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The VA established the secure messaging system. It is a part of the team care concept now. It is answered by the same RN normally, I had my PCP answer before, but not often. It must be up to the PCP to do so, but most of the time the RN replies. I can see how the situation pushes them into this. One PCP can have up to 2500 Vets to deal with, and most of them are seen 2x per year. That's 5,000 - 30 minute appointments a year, or an average of 96 per week. Making the system work for me is my primary goal, and this is the framework that I have to work with, so if an RN answers, as long as it seems to be a competent reply to my situation, then I am ok with it. End of game, either way, VA accountability is established.

VA did an evaluation prior to your ETS then? You might talk to a VSO on that, if that evaluation/decision was defective, you might stand a chance for retro. Maybe need a lawyer for a reopen on this, but if they failed to award you for a valid condition, and you can prove that based on your MEB and PEB, you could prevail. They would give at least the min rating. If the gait was altered in 2004,and you had pain, and you were not awarded anything from that, it might be worth checking into. Remember, regulations state that if a condition causes you pain, then you must be granted at least the minimum rating for it (10%). If you can establish that you had pain reported in the MEB/PEB in 2004, and then document the back/leg condition as it progressed over the last 11 years, they could grant a staged rating as the condition got worse.

Did you check the rating info on your spine? If you have 20% on the lumbar spine already from strain, you probably are covered. There is no addition for arthritis, its all based on ROM for the Spine.

If you have never put in a claim for chronic sciatica (from 2004 medical records) you will not be granted retro for it. If you were denied from a 2004 claim, never appealed, you can reopen, or CUE, depending on the file contents.

http://www.va.gov/opa/choiceact/# Info on Veterans Choice program. From what I understand, it is a case by case situation, if you qualify for it. This link details that info. I would not suggest using a non VA center until you read up on it. It could cost you dearly.

Private MD. Malpractice, failure to diagnose. Take the name of the MD, pull up the license info from the state. ID the states the MD practices in, and make full complaints to every single one of them. If you want, sue the MD. Force them to settle fast to keep it quiet, which is what they like to do. Now, you have this MD's report in your medical history. HIPPA laws allow you to demand that the VA correct them. Do it. Force the VA to follow the reg's, put in the request at the ROI/Privacy office, and make them fix this. Ignore it and it stays for life. Ya, I know, its a pain, you can go on and live your life and never be any worse off for it. You can walk away from it, but its a lot more fun shoving it down their throats. Falsification of medical records is a crime.

22 years ago I gave up drinking. I really needed to, bad. Cause and effect, playing with matches will get you burned, and everyone can become an addict or an alcoholic if you indulge in that manner that creates addiction. So, I swore off any and all mood altering drugs. Back and leg pain be darned, I controlled as much as I could in my head. Still went through serious bouts with debilitating pain for days on end when I had flair ups. I lived through it. Then my PCP sent me to phys. therapy. They gave me this exercise that made my back problem much worse, and then peripheral neuropathy went from 0 to 90 in about 1 week, 6 weeks later I have foot drop, weakness in my leg, and cant walk more than a block or so before my legs are fatigued and screaming at me. They gave me gabapentin. I told them no mood altering drugs, I was a recovered addict/alcoholic and that was a nono. Gabapentin is similar to opioids, and had addictive potential. They removed it from every prison in the country because of the abuse. I got high, for 2 weeks I felt great. Didn't figure it out, when I did, I shut it down. No more, thanks doc, but you are not supposed to do that to me. Be aware. Strongest thing I have is Meloxicam now. If you concentrate hard enough, you can take the edge off the pain.

The bell ringer will be when they see the % of appeals that are outright granted. or remanded for correction Its got to shoot up. It was around 75% error rate before this.

Open a small business. Incorporate it. Put it into your own name, or form a trust for your wife and kids if you want. Being TDIU does not stop you from doing things, you can work in a sheltered environment. Whittle whistles and sell them, make stools and haul them to a flea market. Do something you enjoy. Sign up for VR&E, get independent living to fund the equipment for you. Pay yourself minimum wage or work for free. Hire you wife, your kids, cousins and aunts and uncles, what ever. Their income will not affect your TDIU. Just keep it small, in your home in a protected environment, and it should be just fine.

What is the newest evaluation you have that refers to the right leg? I think the newest I see here is 2010, 5 years ago. Do you have one that is more current, like this year? (This is probably why you were denied.) You posted the answer; “Right Lower Extremity Peripheral Neuropathy. Service Connection for right lower extremity peripheral neuropathy is denied because the medical evidence of record fails to show that this disability has been clinically diagnosed.” If not; Go to your PCP, get him/her to do a DBQ for the peripheral nerves, and submit it as a reopen. There is no CUE because there was no current diagnosis for them to refer to. New evidence would do it. As reopen with a new DBQ, you should claim the C&P exam was deficient, cite exactly why, and present them with the new DBQ showing that your condition is current. Make sure you make the statement that the C&P examiner err'ed in his statement, that the condition has continuously existed since (2002?). They can still give you your original claim date if they determine that the C&P exam was not credible.

Raters cannot make medical opinions on their own. If they discount an IME/O, it must be done because they have a counterbalancing opinion or examination by a qualified medical professional that gives equal or better explanation to the condition. They cannot just say that because one MDs opinion says less likely than not without a valid, detailed explanation, that another MD's opinion is not believable. It must be based on sound judgement made by a medical pro, not a RO, and if they cannot provide a valid basis, they must consider all IMO/E's that you submit. If you go to a specialist, or someone who will provide a detailed thesis per se, providing the nexus you needed, as long as the wording was correct, it is very difficult for the RO to overcome it so that it results in a denial. If you had 2, they must have had a real solid cause. If they did not, then you probably would win on appeal. If they didn't document a valid or believable cause for stating the IMO/E held no weight, then you have a CUE. All things being equal, without a solid reason, this would be a screw up for the rater. You would need to copy/paste your award denial (make sure you blank out your personal info first) to get a solid handle on this. It would tell us the reason why they discounted the 2 IMO/E's you submitted.

It comes down to facts. I learned this from Bertha. Studying info here, I have come to realize that Bertha has opened a big hole in the VA game. They like to omit things like facts in their decisions. CUE's are based on either the correct facts were not before the adjudicator or statutory or regulatory provisions in existence at the time were incorrectly applied. The second part, about statutory or regulatory provisions not being correctly applied is the key. If facts that are contained in the C File are not considered in the process of making the decision, then that is an omission. They have to use all of the info in the decision or its not valid. Study up on what Bertha posts on the CUE issue, either way its great info. Pointing out their CUE is much faster than an appeal. If they are willing to correct their mistakes, without a formal appeal, it is best for everyone. 38 CFR Ch 1 Part 4 Subpart A § 4.2 Interpretation of examination reports. Different examiners, at different times, will not describe the same disability in the same language. Features of the disability which must have persisted unchanged may be overlooked or a change for the better or worse may not be accurately appreciated or described. It is the responsibility of the rating specialist to interpret reports of examination in the light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability present. Each disability must be considered from the point of view of the veteran working or seeking work. If a diagnosis is not supported by the findings on the examination report or if the report does not contain sufficient detail, it is incumbent upon the rating board to return the report as inadequate for evaluation purposes. § 4.6 Evaluation of evidence.The element of the weight to be accorded the character of the veteran's service is but one factor entering into the considerations of the rating boards in arriving at determinations of the evaluation of disability. Every element in any way affecting the probative value to be assigned to the evidence in each individual claim must be thoroughly and conscientiously studied by each member of the rating board in the light of the established policies of the Department of Veterans Affairs to the end that decisions will be equitable and just as contemplated by the requirements of the law. § 4.7 Higher of two evaluations.Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned Note; If you got your decision letter and the 2 denials had a basis that excluded service connection, then a CUE probably would not be helpful. If your IME would help the case, request they reopen/reconsider the claim with the new information provided..

I would also upload it on E Benefits as well. They made the system, you can get a validation that it was uploaded I think, and once its in, they cant hide it or lose it anymore. Mailing it in takes 3-4 weeks to get into the system, that's just back up now.

If there were fact in the records they had when they made the decision that directly contradicted what the decision states, and if those facts would likely have changed the outcome of the decision, isn't that a CUE? I am in the same boat with the lowballing of my rating. Records that existed in the VBA's possession when they made their decision contradict the C&P exam. It is their duty to go over this information, and if the higher rating and the lower rating are in equipoise, they must use the higher rating. Their failure to acknowledge the facts in the rating decision would effectively be a clear error that a lay person can identify, especially if that information inconclusively demonstrates that the higher rating is justified. A C&P exam done by a PA -vs- ongoing medical care by an orthopedic surgeon and a neurosurgeon shouldn't leave anything up for debate, but when there is something that is contradicting, shouldn't the PA take the backseat to the specialist? (I think so.) How do you make the VA CUE themselves?

In the ideal situation, we all could get IMO/E for our claims. Unfortunately many vets are not able to afford them, and rely on the VA to conduct these for them. A large number of those are declined, leaving many vets out in the cold for conditions they acquired in service to fend for themselves, in poverty.

It would be best if the VA were required to record video and audio of the exam and retain it as a matter of record. This would be a simple undertaking for the most part and require very little training for the examiners to accomplish. It wouild be as effective as a dash cam in a police car, protecting both the examiner and the Vet from any conflicts. It would also force the examiners to complete proper evaluations and report them in full, without omission, so that the whole truth is used in our claims.

I think its the total reported by the American Legion also.

So with a 100% condition already for an unrelated condition, you should have the two 30%'ers rated as bilateral, which would give the additional 60% for the SMC. That's basic. This is like a poorly trained clerk making an amateur error that a supervisor should have caught. How do you ask them to CUE themselves? I think when you make the formal appeal, its according to regulation, but reconsideration requests for them to CUE their error should be a simple sweep it under the rug error that they easily correct just as soon as you point it out.

Usually they will see a change in the blood tests that prompt them to test for HCV. The ALT and AST normally rise. Abnormal results is a first indicator. You can also ask the PCP to test you as well.

Secondary conditions are particular to the condition they are tied to. If you have heart issues, lung problems come with it, as do edema and other circulatory issues. If you have liver problems, a host of things can be affected. Chemical exposure from AO had so many, the list is exhaustive. Each individual condition has its own effect, Pancreas can be affected by the liver, kidney, chemical exposure and more. Brain trauma can have another host of by product, not only mental but physical as well, just like spine injury. Your neck specific can cause peripheral neuropathy of the arms, and hands, numbness in the legs can be cause by lumbar disc herniation's just like the neck causes the arms/hands. Many people are affected by cervical and thoraco-lumbar conditions, secondary to them are the effects pinched nerves have on the peripheral limbs. You can actually have your sciatic nerve paralyzed by the lumbar degeneration and get 80% disability for one leg. Both legs are bilateral, so ratings can get pretty high for severe secondary conditions. I've got Foot Drop and partial paralysis of the left leg from L4/5 and S1 problems. Find the specific service connected condition and google them, causes, effects, treatment, see if you have any other condition tied to that, and go talk to a specialist about it. Start with srs.org, and many colleges are tied to orthopedic and neurology sites for their .edu stuff with ton's of facts and reference for spine study and education that are tied to medical universities and hospitals.

The HCV (hep C) issue is a boiling pot. The US Military used Air Injection Guns to immunize millions of people through basic training up to the mid 90's. These guns were capable of spreading HCV. They have awarded disabilities due to this issue. That, combined with the fact that a much higher percentage of ex military have HCV, is an indication that many more should probably be awarded benefits because of it. People can live their whole lives with HCV and never know that they have it until it turns into a fatal condition, like cirrhosis or any one of a number of cancers. Thing is, nobody is out there beating the bush, running the numbers, figuring out how many of us went to the same training, got the same shots from the same guns, tracking us down and checking us for HCV. They have this ability at their fingertips, they probably already have a good idea about what it can cost, and they don't want to go public with this because its huge. People die from HCV, figuring how many are already dead, and linking those deaths to the possibility that HCV was involved, would open a hornets nets of litigation just from the estates of those who are already gone. This is about Diabetes I and II, non Hodgkin's lymphoma, fatty liver disease and cirrhosis, and a host of other condition that are related to HCV. The end result of telling the public all about it would cost billions. The end result of not telling the public all about is immoral, unethical, and leaves thousands/tens of thousands and possibly millions of people ignorant and at risk for all the problems that result from untreated HCV. This include the husbands/wives and children and grandchildren of the affected members. Balance the topic out, and I see why they want to divert so much to treating those with HCV, its a back door to a solution that is nothing more than a half step to evade telling the truth to the public at large. The Choice Card funds can be used to help hide the truth from America.

You should talk to your VSO and find out exactly what is past due. Were they asking for another exam that never got scheduled?

(d) Combat. Satisfactory lay or other evidence that an injury or disease was incurred or aggravated in combat will be accepted as sufficient proof of service connection if the evidence is consistent with the circumstances, conditions or hardships of such service even though there is no official record of such incurrence or aggravation. (Authority: 38 U.S.C. 1154(b)) Lay evidence are statements from the Veteran, his wife, children, family, as well as, buddy statements from service. Just 1 statement from any of his buddies is sufficient proof of service connection. Statements from the Vet, his spouse and family also are capable of providing that evidence if they can validate that the conditions existed when the Veteran got back from combat duty. Also see M21-1MR, Part IV, Subpart ii, Chapter 2, Section B 4. (d.) Accept satisfactory lay or other evidence that an injury or disease was incurred or aggravated in combat if the evidence is consistent with the circumstances, conditions, or hardships of such service even though there is no official record of such incurrence or aggravation. In order for evidence submitted by the Veteran to support a factual presumption that the claimed disease or injury was incurred or aggravated in service, the evidence must be satisfactory when considered alone be consistent with the circumstances, condition or hardships of such service, and not be refuted by clear and convincing evidence to the contrary. References: For a definition of satisfactory evidence, see M21-1MR, Part IV, Subpart ii, 2.B.4.e. For more information on satisfactory proof of combat-related disability, see 38 CFR 3.304(d) 38 U.S.C. 1154(b), and Collette v. Brown, 82F.3d.389 (Fed. Cir. 1996). Note: 38 CFR 3.304(d) is derived from 38 U.S.C. 1154(b), and lightens the evidentiary burden with respect to disabilities alleged to be the result of combat service. (e.) Satisfactory evidence generally means evidence that is credible. It is proper to · consider internal consistency and plausibility in determining whether evidence is credible, and · regard statements that contradict other evidence of record as unsatisfactory.

What reg is it? I was denied DBQ's from my PCP and the Spec, and they refused to give me any appointment to get the DBQ done.

"This week, VA reduced the disability claims backlog to 98,535." So why don't they talk about appeals? Some 313k appeals were on the books as of 24 Aug. 2015. (This is up 25k since Jan 2015.) In Jan 2014, there were 180k appeals pending. If you cipher the numbers, Jan 2014 they had over 600k claims pending. That number dropped 80%. The percentage increase in appeals didn't go up 80%. That's not so bad, no?