VetlawUS

Hey all, would love your feedback...

....I wrote 3 posts giving 10 Tips on getting ready for a C&P Exam.

Here's Post #1: 10 Tips to Help You Keep the C&P Exam in Perspective.

Here's Post #2: Dealing with the C&P Exmainer.

Here's Post #3: Paint a Picture when Talking to the Doctor.

Would love to hear from ya'll....tell me what I missed, where I can do better or give more info....

.....I'm writing another Field Manual for the Veterans Law Blog called the "C&P Exam Field Manual", and I'd like to address as many of your concerns, fears, needs, etc., as possible, to make it the best resource available.

Read the posts, and comment here or directly on the post page on the Veterans Law Blog.

Thanks,
Chris (Veterans Law Blog)

The VA's Regional Counsel has been telling VA Doctors for years not to fill out the DBQs, because they are a conflict of interest between the VA's interests and the Veterans' legal claim....this is BS, in my opinion, as the system is supposed be "non-adversarial" to the Veteran, so there is no "conflict"

That said, there are quite a few VAMC docs that have the backbone to support their patients. Ask your VAMC PCP or Specialist, and if they say no, don't push. If they say yes, ask for the copy so you can submit it, that way they don't put something harmful into the DBQ and send it directly to the VARO.

As to private docs, the VA will honor DBQs prepared by private doctors - in many cases they carry as much weight as a written IMO - but typically only on the impairment rating question. It is difficult - in my experience - to get the VA to accept a DBQ as proof of "nexus", but much easier to use a DBQ to establish an impairment rating.

Here's some more pros and cons on the DBQ in a post on the Veterans Law Blog.

And....a little off topic....but DON'T FORGET to challenge the credentials of VA C&P Examiners that give you a bad opinion:

SMC is an inferred issue in EVERY 100% rating - there is a section in the M21-1MR that discusses this requirement.

So, if you have a 100% rating, and the VA fails to consider SMC , this can be a valid basis for CUE (if you have no more time to appeal the Ratings Decision that failed to consider the SMC.

Just make sure that you can PROVE you are entitled to the specific SMC you seek - in a CUE claim, if you can't show that the "outcome would have been different" (even if the VA did make a clear and unmistakeable error) than you will not win.

Y'all....I know there is a lot of doubt about the current leadership, but here's a story I shared on the Veterans Law Blog about how the leadership helped me to get a Veteran taken care of....

The Blessing and Responsibility to Take Care of Others - A Vision that Could Shape a New VA

I have not doubt that the top of the chain is trying to help....and we are getting more and more calls and emails from the bottom of the chain - the Raters and DROs and Appeals Coaches.

It's the middle management - the career bureaucrats - that are not helping. If McDonald and Hickey can clear out the dregs from the Career Bureaucracy ranks, then we may have a chance at a better VA.

Just my 2 cents.

Y'all....I know there is a lot of doubt about the current leadership, but here's a story I shared on the Veterans Law Blog about how the leadership helped me to get a Veteran taken care of....

The Blessing and Responsibility to Take Care of Others - A Vision that Could Shape a New VA

I have not doubt that the top of the chain is trying to help....and we are getting more and more calls and emails from the bottom of the chain - the Raters and DROs and Appeals Coaches.

It's the middle management - the career bureaucrats - that are not helping. If McDonald and Hickey can clear out the dregs from the Career Bureaucracy ranks, then we may have a chance at a better VA.

Just my 2 cents.

I try my best to stay positive and hopeful when I deal with the VA, but it is difficult.

Looking back at previous VA leaders like Shinseki, etc..., they all made promises to make a difference for the better. A few things changed, but most stayed the same.

There is a real disconnect between the people at the top and the people who work directly with us Veterans. This is evident by the chronic failures that affect us frequently and directly. This disconnect is a prime reason why many of us can confidently say that the VA system is a stressor. When someone has been screwed over repeatedly by the VA, it definitely shows.

Answering the phone or replying to emails is one thing, but we should not have to resort to such specific measures in order to get timely attention. This is just a squeaky wheel gets the oil tactic. Because someone calls a VIP, their issue will get attention it needs (good for them), but it pushes them in front of someone else. As more claimants jump on this wagon, it too will start to slow down. This also will likely not change things at BVA or CAVC level because they are probably out of their hands.

The real change needs to occur further down the line. I am not talking about poorly planned options like the choice card with exciting names, but fail to deliver. The VA needs to get rid of employees who are part of the problem and hire the right people to be part of the solution. We should not have to wait for years on appeals because someone screwed up a claim from the start. We should not have to wait a year for a copy of our C-file. We should not have to learn the LPN just injected you with an overdose of medication. We should not have care providers who dont listen and lie on paperwork. Nobody should die or lose their home because the VA screws up. I know there are processes and procedures in place to deal with most of this, but the amount of red tape is staggering. After you spend a few years with the VA, you start to realize what it is.

It is great when someone of authority reminds VA employees they should be doing what they should have been doing all along.

I have had multiple emails from MS Hickey, after she responded in a few hours to my first one.

yesterday the Director of my VARO emailed me and called me as well.


After that however, I received another email from MS Hickey, that was cced to others at VBA and apparently,unlike the info I got from the Director, my claims might be transferred to a different RO.

That would be GREAT. I sent in all of my evidence with my claims. I have full confidence I will succeed.
That is, if I live long enough too.




I griped in Social today in more detail however because ,when I emailed Ms Hickey a brief background of my last 20 years with my VARO, I think she could readily see that they consistently had ignored my evidence , in practically every issue I had over the past 20 years and that forced me into the backlog, without extending me my basic rights within 38 CFR 4.6.

As I have said here many times 38 CFR is not only basic VA case law, it is a powerful tool that we can use against them.

That is one reg they broke that helped me win my past CUES.

VA is finally seeing,from veterans and their dependents, a true picture of what the claims system is really like for many of us.

It is great because they (VA) never showed this much interest before.

Please don't fall for this Reconsideration "advice" - I have seen more Vets lose more money by listening to VSOs give this "advice".

Please read these posts on the Veterans Law Blog that explain why:

There's no such thing as Reconsideration at the VA Regional Office

Following VSO advice on "Reconsideration" is Flushing Money down the toilet.

You said he was RECENTLY given 50%. You have 1 year from the date of Notice of Action Letter to file a Notice of Disagreement (NOD) to appeal that grant of 50% and argue it should have been 70%.

NEVER reopen a claim when you still have time to appeal. Why?

1) If you reopen, 2 things happen. First, the VA gets confused as s**t....you can't reopen something that is still "open" for appeal. So the claim will sit for at least a year until they are sure it is not an appeal. THEN...they will treat it as a Claim to Reopen - which, for a change in rating will be claim for increase....you lose the original effective date if you win. Check this hypothetical timeline out:

6/1/2013: Original Claim

12/1/2014: VA Decision Granting 50%

2/1/2015: "Claim to Reopen" because you think the rating should have been 70%....the EARLIEST effective date you will get, if you win, is 70% back to 2/1/2014 (one year before the claim for increase).....that means you lost about $2,200 in past due (difference between 50 and 70% from 6/1/2013 to 2/1/2014.

If you file the NOD in 2/1/2015, and win the argument that it should have been 70%, you get the 70% all the way back to the original claim date: 6-1-2013.

Here are some Quick Tips on filing the Notice of Disagreement from the Veterans Law Blog....there is a TON more info about the NOD and DRO process on the Veterans Law Blog.

This MH decision is recent so you are still within the appeal period Kate.

This is not a re open situation at all, as I understand it.

I think I suggested somewhere here that since your husband won his Bad Water USMC claim ,that ratin might garner him TDIU if and when he can no longer work.

I know you dont want to get another costly IMO but because the MH issue is NOT PTSD, an IMO could be used to try to obtain a higher MH rating.

Alex is always right on the mark.

Re opens can also be sending them something that corroborates something they rejected .

This is important for anyone here who intends to re -open a claim denied in the past.

For example, say VA rejects a Buddy statement (which might not have been properly prepared)

An additional buddy statement from someone else, properly prepared with contact info and details etc etc etc, same unit, same time and place, would give credence to the original statement that they may or may not revisit.

A widows claim I posted here a few years ago was a re=open of her DIC denial.

She sent the VA one single piece of evidence. It was an article about an unusual form of cancer centered within a small population of people in a small Korean village.
This rare cancer had caused an exorbitantly large amount of cancer diagnoses in the village, the same type of cancer her husband died from.

She had also proved via his 201 personnel file that he had served in very close proximity to this village.

His whereabouts of his service was documented and established in his 201 file.

The article was new and material evidence, BVA ordered a posthumous C & P exam or VACO opinion, I forget which, and the claim was awarded.

To get back to Kate
I feel you should await the rating for the Camp Lejuene claim and see how VA totally up the 2 separate ratings.

Well, not exactly. The RO is tasked with making sure everything is in order and then issues the Form 8 certifying it as ready. Only then is it entered into VACOLS. The BVA, however, issues the docket number after it arrives in DC physically. If you ask for a BVA Board hearing, the certification doesn't occur until after the hearing (one year). Any submission of evidence w/ a Form 9, unless a waiver of review in the first instance is filed with it, provokes another year of waiting for someone to take another gander at it before they issue a SSOC. Even then it can languish for a while ( a year) until someone gets around to the Form 8. Most do not realize that VA is fond of taking TDIU appeals and shipping them to DC without the SSI/SSD records which they know are required to be included. The BVA promptly (one year) remands it back to the RO for the SSI info (one year). You can see how it takes a decade to get one of these done if you are not proactive and assemble the evidence yourself. Never assume VA will include the SSI stuff, Never.

This is why I strongly disagree with hanging around the VARO waiting for justice if it is a complicated claim. ROs are loathe to take the responsibility. Getting it up to the BVA is paramount for difficult claims and having everything in front of the VLJ when it gets there is even more important. Putting SSI records in the search bar for 2014 BVA appeals will generate thousands of IU cases remanded for lack of the SS records. VSOs seem to be oblivious to this requirement or at least fuzzy on what is needed before you launch to DC. Considering they have the right to look at your C-file, it seems elementary to ascertain the documents are on board before they launch it. J1VO

At least the "bob" option generates action! That alone is an improvement! I'd suspect that you will see the VARO do something, and then go from there.
The something can be almost anything. Send to BVA, or perhaps administratively grant. Wait and see is your current mode.

That's just crazy. A few of us are wondering what's going on with our appeals that were not transferred to the BVA but suddenly decided at the RO level after we sent in our Form 9s. But your appeal has been sitting at the RO waiting for transfer for five years, not a few months. Seems like there is a push to move some of these appeals quickly, so hopefully you'll get an answer sooner than later.

The sad thing is that once you win this thing, and you get your retro, the VA will declare you one more happy customer well served, because justice delayed certainly cannot be justice denied if you get paid what you were always due in the end. Like Fat said, where's the explanation or apology?

The RO has an interest in making the correct decision locally when upper management gets involved. If it goes to BVA and the BVA decision is favorable to the veteran, it will likely go back to the VARO anyway.
I'd suspect that needless BVA hearings that are the result of obvious errors by the RO are not looked upon lightly by the current upper management.

Thanks, Chuck. Maybe that's what's going on at least in this handful of cases and maybe Jeff's too. Hopefully that means that many of us will see some better outcomes sooner.

NEVER GIVE UP

A few points:

1) Service Records SHOULD be in your C-File, but the VA does not always include your entire Service Record file - they sometimes selectively remove portions that they deem irrelevant. Most of the time, they are wrong.

2) Also, ALWAYS request your service records from the Archives every year or so.

Why? Military units are constantly archiving old records and so your files can get updated with additional information from time to time.

3) If you are filing a claim to Reopen a previously denied service connection claim, getting your service records can make the difference between your original effective date (the date of the original claim) or a later effective date (the date of the reopened claim).

Read here to find out more about how newly discovered Military Service Records can affect the effective date in a Reopened Claim.
We make a point to request updates for our clients every year or so, depending on the issues in the claim (once service connection is granted for all the medical conditions you seek, the service records become largely meaningless).

It would be great if you could get your endocrinologist to prepare an IMO giving his diagnosis of your medical condition(s) and also stating your current medical condition(s) are in his/her opinion "at least as likely as not" related to your military service or originated during your military service. The IMO should follow the criteria of the IMO sample on Hadit and the endocrinologist's opinion in the IMO should be supported by reasonable medical rationale. It would also strengthen your claim if the IMO stated your job as a News Researcher had nothing to do with your current disease or the symptoms you exhibited.

If it is possible to get the IMO before your C & P exam, I would take a copy of the IMO and copies of any other supporting documentation to the exam. The examiner may want to review and even keep the evidence you bring with you to the exam, especially if the examiner is an NP or PA. I did this during my last two C & P exams and the NP used the documents to complete their report and I won my claim.

Also, if you haven't already done so, get documentation from your former employer where you worked as a News Researcher showing the exact dates of your employment and perhaps a job description showing your duties. A copy of this document should also be provided to the C & P examiner and to your regional office before a decision is rendered on your claim.

Also, make sure you provide a copy of the IMO to your regional office before a decision is rendered along with any other supporting evidence (medical reports, lab results, etc.) not previously provided.

Georgiapapa.

Sorry to hear of your troubles with the VA. I too had a ton of C&Ps this past week, and we are all just so tired of given the runaround. It sounds like you will be fine once you get in there with the C&P doc. God Bless and keep us posted.

rootbeer22,

In my opinion, most VA C & P examiners do not have the right credentials and NPs and PAs are used in place of board certified specialists. The emphasis is on saving the VA money and not on giving veterans thorough and competent exams.

With the exception of a hearing loss C & P exam performed by a certified audiologist, my other C & P exams have all been performed by NPs. When I went for my C & P for AO presumptive cancer, I expected my C & P exam would be performed by a board certified oncologist or hematologist. To my surprise, I had a NP with a C & P computer checklist who knew very little about my disease. Fortunately, I brought my medical records with me and she used info from the records including an IMO from my oncologist for responses to most of her questions.

Same thing happened when I had a C & P exam for peripheral neuropathy of my lower extremities. A NP used a broken oversize Q-tip to jab me in my legs and feet asking me to let her know when I felt the broken Q-tip. She completed a few questions on her computer checklist and my exam was finished. No EMG or nerve conduction tests. Again, I had copies of my medical records and she made some copies of my records including an IMO from my neurologist.

My above claims were successful but may not have been if I had not brought records with me to the exams and had copies of my IMOs I had submitted with my claims packages. In comparison with a thorough IME performed by a board certified specialist, most C & P exams performed by NPs and PAs are a joke and a disservice to disabled veterans who deserve better examinations. Incompetent examiners and incomplete examinations are one of the reasons veterans claims are denied and end up in the appeals process. Until the VA corrects this situation, the only defense a veteran has for a bad C & P exam is an IMO from a doctor specializing in the diagnosis and treatment of the medical condition being claimed. Unfortunately, many veterans are not in a financial position where they can afford to pay for a well documented IMO. It is not fair but it is just the way it is until Secretary McDonald or someone else actually does something to improve the C & P examination process. JMO

Georgiapapa

Well, I sent Allison an email yesterday and got a prompt response this morning. She is on it! If nothing else but to just check on my appeal status that has been looming since December 2012. She said:

Thadine, I noted by your note that this is an appeal - not a claim. As such there are two different organizations that work these two different issues. I will ask for the status of your appeal and ask them to share that information with us both.

Hey, this works for me and guess what, I just found me another Hero!

Again, i'm not expecting a miracle but I certainly appreciate the response. Thanks BigSarge for posting and i"ll keep everyone posted.

T

Good job getting your foot in the door, Sarge - most of us win in 'chunks'

Big Sarge,

Good advice by Navy. You probably were low balled. You should google 38 USC part 4.130 which is the Schedule of Ratings used by the VA for Mental Disorders including PTSD and Anxiety. Also Google VA form 21-0960p-2 which is the Mental Disorder DBQ (including anxiety) and VA form 21-0960p-3 which is the PTSD DBQ. All of these are good sources for you to determine if you were low balled and the info you find will be good ammo to appeal the low rating and justify an increase. Read them carefully and compare the symptoms noted with your PTSD and Anxiety symptoms. Don't hesitate to seek the rating you have earned and deserve as a result of your military service. JMO

Again, good luck to you