Foxhound6

Finally, I am able to post into this forum thread!! I noticed on Ebenefits today that I am now rated combined at 80% from 30%. My mental health claim was processed and I was awarded 70% for that claim. Awaiting letter to arrive as well as retro. I cannot say enough how helpful this community has been during this process for me and my family. It is a huge blessing and a relief for us all. We thank all of you who contribute to these forums and urge you to continue! Donation and Subscription to follow! Keep fighting!

Thanks!

AWGV001 Thanks for reply. I understand the EED for the claim, I was more curious about once the claim is approved, when might the retro be released to my account?

I noticed one of my secondary claims was decided and in the final approval of decision phase (est completion 1/22 - 1/28). The CP examiner told me she would absolutely be able to tie in my knee SC to my secondary MH claim. My curiosity now is, if it was approved, what might be the timeline on retro/monthly addition? Thanks

You took my thoughts, Sir. I'm eagerly awaiting the decision letter lol The only claim I won on first go was my knee and was service presumptive, right when I got out.

I initially filed the ITF in SEPT 2018. I filed the claim SEPT 2019. They initially denied it in about 2 weeks lol ( i had no real clue what I was doing). While it was going thru the first round, I got onto the forums here and started to educate myself lol. I sent in Supplemental with new evidence (medical stuff, lay statements, etc) in OCT 2019 and here I am now. So I do have about 15 months and counting of retro pay "skin in the game" for this claim. I only have pulled the Docs CP exam from HealthEVet. It has not had a decision given yet, although based on the docs opining negatively, I expect another denial which is why I am looking into the BOD. Just in case it is needed to make an argument..but it has been over a month since the CP and still no word.

Thanks! I feel like it may fall under BOD. However, until I get my decision letter, I wont know what the VA will do. However, I think I am set up nicely to fight it needed. I hope they apply the doctrine..If not, Ill try to argue. If that does not work, like you said, secondary to Knee would be my pressure release valve sorta speak. I was also interested that they had a PM&R doc on staff to do the exam. You're also right that his opinion is puzzling. Perhaps he knows the ratings as well and was purposely trying to walk the line? Hard to tell but it has been interesting for sure..

Vync, you got my brain juices flowing with this thread. Decided to look up 38 CFR regarding reasonable doubt (3.102). I think I may be able to create an example argument based on my claim in hopes it could help others in similar situations? Id like to break this down a bit, highlight what I feel are important terms to note, and get feedback. Ill submit my DBQ here as well so you can see why I am making the argument in the first place. §3.102 Reasonable doubt. It is the defined and consistently applied policy of the Department of Veterans Affairs to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. -This, I think, we are all familiar with....broad interpretations indeed.. but they look at the facts case by case! When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. - After considering all of the procurable (by VA) and assembled (generally our gathered evidence) data, if there is a doubt whether the disability was caused in service, the severity of the disability, or any other point (this is where they can tend to overstep their authority), then the tie goes to the Veteran. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. - The doubt exists because of a balance (a tie) of positive and negative evidence that does NOT satisfactorily prove OR disprove the claim. It is a substantial doubt and one within the range of probability as distinguished from pure speculation or remote possibility. - To not fall under this doctrine, the doubt must be substantial. Meaning, it must be something that isn't formed of pure speculation or a remote possibility. It is not a means of reconciling actual conflict or a contradiction in the evidence. -It is not meant to be used as a way of resolving a conflict or a contradiction in the evidence of the claim. Mere suspicion or doubt as to the truth of any statements submitted, as distinguished from impeachment or contradiction by evidence or known facts, is not justifiable basis for denying the application of the reasonable doubt doctrine if the entire, complete record otherwise warrants invoking this doctrine. - This is important. If mere suspicion OR doubt as to how truthful ANY statement submitted is, the rater should invoke this doctrine and award benefits as long as the rest of the claim warrants invoking this doctrine. The only other way they could weasel out of this would be to outright call your statement(s) false, or the evidence contradicts your statement(s) or other evidence within the claim. The reasonable doubt doctrine is also applicable even in the absence of official records, particularly if the basic incident allegedly arose under combat, or similarly strenuous conditions, and is consistent with the probable results of such known hardships. -This could be beneficial to those in this situation. This means that the doctrine can also be invoked in the absence of official records. Especially if the basic incident happened under combat, or similarly strenuous conditions, and is consistent with the results of such known hardships. For me, the event happened during a training exercise so would not fall under combat, but, the nature of the exercise made it difficult to seek treatment outside of a medic checkup in the field. Also, during the time the CP doc states I did not seek treatment or have notes regarding pain (but immediately states he did see a note in history from 2016 stating I did complain of back pain back a few years back in 2014/2013). I was primarily going to the VA for my mental health as it was a major problem during that time, which the VA has documentation of and I have a claim in for as well. I was also very weary of the VA, especially during the 2014 PHX VA scheduling fiasco. I did tell them about my back and neck pain, however, they pretty much ignored it, saying it was "probably because of my SC knee", at that clinic. I, years later, went to a different clinic that was better and were the ones to find all my issues. My DBQ was medically favorable throughout, it was his opinion that was questionable as to reasonable doubt doctrine the rater may have to look at with my claim. Take a look and maybe let me know any thoughts anyone has? I have found this very interesting. I am not an attorney, these are just my interpretations DBQ Redacted.pdf

This is great! Article may actually have a high amount of relevance to my current claim that I just had a less likely CP for.. I found this bit the most interesting and pertaining to my case regarding the lack of evidence/notes: "The record in the case indicated that local law enforcement had informed VA that it did not have records from as long ago as 1966. In scathing language, the Veterans Court declared that "t is hardly logical to derive a negative credibility finding, even in part, because the [veteran's] allegations are not corroborated by nonexistent records. CP doc stated could not find notes of complaints in my earlier records, however, immediately goes on to state that he saw a note from a slightly later visit that stated I did complain of pain before, etc.. Very interesting, thanks for posting!

That is the plan for now. Thanks for the encouragement! Until I get the actual denial, Ill do some brain storming and research based on his opinion and stand fast. Now, I understand it is possible the VARO still weighs in my favor due to the evidence I have and continuity it shows. I even mentioned in my statement the topic the examiner brought up in his opinion regarding the note about me being told my knee was the issue and no exam or imaging was done to verify. Ill be sure to upload the letter once I receive a decision.

I did find this bit interesting....possible hole in his narrative as well. "Initial visit to the Thunderbird Clinic Oct 23 2013 under review of system notes for musculoskeletal pain some complaints of left knee pain, chronic. No complaints of back pain were noted. The initial note from Phoenix VA May 26 2016 notes back pain." So he is stating he found no notes of back pain on my initial visit to that clinic in 2013. However, he then immediately goes on to state: "In the history, it notes that he WAS TOLD SEVERAL YEARS AGO (2014/2013) that because he has been limping on his left knee he would have back problems and now it is catching up to him." To me, this feels like he just stated there was some sort of "note" regarding me being told that it is my knee/gait causing my back problem back around 2013/2014...… His justification seems to be born of a nice lake and a good lure...? He has a point regarding in service treatment but, hell, I ETS'd about 3 or so months after that event...As a mid 20 something male, general aches and pains are just ignored and pushed through, especially in an infantryman role. Seems my young and dumb days are still haunting me ha!

All I would need is someone to review the current records I have and do an IMO to tear apart this terrible examiner's opinion. I may have a few arguments myself to make if it is denied officially. But my hope now is (very slim hope mind you) that the VARO looks at his "medical" opinion and doesn't find it sufficient to deny the claim based on overall weight of evidence that I provided (primarily continuity of the problem from exiting AD to now). Statements, dates, times, etc. I am also going to go back to look at my old VA notes as far back as I can to see what other things I may find to point toward the pain. I feel this happened (aside from me not going in to be seen before I left AD) because someone in 2013 failed to put my back and neck pain complaints down in the notes....Hopefully the VARO doesn't just side with doc, hopefully they do weigh everything like they should and grant SC...but Im preparing as if they wont.

Ahh I believe I understand now. Yes Mr Bull was an observer to the incident while SSG T was the catalyst so to speak as he was the one who popped the hatch that hit me. I also have my father's statement which picks up right after I returned from AD. I then have my statement and my current wife's statement (my wife also is an LPN with 10 years of long term skilled geriatric care experience). I feel the tilt should be much in my favor to be honest and nor do I feel that his rationale is enough to "technically" deny my claim. But the VA most likely will I'd assume so I plan on that and am trying to begin making my argument while I await the letter.

Yes. The 2013 report he refers to is when I first went to a VA clinic...at around 25 years old...I did tell them about the back and neck but they passed it off like it was expected due to my knee issue and never noted it or did an exam. When I finally went to another clinic (a better one that listened more) and when the pain was much worse in 2016 or so, that is when it was noted and imaging was done...I really don't like that he is trying to use the lack of notes as a less likely opinion. It doesn't seem that relevant considering I have continuity of the issue starting with my father after AD. All statements were done properly and accepted, I did confirm that much before hand.

AWGV, thanks for the idea. I have done so actually. He noted them in his notes. However, he never did mention the SSG who actually caused the event, only everyone else. He even mentioned my fathers statement (i lived with my father once I got out of active duty and complained of the back and neck pain, I absolutely have continuity of the issue from the time I got out of AD to current, it seems he based his "opinion" solely on the fact that there were no notes listed under my initial visit to the VA in 2013) In fact, I did complain and the NP said it was "probably due to my gait and my SC knee" issue and she never noted it. So he is creating evidence based on no evidence? It is a little puzzling honestly.

Thanks Shrek! I have a couple ideas....supplemental route. I did mention to my provider in 2013 about my back and neck but she felt it was more due to my SC knee at that time so she never did imaging or even noted my complaint. The CP doc even noted that I told him that...So i could cite that and his note in the CP exam. If that is his only reservation that is...otherwise ill go to plan B and do it secondary to my knee..

Well this sucks. It appears even after I had a nice examiner, he opined against me. Oddly enough, the reason was because the lack of complaints I made when I initially got out. I even told him that I DID complain about my back and neck pain but the NP just told me it was probably because of my SC knee issue, which he did NOTE! I feel a little betrayed lol Have a look for yourselves... Not even sure how to come back about this now lol It almost like he just shot a torpedo at my entire claim and anything I could say to argue... DBQ Redacted.pdf

One of mine I was apparently double dipping after AD and getting my SC. I didn't know at the time, but doing Reserve drills and having disability, you're supposed to report it/accept one or the other type of deal. Well, they came back at me with it about 2 years later and started to garnish. I want to say they took ALL of it for several months until it was paid. There wasn't a negotiation or anything. Just a letter and no money One might say they can take far faster than they give..

That is an excellent way to manage that. I would give ya two likes if I could. I've learned not to co-mingle accounts, unfortunately in crappy ways.

Shrekthetank I also received this email! I kind of thought there was some progress with my pending claims LOL. I was wondering about this as well.

GB Army I agree! Not having done a C&P like this since 2011 or 2012, I felt good going in but once the ROMS were happening I had no idea how it was going and the mind just ran with it. It's good to hear my experience seems to have been a good one! I'll post the redacted C&P in my Supplemental Claim - Spine post once I can access it.

I just had my C&P exam for my back and neck yesterday. The doctor ordered new xrays of my entire back as well. Today, I got a call from the CP doc, asking to speak to me about my xrays. He stated he found MORE things that were not caught on the xray from a few years ago (Scoliosis and some sort of issue that is making me retain stool, in addition to what the VA had found previously.) He told me "This is a C&P exam so I am not calling to treat you or anything BUT I do have a few recommendations" to which he told me to get the issues followed up on. I am unsure as to the assistance/damage this may do to my claim. To me, it seems like the condition just worsening as the original incident happened close to 10 years ago. However, I guess I wont really know until I can see his DBQ/Notes on My Health E Vet? Anyone have any similar experience?

Berta I received an email back from Marine History Div regarding my inquiries about requesting information. They didnt have exactly what we wanted so it is good I emailed first. However, they did point me in a good direction and provided the MUC for 3d FSR. According to the link in the email, we can fill out a DD-149 and give any supporting documents. From the email, you can request a complete records review in that DD-149. This may be the best bet I think. Hopefully, this information is useful for others as well! UPDATE: Navy Corrections replied stating they do not do that type of inquiry, but forwarded it along to the Commandant of the Marine Corps for processing there.