Okichewy1

You have to remember that the VBA and VAMC are 2 different organizations within the VA system.  When you submit a claim and the VARO gives you an appointment and an exam, that exam is technically part of your claim until the claim is completed.  Once the claim is completed you have the right to view it through a FOIA request.  I have heard that some VAMC (hospitals) are not uploading the C&P exams because they technically are not part of your medical, they belong to the VARO who is processing the claim.
Just my 2 cents.

This sounds exactly like my case.  I went to a C&P exam with a  contract doctor, he never wrote anything about my MOS and what I did in the Marines, VA denied the tinnitus claim.  Finally reopened the claim, same evidence, but VA did a new exam (this time with a VA doctor).  As soon as he found out I was a heavy equipment operator and shot a variety of weapons over 20 years, he was like YES, at least as likely as not to it being connected.  VA miraculously approved that claim.
Keep fighting and good luck...
 

This sounds exactly like my case.  I went to a C&P exam with a  contract doctor, he never wrote anything about my MOS and what I did in the Marines, VA denied the tinnitus claim.  Finally reopened the claim, same evidence, but VA did a new exam (this time with a VA doctor).  As soon as he found out I was a heavy equipment operator and shot a variety of weapons over 20 years, he was like YES, at least as likely as not to it being connected.  VA miraculously approved that claim.
Keep fighting and good luck...
 

This sounds exactly like my case.  I went to a C&P exam with a  contract doctor, he never wrote anything about my MOS and what I did in the Marines, VA denied the tinnitus claim.  Finally reopened the claim, same evidence, but VA did a new exam (this time with a VA doctor).  As soon as he found out I was a heavy equipment operator and shot a variety of weapons over 20 years, he was like YES, at least as likely as not to it being connected.  VA miraculously approved that claim.
Keep fighting and good luck...
 

Just had this done and approved.  I claimed anxiety and depression due to chronic pain in my knee and shoulder (both S/C).  I started seeing a LCSW (Licensed Clinical Social Worker) after my Primary care doctor stated that I had anxiety.  The LCWS said I had depression and anxiety due to medical issues and chronic pain.  I submitted my claim, had to do a MH C&P exam.  Was approved for 30% for Somatic Symptom Disorder (Formerly Chronic Pain Syndrome).  If you feel you have depression due to your pain, get it checked out and then go from there.

Just had this done and approved.  I claimed anxiety and depression due to chronic pain in my knee and shoulder (both S/C).  I started seeing a LCSW (Licensed Clinical Social Worker) after my Primary care doctor stated that I had anxiety.  The LCWS said I had depression and anxiety due to medical issues and chronic pain.  I submitted my claim, had to do a MH C&P exam.  Was approved for 30% for Somatic Symptom Disorder (Formerly Chronic Pain Syndrome).  If you feel you have depression due to your pain, get it checked out and then go from there.

Cool little town there, used to live right down the road in Levittown. Wish I still did with a doctor that is willing to help out the Veterans like this.

Had a MH C&P for depression and anxiety due to chronic pain. Was wondering what anyone thought it may equate too? I was thinking S/C at 10 or 30%. The claim is in Prep for Decision stage now.

This is what the doctor wrote for her MO:

1. Diagnosis

Mental disorder diagnosis #1: Somatic symptom disorder (formerly known as Chronic Pain disorder)
Comments: with predominant pain

3. Occupational and Social impairment

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational task only during periods of significant stress, or; symptoms controlled by medication


Medical Opinion:
It is felt with a reasonable degree of medical certainty that the veteran has somatic symptom disorder with predominant pain associated with chronic right knee and shoulder pain. He has a persistently high level of anxiety about his health and chronic pain symptoms and has spent a lot of time and energy devoted to these health concerns. The state of being symptomatic is persistent (greater than 6 months). His symptoms of chronic pain are distressing and have resulted in significant disruption in his daily life including but not limited to, sleep, pleasurable activities, concentration and mood.

I won my CUE all the way back to 1990 & was granted 30% for PTSD. Now how do I make them pay retro for my two children that were still in school at the time and for my wife. My daughter was 6 and my son was 14. Do I have to file a NOD for the retro payments for them ? Anyone ever had experience with this issue? I appreciate any input. Btw my wife was added as a dependent in 2008 when I was able to reopen my claim for PTSD.

When I won my claim back to 1994 last year, I got an audit. They gave me an accounting of my kids and the payments until each turned 18 and timed out (1995 and 2005). My dependent info was already a matter of record so it wasn't too difficult to accomplish. If you did not have your children/ spouse data/SSNs/Birth certificates in with the 21-526 back then, it's possible you will have to untangle it. A quick call to Allison Hickey or Call me Bob might make it happen in a shorter time. Congratulation, sir.

My VA doctor wrote me a NEXUS letter stating that my OSA was linked to my hypertension and hypothyroidism. Claim was approved within 2 months no C&P required.

The VA did my sleep study (at home and in person) through the local hospital since I live about 110 miles from the VAMC. They paid for it since it was a PCP diagnosis while I was only at 20% S/C. When the study came back through the VA sleep clinic as needing a CPAP and was moderate/sever OSA, they issued me a CPAP through Norco local office. I finally asked my PCP is she thought my OSA was associated with my hypothyroidism and high blood pressure and she wrote me a letter stating so. Sent that in as a claim for secondary OSA to hypothyroidism and it was approved within 2 months, no C&P required.

Good luck..

"am patiently waiting for this claim to complete and see if they fix it themselves, but if not, could this be a CUE claim? "


"I submitted a re-open claim for both in 2014, went to a VA audiologist that stated it should be S/C and also had a NEXUS letter from a private audiologist back up the VA doctors findings."

Have you had a C & P yet?

If the VA awards SC, and it sounds like they will, back to the date of the reopened claim, then YES it appears that you have a valid basis for a CUE claim against the older denial.

It these disabilities were at a ratable level when they denied the SC.

Do you still have the older denial and the rating sheet?

Does the rating sheet have NSC ratings at least at 10% for the tinnitus and the HL?

If you just won. why would you wait for it to be over and file a CUE? That makes no sense. You file a NOD for an earlier effective date based on the EOR. Once the claim is granted, it is malleable. You are allowed leeway to correct anything that is grossly wrong while you appeal. At some point, they agree and give you an earlier effective date. Do not make it harder than it needs to be as a separate filing. If you're pro se or even using a VSO, it makes no difference, They erred. Fix it while you can appeal it as an earlier effective date Fenderson issue..

"On the original denial, they stated that I never had hearing loss or tinnitus claims in my Service record, but if you look at my STR is with my C-file it is all there (I think the private doctor didn't even look at my medical record) but can't prove that. The VA doctor that did the C&P for the re-open claim was mad as hell when I talked to him and he reviewed the denial exam report. There was a lot missed what he stated and he made sure it was in his report."

Do you have a copy of that report?

This could possibly be a 38 CFR 3.156 issue if they deny again.

And a violation of my favorite regulation, 38 CFR 4.6.