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brokensoldier244th
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Posts posted by brokensoldier244th
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We’re not- we had a directive a year out two ago that told us to reduce the number of RFE (request for exams) because they were being set up and then cancelled too often on rvsr review, so they have vsrs look over for current medical first and P&t status is one of the things we specifically look for. Usually it’s on all contentions, or they are static, so it gets left alone.
- Vync and blahsaysme2u
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It would be the same claim you appealed, just remanded back to the RO. Might there be an exam? Sure. P&T is not a guarantee against exams, usually just recurring exams for P&t conditions.
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Sinese isn't a veteran, though, but for all the work he does for them, why not? Separate membership tier, invite only maybe
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What metrics are you looking for and what was the old URL you were using?
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59 minutes ago, Whodat said:
Sorry. Thought maybe you have more insight that is more advantageous for VA and less for the vets. I do understand that your job requires you to quote go by the books, but your higher up don't. I have read case studies for my same situation, I have proven same to include imo. Still denied. You address how things go at your location. You work for the same office/division. When people bashes the VA, guess what, you are a part of that system. You quote regs and laws, but higher up ignores the regs and laws. Who side are you on? Your 100 percent p&t and another job to make ends meet or help vets that are struggling and you just keep shouting out regs. Some people get where they want to be in life but man, I am going to make it harder for others.
Put down your diapers and pull up your rifle and help Vets.
7 minutes ago, Whodat said:Very good @Tbird. Great response on reiterating the rules and or regulations. However, if we have any direct relationship with the VA such as an employee, your occupation should be just your business. Why are we posting as to where I work and what I do and look for.
How about, hey whodat, look at this reg, quote this reg. Not well I look at reviews all day and the Vets mess up by doing this. Hell, the vets that are doing it improperly are not members of Hadit. What good is it doing for Hadit members.
I noted that I was an employee because, while you may not appreciate that I work for 'the man', some others might. Who would you rather hear something from, Joe at the VFW or a VSO that may not have bothered to update themselves in years, or someone that actually works within the system that you are asking about? Take a vote- kick me out, I don' t care. I was assisting with claims long before I worked for the VA, both on and off the internet. If everyone on Hadit did everything right, Hadit wouldn't be here. I tell where vets do it wrong so you don't do the same thing.
- blahsaysme2u and Foxhound6
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You could have done that with less overhead by just calling the VA directly, or a 21-4138 indicating the oversight. *shrug*
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I dont have anything more to say. Pacmanx1 laid it out pretty well.
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15 minutes ago, Mr cue said:
My advice is to do a complaint to Whitehouse hotline. It becomes apart of your record if you have a issues or have to appeal to cavc
Upload a statement refuse the exam.
This might hold up the claim but they have to address the issue or denied it.
An with this no contact with bva or VA but the 1800.
Has end anyway if getting anything address at those levels now.
There is much you can do this is the new thing I am see a lot of post about the VA using these contractor exams. To delay or just keep ordering the same exam over and over. To delay addressing the case.
It's like they have no oversights in them because I have never seen this so much.
Listen I apply for smc benfits they try to open all my disabled. Even try to get a reduction stating my condition had gotten better.
Got my record there were 3 different times they were told I am 25 year protected.
Good luck
That's because a request for SMC is a request for increase based on all SC contentions of record. I've posted the regs for this before.
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That sounds 'off'. Gen meds are only done for post RAD within a year claimants, or IU because all contentions never too be treated asan "increase". Do you have a VSO? They can check the notes in your file and try to see what's up, or 1800 PEGGY.
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Just request a new PW. Creating it will be an issue since it has to have several elements. I just let google generate one, then I copy and paste it somewhere in a file on my computer of running passwords.
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On 9/18/2022 at 7:30 PM, Deagle said:
I am BDD, I think the situation just really upset me because it was super unprofessional, especially asking for details, I have no problem talking about a vague example, e.g. kids being blown up. But to ask for more specific seemed very much out of bounds. Just my thoughts.
No, you're not on a wrong track here- I dont have PTSD MH so my exam at the time and yours were probably quite different in some ways. I/we (VSRs/Raters) see the 'details' and the devil, the examiner doesn't need to probe to the hour and minute- they just need to basically verify that what you are saying to them aligns with what is in your records that we send them, and that you are a reliable narrator. They shouldn't have gotten that into it, in my layman's opinion, and it wasn't necessary.
Once you started to show discomfort (and It happens in lots of these that I read) the examiner usually adds notes in there about agitation, discomfort, anger, evasiveness, etc and moves on. Since we can see the details, evasiveness on your part isn't an indication of embellishment or outright lying- we can go right in there and read the whole thing, and we send the examiners enough that they shouldn't need it, either, unless the records are REALLY thin.
In the case of these types of exams some anger/evasiveness/discomfort actually can help corroborate better than asking about the details themselves because it shows that it obviously affects you. That still isn't a normal therapeutic technique in psych evals, to push for it, though. I asked two friends about it that are both psychologists that work with abused kids whose symptoms often parallel with PTSD patients. They thought it was weird to ask to that level, also.
- Deagle and blahsaysme2u
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Thats because anything higher than hypertension stage one is something to worry about . HTN stage one is easily surmountable by some very basic lifestyle changes and HTN stage 1 barely falls outside of outliers for normal blood pressure when normalized across ethnicity and age. I've asked about this from various family members (I have several nurses and 2 doctors across our extended family), and they all concurred.
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It sound like whomever put in the exam forget to check the box on "needs to verify stressor y/n" so if it's unchecked the assumption is yes. That stressor verification isn't part of every exam
I'm sorry you had to go through that. You shouldn't have. It sounds like you are BDD/IDES and have your records at the ready. You'll likely come out just fine.
I've done some drone troops' exams research and prep, and one former SEAL (not 6). You guys have some interesting commonalities between your jobs. I work more MST, though, than combat PTSD. Lots in common been those too.
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I understand, I'm not taking it personally at all. The VSR has access to your entire file and would have seen all that, but the examiner would not be the one looking over individual news articles about events or operations that you took part in. They are asking specific questions from the form that, for good or ill, is legally required to be used. VA and Congress decided on that, and the requirements for a PTSD exam (or any exam) are laid out as much in CFRs by Congress people as they are by VA regulations (the M21-1 that we use).
Ive attached the PTSD DBQ that is in current use so you can see what information they are looking for, and why they may have asked you some of the things that they did. You can also use this to show that maybe the examiner wento of into the sticks- "hey, this stuff here that they asked me went off into the weeds and wasn't required information, I want a new exam...". T
This is 1 version older than current, it didnt change very much, though- I don't have access to ANYTHING VA right now- my accounts were all disabled yesterday to today overnight. I'm transferring to another RO, so the switchover has me wondering If ill even be able to log in in Monday LOL. Consequently I don't have access to anything that isn't locally stored on my other machine.
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Did you look at the DBQ before you went? There are specific questions they are required to ask. They also aren't 'treating' in a DBQ session, or trying to build a rapport- they are trying to get specific information about stressors and relative effects. That doesn't excuse their questioning style or attitude, but the somewhat direct nature of the exam is because its not a treatment type of session.
You can talk to the patient advocate at the place that you went for the exam, you can also send a 21-4138/21-10210 (either is a valid form at this point until they phase out the 4138) detailing your session, as much as you are comfortable with to be added to your file- it may not result in a new exam, but if the clinician didnt ask the right questions or get the correct information then that, plus their exam report, can often result in a deferral from a rater back to one of us to re-schedule a new exam or IMO based on the previous DBQ, with a different provider. If its an IMO rework request you don't have to go through another exam, either.
VSRs, if they are doing their job, look over the exam opinion reports prior to sending to rating. If the necessary information isn't on the exam opinion report we often reschedule an exam request/rework noting the deficiencies before it goes to a rater and send it to an examiner. Takes less time since it doesn't go to a rater, get deferred, then re-set up exam request, exam, back to rater again. After a few years of doing mostly PTSD I am pretty good at sussing out if the exam report has all the right information or not on it. KIM I don't rate so I'm making judgements on what YOU say, i'm looking at what the EXAMINER says, along with looking through your STRs, personnel, 0781s, etc.
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36 minutes ago, Vync said:
@brokensoldier244thYep. Despite new presumptives like the PACT act, I often listen to other vets discussing similar issues while in VAMC waiting rooms.
- Some never sought treatment while in service because they wanted to maintain a tough guy persona.
- Some never sought treatment after service because they were able to manage with over the counter remedies. With no physician documentation, the VA discounts their lay statements and denies.
- I heard one vet tell another to just file for any and every ache and pain regardless. I was mentally facepalming when I heard that advice. The guys were about twice my size, so it was not my business to contradict them.
- And then there are those who did everything right, but don't want to deal with the VA because it reminds them of red tape from while in the service.
It would be interesting if the VA would post metrics showing how many vets files claims without meeting any of the criteria: no in-service issue, no continuity of symptoms and/or care, and no current diagnosis.
I had 3 out of 15 today in the midwest. It's not usually a whole claim, though, it's the claims that claim everything under the sun 10 yrs later that they found on web MD, including associated conditions, and then reworded variations of same, with no anything for care afterwards- no vamc, no private- just their statement, and that's one of the three elements for caluza.
I don't decide that, though, in the end, the raters do. The standards for what I needed to submit for an exam are extremely low. One of them was a ground pounder so I based all elements on their MOS. Let the raters sort it out.
Somewhere in there I found some contentions that had basis in their STRs though, too. Every day an adventure*¯\_(ツ)_/¯ hands written records suck.
Last day for me in this office. After 3yrs I'm following my job virtually to PR. Full time remote from home not based on an Accomodation. Sounds like my new station is a fustercluck, too. Should be fun, but I get to train some people, too, so, help make change- one person at a time.
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39 minutes ago, Whodat said:
If I see something to that effect and didn't like it, although I need a job and the money for my bills, I do not think think that I could support an organization that turns their left cheek to my band of brothers or sisters, especially if none of them have or had family members that had never served.
Many of them are veterans, it's not just civilians. And what better way to try to enact change, sit around on the outside and expect politicians to do it, or work from the inside?
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23 minutes ago, Vync said:
@brokensoldier244th I know what you mean and it makes sense to a certain extent.
The VA repeated has tended to handle presumptives or denials based on statistics or shortcuts much in the same fashion as manufacturers determine if they should issue a recall. If a very small percentage gets sick, they do as little as possible and deny. Repeatedly, the lawmakers had to get involved and force the VA to handle them.
After receiving a denial, I asked the VA chief of cardiology "why the heart attack happened". They quoted a very low statistical chance of migraine meds causing my heart attack. My non-VA neuro specialist's "more likely than not opinion" scolded the VA for not following FDA instructions to perform certain tests to determine if the med could be continued safely. They went so far as to state that they would not have expected a cardiologist to be familiar with the need to do that. The VA reversed the denial and granted SC.
Another example is when I filed several musculoskeletal pain claims after getting out in the 90s. The VA denied all of them because the x-rays were negative, despite me having limited range of motion. I got some of them SC years later. Recently I had an x-ray which was negative, but my non-VA doc requested an MRI which showed soft tissue damage which would have never showed on an x-ray. It is another case of the VA not being thorough and looking for the quickest way to prevent SC.
Yeah, I know, I see that every day-Im not at all for VA denying etc etc, its just that with as many claims as I see at some point there has to be a line-because I see a lot of claims that are ultimately denied where the veteran literally has nothing - no service treatment, no post treatment, 15 yrs later they file a claim and have nothing to support it- in some cases even their private doctors records don't support any of it. But, they claim it anyway. And those claims are all mixed in with everyone elses that actually have issues that need addressed.
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That wasn’t meant to come across snarky, it was supposed to be funny.
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Neither- the VA isn't like "hey, you live in N. Dakota...do you know Bob?"
I post in a lot of places.
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You are ok with paying every vet that gets cancer, regardless of etiology? That’s why there is a cut off as arbitrary as you may think it is. Just because someone served doesn’t meant that cancer 20 yrs later is service connected any more than back pain or knee problems 20 yrs later are, unless there is a history or at least a plausible presentation of pre symptoms during the presumptive period.
Otherwise every vet with an ache, pain, or disease for forever would be filing even if it has nothing to do with their service. There has to be a line somewhere.
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6 minutes ago, Mr cue said:
Lady and gentlemen the info is out there.
The excuse has change 5 different time.
First VA don't do exam next they don't have worker to do them.
Next they use a system that tell them if the VA hospital can do the exam.
I don't no why you are trying so hard.
Maybe because the complaints have already started coming in about the department trying to schedule veterans comp exam,2 hr away.
When there is a VA hospital closer
We understand the VA department is first to see if a VA hospital is near the veteran can do the job.
But like I said in my case they didn't do that and after complaint.
They send the record to the VA hospital near me to do the exam.
Take it anyway you want
The only thing that has changed, Cue, is the length of the list of things you continually add to this as 'proof' that you are right. Ther is no 'excuse'- I've posted the same thing in as many ways as I am going to. The only person that said VAMC's don't do comp exams anymore is you. No one has made a definitive statement like that- I certainly haven't.
Yes, for whatever reason, you got scheduled not at a VAMC. Likely because that VAMC could not do the exam. Take it as you like, but the only one trying hard here is you. Ive posted the applicable regulation for requesting an exam, ive explained a bit about the process and what it looks like and why. You just don't like the answer.
Opinions on C@P exam
in VA Disability Claims Research
Posted
It says it right there, “ more likely than not…”. Without seeing any of your other evidence, though, there is no way to know. His opinion could be completely opposite the clinical picture presented in the available medical evidence- only you know that.
Assuming that the two track together, yet I, this is a favorable sounding opinion.