C-File, does RO's claims specialist opinion / interpretation of evidence, appear in C-File?

[MKAH]

Just wondering, does the RO's claims specialist opinion / interpretation of evidence, appear in C-File?

Thank You

[ValpoVet]

On 10/2/2017 at 8:58 AM, Berta said:

The VARO might be missing the  word "or" in the rating schedule.

I think it is disgraceful that these farmed out exams become the 'property' of the VA until a decision is made., unlike C & Ps done at a VAMC.

It takes away the right of any veteran to be able to prepare a timely rebuttal to a faulty exam.

I wish more vets would complaint to the Secretary about this.

I think all you can do is wait for the decision, at this point, and if it is legally erroneous, there is potential that you could ask them to call CUE on themselves....... As it might end up being a violation of 38 CFR 4.6, explained in the link....

https://community.hadit.com/topic/60717-the-power-of-38-cfr-46/#gsc.tab=0

The CUE I mentioned there I had filed, and was pending, was awarded not long after I posted this older reply.

It was regarding a HBP claim under 1151, and the VARO failed to consider my sole piece of evidence- which came  from VA Central Office, their head cardiologist, who is also an expert in HBP. I raised hell and they awarded.

There is more to this tactic if you search for GCY VA, (Go CUE Yourself VA ) which has worked for me and a few others here.

------I just realised this might have been a VAMC C & P exam????

therefore it should not take too long to get........maybe....

I have mentioned this MANY times here----

Do not use FOIA for  medical records that belong to you.....lawyers might use it in your behalf but they are not the claimant nor the person the medical records involve.

5 USC 552 covers the Privacy Act, as well as FOIA.

I have used both but never FOIA for anything to do with my husband's medical records.

FOIA takes longer than a simple request, and you can cite the Privacy Act, but FOIA is different.

Berta, 

This is such an important post!!  

I called the eBenefit's phone line this morning and they said my hubby's "decision letter" was mailed out on Friday.  

While I don't have the REASON as of yet, how they came to this determination I 'believe' this is CUE.  I have given many documents, personal private CARDIOLOGIST notes of hubby's IHD and "ALL HIS SYMPTOMS", (Angina, unstable angina, difficulty in breathing).  AND his "MET's" 1-3.  

I am 'ASSUMING' they rated him on his ejection fraction at 55%.  

From what I am learning, the "MET's" alone is the reason for 100%.  

WTF??  My hubby is darn near incapacitated.  I gave them the shipS he was on in Vietnam, and a PICTURE of the hospital ship he was on, to which he was involved with our injured serviceman from land.  

10% rating is REDICULOUS!  

Edited October 3, 2017 by ValpoVet
Wanted to attach the images to prove my statement

[pwrslm]

Hi Valpo Vet,

What is needed to make plans is in the decision letter. It gives the reason and basis for the decision. Until you have that, it is hard to guess why they did it. If it is CUE, you have a year to appeal or request reconsideration and correction. Direct appeal will take a long time, for you to ask them to CUE themselves might take 2-4 months. The delay would slow down a formal appeal, but if it works it may prevent the necessity to appeal altogether. Hold on till you get the decision letter before you make any decisions. Its the hurry up and wait in classic GI culture.

The only thing we know for sure at this time is that they conceded service connection, which is a big step. Next steps is dispute award percentage.

[ValpoVet]

Thank you PWRSLM!!  

Yup!!  Hurry up and wait!  After "ALL THOSE DOCUMENTS" .....UUUUGGGG!!  Thank you for your encouragement!!  My husband is sitting at my side while I do these correspondences.  He thanks you ALL for your service to our country and 'certainly' for helping so many vets with their anxieties.  

I will keep you posted as to what the decision letter reads.

Blessings.  

[john999]

VA's reasoning on rating percentages can be weird.   With AO disabilities a disability that is conceded can often lead to secondary claims that can be higher percentage than the original claim.  Has your hubby ever been DX'ed with impaired glucose otherwise known as pre-diabetes?   A DX of AO related DMII opens the door for a host of secondary conditions.  The difference between a DMII DX and no DMII DX is just a few points on a fasting glucose level test.  Fasting glucose of 123 no DMII diagnosis.  Glucose of 125 you have DMII. 

[ValpoVet]

Hi, John999,

Hubby just had a stent implanted femoral artery, DX=PAD.  I reviewed his blood worksheet and it stated on their 'pre-diabetes'.  I asked his cardiologist to run a full blood work up but he said that is VERY EXPENSIVE and insurance won't pay for it. 

I am in agreement with you about the secondary effects of AO.  On the cardiology private medical records, it even states his COPD.   

Again, I DO NOT HAVE THE DECISION PAPERWORK as of yet, but my contention is based entirely on his MET's.  

That is what the DAV representative told us at the RO in Chicago.  *see attached*  Hubby suffers greatly with all the symptoms of MET's 1-3.  The SO told us to notice the "OR" in the descriptions, meaning NOT "AND".  A disabled vet needs to have ONE but not ALL. 

Back to your suggestion regarding diabetes.  I WANT HIM TESTED as that is the NUMBER ONE question he/or me are asked when speaking to other vets.  I just don't know how to go about getting him tested!!!  

 

 

The representative gave us this paper: 

[Berta]

You mentioned stents-was VA aware of that????

It is likely that stents would resolve a Ejection Fraction to a higher %.

 

"Hubby just had a stent implanted femoral artery, DX=PAD."

Yow ! this is new evidence that VA should have been aware of , since they had all private records!

DX= PAD to me ( not a doctor but VA practically turned me into one)

means  diagnosis-Peripheral Arterial Disease. That can definitely be due to DMII....or to his CAD.

" reviewed his blood worksheet and it stated on their 'pre-diabetes'.  I asked his cardiologist to run a full blood work up but he said that is VERY EXPENSIVE and insurance won't pay for it. "

The VA could give him a simple HB1AC test to rule in out diabetes.

That is part of how they misdiagnosed my husband's  AO diabetes.It contributed to his death.

He also might have PN Peripheral Neuropathy.

Tests : here in NY maybe elsewhere every year I get a Medical advertisement ( I think it is from Lifeline) and they do 5 tests for about 150 bucks, one of which is for diabetes and I assume ( not sure) it involves the HB1AC test.

I would gladly get these tests but I have already had them all.. it is just that this is a Great bargain for anyone who might not have ample medical care or who does not often see a doctor for anything.

PN and PAD are two separate disabilities.

Gee,just checked and  Lifeline has a web site:

http://www.lifelinescreening.com/What-We-Do/What-We-Screen-For/Type-2-Diabetes

But it looks like all they do is the regular glucose blood test-but I could be wrong on that and they have area for your zip code if you want to contact them for Appointment or questions.

 

Edited October 4, 2017 by Berta