bluevet

Yes, do not count the time he is schedule off between school years. The VA only wants to know what time he missed due to his condition

Jester, you just need to understand the rating criteria for bi-polar disorder and then decide which category your symptoms fall into. If you feel that your symptoms fall into a higher category then what you are rated, file for an increase. If you are within your appeal period since you were last increased (1 year of decision date), file it as an appeal and it will be back-dated to the date that you filed for the last increase, providing you retroactive pay from that date. Here is the rating criteria for bi-polar disorder: 1.The general rating formula for mental disorders assigns a 10 percent rating on the basis of occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication. 2. A 30 percent rating is assigned on the basis of occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 3. A 50 percent rating is assigned on the basis of occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 4. A 70 percent rating is assigned on the basis of occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 5. A 100 percent rating is assigned on the basis of total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. § 4.130.

I believe this question wants to know how much time he lost from work due to his illness, while he was employed, but it is vague. Always error on the side of the vet. Since it's unclear, I would add up any time he missed work since 2012 due to his illness and the time he has lost since the doctor ordered him off of work. As long as you can explain where you number came from, if the Va asks, you're fine.

File the NOD (notice of disagreement). You don't need to elaborate on the reasons why you disagree when you file it. You just need to list each of the contentions, the decisions of which you disagree. Example: Tendinitis, PTSD, etc... There will still be plenty of time to gather evidence while waiting for your appeal to be adjudicated. I would elect DRO review if I were you. If the DRO does not find in your favor, you can still appeal to the BVA. Each of these stages will take a long time and give you plenty of time to gather and submit evidence, which you can do at any time during the appeals process.

Buck, Medical rationales and nexus statements have to be backed by the record in some fashion. It is not enough to just find a doctor to state that the disabilty is service connected. Service connection, in most cases, requires an; in service injury,event or illness; a current disability; and a nexus between the two. Without some sort of record that the veteran experienced an injury, event or illness, a nexus can not be proven, no matter how many doctors make that statement. The obvious exception to the rule is that of a presumptive illness if, say, the veteran worked around agent orange and now has diabetes. Even in such a case, the veteran would need to prove that they were exposed to agent orange. ForThem, This is probably going to take some investigating on your part to get what you need to prove this claim. Here is a website containing addresses that you can write to requesting unit rosters. If you know the unit your husband was in and the time he was there, you can get the names of the soldiers who were there with him. Then, you can try to locate them and see if any remember your husband's injuries. If you can find a medic who actually treated him and get a statement, that would probably be a very good start.

If they sent it back to the same doctor, the VA would make a specific request for whatever is missing. If that doctor is no longer available (which as I said above, happens all the time), the they could request a nexus opinion only from another doctor. There are a lot scenarios in which the VA could have requested the medical opinion that you were referring to in you original post. The only way to know who provided the opinion and what specifically they were asked to opine on, is to get your hands on a copy of that opinion. The instruction to the examiner will be on the Medical Opinion form.

There are two parts to a C&P examination ordered by the VA. Part 1 is a DBQ. This is a review of your your current condition and the severity of your current symptoms. Part 2 is a medical opinion. This is an opinion on whether or not your current condition is "At least as likely as not" (50% probablitiy) related to your military service. This is also known as a "Nexus Opinion". In order for a Nexus Opinion to be "adequate" for determination of service connection, it must contain an adequate rationale based on your medical records. If the medical opinion portion of the C&P exam is inadequate, the VA will sometimes send it back to the C&P examiner for clarification. If that examiner is no longer available ( No longer working for the C&P contractor for example), they will request another doctor to provide the medical opinion portion of the C&P examination. There are other scenarios as well, where the VA will order a medical opinion without ordering an entire C&P. It's a common practice.

Do you have SMR's (Service Medical Records) showing any symptoms/problems related to you current condition? They need to be included as well. I have read many posts regarding the "magic words" of "At least as likely as not". I've also read a whole lot of BVA case citations. A nexus letter should contain that statement, but just as importantly, it needs to have a rationale for the determination that your current condition is "at least as likely as not" related to your service. In case after case that I have read, veterans spend good money on IMEs/IMOs, only to have the board give little or no weight to them. The most common reasons for this are: 1. The Independent Doctor did not include an adequate rationale for his/her findings. 2. The opinions were not based on a review of the all of the available medical evidence. If I were you, I would request my c-file, or at least request all medical records in the possession of the VA, before I paid for any IME. If time is a factor, contact your VSO rep at your VA regional office and see if they can get you these records faster.

Sounds great, what's the name of the company and what city are they in? Also, before you pay for any IMO/IME, make sure you have all medical records that the Va has and make sure that the examiner lists them all. This is a huge factor in the weight that the VA rater will give to the opinions. Secondly, make sure the doctor understands that every claim he makes needs a clear rationale. When you get them back, review them and if you don't think the rationales are adequate, don't be afraid to request an edit.

This is the first time I'm hearing about this "NEW DBQ POLICY". Can you point me toward more information about this?

Call your VSO and have them look into what's up with your claim.

Wingnut, I know you're frustrated, but this is an easy fix. The C&P examiner normally only sends the VA a filled out DBQ and a Medical (Nexus) Opinion. I don't think this is retaliation, I think it's just a misunderstanding . It's an easy fix. Get the evidence into the VA as quickly as possible. mail it into the new evidence intake center for your region. Do not send it directly to the R.O. address as this will cause a delay in the evidence getting into your file. You can also fax it in before you mail it. Faxing get's into your file very quickly, but you still want to mail it so that you have a receipt. When faxing, put your SSN on top of each page. If it's too many pages to fax, you can fax in a VBA-21-4138 stating that you have mailed your evidence and a copy of your mailing receipt. Waiting for them to deny so that you can appeal is not a good approach. You want to take full advantage of each opportunity to get your claim approved. It would be a terribly wasted opportunity to let that deadline pass. Good Luck

Hmmm, sorry about that. It's been about a year since I spoke with her. She must have changed her number. I got that number from Dr. Bash. I would keep emailing him more and more often until you get a reply.

Were you denied by a DRO or are you skipping the DRO process and going directly to the BVA? If you are headed to the BVA, you should definitely get an attorney. The BVA is much more a game of law then the earlier stages of the claims process. As someone stated earlier, there are veterans attorneys who will arrange for IMOs and IMEs and will even front the cost for them. Here's one law firm that does this : http://www.veteranslaw.com. I haven't worked with them so don't consider this a recommendation. Just information.

Call Alice Burns - 925-524-0622. She is Dr. Bash's assistant. If she doesn't answer, leave a message. I believe she works a flexible schedule, because whenever I've called her, I've always had to leave a message, but she has always called me back within a day or 2.

My C&P examiner opined that my condition was "less likely than not" related to service. His rationale stated " The bipolar disorder is a condition totally unrelated to service. Bipolar disorder is due to advance imbalances in the brain, cause most likely due to genetic conditions." My denial letter cut and pasted this opinion. As you can see, this doctor gave his opinion on bipolar disorder, not on me or my medical records. According to this doctors opinion, no veteran qualifies for compensation for bipolar disorder. He never mentioned me or my medical history in this rationale. Still, the VA rater chose to accept this ridiculous excuse for a medical opinion to deny my claim. Costing me a minimum of 2 years additional delay. I believe this was because I had filed an FDC and this exam came in very close to the 6 month target time for an FDC claim. So rather than have my claim hurt their FDC stats, he threw me into DRO limbo. The worst part is that there really is no accountability for VA raters who pull this crap. They basically can do whatever they want and get away with it.

What conditions do you need an IMO for?

Are you sure you don't already have a rating?. I;m not service connected, but since my denial, when I log into E-benefits, and click on "Disabilities", I see my condition there, rate at 70% and labeled "not service connected".

From your C&P regarding your level of impairment: 4. Occupational and social impairment a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication Then the doctor lists these symptoms "For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks that occur weekly or less often [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Inability to establish and maintain effective relationships" The rating formula is as follows: 1.The general rating formula for mental disorders assigns a 10 percent rating on the basis of occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication. 2. A 30 percent rating is assigned on the basis of occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 3. A 50 percent rating is assigned on the basis of occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 4. A 70 percent rating is assigned on the basis of occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 5. A 100 percent rating is assigned on the basis of total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. § 4.130.As you can see, your symptoms are kind of all over the map. The doctors opinion suggests a 10% level of disability, yet some of your symptoms fall into much higher categories. Example: "inability to establish and maintain effective relationships", "Difficulty in adapting to stressful circumstances, including work or a work like setting", both of these suggest a 70% level. Some of your symptoms suggest 50%, some 30% and some 10%. Now any reasonable person would look at this and think, "OK, he falls somewhere between the criteria for 30 and 70, yet this doctor chose a level of impairment equal to 10. Don't worry, the rater will most likely ignore that selection and rate you according to the symptoms list.

How far are you from your R.O.? You can walk into your R.O. without an appointment and walk out with a copy of your C&P exam. You may even be able to walk out with a copy of your entire file. It took me less than 20 minutes to get a C&P at the Los Angeles R.O. last week.

USMC_VET to the rescue! Mauree, this is what this forum is all about. I'm not sure how much experience you have dealing with the VA, but be prepared to spend a lot of time waiting. In the mean time, read, read, read as much as you can. Read this forum, even posts that don't seem to apply to you. Read articles on the web. Read BVA opinions. Read the VA manuals for raters and DRO's. The more you understand about the workings and shortcomings of the VA, the better off you will be. Good Luck!

The Attorney is a moron. The DRO can not make a decision that is less advantageous to the claimant than the original raters decision unless a CUE exists. If the original rater didn't reduce the 70% rating than the DRO can't either.

Hi Mauree55. I don't have a lot of answers for you, but I want to bump your post and see if it grabs someone's attention. I haven't heard of someone being scheduled for "C&P Primary Care". Maybe someone else has. MHC usually refers to the Mental Health Clinic, both of those seem to me like treatment appointments were it not for the "C&P" designation. Where are you getting this information from? Did you get a letter or are you finding it online? Maybe someone else has some insight.

When you say records are not in your medical file, do you mean records from you c-file are not listed as having been available for review by the C&P examiner or are you saying that records you submitted are missing from you actual c-file? Whose scanner are you referring to? Yours, the VA's or the PBLO's ?

Ha, sounds like you're screwed, lol. I would just keep calling the number for e-benefits technical issues. Call them every other day until they get sick of you and fix it. Be the squeakiest wheel they've ever encountered until you get some grease :0 eBenefits Questions and Technical Issues 1-800-983-0937 Monday - Friday, 8:00 am - 8:00 pm ET