awgv001

I was also denied at the DRO level. When you file the appeals form, it asks for your choice in the options of in person hearings or video, etc. I have a video hearing coming myself, which is no different than an in-person (aside from the claim of the video hearing being faster somehow, but IMO, appeals are processed....when they become processed.) You can elect to "switch lanes" with the appropriate form, also located on the appeals page in va.gov ...however I have lost the link. It's better (IMO) to wait for the video hearing if you already have a docket number unless you have an absolutely critical reason for standing in front of the VLJ physically.

There's a link to upload evidence on the VA.gov front page? Are you saying once you log in that it won't let you upload the forms because there's no link for a pending claim? https://www.va.gov/disability/upload-supporting-evidence/

Alright folks! I secured a new appt with Neuro THIS WEEK! I got a copy of a DBQ in hand, and I'm prepared to ask a lot of questions, hopefully I don't overload this guy with too much info. I'm surprised that they don't offer a TBI DQB specifically on the DBQ page of the VA - so I'm planning on getting "Review Evaluation of Residuals of TBI (R-TBI) DBQ" which has a lengthy host of questions and further investigation found on NCBI - link provided below as well. Aside from whatever the "normal" workups are for this...What else should/could I do/ask during these appt's? https://www.ncbi.nlm.nih.gov/books/NBK542603/

You don't have to wait 3 months for the scheduled appt. - You can either do a walk-in, or call and schedule, or use MHV to set up an earlier appt. Yes, they seemed to latch onto the other diagnosis and avoided the 05dec2019 documents. Looks like you need an IMO/Nexus to further solidify your claim. Armed with that you can decide how to move forward. Ensure they include medical rationale so they dont dance around with the other "nonsense". Best of luck bud, I have had a terrible time myself dealing with Neuro, and Neuro-related claims so I sincerely hope they can get you the help you need.

@Berta @broncovet @Vync @El Train @CavScout19DRecon @blahsaysme2u @Richard1954 @Buck52 I'll try to keep these in order, have a few things I wanted to share to shed more light on my journey. The first two pictures are of the RAMP decision I got in 2019, and the 3rd image is the SOC (dated 2018?) Note - the claim is in docket at the BVA now. Also attached are the Nexus statements. Another note - (The one from Emory is the Nexus that was IN VA POSSESSION at the time of this RAMP decision, but not the 2 new ones. As always, thank you guys for your time, patience, and consideration. Let me know if there's something more I can substantiate for my claim. Biggest Note - I had lengthy complaints of the secondaries to TBI while in service, and had no issues getting SC'd for those (except the sciatic/back issues) and an initial low-ball rating on migraines. Let me know your thoughts! Ramp Decision Jan 2019 ~~~ In the fourth paragraph below they state I didn't complain of TBI - That's true, I didn't, but I didn't recognize at the time that the symptoms I faced were linked to it. The page below this line is the SOC I received, dated Apr 2018. NEXUS/IMO'S LISTED BELOW Now, I'm not sure why in this particular nexus that the Dr. used the Emory letterhead and not the VA one, as there was a reference in the "reasons" citing about my "private IMO" (This Dr. works at BOTH VA and Emory on alternate days.) These two were not in VA possession at the time of the RAMP decision.

Welcome to Hadit! Following, I go to neurology for TBI and secondary symptoms, wishing you the best when you get your packet/updates!

Good on you for appealing! Same as @vetquest, my small family couldn't take a blow like this, not to mention I'm not at the correct rating right now anyways (pending almost 8 years of backpay once my appeal goes through...) We we're on the brink of homelessness on at least 3 different occasions. Full time jobs are extremely limited in my small town without a college degree. Went through 3 jobs before I re-injured myself to the point that I couldn't work, at least for a while (spine surgery) - several denials, didn't get issued C&P's for a diagnosed condition w/ other caluza elements of evidence. All we can do is press on, until we either dead end, or succeed, and then help other fellow Veterans do the same.

While I can't answer about the multiple exams and timeframes, I can say that you will need copies of the correspondence sent "out" by the VA, no matter where it went, because it obviously did not make it to YOU or perhaps the lawyer. I don't know by what methods you have available for notification, and if the address with the VARO has been updated correctly. It may not be that the VA was misinformed, but had the wrong/old address, or simply mailed it to the wrong person even. This would be the specific "thing" you would need to argue in disagreement with the claims. Since it is a part of your claim file now, it should be available at the RO, or by chance MHV. EX: In my first award packet, I had my award plus an entirely different person's award letter stapled together. With social and details of their claims. This is a very gross error on the VA's part, and I'm sure it happens quite often, because it seems there is no "Quality Assurance" section that gives a second look after the first rater groups get a hold of our information. To summarize, the/your question is : "Advice requested...I have a claim that was denied in part, because there was a scheduled C&P exam that I was not notified of." "What can I do?" In the first post of this thread, this was not addressed as part of your big picture, and it can be edited to include this for further clarification.

@Buck52 I don't know anyone or have information on any specific doctor whom I would like to see, and I live in a very small area with pretty limited options unless they send me to Atlanta. When TriWest called and asked for my preferences I was able to shed light on what I would like (It felt like a breath of fresh air to have a choice in the matter!) So, I requested to be seen potentially within a week if available, and by a woman (I get tight lipped and lock up around male examiners, unfortunately both prior doctors were men.) - for neurology! I'll be sure to get their professional info, and speak up about what I'll I'm looking to have done with my visits. @vetquest Thank you for the information! Looking forward to getting some help. I understand that they may order new scans etc, to which I would be happy to do. Guess we will wait just a tiny bit longer and see. Hoping something will come through next week

I JUST started reading this, I had a C&P yesterday in regard to PTSD w/ depressive disorder, and when I read over the first couple lines here....I was kinda shocked. Your first question came halfway through my exam, and they did not warn me in regard to hospitalization, and though I answered yes, nothing became of it besides an answered entry on my exam, and a couple scribbled notes. I was also NOT asked the question of if I could manage my financial affairs, at all.....Was this a C&P for service connection? Mine was a re-exam...

Best of luck @pete992 - I know how this feels, coming from repeated denials for TBI for the past several years, then getting less-than-average treatment and evaluations... I felt like I was continuously misled both with and without intention. This time around I know what to ask for, and will pursue all avenues to not only be properly documented, but get help for the issues I still face today.

All I'm waiting on is my hearing, I'm in NOD too (but AMA cause I ramped to DRO and got denied...)! April 2019 Docket! (and with new evidence most likely because of the new neuro workups and stuff I am fixing to get too!) I will try to get the new neuro to IMO if it is allowed since it is Mission Act approved, but I don't know what the limitations are to my visits with this specialist....

@Buck52 From the other topics I posted, mainly in the TBI section, I recently spoke to my pcp and got a referral via Mission Act to see a new neuro very soon. I am hopeful, and yet worried about some details like....How many appointments with this person will I get? During evaluations and workups can I have them fill out a DBQ? Would they R/O or diagnose secondaries and provide a significant rationale with them to make my fight more bearable and less argumentive? Can a diagnosis of TBI be backdated to the day the injury occurred even if medical evidence is otherwise unremarkable (aside from the obvious secondaries?) I remember doing a light test, or something of the sort, they lay you back on a table and you can close your eyes and are essentially "resting"? I had something like that done a long time ago (2012) - I barely remember if they hooked up sensors and stuff to me, but I think so..the fact still remains that the first neuro I saw didn't diagnose the TBI and had only reported the syncope. Looking forward to getting more help, most importantly, the medical care.

@Buck52 - Mine was also a private office clinic, outsourced to VES by the VA. Everything else was professional IMO, and her response could have very well been appropriate I guess. She paused at one point and had asked me about any other perticular conditions she may need to know about, and I explained to her about the TBI that I was diagnosed for, but even after diagnosis was erroneously shot down by raters AFTERWARD. Regardless of the SC for that, it still does weigh a significant impact on my well-being, which was more of the point, I believe that she was trying to make/understand for her response in the evaluations. I have never had a sleep study, so I don't know if I have OSA (70% SC for PTSD currently, re-exam complete and awaiting further development ) - but I do have sleep disturbances and wake up at random hours of the night/morning often with dry mouth and headaches...but I also have migraines as attributed by TBI. (NSC yet, but WILL be.) No doctor in the past had ever referred me to one, and I am still learning about "who to see for these conditions" because it seems that if I don't specifically request them, the exam doesn't happen, despite a mountain of injuries. I don't want sympathy, I need a doctor who will R/O other symptoms to primary injuries To make matters worse I still haven't had a C&P for TBI and secondaries, and my claim now awaiting VLJ at BVA (had all caluza elements in tow before it was sent up there). I'm getting treatment, some of my injuries have worsened while waiting for my appeals to resolve...but since it's not service connected... How do we deal with (currently NSC, but will be some day) injuries pending adjudication that worsen while waiting for them to straighten out the first claim before proceeding? would it then become ANOTHER claim!? I may answer my own question here, but it seems to me that the medical evidence would suggest that once service connected, the treatment records showing the criteria for the next higher rating would take place and should have a date effective to the month after such...In a perfect VA world

Recently had an ACE exam myself, and yes, it can be up to 30 days before the information is entered into MHV. The other exams you did were "inside VA" exams? Those show up pretty quick most of the time. My clock just started today for another new exam too, both exams done by VES.

Seems like a strange thing, but I guess they have their reasons. I read up the HIPAA information on NOLO in regard to this... Like...did my examiner feel threatened I wonder? I realize I look like an angry Neanderthal. Otherwise, I'm just waiting to see how this issue concludes, and if I have to go through the gauntlet again.

@GBArmy I have a copy of their information from VES - (Psychologist) 8 years of med, 5-10 years of C&P exams

@VyncIt was offsite through VES --- I'm quite a distance from a RO (mine is Atlanta, GA) but there's a local clinic I regularly go to?? I have to physically go down there to get a copy? It's doable, but man, I may as well grab my whole C-File if I'm going to make that kind of trip, yikes. Everything else about the exam seemed to par - and the examiner seemed to be equally as dead inside as I feel, until this question of information came up at the end.

Will do @vetquest - I left out of there in a hurry after I heard that part (it was the end of the exam) Reminded me of the "bad exam" I had just before I got SC'd for ptsd in the first place.

In which case, that particular receptionist doesn't have SMC knowledge. Do you have a VSO helping you that could assist in clarifying the SMC breakdown?

For clarification then, do you have at least one contention rating of 100% alone? I assume this used to be the case because of the "Housebound" status. If it was reduced to say 70% but would have 0 impact on your 100% P&T rating, then yeah, I suppose you would no longer be IU, but still hold the P&T.

When/if you return to work, the VA will more than likely want to review what contention/rating you are IU for, and then attempt to downgrade it because you are working. If your work is not considered "gainful employment" (less than a certain amount per year) or is a sheltered environment tailored to your needs, then perhaps it won't be revisited. If you no longer are eligible for the 60% rule, and are being compensated for SMC-S, I would separate the amount of SMC into savings and not touch it, until an adjustment/correction is made. Be sure to document your correspondence and attempts to communicate the error with the VA. "C.Y.A." They won't regard SMC as "overpayment" otherwise, unless the argument regarding your claims is - fraud. Then yes, they will attempt to recover anything you stood to gain because of said fraud. I'm not saying this is your case, but that it has obviously happened in the past.

Went to the re-exam today for PTSD. Standard questions and explanations, and very intently impersonal. When I asked about getting a copy of the exam/results, they said that it's considered "forensic evidence" and I cannot obtain a copy of their details or recommendations. (I've never had an examiner NOT share their opinion's/thoughts in regard to my claim at least verbally, even on negative exams... this is the first time that one declined to answer. I most definitely want copies of my PTSD and Migraine exams/responses...otherwise, what chance would I have to stand on to fight in the event of an unfair C&P? Ridiculous. This is as simple as an FOIA request right? or perhaps in a few (weeks?) it will show up information on myhealth blue button?

Your answer is, your guess is about as good as ours. The VA raters are supposed to go with the recommendations provided by the C&P. As for the weight of evidence, typically the more detail something has, the more definitive it is, and gives less wiggle room to speculation and misinterpretation. You'll be able to review your C&P, and you'll also be receiving an award letter that elaborates on any benefits, or denials. Until then, I would suggest finding a hobby you find peace with. SOME C&P's can debate whether IU is a yae or nay, but not all. If it's for PTSD or TBI, those include recommendations based on IU etc. (I'm 70% PTSD myself btw, but not IU) If you get a 70% rating or higher, you can request IU. Do you have a VSO to help you out with some of this?

Don't forget! It's less common I suppose, but very effective! M21-1 III.iv.5.C.3.g. Correlation Between Effective Date for Primary and Secondary SC Disabilities The effective date of benefits for the causal disability is guided by the date of receipt of the claim for the secondary disability.