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Statement from my PCP overturned by C&P Doc?

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silverdollar22

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Had my C&P and found out today that I was denied even though my primary care doctor said that it “was more likely than not “ attributed to my auto accident while I was in the Army. My SMR states from the emergency room that my entire left side had a contusion from the accident. The C&P doctor apparently disregarded both pieces of evidence in her decision. The man I spoke to said he thought that my best bet would be to appeal the decision through the new appeal program. He said that 60% of the appeals were positive. Do I have to wait for the decision letter before I file an appeal? 

                 Thanks,

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  • HadIt.com Elder

Yes you need to wait for a decision to Send in your NOD  and they should send you the correct NOD Form and let you know your options.

Make sure the C&P Examiner wa qualified?

if  you still have the records your PCP Wrote up keep them if you never sent them in for evidence?

you also can get an IMO from a specialist to opien for you,  take the medical records your PCP opinion  and let him read them and ask him/her to give his/her professional opinion they it is likely as not your disability was attributed to or related to your military accident.

with those two medical records and if you use a medical specialist  they will normally over turn the C&P Examiners opinion.

can you put a redacted copy on here when you get your decision IF your denied about the reasons and bases of their decision  or ''What We Decided''  cover all personal information claim # ss # name  ect,,ect,,

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How do I find out if the C&P doctor was qualified? Yes I will post the information when I get it. He said 3 to 5 days. Buck, is the answer yes or no on my question about “can the C&P doctor overturn my primary care doctors opinion?”

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  • HadIt.com Elder

YES if there qualified!

this is the reason for a C&P  The VA uses their opinion in the report of the exam. However  they can be rebuttal against with another Dr.

To know what the examiners qualifications are  look up his/her name and check their Credentials.

I mean you don't want a foot Dr to give his Opinion if you were claiming heart conditions.

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WOW okay! I guess I’ll have to wait for the decision letter. Thanks Buck

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Haven’t gotten my decision letter yet but I saw why I was denied. Almost everything she said was not true including that she didn’t use a gynometer for my ROM. She also said by pure speculation that it appeared that someone changed the emergency room report. I stated that I had to pick up my leg to put my pants on and that I could not sit cross legged and she put I could do that. Bogus 👎

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  • HadIt.com Elder

 Unfortunately the bogus C&Ps

are what causes delays and veterans has to appeal when his decision is denied.

Just wait for your decision, if denied send in your NOD as soon as you can after you get your decision, mail it off the same day (get sign return receipt) or use e benefits. Request the DRO Hearing at this time.

  The R.O.  DRO will send you a letter letting you know your request has been recieved and a DRO Hearing will be at this date/time. (Don't Miss it)

 At your R.O. you sit with a Decision Review Officer and tell him what happen at your Bogus C&P. and present any evidence you have favorable.  he has the authority to overturn the R.O. decision.

he will probably send you to another C&P with a different Doc  or ask you if your willing to take another C&P with a different Examiner?... if you have favorable evidence at this time   the decision will be fairly easy for the DRO.

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