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El Train
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Posts posted by El Train
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I had 5 c&p's for TBI initial claim and PTSD increase. 4 of them were 'at least as likley as not' in my favor. I had one bad c&p out of the 5. I contested this one to the VARO. Later I was awarded 100% P&T. When I got my C-file recently, They had 2 Psyc Dr.s (none which did a C&P) comparing all the C&P's. One of them actually was siding with the bad C&P Dr's evaluation as me being an unreliable reporter. In other words, a liar. The other one ruled in my favor as being a reliable reporter and the two negative opinions didn't make any sense. It worked out in my favor, but they had a couple of Docs try to side rail my claim.
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Buck is spot on. I had a bad C&P(PTSD) for an increase. It went bad from the start when I gave her an outside Psyc DBQ and nexus. This pissed her off and her exam reflected it. I filed a formal complaint with the VARO. The VARO didn't xxxx around. I found myself doing two extra C&P's. 6 months later, 100% PTSD/TBI P&T.
I just got my whole C-file. Surprisingly, they had other Psyc. Dr's taking the bad C&P info into consideration; even though I had overwhelming evidence. They deemed the bad C&P exam as not making sense and that I was a reliable reporter.
Best of luck to you. And as Buck stated, if you don't know an answer, say you don't know the answer or don't understand it. Don't make it up or let them force you to answer.
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I sent a a formal complaint letter to the VARO due to a bad C&P exam. Pointed out a few inaccuracies and other medical evidence. Soon after that, I had more C&P's for the same condition. 6 months later, 100% P&T. The VARO doesn't mess around. Hopefully they fired this examiner.
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Same here bro. But I had the IMO in hand when I went into the C&P for a PTSD increase. Thought I would save her some time. She got pissed and did her damnedest to discredit my Psycs IMO. Except she failed. I immediately upon getting my hands on the C&P filed a complaint with the VARO. Three follow up C&P's later, 100% P&T.
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Was your original C&P done by VA or VA contractor? I've never been denied a claim in which the VA or VA contractor stated 'at least as likely as not'. Outside Dr's nexus and IME have been about 50% approval rate. The VA sent me for C&P's for all conditions claimed. Some agreed with the outside IME & nexus, and some did not. The ones that VA disagreed with were denied.
I think you might have a CUE if it was a VA contractor or the VA themselves. Since they are hired VA guns.
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You get a colonoscopy done? Like you, I got service connected for GERD (0% gulf war presumptive). My IBS claim got denied a few years back because no diagnosis. I got diagnosed by three different Dr's. All MD's (one GI specialist). All had it at severe which should have been 30%. They combined it with my GERD and left it at 0%. Fuckin really? I'm 100% P&T. Not going to mess with it because it won't get me any back pay or increase. If it kills me, then my wife gets benefits. Didn't want to say DIC in that last sentence for unspecified reasons.
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1 hour ago, jfrei said:
my C and P is scheduled for a Saturday at 1030 VideoConnect exam the 26th. Hope it goes better then my last va appointment VideoConnect that I was only able to see the doctor for seconds before we did the whole appointment using texting....Nope Iraq and Afghanistan vet
Just make sure they know they are painful. Maybe a statement in support. Painful to the touch, temperature, scaling, flaking, etc. And fwiw, I believe you qualify as a gulf war vet. Someone will correct me if I am wrong.
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I have 80% overall for scarring. Face and neck scarring at 50%. Scarring with underlying damage chest 30%, scarring with underlying damage back 30%, painful scarring neck, face, chest, 30%. Originally they gave me only 10%. I filed an NOD with additional outside medical IME. Got increased to the 83%. Now I have a law firm trying to get retro pay from 1993. So far they have retro'd it 10% to 1993. So the fight goes on for the rest of it. Maybe they didn't include painful scarring or scarring with underlying damage. Those can add up quickly.
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My TBI claim took about 14 months. TBI is a tough one for VA to determine. I had 3 C&P's from QTC for TBI. Then I had 2 C&P's from QTC for PTSD. Some of these C&P's were combined TBI & PTSD exams. They were just trying to differentiate the PTSD and TBI symptoms for me. A lot of overlapping symptoms. They did separate migraines at 10%.
The only reason I got the TBI claims rolling, was I had two different diagnosis from outside Dr's. One a medical MD and one from a Psychologist. Otherwise they would have threw it out. Guaranteed.
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22 hours ago, MrPain7 said:
El Train: if your already a 100% why would you need a IMO or Dr.bash ???
I wasn't always 100%. I got the IME's for contentions I knew the VA was sure to deny (and they did on a few of them even with IME's). I went from 60% to 100% P&T only after submitting my IME's for new contentions and increases on current claims. Hope my explanation is clear. TBI was one of the new claims is where I have a hard time finding proper explanations. Not knowing the right word or term, etc.
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18 hours ago, jamescripps2 said:
It takes a disabled veteran years of misery to accumulate $10,000 in backpay.
Actually it takes less than 4 months if you get to 100%. But I agree, $10k is a lot of up front money. I paid way less to get Dr. Ellis to provide me with 6 IME's. There's options out there folks.
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I've had a VA NP over rule my MD's IME for a few claims. So go for it.
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14 hours ago, Buck52 said:
You might want to check with Hadit Mod & Member broncovet he is pretty good with these EED's and the regulations to win them.
Do you mean you got an increase for the scars? from 10% to 80%???
I don't think I understand that?..unless you have a combined rating to reach the 80%for another S.C. Condition? Injury or Diseases?
It got increased from 10% to 80% (all scarring related). The VA lowballed me the first go round. They excluded underlying tissue damage, scarring that is painful, and the area in which the scars cover. It's been like this since being in the military. It never got worse or improved since getting out.
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13 hours ago, broncovet said:
If you have CCK and woods and woods, well, you have some of the best. What did they tell you about this?
Your effective date is the later of the "date of claim" or facts found. The facts found usually means the date the doc said you were disabled.
New service records (38cfr 3.156c) should apply here, since you indicated the records were eventually found. If you applied within a year of exit from service, you could get an effective date back to your date of discharge.
Since I havent read your file, I suggest you do as ccklaw, and woods and woods suggest. If you have 2 giant law firms working this, they obviously think you will win.
CCK is very vague with me. We're looking into all options, is the standard answer. I'll let them do their thing and let the chips fall where they may. I did apply within a year of discharge. Right now 10% backdated is a good start (minus attorney fees). The increase to 80% came via an outside MD opinion 'More likely than not, this was aggravated in service. The VA agreed, thus increased to 80% after their own C&P. It sure didn't get worse when I got out. The damage was done and explicitly documented in my service records. I think it's a good case. A battle is brewing my friends.
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I have CCK in partnership with Woods & Woods working it. And I believe they put in an increase for the rating as well.
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Long story short. I claimed scars in 1993 when I exited military. Denied, couldn't find records. Denial letter states 'if we find your records we may reconsider'. Fast forward to to 2017. Found my records in storage, filed again for scars. Got 10%. Filed an NOD and got an outside IME. Had another VA C&P that turned out great in my favor. 80% overall for scars. Hired a law firm to get back pay from 93. They granted the retro at the original 10% and not the increased 80%. Go figure. They aren't gonna give that 80% back to 1993 easily I guess. The fight continues. I'll keep everyone posted.
The fact they backdated states they agree it should be granted I suppose.
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Yes. It would help if you had an MD diagnose it though. I hired one for all my issues. Then I hired a psyc Dr. to verify the Md's diagnosis and do an additional DBQ. The VA then proceeded to do a total of 3 C&P's for it. The first QTC psyc Dr. agreed with both outside medical opinions. The additional C&P's were just for clarification I assume. I'm still waiting to get the C&P's I asked for 6 months ago.
My TBI was from a training accident which knocked me out. It's in my medical records. But now mention of being knocked out. I think your records are better than mine, stating you we're knocked out.
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They probably won't reduce your migraines. Those are secondary to your TBI. But who knows when it comes to VA. I have 70% tbi, 10% migraines. They combined TBI with my PTSD for 100% P&T.
40% is max for Fibro. Basically it's a widespread body pain rating that your friend has. Usually when they can't find what's causing the pain. He needs to look into TBI. It is not an easy fight with the VA. I had an outside Dr. and Psyc. Dr. diagnose me. Then I proceeded to have 3 different C&P for it (long crazy ones). It's tough because they were trying to differentiate TBI & PTSD symptoms. I got denied CFS because of TBI/PTSD symptoms, which makes sense.
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The above answers and sign into vets.gov site. Sign up if you don't have an account. If it's not on there, then they lost it.
I've had diagnosis for IBS, Fibro, & CFS. I got the max for Fibro, denied CFS (due to PTSD symptoms causing same conditions) and 0% for IBS with Gerd, which is BS. Not going to fight it because the IBS is service connected and I'm 100% P&T SMC-S prior to the IBS decision. So no retro if it was accurately rated at 30%. In fact I'm not sure they give you a percentage once you are 100% P&T. It might be just the 0% connection regardless.
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I have one like that rated at 0%. However, the TBI rating was at 70% because of the accident that caused the scar. It took a Neurofeedback Psychologist to figure out that TBI. All other shrinks wanted to treat me for PTSD and throw meds at me. The TBI symptoms are what kicks my ass the most. Just throwing that out there. It took 25 years after service to file for TBI. It's a tricky diagnosis and a tough battle with the VA. BTW I have 80% for other disfiguring unstable, underlying damage, painful scarring of head neck and face. VA originally tried to get away with 10%. Outside medical Dr. opinions helped my claims tremendously.
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I agree with bronc. QTC has been more than fair. Can't say the same with the VA C&P's. I have only had one bad PTSD with a QTC shrink. I complained to the VARO, and got another one. Just don't do what I did and piss them off. Be cool calm collect. And sometimes less is more. Just answer their questions. Don't ramble on.
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I had an in person exam and got diagnosis for IBS, Fibro, and CFS (all presumptive). I got approved for Fibro 40%, 0% IBS (which isn't correct according to the 3 Dr's diagnosis notes), and denied CFS. The CFS denial was based on other symptoms causing it (PTSD/MDD). Not sure I want to contest the IBS. I'm 100% P&T with SMC-S.
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I've had the opposite from the VA. Denied on all physical claims (with plenty of evidence and treatments) and approved on mental issues. I guess they did give me TBI based on the injury that also caused lifelong spine issues. But they combined that with PTSD for 100%. I got Fibromyalgis without any treatment records. Go figure.
Is the VA still accepting the DBQs, as they have retracted them from their website?
in VA Disability Claims Research
Posted
An outside DBQ or IME (in my case), can get the ball rolling for a claim the VA refuses to acknowledge. Or it can be evidence for an increase in an original low ball rating. Yes, the VA will send you to a C&P once you turn these in. In some cases they may agree with the outside assessment, or do their best to refute it. It was both in my case. But in the end, I got a rating of 100% P&T with SMC-S.