brokensoldier244th

If you give an approx time when it started then usually about that far, otherwise , all of it to find when it started Yes, same as for any claim, though you’re going to need a sleep study or a disgnosis to say that you have Sleep apnea vs any number of other sleep issues rooted in MH issues. Yes, same as any- evidence is evidence but someone from the local Quick Treat at Walgreens isn’t going to carry as much weight as a doctor or specialist

True, but then not all medical opinions have the same weight, either. I get a few every so often from Chiropractors writing off on systemic non-mechanical conditions, or Social workers diagnosing PTSD, or examiners that are 8 states away and don't have the records in front of them from the veteran or us, or don't cite anything at all except "in their opinion.....". *shrug*.

If they are in equipose yes, but then im not a rater and I don't have it in front of me. There are claims where the opinions are are not in equipose depending on what each opinion has available to them as the body of evidence, or if an opinion is completely opposite of the evidence of record.

Legally we are obligated to read through all of it, but ill be the first to say that I really appreciate it when someone sends in a claim with at least approximate dates, seasons, a name of a duty station, or highlights relevant pages of their STR or Capri notes if they have them. Sure we get that stuff, too, but if yours is marked and/or highlighted, so much the better. I still read stuff but that other info definitely gives me a place to frame it within the context of the original documents so I can mark it there, too.

Ebenefits has been in the process of being retired for over a year and I would not rely on it at all unless you are one of the few veterans that have a legacy only appeal going on. Everything has pretty much been moved to VA.Gov.

Likely because you have two different opinions, one favorable, one not, therefore that has to be resolved. A difference of opinion doesn't mean SC, as raters can't make medical based decisions they can only go off of what is in front of them. If there is a difference of opinion between two examiners it has to be resolved, meaning the rater ordered the exam asking the tiebreaker to answer a specific question that wasn't addressed, or that was root of the opposing opinions.

What directive is that? I get Capri records on every veteran I build a claim for because it’s required under duty to assist. I have to show proof of all attempts, and negative responses if there aren’t any. It’s been that way for years.

it can be granted at 0% you only get paid if it’s 10%. It’s under dx code 7319, usually

You can have a 0% rating for a condition. https://www.va.gov/resources/non-compensable-disability/#:~:text=If you receive a 0,eligible for other VA benefits.

1. Yes, likely, under PACT, if you fit the criteria, though depending on how long you have had the rating it would be really difficult to drop it or eliminate it. 2. Yes, PACT claims can come in as "New" (526) or Supplemental (0995/0996). Since you would be appealing a prior decision it would be a supplemental 3. Depends. Likely your neurologist DIDN"T just "lump it in there". There is overlap of IBS and FM in some 60+% of cases, and 70% that have FM have one or more symptoms of IBS but maybe not full on. You didn't have to "claim it that way"- the rater looked at whatever you had for medical and they would know about the overlap of FM and IBS, also. 4. It would be another secondary condition if it were claimed/awarded that way.

You dont want to give them to the doctor, they can't do anything with them. If you know your STRs are in VBMS (the 'claim' file) then you give him a list of the approx dates, or even just years. They can ctrl-F search and do the rest. They aren't going to pour over paper records. They, for the most part, don't get paper records anymore, even from us. I send them a list of links or attachments directly attached to the exam request and it all comes out on their end as 1 thing. Contractors, especially. VHA can see the same things we can, with limits, even within our systems. Same with us and VHA- within some limits.

If you are having difficulties in that area, then yes. MH drugs are notorious for this. Talk to your PCP about it to get it on record, and if you claim it you'll have a genitourinary exam (thats the DBQ name, you can go look it up on line and see what it covers), and a prostate exam goes with it (generally) because an enlarged prostate in men can also mimic/cause ED.

Why not just request an increase to headaches, and file for tbi while you are at it? You have an in svc event…

Headaches are all lumped under 1 category for exam purposes. Are you claiming secondary to SC Migraines (specifically) or just headaches? Claim secondary to what you are already SC for and use the words that you are rated for. Don't play doctor, or pull up Web Med and try to self diagnose. It feels like you are strengthening your claim by trying to use the medical sounding words ( I know, ive done this back in the day, and I ended up having to appeal later) but really you aren't. Use your regular words for it, and only get technical if you know its written in your records that way. VBMS takes your contention/claim, and barring some misspelling, etc, or combining of two conditions into "bilateral" to save space, that wording is what goes on the exam request, and that exam request is the question/s the examiner has to answer. If you claim something secondary to "X" specifically, but you don't have a DX for "X", well, the examiner answers the question with "No dx for "X" because that is what they are legally obligated to answer. https://www.va.gov/vetapp21/files2/a21002562.txt -granted https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637068/ -Scroll most of the way to the bottom, or CTRL-F search for "Summary". Granted, you weren't part of THIS study, so you can't cite it directly but you CAN point your doctor at it for saying "hey, this is plausible, right? I have tinnitus, and headaches, could they be connected?" If you phrase it something like that rather than marching in and saying " I want you to write an opinion about my headaches and tinnitus for a disability claim..." Your doctor may run screaming out the door. Lots of practice docs don't like to get involved in the disability process very much- they are afraid you'll sue, or something, and its their license on the line making the opinion. But, if you ask about it in the course of an exam and get them to DOCUMENT that it is a cause for concern, you talked about it, and whatnot, that kinda forces them to write something into their record about your complaint/why you were there, and a summary of what they think (usually). Here is the current DBQ for migraines/headaches. (attached) so you know what the most recent one looks like. Your doctor can fill this out, too, its not a difficult form. Make sure they and you make note of how many time/s a month you are prostrating (have to lay down) and the duration, and if there is dizziness, or light sensitivity, smell, sound sensitivity etc. They also need to include something separate from this that says why they think your tinnitus and headaches are connected (study a, study b, neurology tests, whatever). The second part can be on letterhead from them. This is the 'rationale' portion you hear a lot about. Headaches_Including_Migraines.pdf

Wow! Congratulations !

Scottish- did you contact VA through an app or website at some point about an error you were experiencing, with VA.gov or Ebenefits? If so, that EVSS group would respond to you, in the context of whatever error you may have reported. Other than that, they don't just reach out to a veteran

Sure- but that is different than what Scottish is describing, I think. We (VSRs and raters) do call veterans sometimes if we need clarification of things- its faster than mailing and moves things along faster. Usually in your situation I make a claim level note that is read by the raters that points out the pvt DBQs. Whether or not they are 'complete' and answer all the questions with rationale isn't my lane, though.

I would avoid it. We have an internal helpdesk for internal VA applications but they don't contact veterans about errors. "VA account" is pretty vague and could mean a whole lot of things. If we needed you to correct something, like a dependent or an account routing we could contact you by Letter, MAYBE sometimes by phone, depending on what information is needed (like what body part, can't read name of dependent, etc). As for verification of information- usually WE verify the corrections base on what YOU send. Gender Identity, Name changes, etc. are all verified against existing recent evidence of record submitted by YOU. Sometimes I have changed an address in VBMS based on what is listed in Capri if the Capri (VAMC medical stuff) is more recent than the last communication from you. This happens if we sent out a letter that was returned back to us. We have the ability, after some hoops, to contact your bank of record for current address information, or run a 'CLEAR' background search for public information only. Certain letters are REQUIRED by law to be sent to the veteran and delivered- COD admin decisions, Decision Letters, stuff like that. If it gets bounced back we go into sleuth mode, and sometimes that might involve contacting the veteran by phone. Public Contact sometimes emails veterans, but Tech Support doesn't, and VSRs very rarely. I usually contact the VSO of record and let them do it.

I got you Cue. I know we have static sometimes but the offer of a virtual (hell, or real) beer is out there. We all have our days- sometimes when I come here to read or help I get a feeling of it being 'more work' like what I do, so I sometimes transfer my frustrations of the day at my boss, the VA, claims handling in general, 10 emails a day about changing processes, procedures, etc here. I really need to mind that more, so I don't become 'that guy' who is in gov svc and no longer gives a shit. My boss cautions me on it constantly- my production and accuracy averages are high enough that he worries that Ill burn out. We'll see. Ive got some years to go. Im only 3ish in and im 46, so, I have a few years left.

Not making excuses. Pointing out the obvious, and, agreeing with you. And they do get fired- raters and VSR's both. Not sure what else you want to happen. 'perfection' is not going to be possible, ever. Its an unrealistic expectation, unless you want it done by computers- and I've seen the pilot program claim actions for THAT one. You do not want computers determining claim actions and processing. The error rate for the last batch I helped test was well over 70%.

My raters aren't any better than anyone else's- they screw up too. I overturned an error they called on my last week because they didn't read that it was an INCR claim so a bunch of the required normal documentation wasn't required. They said I didn't pre-prep the claim correctly before requesting the exam. CFR and M21 says you file for an increase you get an exam, pretty much no questions asked (rather than having to have 3 caluza elements, etc). I just shook my head and kicked it back saying "um....did you actually read the 526 they sent?" and CC:d my boss on it. With the number of claims sent in, and processed through VA, there are always going to be screwups. Best anyone can do it 1. give a shit, and 2. spend the time without always looking at the production number for the day. #1 is more important than #2 but sometimes I wonder with a few of my coworkers or those whose work I get from other stations.

I can't speak to what attorneys do, or their examiners, and just because an attorney has an examiner on deck doesn't make the examiner any more experienced at it. I'm in the middle of civilian injury claim due to a car accident. My attorney, who lists 'veteran claims' on his shingle, hasn't been able to figure out how to get VA treatment subrogation records (the ones that show what the VA would charge to an insurance company).....for over a year and a half. This accident is clear negligence- the driver admitted on the scene that they blew a yield sign, which resulted in my car folded in half. This is after I sent him the form that he's supposed to complete, with instructions, and I filled out my part granting the release of info. THEN he came back and said it didn't work (after a month- Um...duh? Nothing takes less than a month at VA, you'd think hed know this). So, I filled it out myself, all he had to do was sign, send to the appropriate release of information office along with the form that says he represents me for a non-VA related legal claim. His office/assistant still can't figure it out. He's resorted to asking ME...you know....since I work at VA, if I could do it. I told him that based on that statement alone I was considering firing him because I can't go look up my own medical records except through VA.gov due federal privacy laws, etc, and those don't have the billing either. I'm just explaining what I see day to day. I submit the exam requests- the ones that I re-submit due to an inadequate private DBQ are sent back to me after I've sent them to rating, and a Rater makes that call whether or not it is sufficient. They also have more training in specific legal and medical areas than we get, officially, though a lot of their training modules are out there for us to take if we want to, and have the time, unofficially. Do they screw up? I'm positive on that. Can I do anything about it? Not really.

The only place on that page that says "10 years" is eligibility for VA care if you aren't already enrolled and don't have an SC condition, and that's if you discharged after 2013. Th PACT act removed the prior 10 yr manifestation language (from 2021) for any presumed condition listed, within any of the locations listed. The language of the PACT law is that if you were in one of the listed areas and have one of the listed conditions "An undiagnosed illness and medically unexplained chronic multi-symptom illness may manifest at any degree at any time."

VA does C&P exams still, it just depends on capacity and availability of examiners to do them. Examiners receive training that a clinician does not have- clinicians are not involved in the disability process. As for a private doc doing a DBQ- its not that hard- its 90% follow the instructions- which some of them don't bother to do. Probably 20% of the exam requests I schedule are due to having private DBQs that are inadequate or do not provide enough backup for the assertions they are making, or are from chiropractors and GPs trying to diagnose hematological blood diseases or cancers or MH issues or some other thing way outside their wheelhouse. Just because M.D or APRN or whatever appears after a provider's name doesn't mean they are the best person to be filling it out. Chiro's especially.

Depends on if the DBQ was: filled out correctly, provided sufficient rationale, actually looked at your records, etc- I see a lot of pvt DBQs that are jacked up and hardly worth anything because they write a few sentences about how "in their opinion" its related to X/Y/Z but provide no reasoning behind it. These aren't a doctor's note to the principal, they have to have certain things in them, and a lot of private doctors don't put enough into them to be much more than a lay statement with some extra weight, perhaps. Generally, yes, if we have private DBQs it can forego the need for a C&P exam, but it depends on how they are completed, what information they reference in your records, if they use solid language (make an actual opinion rather than an assumption, or dancing around it and not making a definitive opinion at all).