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  1. im looking to those with experience with C&P exams and the raters....someone has royally messed up my claim and now i am starting from scratch for pain/loss of use in my left leg and foot. heres the story: way back when- i put in a claim for bilateral knee/leg and feet. the VA couldnt find all my medical records...frustrating as it was they did eventually award my right leg based on some records they found. i found medical records to support the left leg and foot injuries(fractures that have since healed and now ache with arthritis like symptoms- tho i haven't been diagnosed with any arthritis yet) i reopened the claim going on 3 years ago with this new evidence(LOD and medical records showing removed from duty and put on profile for the fractures). the VA in all their wisdom saw this as a reopened claim for "bilateral knee/leg and fee" claim, even tho my right leg and feet/ankles are already SC. i have been to multiple C&P exams for this claim(and at least 5 have been scheduled in total) the first 2-3x the doctor evaluated my left leg and did the angles limited movement tests etc. the VA scheduled mayb 2-3x after those appointments to "evaluate the right leg and foot". i called PEGGY every time and confirmed what the c&P was for and explained i was not asking for increase in my right leg, my right leg is SC and i dont need any evaluation of that leg for this claim! they would cancel the appointment and reschedule and again it would be for my right leg. the last time i called they confirmed the appointment was only for left leg evaluation(saying that the previous C&P evals on the left leg are now out of date or invalid and i need a new one) so i go to the appointment. i get there and the doc starts evaluating my RIGHT LEG!!!! i flip. finally the doc says this is huge mistake bc he can see that the claim is for left leg but they ordered wrong thing and needs to be rescheduled. well the VA now denied my claim saying i refused the exam. WHAT DO I DO?!?!?!?!!? HELP PLEASE bc i am so done with this shite. this claim is not very much but it was one of the first claims i submitted in 2008 and i should get back pay for. also these 2 SC would give me 100% rating sooner than i was previous awarded and that would be extra back pay as well. i feel like i get 1 step forward in a win and 10 back in loses. @brokensoldier244th i know you have a lot of expertise in this. thoughts?
  2. Hi All, I'm back again... still working on claims that started last July, and I apologize if this is a little scrambled. In a nutshell, I'm currently rated 90%, 70 PTSD/TBI/alcohol, 20 bladder, 60 kidneys, 10 tinnitus, 0 headaches, 0 hearing loss. "0" for headaches was because first evaluator would not listen to my comments about them. I also have degenerative disc disease which is related to a training accident but has been denied because when I went to civilian dr. I made a statement I hurt it doing construction. My current PT said (unsolicited) that the injury would not have been from lifting, but from trauma years earlier aka the training accident. Also been diagnosed with hypersomnia that the civilian dr. says is definitely from training accident. More on that in a moment. So hypersomnia is pending claim, high blood pressure is pending, and heart disease is pending. So, filed hypersomnia, heart disease and blood pressure in July via my VSO. The back had been denied, and was asking for review after submitting a buddy letter from PT. At least I thought it was pending review. At some point in August, the VA "combined claims", and put everything into one claim. The hypersomnia apparently is related to PTSD, so VA asked for re-evals for PTSD, TBI, as well as a "general physical" presumably for blood pressure and heart disease. It took forever to get those appointments via QTC, but they are complete now. PTSD as 1 Oct, TBI was 6 Oct, and general physical was early Nov. Then QTC called to schedule an echo-cardiogram of heart, which was 24 Nov. QTC has now called to schedule a re-eval of headaches,PTSD and TBI, and audiology (which I pushed hard for headaches in PTSD and TBI appointments because first dr didn't accurately reflect them). Anyway, QTC said they were calling to schedule ONE appointment for all those, and I said I just had PTSD, TBI, and general physical appointments. QTC rep became defensive and said she could note I was refusing to go. I said I wasn't refusing to go, I'll go where they send me, but PTSD and TBI were done less than 60 days ago, and the appointments are difficult. She said she would call provider to get them scheduled, would I hold. Sure. She came back after 5 minutes or so, said the whole thing needs referred back to the VA because the file/request is not processed correctly, the PTSD, TBI, audiology, and headaches all have to be separate appointments. I asked if she was sure they wanted all those or if they wanted an appointment for headaches that is RELATED to PTSD/TBI/Alcohol Use Disorder and the alcohol use disorder is abbreviated AUD that LOOKS LIKE audiology. Back to "I can note you do not want to attend..." Now waiting on QTC to call back with the reprocessed VA request... In the meantime, I've been checking the VA.gov website, and the one claim has changed to "claim closed" as of 7 Dec (Pearl Harbor Day, how ironic), and nothing further shows. In fact, even less shows than when it was an open claim. My VSO changed jobs and is kind of MIA, so I have no way to "see behind the curtain" and see what is going on. The disc disease claim/review seems to also be missing from all the claim information that is visible on va.gov. Sorry to be so lengthy, but I know detail is helpful. This all leads to several questions: Any insight from anyone about might be going on with the request to have all new appointments 66 days after just having them? Paperwork SNAFU? What happens with the back claim since it appears the additional review may not have been uploaded, and not within 30 days of the decision if it was? The decision was in June. Is that just dead and gone then, or can it be refiled? EDIT**Looks like I may have misread the dates on the website. It appears there is actually a year from the decision to request further review? VSO-the guy I was working with was great, said when he changed jobs to a similar organization he would keep my case, but now I simply get in touch with him. The people in the office now are all kind of new, and have said my case is complicated and I should stick with the original guy. Is there a way to get access to "a file" somewhere, and work on my own claim(s)? or at least be able to get a hint at what's going on? Thanks everyone for listening and any help you can provide...
  3. Good Afternoon All, I have a PTSD claim for increase tomorrow via video conference. I know that if you went in person, they wouldn't let your spouse or SO in with you. I'm wondering if anyone has had any experience with the video conference exam. My wife is going to be sitting next to me when the conference begins and it will be curious to see if they ask her to leave the room. I saw a video from Attorney Chris Attig that suggested it may be beneficial to an impending appeal (if the claim is denied), if the evidence of the record suggests or shows that the spouse was asked to wait outside and that the lay evidence is extremely important to the claim. At my C&P exam in 2015, they said I had to come alone, but I was granted at 50%. Sgt. Wilky
  4. I had a higher level review, and new C&P yesterday, and went to ebenefits this morning, and disabilities and payment history, and letters unavailable this morning. Is that a good or bad thing or is the site just down
  5. Can anyone explain the difference between a C&P examiners Medical Statement vs a Medical Opinion? I'm reading up on Gulf War Medical Exams. I had a Gulf War Medical C&P exam in August which lasted 4 hours; this exam consisted of many DBQs, including one for CFS. Although, I'd already had a C&P exam a few months prior for CFS. It took 6 weeks for the examiner to get the report to the VBA. A few days ago, the VBA just requested another C&P exam for the CFS for "rework" and a medical opinion for CFS. I don't know if I have to attend an exam or if this is something that the C&P examiner is going to do with what's already in the file. I haven't gotten a call yet from VES and when I called them, they didn't really seem to know if I actually had to go in for another C&P exam or not- just said someone would be contacting me to schedule an appointment (?). From what I'm reading in the DMA Gulf War General Medical Examination training Sorting Symptoms Exercise (sharedfedtraining.org), certain conditions require Medical Statements and other require Medical Opinions. The training says for CFS, the examiner is required to provide a medical statement but not a nexus medical opinion. For migraine headaches the examiner is required to provide a Medical Nexus Opinion. I'm wondering why the VBA is requesting a medical opinion if they only need a medical statement for the CFS exam report. From my understating the medical opinion is the one where the examiner has to state the "as least as likely as not" VA language, but I don't know what the VBA wants the examiner to say in a medical statement. Does anyone know?
  6. Hi All, Once again, hoping this is posted correctly. Not sure, but can't quite seem to get the hang of this particular version of a forum, so my apologies if I'm doing this wrong. Real quick background, I'm rated for PTSD/major depression/alcohol/TBI at 70%, kidneys 60%, bladder 10%, headaches 0%, and seems like something else I'm forgetting at the moment. Those were all completed about 13 months ago. Pending is a back issue, hypersomnia, hypertension, and heart disease. Total after VA math is 91% (maybe 92?). I was involved in a training in which another soldier died. Due to the hypersomnia claim, the VA has asked that I be reviewed for the PTSD and TBI. In preparing for those reviews, I've found various mistakes in both reports, some which seem immaterial, and some that may matter. For example: The report states I was cleared of charges at trial. That is inaccurate. I was cleared of charges during the investigation phase due to a malfunctioning piece of equipment. I was never charged (that I know of... 1st sarge got defense attorney involved pretty quick, so I kind of lost track of a lot of the process). I was in the brig for a while, and then on supervised house arrest until the investigation was over, which I told the examiner. Seems immaterial to the overall findings, but still not accurate. The report states that I was "dazed for 3-4 minutes". That is inaccurate. I was dazed for 3-4 days, not minutes. Depends on the clinical definition of dazed I suppose. I have zero recollection of the minutes following the incident (probably 3-4), and only wispy memories of the 3-4 days following the accident. Frankly, as I've thought about it over the past year, I'm not completely sure what is actual memory, and what is "recollection" based on what my squad members who were supervising me told me about the incident. I'd like to get those cleared up, but don't want to get tagged with a "veteran has changed his story" line somewhere. I guess the answer is they are inaccuracies, and I need to take them head on, but was interested in the thoughts of those who have more experience with this sort of thing. Should these inaccuracies be addressed in the these review exams, or is there a different and/or more appropriate process to challenge the inaccuracies?
  7. Hey all, Bit of an update. I have been SC for PTSD at 30% and tinnitus at 10%, denied for two other conditions and my TBI claim was "deferred". I had my TBI C&P about a month ago and in the process I've recieved two notifications on va.gov that two more exams have been scheduled. Well I called VES today after not hearing from them about any new appointments for two weeks and the rep on the phone told me that there was no new exam requested...that the VA actually just "kicked back" the C&P two times. They said they are "reworking" the exam. Anyone experience this before but not get scheduled for a new appointment?
  8. I have roughly one million questions but I'll try to keep it simple. This is the first time I am appealing a denied claim (though not my first denied claim - I currently have 50% combined). Almost exactly one year after my C&P exam I finally got a denial for both of my knees). I did a HLR informal conference and now my va.gov status says "The VBA is correcting an error". Here is the decision I received on Dec. 7th after the Higher Level Review (sorry I couldn't figure out how to add image) and below that are my questions. Decision: 1. A duty to assist error has been identified during the Higher Level Review of left knee pain. 2. A duty to assist error has been identified during the Higher Level Review of right knee pain. Evidence: Timeline from intent to file on 10/2/19 to HLR informal conference on 12/2/20 Reasons for Decision: 1. Higher Level Review for left knee pain The issue of left knee pain was returned for correction of a duty to assist error in the prior decision. We failed to get other records. We will develop for lay statements and if warranted additional opinions. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.159, 38 CFR 3.2502, 38 CFR 3.2601) Favorable findings identified in the decision: You have been diagnosed with a disability. The VA exam dated 11/7/19 showed a diagnosis of patellofemoral pain syndrome. 2. Higher Level Review for right knee pain The issue of right knee pain was returned for correction of a duty to assist error in the prior decision. We failed to get other records. We will develop for lay statements and if warranted additional opinions. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.159, 38 CFR 3.2502, 38 CFR 3.2601) Favorable findings identified in the decision: A nexus or link has been established between your claimed issue and an in-service event or injury. During VA exam dated 11/7/19 the VA examiner provided a positive medical opinion linking your right knee to service. You have been diagnosed with a disability. The VA exam dated 11/7/19 showed a diagnosis of right meniscal tear, right knee instability, and patellofemoral pain syndrome. MY QUESTIONS 1. Am I just out of luck because I didn't seek treatment during Active Duty? 2. Under "favorable findings" it states that "a nexus, or link, has been established between your claimed issue and an in-service event". Isn't that the literal definition of a service connected disability?! 3. What is the error? What have you all seen as timelines and outcomes for this? Thank you to everyone who takes the time to respond and post. Reading these questions/answers over the last year has been both educational and comforting.
  9. Hi Everyone I recently had a C&P exam on the 9th of July, the examiner told me that it would take 30 days for her to do her research and come to a decision about my claim. So the 9th of September was the 30 day mark and the case is still open as of today. I checked my blue button records and she actually made a decision on my claim the same day she said it's less likely than not. So my question is has any one seen results take this long and why would she lie to me and say it's going to take 30 days for her to find results and she made a decision the same day.
  10. Hi Everyone I had a C&P back in Dec for my migraine condition and I was denied and the examiner said the condition was less likely than not related to my car accident. So I filed a HLR and the VA gave me another C&P and I just looked in my blue button records and the C&P examiner this time said that my condition was not at least as likely as not related to my car accident. Can someone explain the difference to me because they sound like they are saying the same thing and thanks in advance.
  11. Shouldn't it be in medical records that I can access on va.gov? My request for a copy of my C&P exam has been in evidence gathering for 6 weeks. What the hell is there to gather?
  12. I have a C&P for Sleep Apnea secondary to Pes Planus and weight gain. What type of questions should i expect?
  13. Hello Everyone I recently had a HLR and the VA came back and said that they found errors with the previous C&P by LHI. So they scheduled me for another C&P exam which I had on last Friday with a VA NP. She asked me the standard question on the migraine questionnaire and then at the end she said she would have to do some research into the connection between PTSD and migraines and that I would have my decision in 30 days. I wanted to know is it normal to take 30 days because all the other C&P exams that I've had I received the results the day after the C&P exam.
  14. So i just finished my C&P for tdiu/increase last week. Everything went well, "can't hold job due to service connected symptoms etc".. Now they're saying "We have requested copies of your disability medical records from Social Security." I just contacted social security and they have no records for me, because I never filed for social security. I'm worried about them denying me because I never filed for social security. Should I be worried? Is this normal?
  15. Just what the title says. Made me uneasy, but I felt like I couldn't say no. I changed the password once I got home, but given my history of examiners sometimes feeling like they can make stuff up or say whatever, I really don't feel comfortable that this guy now has access to everything in the VA online as if he was me, including communications, appeals, etc. I'm pretty sure all of it is linked and he can pretty much screw with anything he'd like. What can or should I do?
  16. Wilson


    My claim status has been in evidence gathering and review for several weeks.Had my c&p exam about a week ago and now my evidence gathering and review has or is showing updated. What does that mean?
  17. Right then, last year I had two C&P exams. Due to living in Germany, the VA hands it off to the VES who schedules everything. The VES contacted me last year in August with a wee questionnaire and also asked if I was available during the next 60 days. Both appointments were done within that time. This year seems a different animal. The VES contacted me at the beginning of March with the same questionnaire and the 60 day question. I had a mental health appointment within 3 weeks! There are still two matters pending. I sent the VES an email at the end of May (near on 3 months) and the response was merely waiting for an appointment. This is for hearing loss and tinnitus. A 90 day wait for an appointment with a hearing physician? Again, I can well imagine a difference between countries, but this seems a wee off. Anyone have insight?
  18. Wondering if anyone has some insight on my current situation. Long story short, I became 70% service connected in 2018 due to a combination of issues, to include 30% for PTSD. During my initial physicals with my VA primary care Dr I screened positive for TBI from a vehicle rollover in Afghanistan and began testing/treatment. I eventually had a neuropsychological exam that Identified several severe cognitive impairments (auditory memory, processing speed) and several more moderate-mild impairments. Based on this I filed a disability claim for TBI in November of 2019. I just finally had a C&P exam for TBI that did not last long. Based on browsing these forums, I am thinking that the neuropsych testing will be used and hopefully the severe cognitive impairment is listed. Two weeks ago I did an ACE exam for migraines related to TBI. I have been sitting around wondering when I will get my decision letter but instead just got informed that I need to do another C&P exam for PTSD. Does anyone know why the PTSD C&P exam is needed now? Are they trying to identify what symptoms are caused by TBI vs PTSD? Can this even be determined? Will they lower my PTSD or combine them? It has been 18 months since I filed this claim and I am getting pretty stressed out at all the additional testing they are making me go through. Maybe am stressing over nothing but waiting around for a decision for 18 months can really put a strain on the process.
  19. Hello everyone, I have not been able to find much information on routine future examinations (RFE). I did not apply for an increase or any new claims. I have a RFE scheduled for bilateral knee instability a little after 5 years of service connection. My understanding is that this is supposed to be an evaluation of the current severity of symptoms and if the disability continues to be a problem and to what extent. I asked the person on the phone making the appointment and she said to be prepared to discuss my event in service and why I think it is service connected. I don't understand why veterans would have to discuss the event in service again and why they think it is related to their current disability if the nexus has been established. My experience has always been that the C&P examiner will not look at any of my records during the examination and if I insist, the rest of the exam does not go very well. I had to appeal a denial due to a bad C&P the first time around and it took a while for them to service connected. My plan was to let him know from the start that this is a re-evaluation, but the moment you try to manage the situation, it can go very wrong for you. All I'm looking for is a fair chance to explain what is going on with me currently and fully comply with VA requirements. The problem is we barely have any time with the examiners and you must make every minute count. Does anyone know what happens during these re-evaluations? Is it appropriate to go back to event in service and how it is related to your disability? Should the C&P examiners at the VA know that this is a RFE and not a new claim? Should I bring anything with me since they almost never look at documents? I appreciate any feedback anyone may be able to provide on this.
  20. Hi Everyone, On January 7, VA contractor, VES, did my C&P exam . After nearly pulling teeth trying to get a copy of the exam from the VA, I finally got it a few days ago. Although the doctor found that I have the condition and found that it was caused by military service, she was way off with her box checks for my symptoms--missing or ignoring several of my symptoms. Also, her assessment of my symptoms conflicted with my privately provided DBQ. It's frustrating because I answered the questions the same way with both doctors. Can I challenge/dispute the VES contractor's C&P findings? If so, where can I find the rules for how to do this? And how much time do I have? Thank you in advance for your advice on this.
  21. LHI contracted with a doctor who is licensed only in South Dakota and Nebraska to perform my husband's C&P exam in Iowa. Can the doctor do an exam in a state where he is not licensed? He did the exam on 12/31/20, but as of today (March 12, 2021) has not returned the exam report to LHI. LHI has reached out to him repeatedly. I have even found out where he practices, called his assistant and asked that he return the report. He will not respond to anyone. The VA has close (denied) my husband's claim without these results, so it has to be appealed. Just trying to figure out WHY this doctor would drive 8 hours, perform a 2.5 hour exam, drive 8 hours back home, and not do what is needed to get paid for his time?
  22. Are C&P exams always ordered? At what point are they ordered? I filed an appeal to the board Dec 2019, AMA, evidence. Still waiting for it to be assigned to a judge. I submitted a nexus letter from my VA psy doc at the time of filing appeal. Are C&P exams always ordered? Or will they bypass since both my VA psy docs have nexus stated in file, plus the letter from one? Thank you. Gene
  23. HI, Okay quick question and I hope I get some quick advice before its too late. Okay so I put in for an increase in my husband's ihd, and his lungs because he's had terrible residuals since he had radiation for lung cancer. We applied for the caregiver program and was approved but the lady told me that his 100% for his lungs was temporary (which I knew) and that I should be trying to get him increased or made P&T so that his overall average would never go below 70%. So I put it in. Well the rep at the VA went in and said that he was Permanent and Total...yay. So I thought they were done because I saw the notice saying a decision letter was being mailed. However, today a lady calls and says she will be scheduling him for a c&p for his lungs. Well as it stands he has 100% for his lungs. They have not set the appointment yet...should I go in and request this cancelled? THere is nothing to gain and I'm thinking the wrong doc could certainly give something to lose especially since she said they will be using a community doctor. It's a moot issue right now right? If they haven't made a decision which obviously they haven't can I cancel or is it too late?
  24. I looked around on here and didn't see an answer (or I missed it) but hopefully someone can answer. I had a C&P at my local VA last Wednesday and was curious to if I can pull a copy of the Dr's notes from that exam from the VA site (Blue Button Report or somewhere else). I'd like to know what he wrote about the exam and try to get an idea of what he said. Thank you!
  25. Hello again. I'm posting this to a new thread although its related to a post of two days ago. I just had my C&P exam on 16 Feb for a PTSD increase. Based on my claim status online which I just checked this morning, 18 Feb, the VA sent a decision letter and closed the claim. Is it possible for the VA to reach a decision this quickly after an evaluation? This claim was submitted as a fully developed claim and the only other evidence I had in my file was a DBQ and narrative or nexus letter prepared by my treating doctor of 11 years. I'm enclosing a screenshot of a status that I asked the VA about twice and received two different answers. I asked them if an exam was required. The status on the screenshot says no longer needed. In one call the VA said it was not required. In another call they said it was required and provided me LHI's contact information. The exam was scheduled and conducted through LHI. Has anyone dealt with this type of inconsistency? Is it possible the VA made a decision without this evaluation considering how fast a decision letter was sent after the evaluation. Or do you think the evaluation was considered in their decision? I contacted the VA this morning and the rep said he cannot discuss the contents of the decision but confirmed that an exam notification was sent out back in January. I also asked him how long it takes ebenefits to show the new rating if the decision is for an increase. He confirmed for me my rating he sees now but this rating is my current rating. How long does ebenefits take to update a rating that may have increased after a decision letter was sent? Thanks
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