mssoup1

Jay, Again thanks for your help. My husband has gotten an IMO on his eye problem before and the doctor stated that it was more likely than not that his eye condition is connected to his skin condition. With this being said, you would think his claim would go through fairly smooth. Well, the VARO wanted to know where this doctor got his opinion from, then denied the claim. We showed the denial to his doctor and he was floored. Had to go to the BVA and at that point he received an instant approval. I do keep copies of everything. All correspondence to the VARO, documentation they send back to us and I have a complete copy of his SMR, medical records from the VAMC, including C & P exams and any IMO's. Each time he visits the VAMC, on our next trip we get a copy of any notes from his previous visits, unless we need them before hand. This way, we stay up to date. Can't get them the same day he goes as it takes them longer to get the information into the system. We are very fortunate because we only live about 25 miles from the nearest VAMC. I feel sorry for those veterans who have to travel so many miles just to get to the nearest VAMC facility. It's really sad. By the way, I completely handle my husbands claims. I do read everything to him and explain it, then have him sign waht he needs to. It has been many years for me fighting the VAMC, but I'm too old to give up now. Guess I'll have a VARO denial plastered to my hand when they put me in the casket, but they can say at least I didn't give in or give up. Anyway, thanks for your assistance and help. Mssoup1

Jay, Thanks for your response. I have responded back to the RO with a detailed letter I wrote up, cited the regs that applied to what I was talking about, sent them copies of these with the areas highlighted, copies of his medical records with the appropriate areas highlighted, along with copies of anything else which pertained to his case and highlighted those areas as well. Any 3 year old could have fully comprehended what I sent in, but they still cannot read or comprehend what you are trying to state. Then again, it may be that they just are not even bothering to read the evidence you send to them. Takes them too much time. Something is wrong when you get a denial and it doesn't come anywhere to making sense, based on the evidence that was sent in. As to inadequate C & P exams, per another posting I had, you would think the BVA and Court of Veterans Appeals would get tired of remanding claims back based on inadequate exams being given. I think that they should weigh the other evidence that you have presented and if that pretty much gives them what they need to approve a claim, then they should be doing that. Instead, they remand it back so the veteran can undergo another inadequate C & P exam. No wonder there is such a backlog in the claims process. But then again, I guess this makes too much sense. Again, thanks for your response. Mssoup1

Berta, You are a godsend to veterans and seem to be able to find things for veterans to help them that could be a big help in their claims. I know this information that you posted will be of great help to me in my husbands claims. Thank you for your time and help. It is greatly appreciated. Again thank you, Mssoup1

Thanks so much for your responses back to me. First, ouir Patient Advocate is of no help. Been that route before. She tells you to first try and resolve the problems yourself. When we told her that is why we were there speaking to her, because we couldn't resolve the problem, she basically said go away and try again. So much for their help. As far as the question someone else had concerning PA's doing C & P's, our VAMC has one. She does the C & P, writes up the notes, gives her opinion and then states that it has ben reviewed by the C & P doctor and he agrees with her opinion. I think this is basically how they get around using PA's for C & P's. As long as the PA has a doctor who claims they reviewed what they did, the VARO accepts their opinion. Also, I am giving the office of the Chief of Staff at the VAMC time to respond back to me before I contact them again. I just recently called them so they may be getting documentation together for a meeting. I explained quite a bit over the phone to them. They also stated that it was possible the Diretor himself may want to be involved in this issue. I hope I haven't overstepped some bounds with this issue, but it is time that someone does something aboujt this doctor. When we walked into the exam my husband made a comment to him about he had heard that he was going to retire. His comment was that they would like to get rid of him, but he wasn't going anywhere and besides they had no one to replace him with. As I stated before, we don't want anything that my husband is not entitled to. But his exams rquired by the VARO could at least be as honest and accurate as possible. It appears that this doctor goes out of his way to write up opinions which will automatically guarantee a denial at the VARO, regardless of what he has to put in them. That is not right for the veterans who are fighting so hard for what they rightfully deserve. Give an honest opinion and then let this and the evidence make or break your case. I do believe that this doctor thinks that unless you are terminal or close to it, then you don't deserve anything. Sorry for the ranting, but I do think it helps other veterans who are working their claims to see what other veterans are having to experience with their claims through the process. Of course, no two will be the same, but it doesn't hurt to know what others are experiencing. Thanks

Just thought I would add a little note about our experience with C & P exams. My husband went for a C & P exam for his claim for an increase in his service connected skin condition. We thought things went well, at the time. He then was scheduled for another C & P exam for service connecttion for hypertension. While we were there, the doctor who gave him his C & P exam for his skin claim saw my husband and called him in, telling him that there were a few things he had forgot to ask him when he was there the week before for his skin and he needed to get those answered. Strange, huh. Well, the next thing we know, he is asking my husband questions about a claim he had in for ED, secondary to his meds for PTSD. We were not told that this was a C & P exam for ED. This is when he became very angry and beligerent with me because I insisted that he look at my husband's complete file which would have a bearing on his claim fir ED. When I finally got the results of the exam for ED, it went on and on about the ED being due to meds being given to my husband for prostrate problems, not his PTSD. My husband has never had nor does he now have any prostrate problems. He even quoted my husbands psychiatrist's name and stated "he was from the Urology Department and the records from that department backed up his findings". Number one, the doctor from the Urology Department that he referred to is not a urololgist, but his psychiatrist. Number two, this doctor is a she, not a he. Number three, my husbnd has never been treated in the Urology Department, so how could there be any records from this department stating anything and he also does not have a prostrate problem. The whole report was horrible and inaccurate. Then, when I called about the results of his C & P exam for his skin problems, I was told that the results of that exam was included in the same report for ED. The only thing stated in the ED report was that my husband was claiming an increase in his skin condition. That was it. When I stated this and wanted to know where the notes were that the examiner took whiole my husband was being examined for his skin, they couldn't tell me anything except that his file and everything had been released back to the VARO. Now the VARO has an incompetent C & P opinion for ED and nothing on his exam for his skin. I hit the ceiling. Sat down and wrote a 4 page letter taking each sentence the examiner wrote and disputed each one. Even told them where to go to get the documents to back up what I said. We hand carried this to the VARO and spoke with someone there about it. I then called the VAMC and filed a complaint with the examiner. I am still waiting to hear from them about a meeting that they indicated that they wanted to set up with the Chief of Staff for us. Not sure where this stands at this point. This probably will hurt my husbands claim in the end, but there was no since in this examiner doing this to any veteran who only wants a fair examintion and not a report based on inaccuracies. Someone has to step up to the bar and file complaints about the inaccuracies of the C & P exams that some veterans are receiving. The veteran only wants a fair shake and not a bunch of inaccuracies which would immediately get his claim denied. I took everything straight to the VARO before my husbands claim could get denied, based on this examiners reports. The first question the VARO ask me was how I managed to get a copy of the C & P exam before the claim decision had been made. I told him we went to the Release of Medical Records Depaqrtment and asked for it. Well. this is where we stand on this. Any input from anyone on whether or not I took the right road on this and whether or not my husbands claim may get negatively affected? Thanks

I think we will personally take this C & P exam report directly to the RO, but I'm not sure that will help unless we find someone there who has the power to do something. We've gone before to get a problem straightened out, but it was as though we never even went. Also, this same doctor gave my husband a C & P exam for his skin and he has yet to release anything on this. I think the VAMC wants him to retire, but they know it would be hard to find someone to take his place. The whole VAMC seems to be losing doctors and can't seem to get any others who want to work there. If I jump on the band wagon too quick disputing this claim, who knows what the C & P report for his skin may contain. After I get the report on the skin problem, I think this is when I make a trip to the VAMC and raise more H??l than they have ever seen. The patient advocate is of no help at all. I am going to ask to speak directly with the Director. This kind of abuse to the veterans has happened too many times, especially by this doctor to let it keep going. He thinks that when you come in for an exam, that you are aasking for something he doesn't think you deserve. Who does he think he is that he can make this decision, expecially when he can't even write up a competent and accurate report? Mad, yes. When I have all the records necessary to get a claim approved and the RO requests an exam from such an incompetent doctor and then use this report to make their decision, disregarding everything else, yes I get mad. Thanks for letting me vent. Mssoup1

Thanks for all of our responses. Should I send in all of my complaints against the incompetent exam, prior to them making a decision on the claim. I would like to do it ahead of time to ward off another denial and then have the paperwork start all over again. Also, what about the examiner hugging me and telling me how sorry he was for treating me the way he did. My husband was standing right next to us and saw and heard him do it. Can this be used against him? If he wasn't so beligerent and angry with us, why would he do that, so it goes to show, also, that his attitude was not that expected from an M.D. Again, thanks for your help. Mssoup1

The examiner had my husbands file, but it was in another office.. The problem is, everything in his report is erroneous. He tried to state that my husband is service connected for GU. He is not. He also tried to say that the meds he is taking which causes erectile dysfunction is for a prostrate gland problem, not PTSD. He also stated that the Urology Department confirmed this. First, my husband does not and has not had any prostrate problems. Second he has never been treated in the Urology Department for anything. Third, the only time he has ever been to the Urology Department was to pick up a prescription that was prescribed by his psychiatrist. Fourth, the med that he is talking about was prescribed to him by his psychiatrist for PTSD and is documented as such. Also, when he called the doctor by name that prescribed the med, he stated that she was from the Urology Department. How could that be. She is his psychiatrist. Also, he called her a he, not a she. In his final opinion, he did state that the med he was looking at that my husband was taking did in fact cause erectile dysfunction, but it was due to the meds being prescribed for prostrate problems and not PTSD. Since the examiner did state that this med does cause erectile dysfunction and my husband is taking it for PTSD (documented), not prostrate problems, can't this be used to get his claim approved? Need your help with this one. Thanks, mssoup1

If you have a valid complaint against a C & P examiner, where would you go? Not only was the exam notes totally inaccurate, like maybe he used another veterans file for review, but I have a complaint on the way we were treated during the exam. Hope someone could lead me in the right direction. Thanks

Thanks Josh and Pete53 for your kind words. I have been 30+ years working with my husband on his claims and when I die I'll probably still be holding in my hand a denial from the VARO. Never thought I could make it through a BVA hearing, but I went in with the attitude that they could kill me but they couldn't eat me. (An old saying). The hearing went well. By the way. On the C & P exam that I was talking about. After the doctor had copped his attitude with me and talked to me the way he did, he had the audacity to hug me and tell me that he was sorry for the way he had talked to me and treated me. This was after we had walked out of his office. I was in tears because I was so mad and so hurt to be treated in that manner. I didn't say anything at this point because I figured he would really put the screws to my husbands claim. Well. I should have kicked his a?? anyway because of the incompetent report he wrote up. I have had 2 heart attacks myself and several small strokes. I sure don't need his crap. But, I try and get revenge. I have taken each sentence he wrote in the exam and described the errors, mistakes and downright lies he wrote. I backed all of this up with documentation from his medical records. This will go directly to the VARO before they can make a final decision on his claim using this incompetent report. He also did a C & P exam on my husband for an increase in his skin condition. Haven't gotten that yet. I guess at this point nothing would surprise me that is written in that report. But, before I can send in this letter, I have to wait to get the results from the skin C & P exam. I am also in the process of trying to find out who I need to talk to at the VAMC about him. I am going to take this report, along with my husbands medical records to them and show them the type of reports he is writing up for veterans. And the VARO is using this as their Bible when making a decision on a claim. Also, I understand that it was a no-no for him to hug me the way he did. Will take that up with the VAMC as well. He should have gone ahead and written up an accurate and honest report for my husband. We would not be at these crossroads now. Again, thanks for your support.

I am thoroughy disgusted. My husband had a C & P exam for ED. This exam was performed by the general C & P examiner and not anyone in urology. No more than they did for the exam, I would not even call it an exam. Well, I received the C & P notes. The more I read, the madder I got. Not one thing he stated in the notes was correct. In fact, there is no way he could have even reviewed my husbands medical files. He may have glanced quickly at a few pages, but I'm reluctant to even say that was done. The claim was for ED secondary to his service connected meds for PTSD. His records contain numerous statements from his psychiatrist that a given prescription she is giving him has a risk for ED. Well, the C & P notes first states that my husband is service connected for GU, but nothing about being service connected for PTSD. He is not service connected for GU. He also made numerous comments about my husbands prostrate gland problems. My husband does not and has never been treated for any prostrate problems. He indicated that one of the medications that we had stated caused the ED was given to him for prostrate problems. Again, he has no prostrate problems. His psychiatrist gave him this medication for his PTSD symptoms and is documented. He also stated that Dr. ?, his urologist, prescribed this medication for him. Number one, this Dr. ? that he referred to is his psychiatrist, not a urologist. He doesn't even see a urologist. He finally stated that the medication in question can cause ED, but since it was prescribed for prostrate problems, that the ED was not due to meds for PTSD. What a crock. He even stated that this was confirmed by their urology department. How could it be confirmed by their urology department when my husband has never been seen by them. I am in the process of disputing this doctors entire report with factual and documented information to send to the VARO before they have a chance to deny his claim based on this inaccurate C & P report. I also want this information relayed to someone at the VAMC to show them the type of exam reports he is giving veterans and the type of doctor they have giving C & P exams. I am not sure who at the VAMC I should go to. Our patient advocate is not the person. We have dealt with her before and she doesn't seem to want to help. She wants you to handle the problems yourself. So, who should we go to at the VAMC to report this. My husband is not the only one who has complained about this doctors reports. Thanks for any guidance you can give me.

Glad I could help some. My husband has terrible skin problems which he has been service connected for for years. About 5 or 6 years ago, he started developing severe eye problems. He had several surgeries with an independent eye doctor because at first he thought maybe the excess skin tissue on his eyelids and around his eyes could be a possible problem. Well, it didn't help. He has been prescribed all of the known medications for his skin and eyes and nothing helps. His eye doctor finally stated that it was his opinion that his eye problem was directly related to his skin problems. The VARO still denied his claim. Wanted to know where the eye doctor got his opinion. We appealed to the BVA and won an instant approval on his eyes. Took a long time to get this claim approved. The main thing with cataracts, it seems, is that there are different causes based on the type of cataract you have. As I said before, the VAMC wants to immediately use age as the cause. But you need to first find out what type of cataract you have, then figure out what the various causes are for that particular kind. Then if you have the problem, you can start from there with your evidence. As you know, nothing is easy when you are trying to get a claim approved, especially when you are trying to get it approved as a secondary condition. I do know that sometimes cataracts can be caused by trauma to the eyes. I did a lot of reseach after I filed my husbands claim for everything I could find on cataracts. If you can get it documented that yours is due to the trauma you experienced, then you may have a chance. A lot depends on your doctor. Some are reluctant to give an opinion. Keep us posted on how things are going and if I can be of any help, let me know. Mssoup1

My husband has a cataract in his right eye. Growing a little, but not real bad at this time. He does have a film over his eye at times. I filed a claim for his cataracts based on the fact that he has taken cortisteroids and steroids for years for his eyes and skin condition, both service connected. I did a lot of research and found that these drugs can cause cataracts. The VAMC eye doctor did not even want to discuss the cataract issue as to the cause. He just had an appointment today with an independent eye doctor. He told us that the cataract he has was not the type that you would normally see with the long term usage of steroids. I do believe him because he was very helpful in getting my husband service connected for his eye condition. I do know that the VAMC likes to blame cataracts on age, if you happen to be an older person. Maybe some others can help with other causes of cataracts. I did file a claim for this, but I guess this issue for my husband is moot at this point. Hope this helps you some.

Berta, I originally received a copy of my husbands SMR's from the VARO out of his C-file. Mssoup1

Berta, I'm new to the CAVC process. Could you shed a little light on what we need to do first? What do we need to do to get on the docket? I know that you have a lot of experience at this stage and any information you could give me to get the ball rolling would be greatly appreciated. This is a complex case that we're fighting, but the biggest screw-up came from the C & P exam. He was given a C & P exam. We fought the exam as being inadequate. They gave him another one by a physicians assistant. She wrote favorably for him, but then when the VARO e-mailed her to clear up the difference in the reports. she e-mailed the original examiner at home to get information from him on the opinion he gave. She then changed her opinion and said that she went along with the opinion of the first examiner, which was unfavorable to the veteran. One big question I have is how he could have possibly given her any information via his home. By the way, the original examiner was home sick that day. He didn't even have the veterans record to look at. The BVA used this to rule against him, as well as other issues. He also had a buddy letter stating that while he was not at the actual scene of the accident that the veteran had, he was aware that it had happened and the veteran complained of being hurt. The veteran had also told him what happened. Because the buddy letter did not state that he could remember the exact day that this accident occurred (after all it was years ago) and that he was not an actual witness to what happened, they threw his statement out the window. The veteran is really at a low point at this stage and anything I can further help him with I will. But, I need your help and the help of anyone else on the Board that can steer me in the right direction at this point. I will also find the BVA docket number so you can read it and see what you think. Thanks, Mssoup1

I live in Roanoke, Va. and have been helping a veteran with his claim. He has already exhausted his BVA appeal. He was denied his claim. I still think because of the screwed up way his C & P exam was handled and the little weight that was placed on his IMO and lay evidence they used put him at a great diadvantage. Also, his BVA hearing was a joke. He had a very rude law judge and all he did was look at his watch and rush us on like he didn't have the time to spend with us. Does anyone know a good lawyer that he can contact that might now help him with his appeal to the CAVC? I think he has a good appeal, but I do think he deserves the help of an attorney that can help him at this point, since he can't go any further than this with his claim. I have heard the name Ken Carpenter. Any input on him or anyone else that you or someone you know has had a good experience with? Thanks for any help ou can give me.

Thanks for the reply. The audiologist during his C & P exam for tinnitus told him that based on our converstation, that it appeared his hearing had gotten worse, expecially in one ear. Therefore, she wanted to retest him. He has had hearing aides for quite some time now, but due to his service connected skin condition, he cannot wear them but so long before he has to take them out because his ears itch so bad. Due to this problem, they have recently sent them off in order to put some type of a covering or something on the part that goes into his ear. They said that this should help with the itching that is occuring. The audiology department has been super in working with both him and I on his hearing problem. I didn't think that the new hearing results would put him high enough for a rating higher than 0%, but wanted to make sure since he just had a new test performed. Thanks again

My husband recently had a C & P exam for tinnitus. This included a hearing exam due to the fact that he is already 0% service connected for hearing loss. The examiner told him that his hearing, especially in one ear, had gotten worse since his last exam. These were the results: Right ear: 500 Hz = 15 dB 1000 Hz = 25 dB 2000 Hz = 25 dB 3000 Hz = 50 dB 4000 Hz = 55 dB right ear average: 39 dB Left ear: 500 Hz = 20 dB 1000 Hz = 25 dB 2000 Hz = 30 dB 3000 Hz = 65 dB 4000 Hz = 75 dB left ear average: 49 dB Speech Recognition Scores: 82% for the right ear and 84% for the left ear. Does this qualify him for a rating higher than 0%? Thanks

Berta, Thanks for giving me the link for the hypertension exam. According to it, he should have been given 3 BP readings. He has had ongoing hypertension, but no cardiac disease that he knows of. I don't understand why she did not following the C & P exam form for hypertension and take the 3 BP readings instead of only taking 2 and then stating she would use several from his previous medical records. The two readings she gave him was high. Makes you think she is handling it this way to justify a denial. She did send him to X-Ray for a chest x-ray and to the lab because she stated that his previous lab work showed that his potassium was low. What does this have to do with his hypertension claim? I originally put in a claim for hypertension based on his blood pressure reading that was documented at the time of his entry into the military and that on his separation papers. His blood pressure reading was fine when he went in, but was 130/90 when he got out. No where in his in-service military records did it show that they ever took his BP at any time he went to sick bay. They only treated and documented what he was there for and sent him on his way. After all, they were at war and they were lucky to get anyone to even look at them to treat the visible problem. He told me that in order for them to get that low a reading at separation was that he had to wait and was given a BP reading several times. I guess they felt that this was an exceptable reading for separation. The AMA states that this reading is considered hypertension and should be monitored. No one told him anything. After he got out in 1969, he had to go to the doctor for something and that is when he was told that his blood pressure was high and they put him on medication. He stayed with this doctor for a long time. In 1977, he does have a C & P record which states he had hypertension. Along the way, he changed independent doctors and had his records transferred to the new doctor. Later on, when we tried to get his records from the first doctor, they stated that they no longer had the records and that they had been purged. This means we cannot get the first date that he saw this doctor. The doctor he transferred to did put in his records that the patient had had HBP for X years and that he had seen Dr. ? years ago for HBP. He has been treated for a number of years now for HBP and, again, has been on medication. He continues to have high readings, even though they have him on medication. His C & P exam verified the HBP. I stated in the claim that his reading at the time he entered the military showed his blood pressure was normal. Even though the word "hypertension" was not spelled out on his separation papers, his blood pressure reading was 130/90 which is considered high. We could not retrieve the records from his original doctor, but we do have a statement in his medical records from the second doctor that he was treated years ago by this doctor for HBP. He even has fairly recent medical records from the VAMC when his BP reading would be ?/90 they stated hypertension. My argument is that he had HBP when he left the military, period. When I tried to tell the examiner of his blood pressure reading at separation and to show her the medical records of where he had been treated for years for this, she did not even want to hear it. She claimed that the 130/90 blood pressure reading was normal back in 1969 and even though one of his doctors had stated that another doctor had treated him for years for HBP, he didn't say how many years ago. I think with the evidence presented, my husband should at least be given the benefit of the doubt on this. After all, she cannot even read an exam form which told her to take 3 BP readings and she only took two. When he went before the Board of Veterans appeals, they wrote in their remand that he was seeking a claim for hypertension based on his reading at his discharge and also that it was secondary to his PTSD. I'm not sure where this came from. Maybe during the BVA hearing a discussion came up that it was possible that his blood pressure problems were still high due to his PTSD, also. I'm not sure. Anyway, I am so confused on which way to go. I'm waiting on his C & P results from his PTSD and hypertension exam to see what they wrote and then take it from there. The BVA remand stated "The record reflects that the veteran has not been afforded a VA examination addressing the etiology of his hypertension. Given his blood pressure reading at discharge, the elevated blood pressure readings within several years after service, and his current treatment for hypertension, the Board concludes that such an examination is warranted." They also stated that they wanted the examiner to state whether the hypertension is etiologically related to his service, or was present within one year of his discharge therefrom. The examiner should also provide an opinion as to whether it is at least as likely as not that the hypertension was caused or chronically worsened by the veterans service conncted PTSD. I know this is a long posting, but while I may get some insight from some of you on what to do or the direction to take, I am hoping that by detailing his situation it may help someone else who is fighting for this same problem. Thanks to all. P.S. Since this is such a detailed discussion on this one issue, I will make sure I let everyone know the outcome so they will have a better insight on how this claim started, how it was handled and the end results.

Thanks for all of the replies. I do go and pick up all of his progress reports, etc. on every visit he makes to the VA. Amazing what you learn from these reports. Sometimes I think that they have confused my husband with a veteran before or after he was seen, because some of what is written in his record wasn't even discussed in the visit. I know because I always go with him and stay with him during the entire exam. We tried to get this corrected by going to the Patient Advocate, but she told us to work it out with the doctor. If we still had problems, then come back to see her. If we could have worked it out with the doctor to begin with, why does she think we wasted our time to wait outside her office to speak to her. I am waiting on the results from his C & P. The examiner went out of town for a week, so I have no idea when he will do the write-ups and get them into the system in order for us to get a copy. I intend to review these with a microscope because I think I have a long battle ahead of me. I think just the attitudes alone told us that these claims were going to be denied. It appeared that before the exam even started, they had already made their decision on how they were going to handle these. I'm use to fighting to get him what I feel he rightfully deserves and I have no intent of letting up now. We do have a SO, but the last two times I have spoken to him, he had to end the conversation because he had other things to do. This is why I have and will continue to handle my husbands claims myself. Even though he is of no help, the record does show that my husband is being represented by a SO, which seems to be what the VARO wants to see. I have another question. Is there a C & P exam form for the doctor to use when doing an examination for hypertension. Also, I thought that if the veteran did have a long standing problem with hypertension, then the examiner needed to take his BP three times and document those readings. When the examiner came into the room, she told my husband that she needed to take three readings of his BP. She then proceeded to take one standing and then one lying down. When he asked her about taking the third reading, she stated that she was going to use a couple of readings from his past doctor visits. I think the reason she did this is because both of the readings she took while he was in the exam room were both high and she needed other readings to help tip the scale on the negative side for him. If three readings are a requirement, I cann call her hand on this. Thanks so much for your help and support. Right now I need all the help I can get. My stress level is working on overload. Thanks again

Thanks to all responded. I sent the VARO copies of all of his medical records which stated the side effects of PTSD meds, which included ED. I highlighted each of these areas so they would not have to read the entire record. When I told the examiner of this, that is when he jumped on me and told me that he was only concerned about his current meds and could care less about what he has taken in the past. He claimed that once you were taken off of one med which could cause this, that the ED went away. I even sent the VARO medical articles which states that while ED may reverse itself once you are taken off of the med that is causing it,that this doesn't always happen for everyone. He didn't want to listen to anything I had to say. Again, he upset me so bad that he had me crying. You could tell that he was ready to deny the claim before we even entered his office. His other theory to the ED was his hypertension meds. I told him that my husband had been on these meds for years and that the problem did not occur until he had starting being prescribed meds for PTSD. Didn't matter. I may as well have been talking to the wall. Another issue is that I thought that a urologist would have to perform the C & P exam for ED, instead of a primary care examiner. We do have a SO, but is no help to us. We cannot change at this point because of where his claims stand. I have and will continue to handle my husbands claims myself. His SO puts forth no effort at all in his claim. I write his letters, handle his denials, do his research and go to all of his doctors visits with him. But, if C & P exams are going to be handled in this manner, the VARO will use this information and forget anything that you have presented on his behalf. This ends up being a no win situation for the veteran. You can argue your point all you want, but most of the decision is based on the results of the C & P exam. Basically, the same scenario happened with the C & P exam for his hypertension. Didn't want to hear anything I had to say and I got the feeling that his claim has been decided before we even walked into the office. They come up with all kinds of other reasons for the condition to keep from giving you a positive decision. The bad thing about these C & P exams is a lot depends on the examiner and department the exam is being given in. He had an audio exam for tinnitus and the examiner was great. You could not have asked for anyone nicer in dealing with the veteran. I think this claim may get approved, but even if it doesn't, she listened to us, read his records and gave him the examination that was required with a lot of professionalism. I am waiting for the results of the exams to be completed and I will then read them and go from there on what my response will be to each one. We're not asking for anything that he is not eligible for, but at least give us a fair chance and listen to the evidence we have before they make their decision. Thanks for listening. Any further input would be appreciated.

I have a couple of questions concerning 2 c & P my husband had. The first was for erectile dysfunction. While I am trying to explain that he did not have this problem until he started taking medication for his PTSD, the examiner jumped down my throat and told me that he really didn't care what he had taken in the past. Any medication which would have caused this that he had previously taken would have corrected the ED problem shortly after being taken off that medication. He told me he only wanted to talk about what he was taking now. I told him that I should know better than anyone else when and why this problem occured since I am married to him. For some, maybe the ED problem does clear up after being taken off the medication, but his did not. I told him that medical record after medical record showed that he was constantly being warned of the side affect of ED with the medication that they would try him on. Before he took my husband back to examine him, he hugged and apoligized to me for screaming at me. I teared up and told him he didn't understand how this problem has affected us. I guess this is a quick denial for us, and I sure did not appreciate the way I was treated by him. The next C & P was for hypertension. When I told the examiner that his blood pressure was normal on entering the military and was 130/90 at separation, she told me that the diastolic number 90 was not considered abnormal during the year of 1969. I also told her that the doctor that he stopped seeing the doctor he had been seeing since he left the military and started seeing another doctor. He had his records transferred to this doctor. We could not get the records from the first doctor because they stated they had been purged, but the doctor he transferred to wrote in his record that "his BP was elevated - has been up x yrs for diastolic - seen by Dr. .... years ago for this." This note was written in 1990. He also has been on blood pressure medication for years. We also have a record from 1977 from the VAMC that showed his blood pressure was 150/100 and diagnosed with hypertension. I also thought that the examiner was to give the veteran 3 separate blood pressure readings. She gave him one sitting and one lying down. When we inquired about the third reading, she said that she was going to use 2 from previous visits to the doctor. So, I guess this is another denial. Anyone have any input on these issues which may help. Thanks

I would like to respond to the question concerning the Vet Center in Roanoke, VA. Don't know much about the other Licensed Social Workers there, but Dan Karnes is super. He has more concern and compassion for the veteran than anyone I know. As far as the SO's in Roanoke, VA., I will leave that question alone. At the Salem, VA. VAMC, I guess it is like any place else. Depends on the department which you need medical care as to the type of treatment you get. My husband is currently on fee basis for dermatology because they no longer have a dermatology department. Audiology department has been great. Eye clinic is so-so. Don't really tell you anything, but if they do find something, they seem to downplay it because you may have a claim and they don't want to say anything which may help you. The lab has really improved as far as blood work is concerned. Time spent waiting has really decreased, which has been a great improvement. Primary care depends on who you are assigned to. If you do not like a doctor who is treating you and you go to the patient advocate, they tell you to first try and work it out with the doctor and if that doesn't work, then come back to them. Duh! Why do they think you came to them in the first place. Have tried to use the patient advocate route twice with no help. In fact, the first time we used them, the information they sent to the doctor concerning the problem was no where near what we had stated to her. So, instead of assisting us with our problem, she managed to get everything blown completely out of proportion. We could have done better than that without her help. Hope this information helps.

Wallyg, Thanks for your advice. Everything I give to the VARO is in such simple and plain language that even my 12 year old grandson could understand what I was saying. I take each claim and work it individually from the rest. I put each in its own folder, put the type of claim he is filing for and his claim number on the tab portion. I highlight all of the portions of the evidence I include so they only need to look at those portions and nothing else. This should save them a lot of time in reading an entire document or medical record or letter that I send to them. It is hard to make it any easier for them. I also include a copy of any regulation that might apply to that particular claim and I again highlight the areas that pertain to the claim. I put everything they could possibly need to look at or review in each folder to keep them from having to look up anything or request anything. But, they still take forever and then act like I didn't send them anything. I feel as though I have done their job for them. I only ask that they review the claim on its merits and render a decision in a timely fashion. After all, several of these claims are close to 6 years old. I was told when I took the last, very detailed evidence in to the VARO, documented as I described above that they rarely ever saw information for a claim to come to them in such an organized manner. Words sound great. Now do something with it instead of sending me canned letters which contains a lot of words, but says nothing. One other reason that the SO gave me was that they were probably in a stall mode at the VARO because the budget had not been approved yet. Not my problem. If I have a valid claim, then process it. I have noticed lately that there are very few postings put on Hadit that are success stories compared to about 6 months ago. Maybe there is something to this. I'd rather they not tell us anything versus sending us a letter which means absolutely nothing and only tends to stress us out more. Thanks again for your input. I think we will wait until these 2 C & P's are over and we have a copy of them. Then we will make a personal visit to the VARO and ask to speak to someone who is competent enough to talk to us about the contents of his claims. I can't really fault the people who sit at the desks in the main portion of the office who answer the phones. We are usually given to one of them to talk to and the only thing they are trained to do is look at a screen and read to you what it says. The last person we saw there could not even read and understand what was on the screen. We left not knowing anymore than when we walked in. Bev.

My husband currently has claims sitting at the VARO. Some of these are remands back from the BVA. Others are new claims. The ones from the BVA, on remand, have been back at the VARO since the first of February 05. Last week, we get a letter from them telling us that they are currently working on these claims (minus one which I will discuss later). They want us to send in medical records or any other evidence which we may have. They even sent us Release of Information Forms to fill out. They also listed the evidence which they have currently received from us. Well, I have sent them letters explaining exactly what we are claiming, why we are claiming it, gave them their regulations to back up what we feel states why the claim should be approved, letters from myself, letters from the Vet Center, medical articles, lists of medications which he has taken or is now taking, a copy of all of his VAMC medical records that were highlighted for them showing that which pertained to the claim, but they still want more. Most of what I sent to them was not even listed on their letter as evidence they received from us. Are they not looking at his file before sending letters out? Also, they stated that they were sending us a form for my husband to fill out if he wanted his claim expedited. He hasn't even been afforded a C & P exam on some of these claims and I am certain without those, the claim will definitely be denied. Why would we want to expedite his claim when they haven't even fullfilled their obligations to him? Also, at the end of the letter we got from the VARO, there was a Release of Information form attached which has another veterans name and social security number on it. Wonder what he received which should have come to us. Well, a couple of days after getting this letter, he received another letter stating that he was being set up for 2 C & P exams. One for audiology, which he is claiming tinnitus for. The other was for a general C & P exam. I am to assume this may be for his claim for an increase in his current service connected skin condition and NSC hypertension claim. He is also claiming erectile dysfunction due to medications he has been taking for his SC PTSD. Doesn't he need to have a Urology C & P exam for this? Also, he has a claim in for cataracts which is currently NSC. Doesn't he need an Ophthamology C & P exam for this? A general C & P could not cover these medical conditions. The other issue that the letter did not even cover was for his claim for an increase in his SC PTSD. We don't even know where this claim stands since they did not state in the letter we received that it was being worked on. Nor have we received any information about a C & P exam for this. This is a claim on remand back from the BVA. I am so confused with this letter. You would think in reading it that these are all new claims and they haven't received anything from us with enough evidence to go forward in our favor with the claim. It really makes me think that they are stalling as much as possible to keep from deciding the claims. Our SO called us about the letter we received because he has just gotten his copy. Well, I don't mean to be so negative about someone, but this person has no idea of what is going on. All he can do is read parts of the letter to me and then say this is what they are saying they want. I told him I could read. I needed some explanation on why we even received this letter, based on all the information I have already given the VARO. I also asked him why they did not even include his PTSD claim in the letter. He couldn't answer anything I asked him. Finally, he said that he had to end the conversation as he had some errands to run before going home and to call him after my husband had the couple of C & P's he has been scheduled for. He knows nothing about the rules and regulations and cannot answer any questions you put before him. He cannot even offer you any help in finding out any information on your claim. He has an office in the same building as the VARO. I never call him for anything because he has no help to give and only makes me more frustrated that I already am. Also, in the BVA decision, they told the VARO that we had requested a regional office hearing several times before our BVA hearing, but we were never given one. The letter stated that the VARO was to ask the veteran if he still wanted a hearing and if so he was to be given one. Even though some of his claims are remands back from the BVA and some of the others are new claims, should we request a regional office hearing at this stage or is it too late on the BVA remanded claims? I know this is a long posting, but my husbands claim process is becoming very complicated. Any help, input or comments you may have would be greatly appreciated. Thanks, Bev.