Rattler

I filed for a higher-level review on September 28, 2022. I ask the VA to QUE itself on an Earlier Effective Date August 2017 on my PTSD and unemployability (UI).  I was granted 70% PTSD and 100% UI as T & P on November 19, 2021. I ask for a personal phone call on the higher-level review.
The VA jumped on it and setup the phone call for October 7, 2022. The phone call seamed to go my way and the higher-level review officer said she would have a decision in about a week. So, I check VA.gov the end of the next week and it said they had made a decision on my higher-level review claim. As it still takes about a month for them to get the letters, I called 800 Betty to see if they could email me a copy of the letter.  In the process of that the 800 person says you probably need to check your bank account.  Now I know what that means in VA speak. It means that they have made a deposit in you bank account of a new upgrade ratting of they have deposited back pay in your account. So, I check VA.gov aging and the filling notice was there.
________________________________________________________________________
“Benefit payments and debts.
 Your total VA debt balance is $0.
We deposited $145,654.29 in your account ending in XXXX on October 13,
2022
Type: Compensation & Pension – Retroactive.”
____________________________________________________________________________
After picking myself up off the floor after having fallen out of it. (and it takes a min. after a total knee)
I checked the bank account same thing.
I want to thank Berta, brokensoldier244th, broncovet, Vync, pacmanx1, retiredat44, GBArmy, and others hear at Hadit.com for all the help and time they put in hear.
Now if we can get a good decision out of the Supreme Court in Arellano v. McDonough I’m going to make the pay me back to July 21, 1977 when I got discharged.
 

I had a similar thing happened to me this year. I had the VA community care do a total knee replacement on March 14, 2022. After a 4 day stay in the hospital, they decided to send me to a rehab facility for about two weeks.  I had transport lined up to take me from the hospital to the rehab facility via some retied veteran friends from church. (Go Navy) Well the powers at bay decided
I need to go via ambulance, so they made the arrangement for the ride.  So I get bounced around in an ambulance for 35 miles to this so called rehab facility.  (The rehab facility is another whole post.) I stayed about 1 ½ hours than checked my self out and had the wife take me home to do me rehab. (Another whole post about getting that done)
 
Anyway, so months later I start getting notices in the mail that the ambulance bill had not been paid. So, I call Community Care about why it wasn’t getting paid. I was first told that it was because the ambulance co. didn’t submit it right. So, I got instructions on how and where for them to submit it. So, it goes to United Health Care the ones who process the community care claims.  Well I get a notice in the mail from United Health Care saying that the claim was denied because it was a non-emergency. I aging call Community Care about the denial. They say well travel at the local VA hospital (Birmingham AL) should have paid for it, so I get transferred to them the person at travel says they are denning it because I did not stay at the rehab facility. I ask them what that had to do with them paying for an ambulance ride that they ordered? They said no not paying for it. After a week and a half of my life I will never get back I gave up and called the Whitehouse Hot line. They went to work on it, they told me to file for a higher-level review. Within the next week, I receive about 5 calls from different people in the local VA.  In the end they paid the bill.
I said the above to advise you not to take no for an answer no matter what you get told by the VA especially when you know that the VA is required to pay.

I will open up this can of worms....
 
VA policy: "Decision makers may not arbitrarily or capriciously refuse to assign weight to a claimant's evidence or develop with the purpose of obtaining
evidence to justify a denial of the claim" (M21-1 V ji.3.B.1.a). This prohibition was emphasized in a law review article published by the BV A: "additional evidence should not be procured for the sole purpose of
denying the veteran's claim" (1 Veterans L. Rev. 94 (2009)). Even CAVe has strongly affirmed this policy: "Because it would not be permissible for VA to undertake such additional development if a purpose was to
obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for its decision to pursue further development where such development reasonably could be construed as
obtaining additional evidence for that purpose" (Mariano v Principi, 17Vet. App. 312 (2003)).
 
 

My guess is (without seeing the C & P Exam) is he was trying to explain what shoulder and your  capacity of each. I have yet to hit them up on reopening  my right shoulder claim. It dates back to a claim in 1993. I went with my father in law to his C & P Exam on his shoulder and the NP never referred to his as function 1 or function 2. Have been before the Board of Veterans Appeals more than once if your claim goes that far I would say that the BVA would say that the C & P Doc did an inadequate exam by not giving a good narrative. (Again without seeing the C & P Exam) Best of luck.

I will open up this can of worms....
 
VA policy: "Decision makers may not arbitrarily or capriciously refuse to assign weight to a claimant's evidence or develop with the purpose of obtaining
evidence to justify a denial of the claim" (M21-1 V ji.3.B.1.a). This prohibition was emphasized in a law review article published by the BV A: "additional evidence should not be procured for the sole purpose of
denying the veteran's claim" (1 Veterans L. Rev. 94 (2009)). Even CAVe has strongly affirmed this policy: "Because it would not be permissible for VA to undertake such additional development if a purpose was to
obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for its decision to pursue further development where such development reasonably could be construed as
obtaining additional evidence for that purpose" (Mariano v Principi, 17Vet. App. 312 (2003)).
 
 

That was the best explanation of that ruling I have read.

The only way you can get your benefit's is to. 1. Apply.  2. talk to them about your problem. There is a lot of paranoid advice put out by the barracks layers and dumb VSO about the VA digging in your file to try and take away your benefit's. most of it is BS by someone who has no idea.  When a VSO starts talking BS I drop them like a hot potato. 

You need to ask the person at the state office if you signup to have them be your VSO if they will have print access to you file. If not they are not fully certified as a Veterans Advocate. In my state office there is only one person who has that kind of access to your file. The other two can look and file forms bur doesn't have the same level access or don't know how to use it. The print thing will have a lot of importance because you will want copies of some of the doc's you talked about above.

CUE you should use the "DBQ Election, Duty to Assist Waiver, &  C & P Decline Notice to VA Regional Office" in the attached VA Form 20-10208, "DOCUMENT EVIDENCE SUBMISSION"  that I posed in another forum and have attached below. 
To answer everyone's question YES you can waive the VA's duty to assist. (or there no assistance). If you use the Regulations in the form you can also refuse the C & P Exam and tell them to use the medical records in your C-file to make there decision. (assuming that you have evidence in your C-File)
____________________________________________________________________________________________________________________________________________________________________________
DBQ Election, Duty to Assist Waiver, and C&P Decline Notice for 526EZ and 0995 claims signed 02/10/2022.
- I ELECT TO USE PRIVATE DBQs IN LIEU OF REPORTING FOR C&P EXAMS.
-IWANEANYPARTOFVA's "DUTY TO ASSIST" (38 USC5103A(d)) RESULTING IN C&Ps.
- I DECLINE TO REPORT FOR ANY C&P EXAMS.
- I WAIVE TELEPHONE CONFIRMATION OF THIS ELECTION.
- I request compliance with M21-1 IV.i.2.C.i.d: "If the examination facility cancels a pending examination
request based on a Veteran's election to submit a privately prepared disability benefits questionnaire (DBQ)
in lieu of reporting for a clinical appointmen4 then follow guidance as it appears in [IV.i.2.C.i.e]."
-This DBQ election is not a "refusal" to attend C&Ps nor does it trigger the denial provisions of 38 CFR 3.655
and M21-1 IV.i.2.G which are based on "failing to report." M21-1 IV.i.2.C.1.d restricts VA:s definition of
"failure to report" to an actual "No Show" for a C&P appointment. I am not a "No Show" and I am not
"refusing to attend" or "failing to report." I am merely exercising my choice under VA policy to use private
DBQs instead of C&P exams to provide the medical information for my claim.
- Federal statute requires VA to weigh private DBQs equally with C&Ps (38 USC 5101 as amended by Pub. L.
116 315, title II, 2006(d), Jan. 5, 2021, 134 Stat. 4976). This equal status is now expressed most explicitly
by the policy regarding increased rating claims: "Do not routinely request an examination if a disability
benefits questionnaire, completed by a private or VA physician, was submitted" (M21-1 IV.i.1.B.1.g).
However, this same principle applies to all types of claims.
- I submitted DBQs that are adequate for rating my claim. M21-1 V.ii.i.A.3.j allows that "A statement
from any physician can be accepted for rating purposes without further examination if it is otherwise
sufficient for rating purposes" and has a proper diagnosis. This policy derives from 38 CFR 3.326 which
makes a similar declaration. Further, my DBQs meet the definition of "competent medical evidence" (38
CFR 3.159(a) (1)). If my DBQs are insufficient in any way, then VA must contact me or my private physician
for correction (38 Use 5101). It is improper to send a private DBQ to a C&P examiner for clarification when
they did not write it in the first place. Such action could only be construed as an effort to "develop to deny"
by VA.
- Congress has declared its support for Veterans using private medical evidence to support their VA claims
because it "properly protects veterans" (38 USC 5101). Consideration should be given to the DBQs I have
submitted with my claim. They are sufficient for rating purposes, and they make C&Ps unnecessary.
-VA cannot "develop to deny" a claim. Since I have already submitted a complete package of private
evidence, any further development with C&Ps would violate VA policy: "Decision makers may not arbitrarily
or capriciously refuse to assign weight to a claimant's evidence or develop with the purpose of obtaining
evidence to justify a denial of the claim" (M21-1 V ji.3.B.1.a). This prohibition was emphasized in a law
review article published by the BV A: "additional evidence should not be procured for the sole purpose of
denying the veteran's claim" (1 Veterans L. Rev. 94 (2009)). Even CAVC has strongly affirmed this policy:
"Because it would not be permissible for VA to undertake such additional development if a purpose was to
obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for
its decision to pursue further development where such development reasonably could be construed as
obtaining additional evidence for that purpose" (Mariano v Principi, 17Vet. App. 312 (2003)).
-VA cannot arbitrarily minimize or deny benefits. Rather, the official pol icy is to "award benefits where
supported under the facts and law or when the evidence is in relative equipoise or balance while denying
only when we must under the facts and law that require it" (M21-1 V.ii.1.A6.b). I request application of this
policy to my claim and the private medical evidence I have submitted. According to the facts and the law, my
claim can be decided without C&Ps. I request that VA simply proceed with a decision on my claim based on
the evidence already in its possession.
(See The continuation pages attached to the form for more supporting Reg's.)
 
 
 
DBQ Election, Duty to Assist Waiver, & C & P Decline Notice to VA Regional Office.pdf

Vic
I think the argument the VA Lawyer made is lame. Its an obvious attempt to put a stop to people using CUE claims to defeat a bad ruling. I don't think they can win but with this Suprema Court who knows.
"The government, by contrast, argues that when Congress enacted the “clear and unmistakable error” provision, it was codifying a longstanding VA practice, enshrined in VA regulations, of allowing final benefits decisions to be revised only when they reflect “a very specific and rare kind of error” that excludes “the otherwise correct application of a statute or regulation where, subsequent to the Board decision challenged, there has been a change in the interpretation of the statute or regulation.” The government also argues that under established Federal Circuit case law, a finding of clear and unmistakable error cannot be made when “the prior board decision represents a correct application of the statute or regulation as it was interpreted at the time of the decision.” In the government’s view, all that is needed to defeat a claim of clear and unmistakable error is a showing that the agency’s decision was consistent with the prevailing interpretation of the relevant statute or rule at the time the decision was made. 
The government also takes issue with George’s characterization of the legislative history and the case law regarding reopening of Social Security claims, citing different Court of Appeals cases that hold that a request to reopen a Social Security claim “is precluded” if the request is premised on “a change of legal interpretation … upon which the initial determination was based.” In addition, the government contends that George’s reading of the statute would give insufficient weight to the finality of judgments, a significant concern in administrative law.
Finally, the government argues that even if “clear and unmistakable” error review were available for mistaken legal interpretations, George’s case would not be entitled to relief. In order to demonstrate a clear and unmistakable error, a claimant must show that “the result would have been manifestly different but for the error”; the government argues that this means that George would have to show both that his medical condition worsened during the three months when he was serving in the military and that that worsening was caused by his military service rather than by “the natural progress of [his] condition.” The government argues that based on the evidence in the record, the question of whether the worsening of George’s medical condition was caused by his military service or merely the result of the natural progress of his preexisting schizophrenia is one about which reasonable minds may disagree."

The Supreme Court of the US heard oral augment in GEORGE v. McDONOUGH. The basics of this case the VA is trying to take the teeth out of CUE Errors and lesson there effect. Below in the link to the audio of the oral augments. I you are intreasted in VA CUE errors its worth a look. Its over on hour so its a little long. Note this case has not been decided by the court yet.
 
CUE Goes to SUPREME COURT OF THE UNITED STATES, GEORGE v. McDONOUGH
SUPREME COURT OF THE UNITED STATES, GEORGE v. McDONOUGH, SECRETARY OF VETERANS AFFAIRS - 21-234_bq7c.pdf

Wow It looks like in the new directive they have to do DBQ's if you request it. It would be interesting to push the local buttons to see what they say.
"(c) Completion of DBQs to Support VA Benefits Claims. A “no wrong door” philosophy must be adopted to accommodate Veterans bringing a VA DBQ form to a VA medical facility for completion.
1. Veterans may ask their primary care or specialty care provider to complete a DBQ for conditions which are already diagnosed and documented and for which the provider is treating the Veteran. DBQs can be completed by the treating provider during a routine office visit when there is sufficient time and the medical information is available. DBQs can also be completed outside of an office visit, or an appointment can be scheduled for completion. (See VHA Directive 2013-002, Documentation of Medical Evidence for Disability Evaluation Purposes, or subsequent policy issue, on the VHA Publications Web site).

2. If a VHA treating provider has questions regarding DBQs including which DBQs they can or should complete, they may seek further guidance from VBA. Additional guidance and information on completing DBQs can be found on VHA’s Office of Disability and Medical Assessment (DMA) website. Guidance specifically for primary care providers is located in DMA Fact Sheet 12-002, “DBQs and Primary Care Providers”. For a complete list of DBQs, see VA’s DBQ Switchboard Intranet page (NOTE: These are internal VA Web sites that are not available to the public) or at VA’s external, publicly accessible VA DBQ Switchboard Internet page.

3. For requests for completion of mental health DBQs, it is recommended that the Veteran’s treating provider not complete the DBQ to maintain the integrity of the patient-provider relationship."

I think this is the one you are refuging to. I was told the lunge in it allowed the provider to choose if they wanted or not to fill out the form. My provider tried to tell me it would be a conflict of interest because they were treating me. (go figure)
VHA Directive 2008-071, Completion of Forms by VHA.pdf

Wow It looks like in the new directive they have to do DBQ's if you request it. It would be interesting to push the local buttons to see what they say.
"(c) Completion of DBQs to Support VA Benefits Claims. A “no wrong door” philosophy must be adopted to accommodate Veterans bringing a VA DBQ form to a VA medical facility for completion.
1. Veterans may ask their primary care or specialty care provider to complete a DBQ for conditions which are already diagnosed and documented and for which the provider is treating the Veteran. DBQs can be completed by the treating provider during a routine office visit when there is sufficient time and the medical information is available. DBQs can also be completed outside of an office visit, or an appointment can be scheduled for completion. (See VHA Directive 2013-002, Documentation of Medical Evidence for Disability Evaluation Purposes, or subsequent policy issue, on the VHA Publications Web site).

2. If a VHA treating provider has questions regarding DBQs including which DBQs they can or should complete, they may seek further guidance from VBA. Additional guidance and information on completing DBQs can be found on VHA’s Office of Disability and Medical Assessment (DMA) website. Guidance specifically for primary care providers is located in DMA Fact Sheet 12-002, “DBQs and Primary Care Providers”. For a complete list of DBQs, see VA’s DBQ Switchboard Intranet page (NOTE: These are internal VA Web sites that are not available to the public) or at VA’s external, publicly accessible VA DBQ Switchboard Internet page.

3. For requests for completion of mental health DBQs, it is recommended that the Veteran’s treating provider not complete the DBQ to maintain the integrity of the patient-provider relationship."

Yup the language in them was right on. I haven't seen anyone post anything like it. I thought it would be helpful for people to cut and past it in there own forms.  I am fixing to go after the VA for an EED on my PTSD T & P as they lowballed it when they awarded it. When I can get up on the PC in a week or so.

I'm with you MR CUE I get it. I the guy who people out side of hear say they are going to un leash the Pitbull on them. I do not take any Crap VA, Cooperate Layer. I make Cooperate Layer's cry "But judge he is filing to may Motion's I having to work for a living." 
Anyway how I found out to making them back down on the C & P Exam's until they get the one they want I use the Whitehouse Hotline and told them that they were trying to do multiple C & P's until they get what they wanted.  It took about three week and they called me back and said I had 70% PTSD. I challenge them because they denied my UI two weeks eelier. They CUE themselves and gave me the UI 100% P & T.
The problem is most Vets don't know how to address there issues with whoever they are dealing with.
  
What is the White House VA Hotline? The hotline’s pilot began under direction of the Veterans Experience Office on June 1, 2017, and entered phase two on October 15, 2017.
White House VA Hotline:  1-855-948-2311.
Calls are answered by a live agent 24 hours a day, seven days a week, 365 days a year.  The hotline is staffed by more than 60 agents who have had extensive training on VA programs and services.  Most of these agents are a Veteran, military family member, caregiver or a survivor.
The White House VA Hotline conducts immediate warm hand offs for at-crisis risk Veterans needing the services of the Veterans Crisis Line.
Trends identified by the hotline will be used to rapidly respond to systemic inefficiencies and empower VA employees to resolve Veteran concerns quickly.
Veterans should continue to use existing VA customer service hotlines:
https://www.wowktv.com/news/special-reports/white-house-hotline-helps-veterans-in-need/
 

Glade I could help.. I found that by accident from another post where I was looking for there contact phone number.  That info was not there 2 mo. ago. 

If you want an appointment at your RO the VA has an VERA Appointment Scheduler (Visitor Engagement Reporting Application) that  you can use to schedule an appointment at your RO either virtual or in person. (See Link Below) 
https://vets.force.com/VAVERA/s/
You can look up your local RO Office hear 
https://www.benefits.va.gov/benefits/offices.asp#A
You can also use the QR code at this VA web page to access it.  (Montgomery AL Office as an example) 
https://www.benefits.va.gov/romontgomery/
 

I am familiar with the VA claims Inside.  This is a word of warning please take notice of there below fees. They show up under different names porting to have helped over 4,000 veterans in the few years that hey have been around. In there initial offering to vets  was "VA Claims Insider Elite!"  I can not stress this enough.  1. They are NOT VSO's. 2. They are not ACCREADED by the VA. Below is an out take from one of there contracts where they want you to sign over your future benefits.  They have changed some of this to a pay for service on one of the other web sites. (You Pay up front)
"Services
VA Claims Insider, LLC is a service-disabled veteran owned medical consulting firm,
and our mission is simple: Veterans helping Veterans get the VA disability rating and
compensation they deserve.

We fulfill our mission by offering veterans a suite of digital products and services, to
include DBQ reviews and medical nexus opinions from our network of private medical
providers.

We operate a membership-based business with two-programs: (1) Mastery and (2) Elite.
Mastery is a self-paced online course intended for informational purposes only. Elite is
our premier medical consulting program intended to help veterans connect with qualified
medical professionals for DBQ reviews and medical nexus opinions.

VA Claims Insider, LLC does NOT represent veterans before the VA or BVA in
connection with any claim for VA disability benefits, EVER, nor do we operate as
accredited VA claim agents.

Furthermore, VA Claims Insider, LLC does NOT prepare or file VA disability claims for
veterans. You shall prepare and file your own claim or work with an accredited VA
claims agent, many of which offer services for FREE. Veterans may search and find
Accredited Attorneys, Claims Agents, or VSO Representatives by clicking HERE.

There are completley FREE resources available to assist veterans in the preparation,
presentation, and prosecution of VA disability claims before the Department of Veterans
Affairs. Veterans may search for and appoint an accredited VSO by clicking HERE.
VA Claims Insider, LLC can terminate our medical consulting agreement with the client
for any reason including:

1. The client fails to comply with our instructions or terms and conditions in any
manner.

2. We feel the client is acting in an illegal, immoral, or unethical manner in an attempt to
defraud the Department of Veteran Affairs.

3. The client fails to make timely payments upon services rendered.

i) Payment Terms
We never charge up front fees for our medical consulting services, to include DBQs or
medical nexus opinions. The private medical providers in our referral network, however,
do charge $100 per Disability Benefit Questionnaire (DBQ) review, and $200 per
medical nexus letter. The independent psychological evaluation with a U.S. board
certified psychologist is $395. There is a one-time, non-refundable medical records
review fee of $100 for DBQ reviews and medical nexus letters. Please note: NONE of
these medical consulting services are required, and you as the veteran may obtain DBQs
and medical nexus letters from your own medical providers for FREE.

If you do receive an increase in your monthly VA disability benefits, our medical
consulting agreement and privacy policy stipulates our standard fee of 6x the monthly
increase, payable one time, either lump sum at a 10% discount or over 12 months at no
interest. For example, if the veterans rating before utilizing our services is 50% at $1,000
per month, and the veterans rating after utilizing our services is 90% at $2,000 per
month, the veteran would owe VA Claims Insider 6x the monthly increase, or
$2,000-$1,000 = $1,000 x 6 = $6,000. In this example, if the lump sum option is
selected, the total owed woud be $6,000-$600 (10% discount) = $5,400. In this example,
if the monthly payment plan is selected, the total owed would be $6,000/12 months =
$500 per month at no interest.

After services have been rendered by VA Claims Insider, LLC there are no refunds. We
never send an invoice until after you have received an increase in your VA disability
benefits."

I know I am talking to the wall hear but.......
So you are going to pay $1995 to a doctor who you don't know anything about. Who you have not seen his CV to know his credentials that the VA will use make there decision to except his IMO / Nexis or not.  None of the people you are talking to are accredited by the VA. There are Doctors that have been listed hear like Dr. Ellis, Dr.  Bush, and Dr. Thomas J Seiter MD, and  Dr. David Anaise. All have proven wins with the VA, and BVA. They may charge a little more than the $1995 but you get what you pay for. I can buy a BBB A+ rating with them by paying there dues. These people are con men plain and simple they are going to tell you what you want to hear to get your $$$$$$. PLEASE RUN the other direction. Go to one of the above doc's call them ask questions tell the Doc's what you are trying to do. Most of them will give you a free consult. 
See this link to who people hear recommend.
RE Has any one used the following Doc's for IMO's and nexus letters
https://community.hadit.com/topic/86474-re-has-any-one-used-the-following-docs-for-imos-and-nexus-letters/
 
 

I'm with you MR CUE I get it. I the guy who people out side of hear say they are going to un leash the Pitbull on them. I do not take any Crap VA, Cooperate Layer. I make Cooperate Layer's cry "But judge he is filing to may Motion's I having to work for a living." 
Anyway how I found out to making them back down on the C & P Exam's until they get the one they want I use the Whitehouse Hotline and told them that they were trying to do multiple C & P's until they get what they wanted.  It took about three week and they called me back and said I had 70% PTSD. I challenge them because they denied my UI two weeks eelier. They CUE themselves and gave me the UI 100% P & T.
The problem is most Vets don't know how to address there issues with whoever they are dealing with.
  
What is the White House VA Hotline? The hotline’s pilot began under direction of the Veterans Experience Office on June 1, 2017, and entered phase two on October 15, 2017.
White House VA Hotline:  1-855-948-2311.
Calls are answered by a live agent 24 hours a day, seven days a week, 365 days a year.  The hotline is staffed by more than 60 agents who have had extensive training on VA programs and services.  Most of these agents are a Veteran, military family member, caregiver or a survivor.
The White House VA Hotline conducts immediate warm hand offs for at-crisis risk Veterans needing the services of the Veterans Crisis Line.
Trends identified by the hotline will be used to rapidly respond to systemic inefficiencies and empower VA employees to resolve Veteran concerns quickly.
Veterans should continue to use existing VA customer service hotlines:
https://www.wowktv.com/news/special-reports/white-house-hotline-helps-veterans-in-need/
 

Call up her office and tell them you need a response or you will file a complaint on her to the Bar Association in you state. One of my pet peeves is an attorney that does not timely respond to client request.  The bar threat will get her attn. If it does not you need to get a new one as you are not the first to file a complaint on her.

The https://the360veteran.com/index web site or its other forms is a scam See there attached price sheet. The other one that is a scam is The Veterans Claims Insider and its associated sites. The Veterans Insider stared out wanting Vets to sign a contract that guarantees you pay a loge amount of your benefits up front. Most of there "couches" are not VA certified reps. They also have an up front fee for access to there sight. I reported them to the VAIG but they are still out there. Any one who wants you hard paid for benefits needs to be locked up.  I would not pee on them if they were on fire in the middle of the road.
 
360Payment Information.pdf

Well no matter what anyone tells you. The VA will send you to more than one C & P Exam trying to get one they want that will denies your claim or down grade your %.  I recently experienced it in my PTSD claim. They sent me to a PHD to decided if I was "insane" at the time of my discharge. He gave a favorable saying I was insane and was sulfuring from PTSD. They than tried to to send my to a second PHD to determine if I had PTSD due to MST. I called up Betty and told her that I would do another C & P bout only would see the 1st PHD. (I didn't refuse the exam) So I go to the Exam and the same PHD says the same thing that I had PTSD due to MST. So the VA wanted an IMO to decide I guess if I was UI. I called them up and said I wanted it done my the same PHD. He does the IMO in my favor.  
I file for another claim for my right knee and secondary left knee an bilateral hips. So the VA tries to send me to LHI for a C & P. When LHI calls for the Exam they try to schedule me with a NP. I tell them because this is a complex orthopedics exam I want them to send me to a MD no NP's. Well the person on the phone puts me on hold ang goes talks to a supervisor or some one and comes back and tells me that they do not have any MD's in my area only NP's. So I call the VHS the one's who did my PTSD C & P and asks them if the had MD to do this type of exam and they say yes. So I call the VA up (800 you know who) and tell them LHI said they did not have any MD's to do a complex orthopedics exam and I am requesting an MD because of the complex orthopedics exam. So they have QTC they and setup an exam with a NP. So I explain to them that they had to send me to a MD because it was a a complex orthopedics exam. So they search and find one 100 miles away. Well that Doc was a VA hack who did not read the medical records (From 2008 to present) she low balled me at 10%. The VA requested a IMO to back up that doc that wrote.
"One's R knee and L knee are anatomically discontinuous and physiologically unrelated. An injury to one's knee will not result in any chronic pathology of the contralateral
joint."
He went on to say. "As also noted in ortho TRs from 12/1/2004, pt's work setting entailed frequent walking up and down stairs, as there was no elevator. His treating orthopedist felt this
repetitive use of stairs was the etiology of aggravation of his symptoms."

"Thus, based on the evidence of record, there is insufficient evidence to establish a nexus, with greater than 50% probability, that this pt's current L knee Condition is at
least as likely as not proximately due to and/or the result of his R knee condition."
The treating orthopedic surgeon who has seen me from 2008 to the present and became my Community Care Doc in December 2021 made the statement no. 2 above. The PHD only used half of that statement. The now Community Care Doc has schedule a right knee replacement surgery for March 14, 2022. that means the VA will have to rate me at 100% for 13 Mo. and reduce it to 50% after that. The Community Care Doc has agreed to do a IMO and the DBQ's on the 24 of this Mo.
I have said all the above to this end. There is a way to refuse there C & P Exam's and if you don't think you need one you can tell them that you want them to decide you claim "on the evidence in the record".
broncovet  or some of the others can quote the REG's for the above.

You only need 70% plus proof that you are UI for the VA to rate you as such. That is what happen in November to me. I am curlily working on my EED.