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Everything posted by SemperFiGeek
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New 'member' Steve, re: Dr Bash
SemperFiGeek replied to Berta's question in IMO Independent Medical Opinion
Shes still going @Tbird @Buck52. No consequences here for cyberbullying and defamation? Shame. -
C&P Exam Results, WTH is going on, Please Help!!!
SemperFiGeek replied to Navy04's question in Veterans Compensation & Pension Exams
don't trust them. ask for a personal hearing in writing within 30 days on the reduction. who knows what they will try and reduce later to knock you down. Write a sworn declaration that your scars are painful and that will count as new and material evidence. -
Sleep Apnea added to schedular?
SemperFiGeek replied to Steve G.'s question in VA Disability Claims Research
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Need some guidance -scratching my head on a denial
SemperFiGeek replied to AF_Comm_Vet's question in VA Disability Claims Research
apologize for any confusion but was just making sure you submitted the imo document itself with each claim because many times lazy folks at the VA won't go back and really read the record so submitting everything again helps and not just new evidence. -
Need some guidance -scratching my head on a denial
SemperFiGeek replied to AF_Comm_Vet's question in VA Disability Claims Research
on the most recent claim you submitted did you include the imo with the submission or was it just in the record? -
Need some guidance -scratching my head on a denial
SemperFiGeek replied to AF_Comm_Vet's question in VA Disability Claims Research
did you submit them again with the new claim? -
Need some guidance -scratching my head on a denial
SemperFiGeek replied to AF_Comm_Vet's question in VA Disability Claims Research
I got my QTC exam pretty quickly before the claim was decided by emailing bob mcdonald directly for them. -
Pretty sure these are the five options you are referring to that a VSR is able to request from examiner: 1. Medical opinion for direct service connection Choose the statement that most closely approximates the etiology of the claimed condition. a. The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness. Provide rationale in section c. b. The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. Provide rationale in section c. c. Rationale: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 2. Medical opinion for secondary service connection a. The claimed condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of the Veteran’s service connected condition. Provide rationale in section c. b. The claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service connected condition. Provide rationale in section c. c. Rationale: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 3. Medical opinion for aggravation of a condition that existed prior to service a. The claimed condition, which clearly and unmistakably existed prior to service, was aggravated beyond its natural progression by an in-service injury, event, or illness. Provide rationale in section c. b. The claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness. Provide rationale in section c. c. Rationale: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 4. Medical opinion for aggravation of a non-service connected condition by a service connected condition a. Can you determine a baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to aggravation or the earliest medical evidence following aggravation by (service connected condition)? Yes No If “Yes” to question 6a, answer the following: i. Describe the baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to aggravation or the earliest medical evidence following aggravation by (service connected condition): __________________________________________________________________________________________________________________________________________________________ ii. Provide the date and nature of the medical evidence used to provide the baseline: ____________________________________________________________________________ iii. Is the current severity of the (claimed condition/diagnosis) greater than the baseline? Yes No If yes, was the Veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond its natural progression by (insert “service connected condition”)? Yes (provide rationale in section b.) No (provide rationale in section b.) If “No” to question 6a, answer the following: i. Provide rationale as to why a baseline cannot be established (e.g. medical evidence is not sufficient to support a determination of a baseline level of severity): ______________________________________________ ii. Regardless of an established baseline, was the Veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond its natural progression by (insert “service connected condition”)? Yes (provide rationale in section b.) No (provide rationale in section b.) b. Provide rationale: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 5. Opinion regarding conflicting medical evidence I have reviewed the conflicting medical evidence and am providing the following opinion: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Proposed Reduction
SemperFiGeek replied to texboyer's question in Veterans Compensation & Pension Exams
If you are still within the 60 days from the date of the proposed reduction letter then file a new claim for increase for that issue. It will trigger a new exam. -
Tip I learned recently: If they send you a proposal to reduce immediately request a personal hearing within 30 days and file a new claim for increase within the 60 day period following and you will get a new exam before they decided on the reduction which gives you another shot to get it right. I received a proposal to reduce on 12/9/2015 and have all new exams scheduled for next week because i filed for increase again for the conditions they wanted to reduce. It confuses the heck out of them and they have to follow the rule most favorable to the veteran.
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C&P Exam for PTSD increase - might have backfired!
SemperFiGeek replied to Navy4life's question in Veterans Compensation & Pension Exams
Every reduction proposal comes with a letter that says if you don't agree with the adverse action you have the right to personal hearing if requested within 30 days of the date of the proposal to reduce. The law says the VA cant reduce your rating until you have the personal hearing which at this point its taking the VA about 6 months to actually get the hearing. Thus the benefit in filing a new claim for increase a few days after you request the personal hearing is that you will get new exams long before they get to a hearing and thereby have strong new evidence against the reduction for the hearing or they'll cancel out the proposed reduction completely and just decide the new claim(which is happening in my case). The best way to request the personal hearing is in writing. Use the IRIS system the day you get the letter or fax it to the centralized mail system. If you live far from the regional office you can request a video hearing. -
ptsd QTC/IMA Exams
SemperFiGeek replied to ozwald71's question in Veterans Compensation & Pension Exams
just make sure you prepare by reviewing the dbq because if the review shows any improvement they will reduce you!! -
C&P Exam for PTSD increase - might have backfired!
SemperFiGeek replied to Navy4life's question in Veterans Compensation & Pension Exams
Tip I learned recently If they send you a proposal to reduce immediately request a personal hearing within 30 days and file a new claim for increase within the 60 day period following and you will get a new exam before they decided on the reduction which gives you another shot to get it right. I received a proposal to reduce on 12/9/2015 and have all new exams scheduled for next week because i filed for increase again for the conditions they wanted to reduce. It confuses the heck out of them and they have to follow the rule most favorable to the veteran. -
Just wanted to give you all an update that I challenged the exams and was granted new exams for my knees and shaving bumps. The request for the new exams was put in on Friday 2/19. My question now is if they are requesting new knee exams are they getting new medical opinions based on those new exams since I was denied secondary connection for my ankles and back based on the faulty knee exam..
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Medical Opinion-Nexus Request Form Template
SemperFiGeek replied to SemperFiGeek's question in IMO Independent Medical Opinion
did they say why the couldn't print it? -
Medical Opinion-Nexus Request Form Template
SemperFiGeek replied to SemperFiGeek's question in IMO Independent Medical Opinion
Hope it's useful. Once I saw it in my claims folder I couldn't understand why the VA just didn't make a similar medical opinion request form available to all Vets to use. They could take that money they spend on contract exams And pay more vets directly!!! The one here can be easily edited for your specific use. -
Medical Opinion-Nexus Request Form Template
SemperFiGeek posted a question in IMO Independent Medical Opinion
Reformatted the one from cfile for our primary doctor. Sharing in case anyone else can make use of it. MEDICAL OPINION - Nexus Request Form.docx -
Anyone used Dr. K. Edwards for IMO? Former VA Doc
SemperFiGeek posted a question in IMO Independent Medical Opinion
Has anyone used Dr. K Edwards and have a review. here is his website: http://www.vadisabilityclaimsrelief.com/ -
VA tamepered with my Rating Code to claim CUE
SemperFiGeek replied to SemperFiGeek's question in VA Disability Claims Research
sharing here too so other vets can make sure they didn't get screwed in a similar same way. -
VA tamepered with my Rating Code to claim CUE
SemperFiGeek posted a question in VA Disability Claims Research
I just realized why the error occurred and in my opinion its a clear case of VA retaliation. What sucks is I would never have found this out if not for folks on this board and getting a copy of my cfile. These folks screwed me by tampering with my records because of a negative interaction my wife had with a rater about the severity of my knee pain at a VBA outreach event held here in January 2015. Two months later the VA sent me a CUE in my rating decision letter claiming pyramiding. Somebody changed my rating code and then tried to make CUE off of it. Look at the change in my rating code sheets below. The first 3 have the original rating decision sheets have shin splints coded as 5262-5022 and then the fourth one where they claim the CUE from the code had somehow magically changed to only 5262 so it doesn't look analogous: -
Yes, I have a copy of the exam report from QTC and will copy here. The doc who did my exam is a disgraced former OBGYN who was sued for malpractice for an infant death. Her error is public record on the state medical board site.