Chuck75

The survey form is defective, in that you cannot use the same vertical column for more than one answer.

As I understand it, SSA requests what they need, and you gave them permission to do so with the form(s) you signed. (As well as the likely location(s) of the records. In theory, the VA regional office (VARO) should have a copy, and the VAMC may have a copy with most current medical records. SSA will go by what they get from the VA, unless there is some reason to do otherwise.

I would have to say that the exit physical I had in 1968 was a joke. I had a partially healed incision on my abdomen from surgery about six weeks before. They discharged me from the hospital and the Navy expected me to be able to haul a sea-bag weighing over lbs around. (I just barely managed, and naturally, it caused the incision to drain.) Anyway, it was the usual choice of saying I was basically OK, or spending an indefinite amount of time in a Navy hospital located at Treasure Island Navy Base. Since the base had several "schools", the hospital was about as "ch-- sh--" as the schools. I ended up going over to the "duty driver" section of the motor pool, volunteered, and spent most of the time waiting for seperation goofing off at the motor pool.

There are back institutes in Florida that do micro surgery for disks, etc. that may be able to help you, even with serious heart problems. http://www.microspine.com/AboutUs_java.htm Is one of several in Florida. I do not recommend any particuliar one, or not recommend one.

I'd use the SSA rep, unless you have a problem with the rep. Establishing a friendly and courteous working relationship is a must if you are to be successful. After requesting my SSA records in writing, the rep dumped them to CD for me, and called me when they were available. This included the reps remarks about me at the initial (Key) interview. These remarks can be of immense help or literally kill your chances of a successful outcome. There were key phrases and statements involved. One in particular comes to mind that I cannot repeat publicly. It can be taken to mean "one of our own". (Even though I was not a GS or WG direct government employee.) The rep told me to make the request. The day I did so by delivering the letter in person, the duty rep (different person) gave me some flack, and obviously did not want to accept it. Finally, I told the duty rep that what she did or didn't do with it was her decision, and please date stamp my copy as well as the original, and then give it to the rep handling my case. After politely listening to the duty rep hemming and hawing around, I left with the date stamped copy, and called the rep handling the case in a few days to make sure that the letter had made it into the records. Obtaining the records is the first step you must make if you intend to disagree and appeal any part of an SSA decision, just as it should be with the VA process.

This in itself is interesting, because the second Dr. did not participate in the C&P or examine you. So what we seem to have is two Dr's seeing the same C&P test results differently. You can argue that the second Dr never examined you, and the first did. A good IMO can also look at the C&P results, and if necessary and possible, refute the unfavorable statements. Opinions are not physical fact, they are opinions from "qualified" medical personnel. The VA's idea of "qualified personnel" is sometimes wanting.

"privacy act issues"? Who is he kidding? If you submit the correct forms, including the FOIA form or letter, and the VA does not provide the requested information, or leaves out part of your records, you can start a complaint process that Berta can tell you about. Remember it's all a paper war.

When I applied for SSA disability, I (as you did) included pertinent VA and private medical records, as well as the filled out privacy act requests authorizing SSA to get medical records. I did identify the VARO that actually has a copy of my records, as well as the VAMC and veterans clinic under the VAMC. Actually, the SSA decision in my case was based solely on my private medical records. I did include a statement that "to the best of my knowledge" which was gained by a review if all the medical records-- that the VA records were less accurate and consistent than the private records, and that the VA records had data that was obviously "gun decked". One area that was obviously falsified was referrals to VA specialists. Only two referrals were ever made, one of which was a "video consultation". The VA neglected to tell me beforehand that this was to be the case. If I had known, I would have gone to a private specialist instead. A hundred and twenty two mile round trip for a "video conference" is not worth the time, effort, and expense.

I would say so, and also get an independent medical opinion (or two) by a Dr. that is qualified in the specialty that deals with the medical problem(s) you are seeking compensation for. My personal opinion is that both C&Ps should be in your records. And the fact that one is favorable and one not can be dealt with. Since they negate each other, a very favorable IMO should stand on it's own, and tend to validate the favorable C&P. On the other hand, do not be too surprised if the favorable C&P somehow disappears from your records. There is always the question to make the VA answer- Why did they order a second C&P if the first was favorable? If done properly, it's possible to nullify the unfavorable results. Also, if the unfavorable C&P results in improper medical treatment by the VA, an opening may exist for malpractice.

You will need the attached form as a start. It may be better to -- Hand carry it to the VA-- Or, file it via Dr. Bash to the VA. The problem is to get a response as soon as possible from the VA. Remember Dr. Bash needs both the medical records and to mollify the VA, your service records. A second from may also be needed, having to do with the freedom of information act. The major reason for this form (It really can be a letter with the appropriate words.) is to put the VA on notice that it is receiving a request covered under the FOIA law, and there are possible repercussions if it does not comply with the time limits set by the law. (Mainly, you complain, and they get a black mark.) The time limit is something like twenty working days. 3288.pdf

Now tell me how the VA can justify selling drugs for $8.00 copay. Wal Mar says that they make a profit on the $4.00 drugs, and that they are not loss leaders. Congress authorized "Co-Pay" not that the Veteran had to pay the full cost or more for a drug. Co-pay implies that the veteran is paying for part of the cost of the drug. Wal Mart just announced new additions to it's $4.00 drug list-- Looking at the list-- Loratadine 10 mg Metformin Multiple common antibiotics Lovastatin Pravastatin Carvedilol Ranitidine Isosorbide Mono Lisinopril Nitroglycerin Note Not available in the following states CA,CO,HI,MN,PA,TN,WI,WY,ND Some states have price controls making the drugs HIGHER. Link to complete list http://www.walmartfacts.com/Media/128353621649843750.pdf

Why did the ultrasound pinch and hurt? This is not too common. I've had the proceedure done several times, but not by the VA. The only reason I can think of is that the ultrasound head had very poor sensitivity, and higher than normal pressure was needed to overcome the lack of sensitivity. (Marginal or defective medical equipment?)(Poorly skilled operator?)

Why else would the VA ask for "clarification"? If the evidence is in at least "equipoise" As the VA seems to believe, it would be resolved in the veterans favor, unless the VA can come up with something to counter existing records, even if the records were generated by the VA. "Would clarification of a favorable C&P exam be to the point where it would be unfavorable after the clarification?"

I have been charged $24 for one bottle containing a prepackaged 90 day supply. Even worse, this can exceed the retail cost of the drug. (Esp. at Wal-Mart pricing) Since it is a three month supply, my insurance company does not pay the VA for several reasons. 1. More than 30 day supply. (Insurance company pays for only a 30 day supply) 2. Amount billed by the VA exceeds the retail cost of the drug after insurance copay is applied. (The insurance company has a cost table that it goes by.) The insurance company does not care about VA co pay paid by the patient, except to reduce the amount it might pay the VA. By the way the medical insurance is the same plan used by the state gov. and public school systems. I receive an itemized statement showing what was paid to drug stores etc. ,but not to the VA. Never could get the same answer twice in a row as to why this occurs.

Do you have anyone (family, doctor,nurse,lawyer, social worker, SSA clerk,etc) that can assist you in filling out the necessary forms?

Maybe, using the I got better, then I got worse logic. Maybe not, using the logic that you were able to work with the condition. Flip a coin.

I guess this means that I am now a bona-fide combat veteran. The VA already has my claim(revised) & NOD (on original decision) in process. Since PTSD is not part of the current claim, although a back injury is,do I need to give/send the VA a copy of the three page document? Do I need to obtain a certified DD215? Since the citations were under "combat conditions", do I need to obtain copies of the actual citations? (have only one so far) (Extract) From: Navy Personell Command Retired Records Section Pers 312D2 9700 Page Bvd. St Louis Mo 63132-5000 Correction to DD Form 214 (on Form DD215) Add: Combat Action Ribbon Navy Unit Commendation Meritorious Unit Commendation Vietnam Service Medal (w/2 Bronze Stars) Republic of Vietnam Meritorious Unit Citation (Gallantry Cross Medal w/Palm)

This one is of great interest to me, since I am one of the veterans that is "requied" to split multiple pills. In addition, many of my pills are supplied in various numbers, with a maximum of three months in one bottle, and a minimum of one month. When I started getting meds from the VA the "co-pay" was $2.50, reasonable since our private insurance had a co-pay of $5.00. At the same time the VA went to $8.00 the private insurance went to $15.00

Success, at least partial! Got a call today from the local SSA office. I had "appealed" the effective date that they had originally assigned. I made it clear in the letter of appeal that I was appealing only the effective date. The call was from the SSA person that has been handling the claim since I originally filed it. The end result-- Retro pay is due. The effect date of disability is changed back one year or so. They sort of met me half way, in that I contend that the disability began at the end of my last employment, and they set a date that starts ~ six months after that, and then added the usual 6 months. I can't argue this with a 100% chance of success, since medical information (tests, etc.) always follow the actual condition. It seems that SSA likes to use dates of tests as to when a medical condition is present, and disregards the period where symptoms are present, and the cause is eventually confirmed by later tests. In any event this ups the monthly payment by $35, and adds one year of retro or so. Both times, the claim went thru the "Q&A" process. The fact that I had reached 62 when I originally filed helped rather than hurt, in that SSA was going to have to pay me anyway, regardless of the exact amount.

The problem with CUE is that you have to have someone helping you that really really understands the system and the approprite law & regs. After reading some of the unfavorable decisions concerning CUE, I would have to say that many VSO's don't have enough knowledge of the CUE process and requirements to assist in a CUE claim.

Did the VA explain in writing why they picked the May 07 date? Or is this the date of some event, such as an exam or IMO? If you filed a NOD within the time limits for the original claim, thier answer (when they get around to it) will be interesting.

That is very fast, considering the past times of several months. I'm curious, and would ask if you are a recent veteran of the wars in the Mideast, Afghanistan, or a Vietnam Veteran.

The crux of the matter is that the IMO can be considered "New" evidence, allowing you to take advantage of the law. (If it comes to that) If the VA awards a lower % than you believe is proper, it can be used. If you believe the evidence you have already submitted is sufficient, I'd be inclined to let it ride until you get something back from the VA that helps you decide to submit or not. On the other hand, there is language in the regs that is to the effect that you should submit all the evidence you have prior to a decision. Also, submitting additional evidence "may" delay a decision.

Yes, depending-- A.O. exposure Diabetes II + History of High blood sugar. Heart & vascular problems. If diabetes preceded other medical issues. There is something called the "metabolic syndrome" It will likely take an Endocrinologist's IMO to get anywhere.

So did I (89% rounded up to 90%) 70% (30% remaining) 70% 40% 40%x30% 12% 40% 40%x18% 7% 89% rounded to 90%