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Showing content with the highest reputation on 02/04/2019 in all areas

  1. 1 point
    You can immediately ask for a different doctor to do the exam. When I say 'flawed', I mean the examiner did not have the expertise to opine on your claim, or the doctor did not have any of your medical records, to include SMRs in many cases, or the doctor failed to consider any other probative evidence that you moght have brought with you to the C & P yet the doctor didn't want to see it--- or the examiner LIED. There are probably many more reasons why an exam can be flawed. This AM I received a call from OAWP-VA-DC, as to the ongoing investigation they are doing based on my other complaint . I have more evidence to send to them-we went over some of the evidence they already have- it is solid to support my complaint-It is a different issue than this post is about- But then I mentioned to the Triage manager the C & P situations I see so many of you here are dealing with. I told him of 2 of my C & P exams (posthumously done on my husband) and am waiting until Jan 15, 2019 for a copy of one of them-to adequately prepare a OAWB complaint. on that matter, which affects so many veterans....and I am sure I am not the only survivor of a vet who has had this problem consistently with the RO I deal with. He was shocked at what one SOC C & P examiner had stated..... I told him this was only one of many C & Ps they did- all wrong, to deny my claims. (all awarded since-yet not the point)) Would anyone here be willing to follow up my next complaint on the C& P problems many here have? If it took a costly IMO/IME to get a full reading of your evidence, and then attain an award, tell them that. If your are in financial diffculties and cannot possibly afford an IMO/IME, tell them that. If they lied about your condition , tell the OAWB that- and give evidence to show that they lied. Be prepared to attach the C & P exam to the email you send to them, and attach any other evidence you feel they might need. I told the OAWB Triage manager I have seen many C & Ps over the years that are highly erroneous and deny many valid claims . Claims that will add to the backlog and if they are valid they should never even be in the appeals process at all. If you prepare a complaint, specific only to the C & P problem, you can refer OAWB to my complaint ( Berta Simmons, NY ) that will be at OAWB on the 16th of this month.I am waiting until the 15th to see if VA will send me a C & P exam I requested.Whether I get it or not the complaint will still be filed on the 16th. I do not really have a dog in this fight because so far I won any claim VA gave a lousy C & P on.I only needed the IMOs I have for one claim. Something needs to be done about this situation.That wont happen with one complaint from a dead veteran's widow. The only evidence I have is my own personal letters and C & P exams from the VA, And the info from NVLSP and GAO-which covers all veterans but is general, and not specific to what many of you really go through with C & P exams, that are geared to what the VAROs want- and that is - to deny the claim.
  2. 1 point
    Although there have been some successful claims awarded be the BVA- the sqaumous cell carinoma is not an AO presumptive. I have found two of those awards and we had one here about 8-9 years ago. Before I post them here, can you scan and attach to this thread a copy of the denial letter from the VA. We need to see their medical rationale for the denial. Cover your C file #, name, address prior to scanning it.
  3. 1 point
    That is great, when there are two conflicting medical opinions they are supposed to resolve reasonable doubt in the favor of the veteran. The RO might not do this but BVA usually does, not that you want to have to go that far.
  4. 1 point
    Vetquest, Thank you for the help. I do plan to do as you have written. Stressing out now about the exam, what will I say and so on. I at least have that day and the next requested off in case I need it. Thank you again.
  5. 1 point
    It is your right to request your wife accompany you to the exam. My VA neurologist did not allow my wife to attend but a sympathetic doctor will allow this. Remember when you are in the exam tell the truth but when the doctors asks about your symptoms describe your worst day, not a day when everything is going as supposed to. They will probably being up some sensitive things but remember that the exam is a chance for you to show how PTSD affects your life. Good Luck.
  6. 1 point
    I cannot stress how important it is to have a doctor state it is more than likely than not that your RA is related to your ankle injury that occurred in service. If he is out for your best interests he should add this to your DBQ or IMO. Your C&P examiner eluded to this but did not come out and say it but if your doctor is willing to say this it brings up reasonable doubt and that is supposed to be done in the veteran's best interest. Please speak to your doctor and see if he is willing to add this.
  7. 1 point
  8. 1 point
    VA was dinged by the IG for unnecessary C&P exams over the last year. I would make sure that your VA PCP thoroughly documents your migraines. Review the DBQ associated with migraines and get the PCP to enter as much into the record as you can that the DBQ asks for. Once it is done, get a copy of your blue-button report from the EVet sight 3 or 4 days after your appointment when it updates. In the BB report, highlight the documentation, and bookmark it in PDF format. Write a short note to "whom it may concern" about the documentation you are providing, and drag it in PDF format into the beginning of the BB report before you upload it. Upload it as VA/Govt medical records. This is acceptable clinical evidence. The rating official can send this information to a medical professional for an opinion if its necessary. They might still send you to the C&P, but because of the evidence submitted in the BB report, you are way ahead of the game. Note that over 55, both USC and CFR, as well as the VBA''s M21 training manual forbid them from conducting C&P re-examinations without specifically noted causes. I was scheduled for 3 C&P exams in 2.5 years, and the last one I raised cane and they cancelled the entire exam, and completely deleted it from the record.
  9. 1 point
    It looks to me like an inadequate C&P exam. The examiner clearly and unmistakably fails to use the legal terminology to substantiate your claim. I don't see the minimum threshold of "at least as likely as not" the veteran's condition is due to or the result of military service/SC condition. The rationale is insufficient. This will most likely delay the process and will get sent back to the examiner for clarification. It's not a granted or denied claim. That's the good news. If it does get denied. You'll need to appeal immeadiately on the basis that the examiner failed to provide the legal terminology to substantiate your claim.
  10. 1 point
    3.8. Claim Backlogs and Delays This is the ultimate truth, the VA just doesn't care about Veterans, and you have to choose your battle plans correctly to prevail against the systematic abuse of us Veterans... It is no secret that VA continues to be plagued by a large backlog of claims. Despite repeated promises and commitments for improvement, VA's backlog has actually grown significantly over the last few years. For example, by VA's own accounting, the Secretary's stated goal of 125 days to reach an initial decision has gone from being met in approximately 2 out of 3 claims to only 1 in 3 claims. Worse yet, the average time for a decision by the Board of Veterans' Appeals is approaching 3 years and the time for a decision to return from an appeal to the Court can be 7 or 8 years. There is no such thing as a "financial hardship" or "hardship" claim or any other shortcut around the backlog for initial or reopened claims. Despite widespread misinformation, there is little, if anything, that a veteran can do to "speed up" his or her initial or reopened claim at the regional office level. This does not mean that some raters will not take such circumstances into consideration if they know the claimant's situation. But because severe financial circumstances, a terminal illness, or other hardships do not qualify a claimant for any special treatment, a claimant cannot demand such treatment. The only exception is for the claims of veterans that are or on the verge of becoming homeless. In such cases, the Secretary has directed expedited treatment of claims. Even this action is not a legal requirement, only a VA internal priority. The Board does allow "advancement on the docket" of appeals from claimants that are "seriously ill" or "under severe financial hardship." The Board will also consider motions from veterans over 75 years of age. Whatever the reason, veterans seeking to advance on the Board's docket need to be very specific about why they should be able to do so and submit supporting evidence (such as a doctor's statement or foreclosure notice) because many veterans are ill or are in financial difficulty and everyone cannot be given priority by the Board. Other than filing a motion for advancement with the Board, attempting to "put pressure" on a VA office, the Board, or the Court is not only a waste of time, it can result in additional delay because the C-file may be removed from the line waiting for decision so that VA can respond to such attempts. This includes Congressional "inquiries," which are often just exchanges of form letters. There is slightly better news for claims remanded from the Board and the Court. VA is required by law to provide "expeditious treatment" of remanded claims. The Court has made clear that remands must receive higher priority development than other claims. How long VA can take to resolve a remanded claim under the "expeditious treatment" rule is not clear, but claimants can at least point to this requirement in dealing with delays in remanded claims and, if necessary, seek a Court order for VA to make a decision. In all cases, the best thing a claimant can do is to quickly respond to each VA request with clear and to the point responses do not give VA any reason to delay making a determination. The Secretary has a statutory obligation to expeditiously process remands from this Court. Thus, not only must the Secretary ensure that he completes the Court-ordered task, he must do so in an expeditious manner. 38 U.S.C. §§ 5109B, 7112. Excessive delays in the processing of remands ordered by the Court cannot help but sap public confidence and impugn the Court's dignity, as from the outside it invariably appears that VA is ignoring the valid mandates of an institution that has express authority over it in matters related to veterans benefits. See Erspamer v. Derwinski, 1 Vet. App. 3 (1990) (discussing delay in administrative action and public confidence). Furthermore, the Secretary's obligation to process Court remands expeditiously is integral to this Court's jurisdictional authority to remedy unreasonable delays in the processing of veterans' claims. See Vietnam Veterans of America v. Shinseki, 599 F.3d 654, 659660 (D.C. Cir. 2010) (suggesting that the U.S. Court of Appeals for Veterans Claims may have exclusive jurisdiction over claims concerning unreasonable delays in processing); see also Ribaudo v. Nicholson, 20 Vet. App. 552, 557 (2007) ("With respect to matters relating to veterans-benefits claims, however, Congress adopted a very different approach to judicial review. A decision of the Board can only be appealed to a single venuethis Court." (citing 38 U.S.C. § 7252(a))). Therefore, failure by the Secretary to comply with his obligation to process Court remands expeditiously, is the same as noncompliance with the remand order itself, even if the Secretary eventually complies with the substance of the order. Harvey v. Shinseki, 24 Vet. App. 284, 288 (2011). "While there is no absolute definition of what is reasonable time, we know that it may encompass 'months, occasionally a year or two, but not several years or a decade.'" Community Nutrition Institute v. Young, 773 F.2d 1356, 1361 (D.C. Cir. 1985) (quoting MCI Communications Corp. v. FCC, 627 F.2d 322, 340 (D.C. Cir. 1980). Erspamer v. Derwinski, 1 Vet. App. 3, 10 (1990). When delay is alleged as the basis for a petition for writ of mandamus, a clear and indisputable right to the writ does not exist unless the petitioner demonstrates that the alleged delay is so extraordinary, given the demand on and resources of the Secretary, that it is equivalent to an arbitrary refusal to act. Compare Costanza v. West, 12 Vet. App. 133, 134 (1999) (per curiam order) (addressing an 11month delay and finding the petitioner did not demonstrate that he lacked alternative means of relief when he did not undertake to resolve delay prior to filing the petition), with Erspamer v. Derwinski, 1 Vet. App. 3, 11 (1990) (addressing a three-year delay and finding petitioner had no adequate alternative means for relief when she contacted the regional office more than 30 times before filing her petition with the Court).
  11. 1 point
    Seattle is now a RAMP regional office and no longer does claims or appeals, Jamezam. Everything is put into the NWQ and can be adjudicated darn near anywhere. There are 10 RAMP ROs. Seattle, Waco, San Diego, Atlanta etc. I see a lot done in Houston and Winston Salem. It figures. Just about the time I get to know all the DROs in Seattle and then they change the rules. Oh well, now I get to know them all over the US and Puerto Rico. I see you used JohnPaul and his sidekick Cory. Good people.
  12. 1 point
    You ever notice when you approach a VA clerk they usually don't look up at you. You have to stand there until they finish talking to their girl or boy friend on the phone. I am not saying that private doctor's offices don't have rude clerks but the VA is in a world of their own. Don't be nasty to them because they will cause you more trouble than a doctor. I never get mean with the clerks because they can lose your paperwork.
  13. 1 point
    Always tell the truth at a C&P. If you lie they might not find out but you would be in a world of hurt if they do. Honesty is the best policy.
  14. 1 point
    Hey Jamezam, I am currently in the same boat as you! I have a partial grant with 2 remands from may of last year. During that time I have contacted the regional office-800-VSO-and the BVA with no luck. Within the last two week I have reached out to both of my congressman, the white house hotline and all the previous with the 10-02 Fast Letter. I will reply back with any update as to what works if it does (hoping the squeaking wheel gets greased)
  15. 1 point
    You can make an anonymous complaint by calling this number: OAWP Anonymous Toll-Free Disclosure Hotline: (855) 429-6669 But it is best to file an email complaint here: OAWP Email: vaaccountabilityteam@va.gov They do not use snail mail. I have sent them unredacted stuff I have received from the VA.
  16. 1 point
    Update: ebennies updated. My percentage increased and letters updated as well. Retro pay has not updated as of today.
  17. 1 point
    The Basser Man is RIGHT!!!! 1. The criteria for assignment of an earlier effective date of August 12, 1986, for the award of service connection for PTSD, are met. 38 U.S.C.A. §§ 5107, 5110 (West 2014); 38 C.F.R. §§ 3.151, 3.155, 3.156 3.400 (2016). 2. The motion for revision or reversal of the November 2004 rating decision on the basis of clear and unmistakable error is dismissed as moot. 38 U.S.C.A. § 5109A (West 2014); 38 C.F.R. § 3.105 (2016)." https://www.va.gov/vetapp17/files2/1713369.txt The vet has a bad conduct discharge originally which was changed to HD. The decision says: "This appeal was initially certified to the Board as a motion for revision of the November 2004 rating decision on the basis of CUE. For the reasons discussed in greater detail herein below, the appeal is actually a direct appeal for an earlier effective date for the award of service connection for PTSD. As such, the Board has recharacterized the issue on the title page." In other words, as the full decisions shows, the CUE became moot due to the appearance of the missing STRs....and the Earliest effective date (EED) was awarded. This Cue awarded back to 1993: https://www.va.gov/vetapp14/files4/1431325.txt In Part: (BTW -the vet's attorney was Ken Carpenter, one of the best there is-and one of the first vet attorneys I ever talked to years ago....as an advocate- not about my claim...maybe he would do a radio show with us sometime...) "ORDER The May 2002 RO decision was clearly and unmistakably erroneous because it failed to reconsider the Veteran's initial claim as required under 38 C.F.R. § 3.156(c)" and: "The Veteran contends that the RO committed CUE in its May 2002 rating decision by failing to award an effective date of October 15, 1993 for the grant of service connection for PTSD. For the reasons set forth below, the Board agrees." It doesn't get any better than that!!!!!!! We have plenty of info in our CUE forum and on 3.156(C) And there are many other similar awards here and at the BVA. Odd how many involved PTSD........
  18. 1 point
    I looked at your exam and quickly rated it. It looks like you should expect 40% overall. 10 for skin, 10 for right ankle, 10 for left ankle and 20 for thoracolumbar spine. Unless this is a pre-discharge claim, the knee condition will probably be denied because there was no mention of treatment in service. BTW, I'm a rating specialist at VA.
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