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Richard1954
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Posts posted by Richard1954
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31 minutes ago, broncovet said:
You can not "force" a C and P exam UNLESS so ordered by the BVA. The VA has a policy to not use a C and P exam "unless necessary". A C and P exam is likely not necessary if any one or more of the following exist:
1. There is already evidence in the file. Remember "evidence" is evidence, there is nothing special about a C and P exam except that, sometimes the VA will request the doctor supply some specific answers to questions. In the case of an increase, you need documentation that your symptoms have gotten worse.
2. That a C and P exam wont change everything. For example, a C and P exam is unnecessary if you do not have an "in service event"...this would have had to have happened "in service" and a C and P exam wont fix that problem.
Its true that a new exam "may" be good for you, if the exam documents worsened symptoms. However, you could do the same by simply making an appointment and telling your VA doc how your symptoms have worsened since 1986.
I can' t help but disagree. I have forced c/p exam just last year. I had opened 2 new claims and reopened 3 claims in the last year. Most of the Medical evidence was based on VA Medical records, and I still had C/P's even when two C/P exams were claimed to have been done over the phone. I raised hell, and they ended up doing an actual physical C/P exam. Most veterans won't have an examination in va records or any other medical record that qualifies for a VA Exam unless they are actually done on the VA Form... That is one reason c/p exam are done, another reason to request a c/p doctors opinion. And trust me I know an c/p exam done in person makes a lot of different than the review of the record especially, when the va only reviews the va medial file like in my case for TBI and then denied claim, until I raised hell, and went to a new C/P e exam with all the information that had been submitted with the claim.....that did not come from va records. My TBI was in service, and had been ignored by the va for over 31 years(even though in was in the medical file) because it wasn't called a TBI in 1986 it was called a concussion. I did my research when the newer veterans started getting TBI claims and found TBI was the new name for concussion. In fact in 1986 VA did not have a rating for Concussion or TBI go figure... Just Like sleep apnea, ( which I just got awarded last year, base on active duty and private medical records). in 1986 they did not even have the name sleep apnea. So you see a C/P can make a big difference if it is done right and the doctor is willing to ask questions and listen during the examination. And yes you can force them to do a a physical C/P exam. TRhe ACE exam procedures will screw a veteran up badly.
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41 minutes ago, Buck52 said:
Reopened Claims
Normally, the effective date for a reopened claim is the date of receipt of claim or date entitlement arose, whichever is later.
Can't figure out what all that had to do with my initial post. Which concerns the VA requiring all claims to be submitted under the New expedited claim process. That wasn't supposed to go into effect until Next year. Now we have no choice, now we have to seek out an examination using va exam form before we can submit claim. Now looks like va will not do any c/p exam in person. Now it looks like you must submit all the medical evidence with the claim ( my understanding they aren't going to get medical records) So now you see how they call it an expedited claims system. They do nothing but review the claim and make a decision. I see a lot of appeals. Garbage in Garbage out... If you don't have a veterans service officer you may be forced to get one.... I am stubborn, I do all my claims myself.....Anyway I feel a lot of shafting comping to pass.
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I just tried to file a reopen claim for my right knee ( hasn't been reevaluated since 1986) I tried to do it on line. VA Is screwing us. The are forcing anyone using the online claim system to file the claim under the new system. That means that are going to make you have a docor fill out the exam paperwork for the issue, and sub,it that will all Medical evidence. They are not going to do a damn thing for us. They want us to do it all. I told you guys this new system sucks.I am going to file the old way, and force them to give me a C/P exam. I don't trust this new system at all... they are in such a hurry that mistakes are going to be worse than ever before.
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16 hours ago, Okemos_Veteran74 said:
I admit it. I am lost. I don't understand a lot a lot of the posts or responses concerning the concerning SMC S orhow to qualify for it.
In my case all of my injuries occured from one service connected injury. So would that mean that I would never qualify for SMC S because my additional disabilities are related to my tbi accident/injury? I Have heard Buck52 write something about that onlybeinv one of three ways of qualifying for SMC-S.
Maybe someone could write a bookentitled "VA Benefits, For Dummies", if someone hasn`t already.
OK PVA of America made a great book its dated 2004 but it still applies for the most part so I am going try to upload it PDF for you SMC Guide.pdfSMC Guide.pdf
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I don't know if it will add to the time it takes to process a claim, but I do know that all veterans should fight against the practice of Acceptable Clinical Evidence exams. This is the name of C/P exams that are conducted over the phone. They do not allow a doctor to actually examine the veteran, they just review the records ask a few questions over the phone sometimes, and sometimes they do not even call the veteran. I had a ACE conducted on me for a heart condition with out my even knowing it, when I raised the issue in a public forum at the Local VA, and demanded a hands on exam which I finally got. Not less than a month later another doctor called me to do an ACE for sleep apnea. I hung up the phone on the doctor, ( who actually trained to be a doctor in Burma) and immediately called the VA and demanded them to do a hands on exam or I would immediately get my Congressman involved, ( who's office is on the way to the local va). The results of the ACE heart exam were actually different than the hands on exam. The results of the ACE sleep apnea exam actually resulted in a denial 4 days later. The hands on exam was different and I was awarded Sleep Apnea 50%. Look, hands on C/P exams present problems from foreign educated doctors, to doctors educated in a foreign country, to PA's who have no business being a PA, to NP who in my experience are the worse. And to top it all of you get someone who has an accent so thick you cannot understand a thing they say. But with all the problems, they are still better than an ACE examination. It should be unlawful for an ACE exam for compensations purposes or for that matter any other purpose. The va does this to save money and no other reason. The started doing ACE's in 2013 and in some cases they will call identify themselves as a va employee ask a few questions about a condition and then never tell you what they are really doing it happened to me. I don't like these exams, its not fair to the veteran, and there is no way that an ACE will catch all the problems. Fore example try doing an ACE for a knee injury, how in hell can the examiner see your face wince in pain when they can't even touch you! Anyway best of luck to you , I hope you get the award your looking for.
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On 5/8/2018 at 2:29 PM, stumpy579 said:
I Until then they are sending out invitations once per month and they are going by NOD date oldest to newest.
My pending NOD's are about 18 months old and I received the first invitation 2 months ago, so that doesn't seem correct
I think the idea of the invitation was to get some veterans into the new system and for the va to get a feel how quick the process would go before the Feb 2019 activation date. I think what will happen is that all claims from that date will automatically go into the new system. It seems to me if this new system is supposed to be so quick, that it would just make more sense to move all claims over to Ramp after the Feb date. I just don't trust the VA to actually move any faster. When people get in a hurry, that is when mistakes are made, and that is the biggest problem with the present system. A newer quicker system will in all likely hood make more mistakes.... The VA needs more people to do the work more than anything, and unless they get more people, a new system isn't likely to be any better.
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On 5/8/2018 at 2:29 PM, stumpy579 said:
I Until then they are sending out invitations once per month and they are going by NOD date oldest to newest.
My pending NOD's are about 18 months old and I received the first invitation 2 months ago, so that doesn't seem correct
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On 5/7/2018 at 5:22 PM, Buck52 said:
Also if Veteran opts to the RAMP Program and feels its only a waist of time or to slow for what ever reason they are not satisfied with the RAMP Program they can opt out and go back in the traditional claims process.
I don't think that is correct, once in you cannot go back... at least that is how I understand the letter that I received....
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On 5/6/2018 at 2:00 PM, pwrslm said:
I think that this is the exception rather than the rule. If it took 10 years for everyone to get a NOD replied to the stink would really make the VA pay attention. Press would be all over that!@!
I'm not even sure I will get a SOC by then (if they dont grant my increase).
I don't think it was the exception...actually I have been told 10 years was really fast.... go figure....
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On 5/7/2018 at 2:32 PM, Gastone said:
R-1954, TBI's unless Severe Scaring or Dents, is currently Rated for directly associated MH and Physical Residuals currently DX'd , what exactly did yourTBI Award Letter assign the 40% SC too?
Any chance of posting a redacted copy of the C & P TBI DBQ and Award letter, could be very informative?
8045 TBI w/memory loss & Encephalomalcia ( brain damage)
40% from 09/20/2016
thrown our of a military Jeep in 1975 while moving hitting head and being unconscious for 3.5 days
Sorry it takes to much time and effort to redact, copy and post so this will have to do....
(Notice the award date... now I have a claim for cue to go back to 1986 when it should have been awarded)
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Yes a VA doctor can write a medical opinion, in fact by VA regulation they must write an opinion when you ask them too.( see VHA DIRECTIVE 2008-071) In the past, I have gotten statements from VA doctors in support of my claims, but with the exception of one time, I always seek a second or third medical opinion in writing. I never rely on an opinion from a C/P doctor. The VA is not supposed to be adversarial, but you will find that if you rely on a VA c/p opinion most times the claim will be denied.
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In my opinion the VA will almost never look at any condition other than the condition that you are claiming in your request for service connection. Sometimes , the va will have to look at the other condition for various reasons, however a reduction is not normally one of them. Broncovet made a very good point, many people have repeated the scare tactics over the years but it simply is not true. I believe no matter what your rating is, if you feel the VA should award you additional compensation, and you have the medical evidence put in the claim.
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On 5/3/2018 at 3:36 PM, Grumpbox said:
@Richard1954 Richard - fill me in on all should know about Medicare, please Sir??
Lets say I do this...apply for SSD. Naturally, I will lose my Tricare.
Question 1. I assume my daughter who is under 18 and wife can continue to remain on Tricare? But I will have to start Medicare, which comes out of my social security disability. The social security office told me this amount was about $134.00. However, I researched the Medicare.com site and this is for Medicare Part B. The entire Medicare program is a conundrum to me.
Then there is drug coverage? But can't I continue to receive this through the VA?
No you do not lose your tricare , your family remains on tricare, in two years Medicare will allow you to buy Part B, and when you buy part B, you will pay for your family to stay on Tricare, but tricare will be free for you and becomes your second payer. You family will still have drug coverage under tricare and in your case VA.
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On 5/4/2018 at 6:33 PM, seminoles said:
The problem I have with Champva is that no one wants to take there allowable, or even bill it. It is horrible. That is why we keep our other plan.
Champva pays exactly the same that Medicare and Tricare pay. So if you can't find someone to take it... chances are they aren't going to take Medicare or Tricare either... Also Tricare nor medicare pay for dental. anyway.....and I don't think Champva does either
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On 4/26/2018 at 3:20 PM, Wayne TX said:
If you have say multiple NODs just recently denied........there's one you really feel strong about and need that one to qualify for TDIU consideration..........can you just file for that one individually and let the rest (smaller percentages) just play out by filing a Form 9 under current BVA Hearing process backlog In other words, where multiple denials are involved can you choose what denials to opt into RAMP or do they all have to be done together under Form 9 and not be separated?
The opt in letter I received made it very clear, if you opt in it covers all issues not just one issue...
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On 4/9/2018 at 8:07 AM, broncovet said:
In other places, the VA has said that Vets who opt in to Ramp will be given priority at the BVA docket, so its even possible or likely that opting in to ramp could get you to the BVA earlier, also, as your Ramp would propel you above all the other "non Ramp" vets awaiting for BVA.
Giving ramp claims priority over those already in the system would violate the law of first in first out ... just doesn't seem right...
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only 2,462 veterans opting in out of the 84,546 veterans invited. That’s about a 3 percent opt-in rate, which falls well below VA’s projected 10 percent rate.
As I said in another thread. I spoke with a few lawyers who recommended against opt in to ramp. They explained that the VA doesn't have a handle on how this is actually going to work. I myself decided not to opt in because I understand the old system. No telling how long it will actually be before anyone understands the new system. With only 3% opting in, that tells me that other veterans, ( and maybe lawyers) have less than favorable opinions about this new system. I also don't like the 43% rejection rate... How long will it be before these veterans get an accurate review, or are able to appeal on those decisions.
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On 5/4/2018 at 2:32 PM, Michaelreconscout said:
This is a tricky brain buster. I need all the help I can get, any recommendations are welcome!
So this is a complex case. I am about to receive a decision for a TDIU claim that I filed 3/2018. I have alot of evidence, a good C&P exam for once, and a professional vocational evaluation, so I am thinking things are looking ok, but I know with the VA anything can happen, and ive seen it. I am currently 80% combined (70% PTSD, 10%back, 10% knee, 10%tinnitus, 0%tbi) effective date 3/2005. In 2008 I filled out a va form 21-8940, and filed for TDIU, (I was still 80%) combined. This is what happened:
I can't help but wonder how any one gets 0% for a TBI. I went in for a C/P exam on my TBI and answered a few questions and was awarded 40%. It was the easiest c/p I had ever attended, in fact thinking back if I had worded a few of my answers differently I am confident I would have been rated even higher. Anyway....
I don't think there is any CUE, the va proposed to reduce your disability for PTSD, and denied your claim for TDIU on 8 Nov 2007. Then it appears a new claim was opened in May 2008, . and they decided not to reduce the rating of PTSD 70%. Previously they said that you could perform sedentary work, they apparently decided that you did not meet the requirements of TDIU, and therefore they are not obligated to send you any forms. Did they reduce any ratings at all?
Now at one point you said that the PTSD examiner said you could not work, but they also said you could perform sedentary work.. Very confusing.
Seems like some information is missing?
How may rating decisions did this entail ?
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On 5/4/2018 at 11:49 PM, pwrslm said:
I put in my NOD about 60 days ago. The letter back states it can take them over a year to do the Review/SOC, and after that I have to file a fm 9 if I still want to appeal.
I think at this stage, no matter which way I go, I won't get to the VBA before Feb 2019. TGuess again, I just had a case at the BVA that took 10 years to get there......I'm not kidding this is not laughing matter, 10 long years......
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10 hours ago, Berta said:
The OGC Pres Op 09-94 cited ,states:
The widow, in the case above , like me , continuously appealed any negative decisions from the VA, thus we had no "final adjudications" of our claims when ,in her case, Bradley V Peake was decided and in my case, when Gardner ( USC 351 ) was changed to Section 1151 USC..
Again you may be correct but I can't help wonder why the BVA said:
When the Court issues a decision invalidating VA's interpretation of a statute or regulation, this does not amount to a change in statute or regulation. Indeed, when the Court issues such a ruling, it is, in effect, informing VA that it has been misapplying the existing statute or regulation. Therefore, the RO is incorrect to consider the date of the Court's decision in Bradley as an effective date based on a change in VA regulation.
Because if they made the decision based on the claim having never been final, then the about statement was not a necessary statement.
I am confident that the BVA will continue to deny any claims that were finalized before the Bradley decision.
However, the VA had two conflicting General Counsel Opinions in effect prior to the courts decision, one saying Housebound should be awarded, the other saying do not award. How did the VA justify this issue ? The VA never tired to reconcile the opinions, so how could they just deny the SMC without regard to the other opinion that said to award. I bet years ago there was some discussion about this so I won't go into any long winded discussion now .
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On 4/1/2018 at 5:07 PM, asknod said:
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I have never heard of Allsup.... are they new?
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2 hours ago, Berta said:
The widow, in the case above , like me , continuously appealed any negative decisions from the VA, thus we had no "final adjudications" of our claims when ,in her case, Bradley V Peake was decided and in my case, when Gardner ( USC 351 ) was changed to Section 1151 USC..
So that is how I interpret this statement:
I see what your are saying, but in this case the BVA denied her claim once and she went to the court, who vacated it and remanded it back to the RO, the regional office then gave her a date based on bradley and then and only then did the BVA say she was entitled to the Aug 2003.The BVA may have decided her case this way because of what you say. But if that is what they are saying then why did they ( the BVA) deny it on the first go around.
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I have found a decision on the BVA that determined that retro for Housebound should go back to the date the veteran met the statutory requirements for SMC, not the date Bradley v Peake was decided which was 26 Nov 2008. It granted 14 years of retro
The claim was originated on 31 Jul 2008 for accrued benefits 4 months before the Bradley date
The veterans widow appeal the case all the way to the Court of Veteran Appeals
it was remained back to the regional office in Jan 2016 which vacated a Jul 2015 BVA denial
The RO awarded a claim back to 26 Nov 2008 the date of the Bradley decision
The widow appealed it again indicated veteran was due SMC on 2 Aug 2003 the day veteran was awarded TDIU
The BVA said:.
When the Court issues a decision invalidating VA's interpretation of a statute or regulation, this does not amount to a change in statute or regulation. Indeed, when the Court issues such a ruling, it is, in effect, informing VA that it has been misapplying the existing statute or regulation. Therefore, the RO is incorrect to consider the date of the Court's decision in Bradley as an effective date based on a change in VA regulation.
By rating decision of September 2008, the Veteran was granted TDIU from August 2, 2003. He met the statutory requirements for SMC, by reason of housebound status, at the time of the claim.
But for VA's interpretation of 38 U.S.C. § 1114(s)-later determined by the Court to be incorrect-the Veteran would have been entitled to SMC benefits from the date of his claim. Accordingly,
based on the guidance offered in VAOPGCPREC 9-94, the effective date of the claim should be retroactive to the date the Veteran met the criteria for the award, now August 2, 2003,
because at as a result of the award of TDIU, which counts as a single disability under the Bradley and had other service-connected disabilities that (1) involve a different bodily system
than the 100 percent disability and (ii) are rated at a combined disability rating of 60 percent or higher.
38 U.S.C.A. § 1114(s).Decision Date: 01/10/18 Archive Date: 01/23/18 DOCKET NO. 13-17 517 ) DATE
https://www.va.gov/vetapp18/files1/1801821.txt
Be advisied
in VA Disability Claims Research
Posted
They may have discretion, but go to a VA open house that have the local congressmen and veterans organizations and see how fast they change their tune. The is always a way around the va policies if one is willing to take them on, of course you have to pick your fights, but in this case I did and I won.