]

I think the problem with electronic records [evidence] the rater can scroll through it quickly without reading it. For what it's worth; my lawyer has always told to to submit evidence "old school" mail them with return receipt. When I went to the last C&P the examiner had the med records I sent it. And he use them to grant my claim. Also, I sent my lawer a ton of evidence for my claims and she always distilled it down to the bare essentials that went right to the point. I hate to say it but the raters are too busy or too lazy to go through a long list of papers. Just my opinion. 

If they deny maybe a CUE is in order siting your evidence was not considered or the C&P examiner did not have the complete C-file available. But don't lose hope my last claim went very fast with favorable decision and I was thinking the same thing, every thing is moving fast on this one. A big factor was I pulled an examiner with empathy for veterans, there are not many but they are out there. Good luck!

 

[Carl the Engineer]

cd928,

Almost all initial claims will require a C&P exam.  Sometimes, after the initial exam, you my have a paper C&P where your attendance is not required or expected, but that is rare.  That is where the rater is asking the examiner to opine on something and the examiner can do it without seeing you personally.

Also, the C&P examiner can be just about anyone in the medical field and as is said here often, he could be the janitor.  Basically, some look at your records and some don't.  And that is because they are answering questions on a form.  Like measuring Range of Motion.  Your private doctor could say your ROM of your shoulder is 60, but the examiner is going to measure it anyway.  The rater is going to decide which to use.  If the C&P examiner says 60, well then you have to fight for the 30, etc.  So, yes, the C&P examiner may not use your records.

Not to be critical, and I hope you appreciate this, but the VA has a habit of denying.  And almost all initial claims that get service connected are low-balled.

The VA comp is not VA healthcare.  Two seperate missions.

Hence the fight,

Hamslice

2009-30%, 2011-40%, 2014-60%, 2015-70%, 2016-80% and hopefully 2018-90%

 

[MikeHunt]

13 hours ago, Henrici said:

I sent my lawer a ton of evidence for my claims and she always distilled it down to the bare essentials that went right to the point. I hate to say it but the raters are too busy or too lazy to go through a long list of papers.

Excellent advice.

The documents are there, don't worry. Examiner just didn't read them.

A VSR schedules exams- Not the rater. They're under so much pressure (again, think of Henri's advice) that if they find ANY evidence they just schedule an exam, and stop reading.

The VA process is actually that quick- What holds it up is 'development,' where the VSR has to get records from various sources before scheduling an exam. If you write you were treated at a VAMC in 1978 on line 14 of 526EZ, you're in for a long wait. Again, think of Henri's post.

[cd928]

Thanks to all of you for the good advice.  I'll just wait and see what they do.