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ed33
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Posts posted by ed33
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Hi everyone,
I had questions about my BVA appeal. I was denied my higher level review so I opted to keep moving forward with a BVA review. When filling out the appeal I selected the in-person or video conference option. VA.gov shows I am waiting for my video conference date. However I am local to Washington DC and would like to actually go in person in front of the judge. How do I go about selecting that option? Do they just look at where you are located and pick an appropriate option? During the process it never specifically asked if I wanted in-person or video.
I appreciate any info anyone can provide.
Thanks
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50 minutes ago, Vync said:
Here's a link to the Gulf War presumptives page: https://www.publichealth.va.gov/exposures/publications/gulf-war/gulf-war-winter-2016/gulf-war-presumptives.asp
I agree with the other members. However, the wording "skin conditions" appears to be all-encompassing. That site does not indicate any exclusions. In my non-professional opinion, any kind of skin cancer could be considered to be a skin condition.
I looked up Gulf War presumptives in M21-1 (the VA policy guide) and here's what it says:
https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014557/M21-1,-Part-IV,-Subpart-ii,-Chapter-2,-Section-D---Service-Connection-(SC)-for-Qualifying-Disabilities-Associated-with-Service-in-Southwest-AsiaWhich takes us to the skin rating criteria: §4.118 Schedule of ratings—skin.
That's for the "diagnosed" illnesses and there are many.
If the skin condition is undiagnosed, they appear to rate it like eczema using this code
So if you look at the example at the bottom about sleep apnea it says it would not fall under that code of presumptive because it is a known diagnosable condition. It had a name and we know what it is. Similar to skin cancer. They already know what I have and it has a name and it’s own category. I think the skin conditions they’re referring to under GW means just random skin things that they don’t know what it is but have to rate it somehow. That how I read that part anyways. Ugh. Why do they have to make this so confusing. I can’t believe I can’t get a lawyer to speak with me. I’ve even offered to pay out of pocket and I can’t get a reply.
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14 minutes ago, shrekthetank1 said:
Hi ed33,
Almost any kind of skin condition is going to be brought into it! I hope you have filed for this as I for get when the presumptive period runs out.
So the VA loves to throw words in there as undiagnosed illness to cover many things, so this gives a much broader range for a lot of things going wrong! Skin conditions are covered in this blanket.
I have one that only 4 people have been SC for the last time I checked. I am sure there are more now. The issue I had was getting my issue named. Once they named it they then had to decide how rate it! Now almost 6 years later we are getting closer to getting it correct.
I would file ASAP but also look up your condition and know what they are going to ask you in the C&P exam.
So I’ve already been denied for the initial claim and the higher level review. I just submitted for a BVA board review but now I’m realizing that this GW may help my situation. So just to clarify you’re saying basal cell carcinoma skin cancer should fall under GW presumptive even though it is a diagnosed condition vs the undiagnosable term?
also do I need to specify at any point for them to look at it as presumptive or are they supposed to do it automatically. Basically how do I get them to look at it from a GW perspective.
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Hi Everyone,
I've got a quick question about Gulf War Syndrome. I just recently found out that the Gulf War syndrome applies to veterans of OIF/OEF, not just Operation Desert Shield/Storm. So I am 36 years old and am up to 11 Skin cancer spots and counting. The definition for GW presumptive conditions states "undiagnosed illnesses" to include skin conditions. So my question is would Basal cell carcinoma cancer count as "undiagnosed" since technically it is diagnosed as such? Or are they only referring to skin conditions that they don't know exactly what they are?
Thanks for the help
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4 minutes ago, shrekthetank1 said:
I would call the BVA today and see what the status of your appeal is and let them know you have not received anything yet. They are not typically that slow at sending a completed appeal out.
Thanks for the input. Have you ever seen that term before under the issues tab? I can't really tell if its good or bad. kind of depending on how you read it i guess
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Hi everyone,
So my appeal was closed on July 15. I haven't received my letter yet but under the issues tab on va.gov, where it used to say the items i was appealing, it now says "compensation issue." Is that normally what it says just when they close the review? Has anyone seen any other terminology in that section?
Thanks for your input.
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1 minute ago, GBArmy said:
Hi Ed. The results will show EVENTUALLY in ebennies. It is just unreliable, indicates incorrect status from time to time and usually is late or premature. Like I said, just not reliable. The only reliable update is when you get your BBE, your decision letter. Should show in a week or so usually. Rela
got it thanks. So I guess there's still hope of an award. I'll just wait for my letter.
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Hi everyone,
My Higher Level Review was completed last week. When my initial claim was completed ebenefits updated my "disabilities" section long before I got my decision letter. Does anyone know if the same is true for the HLR? Basically if the decision was reversed should it be already showing in eBenefits? Because it doesn't even show anything about my appeal anywhere on ebenefits.
Thanks
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Hi everyone,
I about to submit for my appeal and I spoke with a law firm yesterday about representation. They are going to look over my letter and decide if they want to take the case. My question is, is it even worth using one at this point? I think I want to just do the higher level review so what would a lawyer actually be doing other than submitting the form and maybe participating on the conference call with the reviewer. I'm not sure at this point that would be worth giving up 30% of my award. What do you guys think?
Thanks
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19 minutes ago, vetquest said:
Do not be surprised if you need to go to the BVA. It seems RO's are missing common sense and reasoning ability. The BVA is where evidence is read and considered correctly.
yea. It seems as though if they don't have a clear cut "incident" in your service medical records they can't piece anything together. It's like, how do you prove exposure over years worth of time? They just want a one shot injury that you went to sick call for.
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Just now, Buck52 said:
Appeal this you may need to go get a IME/IMO from a specialist to rebutt this examiner.
its unfortunate but that's what most of us has had to do.
Yea i'm definitely going to appeal. I have my nexus letter from a well renowned surgeon who actually worked at Walter Reed for 5 years. I feel like the rater just completely missed the point I'm trying to make. If I can have the conference call with the "Higher level review" I think it can get cleared up.
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21 hours ago, vetquest said:
Can you post your denial here. Redact personal information and post it. We can help you a lot more if we can see where and why you were denied. Do not expect the VA to be rational. It appears many cases in AMA are being denied. You can fight your denial with service records, doctor statements, and other evidence. You are only beginning your VA adventure and it is a tough one.
Here is the excerpt from the denial letter. A brief back story....So I had 4 cancerous tumors removed from my head and face leaving significant scars. I'm 35 yrs old. Obviously Skin cancer takes time to develop. I provided a nexus letter with specific examples of extreme and prolonged sun exposure during deployments. My face has nothing to do with my back. This was there response.
"On your recent VA examination, the examiner opined that 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. The following rationale was provided: Upon review of the medical history and service treatment records, the moles noted during the veteran’s active service in 2005 were located on his back and were noted benign at that time. The veteran was diagnosed with skin cancer of the face in March 2018. The malignant moles that were diagnosed as cancer in 2018 were located on the veterans face and not on any moles on the veterans back. There is no documentation in the veteran’s medical records regarding further development of pathology regarding the moles on the veterans back noted during service in 2005. Therefore, a nexus has not been established. The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service moles "
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Hi everyone. Thanks for all the great info on here. I recently go my denial letter for skin cancer and scarring on my face. In the denial letter the C&P examiner referenced an exam from 2005 and a mole on my back as being benign. There for the skin cancer on my head and face isn't service connected???? I have a tremendous amount of factual evidence and a very strong nexus letter from my surgeon. So i guess my question is what my appeal option should be when the denial letter explanation is so far off it doesn't even make sense? I can't even rationalize what they are trying to say because it is so far off base. It seems like the Higher level review option might be the way to go because at least I can get on a phone call with them and explain what's going on. Does anyone have experince getting a conference call with the reviewer under this new appeal system?
Thanks for your input.
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1 minute ago, broncovet said:
A second c and p suggests that the first doc missed something, or it was unclear.
Its probably good news. If you lacked evidence, it just would have been denied.
A second C and P exam probably means you are only missing "a little" evidence, and it needs clarifying with a second exam.
You are almost there.
oh i see. When the VA requests a second exam, do they specifically spell out what the nurse needs to verify or do they just generically tell them, "do another exam"
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Hi everyone,
Looking for some insight. I have a second C&P exam scheduled for the same issue. Only this time one of the requirements is a "DBQ Medical Opinion - MED"
Is there any significance of having to do a second DBQ for the same issue? Are they just looking to clarify something? Why didn't they ask for the Medical opinion the first time?
Thanks for your input
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3 minutes ago, Berta said:
OH! Thank you for correcting me right away!!!!
You should do OK with this claim!
They better consider your medical opinion !
I apologise that I thought the scars were from acne-
Scar ratings are found in that BVA decision above ,I think, and in the VA Schedule of Ratings here under that topic.
I believe MANY vets have skin cancer from long weeks in the sun during service and might not even know that it can be service connected as to the residuals.
great. I appreciate all of the info. I will keep you posted when I get my copy of my C&P exam. I'll be curious to see what it says.
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4 minutes ago, Berta said:
It appears you claimed acne. This is a recent decision freom the BVA.The veteran had evidence in his SMRs of the acne, treatment for it, and did not have any acne when he entered the service.
He also had an IMO from a dermatologist.
https://www.va.gov/vetapp18/files8/18125095.txt
no thats not me. that was just somebody else that commented about their own case
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10 minutes ago, Berta said:
These types of CUEs are easy and take minutes to prepare- depending on what the decision actually states.
VA can reject an IMO/IME but they have to give a good reason. That alone would not be a CUE.
If they completely ignore a valid IMO/IME, they have violated 38 CFR 4.6 and can swiftly correct that within the appeal period ( meaning no need for a NOD if they rectify the CUE and give the independent opinion full weight , and reverse their decision.)
But, we do not know what the nexus is here- I will try to find this vet's past posts.
If it is a nexus that would require an eye witness account, that would be a situation the IMO/IME doc could opine on, yet the VA would still want proof of the nexus- the actual link of something in service to what they are claiming.
So I have 4 spots so far of skin cancer at 35. 2 years total spent in iraq/afghanistan. I was required to spend several hours every single day out in the sun with no headgear since we were out on a flightline. My doctor stated that all that time out in the direct sun "played a significant role in contributing to his skin cancers and has increased his risk in developing future cutaneous malignancies"
So the three surgeries Ive had on my face so far have left some pretty significant scars.
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2 hours ago, Berta said:
Make sure the VA has his DBQ and nexus statement-
What you are describing is a contracted NP from VES, who might not have a clue.
If they deny without consideration of the surgeon's opinion, that would be a CUE and I can write the CUE for you- based on whether you can scan and attach the denial here, and what it says.
It is possible they wont deny, if the IMO/IME was medically favorable.
"It was weird that when I asked her if she submits an opinion about SC she said no. "
That is concerning but then again is your Nexus strong?
( Cover C file #, name, address prior to scanning it, if they deny.)
Ive got a copy of my nexus letter if you wouldn't mind giving it a quick read. I feel like it's pretty strong. How do I upload documents here?
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2 hours ago, Berta said:
Make sure the VA has his DBQ and nexus statement-
What you are describing is a contracted NP from VES, who might not have a clue.
If they deny without consideration of the surgeon's opinion, that would be a CUE and I can write the CUE for you- based on whether you can scan and attach the denial here, and what it says.
It is possible they wont deny, if the IMO/IME was medically favorable.
"It was weird that when I asked her if she submits an opinion about SC she said no. "
That is concerning but then again is your Nexus strong?
( Cover C file #, name, address prior to scanning it, if they deny.)
Ive got a copy of my nexus letter if you wouldn't mind giving it a quick read. I feel like it's pretty strong. How do I upload documents here?
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3 minutes ago, broncovet said:
"Distortion" is an example of a "judgement call" made by the decision maker. Did your doc mention "distortion"?
Not sure. But all the scars checked off almost all the boxes of the 8 characteristics for rating scars. I guess the rater can just look at all the pictures.
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1 minute ago, broncovet said:
You need to make sure the VA has , in their possession the "favorable evidence". VA seems to have a knack at losing our favorable evidence. I suggest you read over your file.
The Board "can" elect to favor one medical opinion over another, but has to give a reasons and bases as to why they found one medical opinion more probative.
A key component is did your private doctor supply "all" of the requirements:
1. Did the doc state he "reviewed your records"?
2. Did the doc supply a CV with his opinion? Was he qualified to make said opinion? A surgeon may not be qualified to opine on, say, PTSD.
3. Did the doc give a medical rationale as to why he made his stated opinion?
If any of these components are lacking, the VA can reject this opinion.
Definite yes to all three requirements. And he worked 5 years at Walter reed.
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24 minutes ago, vetquest said:
Usually when there is positive and negative evidence the decision goes in favor of the veteran. Especially a doctor's opinion against a nurse's. If they do not you have a very solid claim at the BVA.
Good to know. Thanks. I seriously doubt she even looked at his DBQ or nexus letter. It was weird that when I asked her if she submits an opinion about SC she said no.
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8 minutes ago, El Train said:
My face from collar up to cheek bones is scarred from bad cystic acne. Easily 50% of my face. The VA Doc denied me, the QTC second opinion disagreed with her and I was low balled at 10%. Got a third opinion from a Dr. I hired who suggested based on VA ratings 50%. Have another VA C&P next week by VA for re-eval. I'd guess an increase from 10%, but who knows with the VA docs. They may decrease me for the hell of it. Then I'll get another opinion to overrule them again. They are painful, palpable, discolored, and well documented in my records. I'll let you know how it goes.
Did you have to prove the acne was service connected first?
Question about BVA appeal
in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC
Posted
Yea that's weird. So I filled out a VA Form 10182 (maybe it was the wrong form). But the only option to check says "Hearing with Veterans Law Judge: I want a Board Hearing and the opportunity to submit additional evidence in support of my appeal that I will provide 90 days after my hearing"
It doesn't have a place to specify anything further.
Did I fill out the wrong form?