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Rockhound
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Posts posted by Rockhound
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I don't have have medication coverage and I'm not particularly fond of the VA. I spend about a $100.00 in co-pays a month for my meds. It would average out a bit higher if I was on a medication plan and I wouldn't be guarentied that all my meds would be covered either.
I just wished that they would make in a standing directive that if a Veteran wanted a written opinion that they would have to comply instead of saying they didn't want to get involved with claims you might have against the VA for benefits.
Rockhound
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Thanks Wings: I would have had no idea how to search out this old of a VA manual. We have a State Law library, but it means traveling about 50 miles to get to it. Just to give you and idea the trouble it would be for me to do this.
1. Schedule ride with Access Van to take me into town.
2. Catch the commuter local transit bus from one city to another
3. Depending where it drops me off in the other city closest to library, drive my electric wheel chair their or
4. catch a local bus to location or as close as I can get.
5. Repeat in reverse to get back home. about $15.00 for round trip and then at least one meal to keep my blood suger up.
Sent an inquiry though, how it bear fruit. Will be checking the University Library on Monday to see if the have the USCodes. The University Library is a Federal depository so it probably has them. I know for a fact that they had the CFR's on micro fiche.
You have been a great help.
Rockhound
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I can't answer your question to any certainty, but I do know that since the VA Hospital is a Federal Institution, the Dr's those working there that must hold licenses, don even have to be licensed in the state the VA Hospital is in. Makes it hard to track their credentials down sometimes.
I would like to know what credentials my original claim Examiner's were. He only signed it as and M.D. which to my way of thinking ment he as a general priacte type of Dr. Yet he was making opinions for psychiatric problems.
It took some doing, but I was able to track him down, but he no longer holds a practicing license and would not make any comment on anything, just said sorry can't help you.
Rockhound
found this, you just never know:
MOLDE, DONALD A., M.D.
8/13/1992
Charged with 5 counts of violations of NRS 630.304(5), influencing a patient in order to engage in sexual activity with the patient; 2 counts of violations of NRS 630.301(3), gross or repeated malpractice; 1 count of violation of NAC 630.230(1)©, engaging in writing prescriptions for controlled substances in such excessive amounts as to constitute a departure from prevailing standards of acceptable medical practice and violation of NRS 630.306(2)(B), engaging in any conduct the Board has determined is a violation of the standards of practice establsihed by regulation; 1 count of violation of NRS 630.306(7), continual failure to exercise skill or diligence or use methods ordinarily exercised under same circumstances by physicians in good standing practicing in same specialty or field. Issued public reprimand. Found guilty of 1 count of violation of NRS 630.306(2)(B) and NAC 630.230(1)©, and 1 count of violation of NRS 630.306(7).
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Can A Veteran ask for a personal hearing in a CUE claim and how does he go about doing it?
Rockhound
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Wings: Thanks for the information and don't take this personal. I hate search engines, no matter how I word the search criteria, nothing like what I am looking for comes up and spending hours upon hours looking through each and every page that does come up, is not my fun, in fact it is literally quite painfull on the posterier and doesn't do my eyes any good either.
I can't even find specific cases at the COVA or president opinions at the OGC sights.
When I do find something, the files are incripted with some obscure file name or number that won't open on any thing I have in my computor for that purpose.
The latest was looking for the case of Demrel V. Brown, found a file, but can't open it.
Rockhound
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John999: That's what I am saying. Had their not been an error, the Examiner's report wouldn't even hold up to the scruitny of what it takes to make a change in a diagnosis. So not proving the personality disorder was an alternate diagnosis and the examiner not being able to concure or disprove the findings of the Naval medical board, the examiners report is worthless as evidence for rating purposes and since the Navy Medical board was loaded, with the test, exams and observation done or taken, then service connection should have been awarded.
Heck, I can't even get an IMO to concure with me on the matter, because he wasn't their at the time and any report written afterwards isn't admissable. It isn't even a matter of interpretation, it a matter of how the Adjudicator didn't apply the statutes and regulation extent at the time.
All worked up over this every time I think or write something about it.
Rockhound
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I'm pretty sure that I have figured out how to present a CUE claim, except when it comes to where, for CUE to prevail, it must manifestly change the outcome.
I can prove that the VA Claims Adjudicator failed to apply pertinate statutory and regulatory provision extent at the time that caused the clear and unmistakable error,
But I am having trouble understanding what "Manifestly change the outcome" means. what types of outcomes are we talking about?
In my case, although it concerns a change in the original diagnosis to an alternate diagnosis. The adjudicator failed to follow statutory and regulatory provisions extent at the time, i.e.
1. He did not get cirtification from the examining physicain to support the change of a diagnosis
(a) certification must contain a summery of the facts,findings, and reasons that support the
change in the diagnosis.
2. Their is nothing in the records that Adjudicator then considered what the change ment,
since he did not have the cirtification from the physician to guide him.
3. Their is nothing in the records that once the Adjudicator considered that severance of
service connection was warrented, a rating was prepared setting forth all material facts and
reasons, and submitted it to the Central Office for review.
4. and lastly, if it had gone to the Central Office, although their is no indication it did, and was
approved, the claimant was supposed to be given 60 days for presentation of additional
evidence to show that service connection should be continued.
Since the VA Examiners report did not have the certification that the original diagnosis was clearly and unmistakably in error and that his new diagnosis was the correct one, the VA Adjudicator could not make a determination or a medical opinion of his own and use this new diagnosis as an alternate one. Since the VA Adjudicator failed to send the report back to the VA Examiner for clarification, the report can only be interpreted that his diagnosis was a new and seperate diagnosis.
How do you show, how all this would Manifestly change the outcome of my claim.
I know that the evidence by the conferance of Naval Dr.'s and Psychiatrists would outway the VA Examiner's ambiguous report, at best, with his present diagnosis, since he states in his report that he could not solidly support the original diagnosis based solely on the history and not on any tests, exams or observations any longer than the exam itself, that he conducted, to support his opinion. Again, he based his whole opinion on the history, that it would be difficult to substantiae, in his opinion a solid diagnosis of schizophrenia. Not with standing or consideration, that the disorder was in remission, at the time of the examination.
It appears to me that the VA Examiner's report was insufficiant for rating purposes, so how do I prove that my claim would have manifestly changed if the report was so lacking. They can't go back and ask for clarification from the VA Examiner, or for that matter, the VA Adjudicatior either. It's almost as if the claim remains open, since the question of service connection of the original diagnosis from which service connection was predicated upon was never legally adjudicated.
Anyone want to run with this and give me their opinions and/or questions?
Rockhound
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Doesn't matter to me what they had, they had to have some sort of manual to follow that told them how they are supposed to do things, give them directions that co-insded with the CFR's and USC's to make their decisions. So long as it covers the years 1973 to 1974
Rockhound
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I am looking for a past issue of the VA Claims Manual M21, for the years 1973-1974 Need to site some information for a possible CUE claim. Just need it for my research and to put a copy of certain parts into my computer.
Rockhound
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If a current diagnosis means. I have had one on the books for three to four years now, that i am still to this day being treated for. Then yes I guess I have a current diagnosis. That would then only leave a Nexus letter that needs to be written. It will probably have to come from the VA because I cannot find a psychologist or psychistrist who takes Medicare to help defray my costs for an IMO. I'm going to try and get seen by the Adult mental health services here, they work on a sliding scale on ability to pay, will have to see what it will cost, maybe medicare will be enough?
Rockhound
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Carlie: although the benefit of the doubt cannot be the basis of a CUE, (asthma, is as likely as not to be service connected.") The benefit of the doubt is not in question, the application of the rule is. At the very best, the report is insufficient for rating purposes due to the comflicting statement by the Examiner that ended by putting the question of SC in equipoise
If VA failed to apply a particular regulation when adjudicating the
claim, that failure could be a basis for the CUE claim that was . See Damrel v. Brown, 6
Vet.App. 242, 245 (1994) (quoting Russell, 3 Vet.App. at 313-14)
("statutory or regulatory provisions extant at the time were incorrectly applied").
Rockhound
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Berta: You think your confused, you should see it through my eyes: LoL
The original diagnosis for which I received my medical discharge was for an
"Acute Schizophrenic Episode, in remission. (DNEPE) DC #2954 or VA DC #9205 manifested by agressive, assaultive and hostile behavior, with no know precipitating event, followed by a period of catatonic stupor, now in complete remission. He demonstrates moderate impairment for future social and industreial adaptability, but severe impairment for future military service."
It goes further to say, "associated with Depression and Anxiety, Listing that the condition was probably perminent.
Of course the acute schizophrenic episode, in remission was what was changed, (illegaly in my way of thinking) to a personality disorder. Nothing was ever mentioned about the effects it caused concerning social and industrial adaptablity with depression and anxiety.
Although I have been able to subsist in society, my records speek of many jobs, poor college records, moved around more than what I would think was normal, three failed marriages, letters from employers, One mental health evaluation that treated me for depression, in 1979 and one psychologist Phd. who listed me as having an Adjustment Disorder with Mixed Anxiety and Depressed Mood, in 1999 an then their was the diagnosis of the Adjustment Disorder with Depression and Anxiety that led to my NSC pension.
I guess all I can say it that I demonstrated an adjustment disorder with depression and anxiety in service, which was said to probably be perminent. Personal records showing a considerable difficulties adjusting to social and industrial norms. treated for problems with ongoing depression and anxiety, and two concurring findings of an adjustment disorder with depression and anxiety.
All I would need I think would be a Nexus letter, that they all are for one and the same disorder.
To get me past the new and material evidence rule in order to reopen my claim. Although to me, this is a claim that has never been considered except for the NSC pension and If I remember right, they should have considered it for SC at the same time as an implied claim?????
Sorry for the long post, learning bits and pieces, doesn't give you as good a picture of my problem.
Rockhound
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Cowgirl: Reminds me, I wore my riding chaps to help keep the cold of my legs, when I went into town the other day. The only thing I had to ride was my electric chair. LoL got to get my mind back on subject.
If I should file this claim action and they deny it, saying the same old thing, that the acute schizophrenic episode and its trailer was changed to a personality disorder, can I then appeal bringing to light that their change of diagnosis has no basis in fact, since the VA C&P Examiner did not state that the original diagnosis was clearly and unmistakably in error. finally getting them in my cross hairs as it were?
Rockhound
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In 1974 I lost my original claim when the VA said that an alternative diagnosis was made, changing a psychiatric diagnosis to a personality disorder.
Now I have in the records where the VA had awarded me a 50% disability for pension purposes, for an Adjustment Disorder with Depression and Anxiety. and 30 % for Sarcoidosis and gave me 100 % IU but this was only for pension.
The original diagnosis I had when I left service was for an Acute Schizophrenic Episode, in remission demonstrtating moderate impairment to social and industrial adaptability. associated with depression and anxiety. The nervous disorder as they called it was changed to a personality disorder, but nothing was said or done about the moderate impairment to social and industrial adaptability associated with depression and Anxiety. Get where I'm going with this?
Would it be worht the trouble to file for the Adjustment disorder with depression and anxiety as Service connected using my existing medical and treatment records to substnatiale the claim.?
Would it still be necessary to get an IMO, to prove Nexus even though their appears to be enough evidence in the records to show a continual problem with this new claim?
Also would it be classified as a unadjudicated claim that might have a much earlier claim date than the NSC claim that brought to like the similarities of diagnosis?
Any thoughts or rules regulations, or laws that might help me understand if this is a course for a claim would be most appreciated.
Rockhound
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This is my own opinion and may not have any backing by any regulation or law, But I feel that such directed statements like that last one, makes me feel like they are directing the C&P Examiner to say just that. directing him to say that his opinion would be pure speculation and not supported by anything he could see or find on tests or from examination.
It reminds me to much of the C&P instructions that I got for my psych evaluation that put a personality disorder on me and I'm still fighting against that directed opinion.
Rockhound
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While trying to put my records in better order, I cam across a letter for a claim I filed back it 1979 or at least the letter is dated 1979. It reads as follows:
May 15, 1079
###/###A
SS#
My name and address
Dear Mr. XXXXXXX
This is regarding your reopened claim for entitlement to service connection for your nervous condition.
All the evidence of record has been reviewed including summary report from BXXXX County Mental Health Service. The evidence does not warrant any change in our previous denial for service connection for you nervous condition.
Sincerely yours,
Name
Adjudication Officer
Enclosuree
#########
CC
Disabled Anerican Veterans
I'm not sure what this means, If this is all they sent me, it appears they have completely violated the whole concept of a SOC Any Ideas what this could mean to the subsequante claims I have filed since 1979? I thought it might be concerning an appeal of a 1974 claim, but it say about reopen claim. I'm confused
Rockhound
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tssnave: No, your not the only one up late, I'm a night Owl as a rule, not the norm. You are correct why a social worker would come to the home. When a psychiatric diagnosis is given and they believe their might be some concern as to you handling your financial concerns.
If they say you cannot handle your own finances, I hope you have a trusted family member or friend who will handle them for you. I wouldn't mind them making me go that route, as long as the person lets me spend the balance after food and bills as I choose, but then again, you may be at their mercy when it comes to having any spending money of your own.
I think also that the VA must approve of someone you choose, not mearly that you want them to.
Hope your not so far gone, otherwise you may have another fight on your hands to get control back of your money and it could cost you in the percentage of your award. But then you will have to apply for IU if you are not less than 60 or 80 percent. not sure where IU can be applied. I think it changed since I last checked into it.
If a social worker came to my place, she would probably want me put in a home, sometime I just can't function enough to do much around the house. Plus it costs money to keep everything clean, including myself and I can't be cleaning all the time. LoL
Rockhound
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Berta: You mention a lot about the OGC, Office of General Council, I presume. What is their function and how does that relate to helping you in your claims process? I don't think my claim has recieved proper handling and when I tried to file a CUE claim, the VARO acted like they didn't know what it was and they took it to mean an new claim to reopen for new and material evidence. It got so messed up, I got a DAV rep involved and he went with their thought and of course since I wasn't prepared with any new evidence, the claim went no where.
I had better luck with AMVET earlier and got a non service conected Pension, whiched helped me considerably with my SSDI claim.. But I guess he was to good, cause they fired him soon after I got my pension. Don't know why he was fired, since he did alright by me.
Is their a Web site for the OGC to read a Organization statemen?
(not the right word I think, but close)
RockHound
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Thought I posted this before, but could not find it: Where do you get the medical facts to back up your disease and or injury? The ones that the Medical community accept and the VA will accept as fact. Just looking for back up material to support my Dr/psychiatrist when the time comes.
Rock Hound
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I was hoping to get one of my psych Dr's to look over my claims file to see if he could help me out. It looks like I'll have to either pay for another copy, since I have used up my aloted number already or I'll have to set aside a day to go in and review my file to see is my own files need updating, which I'm sure they do.
Bummer
Rockhound
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Thems fight-n words, calling me a dam Yankee. I was born in the great republic of Texas. Call me a Yankee will ya. LoL Freezing Fog is basically when the theirs a difference in ground and air temperature that creats the fog, then the air temperature drops below freezing, causing the moisture in the fog to freeze. you either end up with tiny little clusters of snow like flakes, and mean real tiny, or you get hard as rocks little rain drop shaped hail. Just depends on how much moisture. the more moisture the bigger and harder the snow like clusters.
If the housing market hadn't of taken a dive, I would already have gone south, but I'm stuck hear for now, so I got to make the best of it.
Rockhound
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Hoppy: I already have a diagnosis that is NSC/non service connected for an Adjustment disorder with depression and anxiety that was rated 50% for pension purposes. I know for a fact, a lot of good that is, that my original diagnosis of Acute Schizophrenic Episode, in remission, demonstrating moderate impairment to social and industrial adaptability are about as one in the same as you can get.
I'm even now being treated for schizophrenic thought and ideals and some recent psych tests, onof them the MMI I think it is, says I'm slightly schizophrenic. Now all I got to do is find that report again and see who the psychiatrists were and see If I can get them to help me out with an evaluation and possible nexus letter.
My most recent problem has been that anyone who want to help me, isn't around long enough to do me any good. our VA hospital is a teach hospital, even my psychiatrist who dispenses my meds have been switched a few times. by the time my next appointment comes around I will either get my old psychiatrist back, who took a leave of absence or I will be getting a new one agian. whcih would make it three in four years.
lousy day today, tired me out good, I'm beginning to ramble so I better see about my meds to see if its time.
Thanks for the infor and pep talk.
Rockhound
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Well, I'm good for another year of being carried around by a handicap access bus and city bus. The exam, it wasn't much of anything, they asked if their was any changes that would make it easier or harder for me to use these forms of transportation and that's about all. Seems like they could have asked me over the phone, but I guess they had to see me in my chair and with my oxygen on standby. misserable day, freezing fog, wind, snow, and rain, all in the same day. Oh Boy!
Rockhound
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Check the answer, not exactly what I asked them about.
Veteran/Inquirer
01/07/2008 05:18 PM
Are Doctors at a VA hospital, that are treating you allowed to request your C-File, so they may review your records and make an opinion as to whether or not your present medical condition are as likely as not related to medical conditions you had while on active duty?
Can they give a Independant opinion on a prior diagnosis given while on active duty, that was a psychatric one and as to the correctness, of a new diagnosis of a personality disorder that was used as an alternative diagnosis, replacing the original?
Thank you.
Response (Department of Veterans Affairs)01/08/2008 02:23 PM
Sir,
Claim folders do not go over to the hospital during Compensation and Pension examinations normally with one exception. When we are asking for a specific opinion on an item of when there are psychiatric exminations to be done. Then the claim folder is available for the physician whether he chooses to go through it or not. It is up to each physician to conduct each and every examination that we have requested in accordance with established medical protocols. They have the liberty to also report on physical or mental issues that may be compensable for service connection even if we have not specifically asked for an examination on the the specific item or items.
So, what he is saying that during a C&P the Dr doesn't get to see your C-File unless they are asking for a specific opinion when their is to be a psychiatric evauation. So how that doesn't sound correct to me.
Without seeing your C-File, how is the Dr supposed to know if you had something in service for sure, they are certainly not going to take your word on the matter now are they.
Then again, I wasn't asking about a C&P. I was asking about an opinion from your own treating physician, so he can tell you whether or not your problem now is as a result of when you were in the service. Their again, he would need to see your C-file to see what records he would have to review in order to give you a proper opinion of nexus, otherwise the VARO is just going to say he didn't review your records so his opinion mean little or nothing to them.
Is it just me or is their something wrong here?
Rockhound
Dr. Referal ?
in VA Disability Claims Research
Posted · Edited by Rockhound
Can you request and get a referal to another Dr.? Even if it means going outside the VA Hospital system, to get one to see and the VA will pay for it?
I need to get in to see a ENT DR. and we only have one with a Nurse Practitioner, both of whom I do not get along with very well. I disagreed with his assessment of my Nose problem and he wrote an assessment of my problem in a very bad light of my attitude towards his idea on how to treat my problem.
1. He said I was a candidate for a traciotomy because of my weight, with out even the
benefit of a sleep study to show him, that I do not have sleep apnea to such a degree
that it would be necessary.
2. Once he prescribed metal springs for me to stick in my Nose when I slept. Try
sticking metal springs up your Nose and you'll know what I went through. Not only
was it painful, but it caused irritation to the lining of my nostrils that they began to bleed
before I stopped using them.
3. Then he said my deviated septum was on a different side than what I believed, telling me my other
side was the side that was about 50 blocked. but when I ask why then was my other
side blocked completely he got all defensive.
4. Plus he said I didn't use my Nasal spray, when I do. I need it to keep my nasal passages
open, even though it is a corticosteroid and not recommended for long term use, but
nothing else works and I need to keep my nostrils open at least at night, so I can use
a nasal canula for oxygen to treat a Nocturnal Hypoxia condition.
Second question concerns the first. I'm not a very good candidate for going under the knife to try and fix my nose and their would be no guarenty that it would improve my problem either. As I mentioned above, I have Nocturnal Hypoxia caused by a restrictive lung condition, a good portion could be blaimed on my weight. But to treat it, I have to use a nasal canula to feed oxygen to my lungs when I sleep. I also have to use, as mentioned, a cortcosteroid nasal spray, which is prescribed at its highest dosage recommended.
Since my nose is Service Connected at present at 0%, what is the likelyhood that I can get an increase in the rating to no less than 10% or not more than 30% for exasserbation of a NSC problem, which is the Nocturnal Hypoxia? Without the continuous treatment of my Nose, I can not treat the Nocturnal Hypoxia. To not treat, that is to not use the oxygen could lead to a heart attack or worse, even sudden death syndrome during sleep.
I know, I write to much information, but I don't know how to use just a few words to explain things. Sorry.
Rockhound