C&p Evaluation For Appeal

[hp1030]

Sir's And Madams:

I will be evaluated this next Friday by C&P in the continuation of my appeal.This after they reduced my disability benefits(2004-2005) from 50% to 10% disabling after over 10 years of this condition been established without any improvement .

The evaluating doctor will be the same doctor that reduced my benefits without even looking at my medical record, as per copy of the evaluation for skin disorders that reduced my benefits.

I have lesions on my face, back, trunk,upper and lower extremities and buttocks, but he wrote that the extent of involvement was only 10%. Should I express my concern to him about this???

Some weeks after, I saw this doctor for the first time as a Dermatologist in consult from my PCC(not a "C&P evaluator") and he wanted to take me to the local Medical School for a conference in regards to my skin condition...???!!! Very interesting case, he said.

I have plenty information from my VA medical records of treatment consult, and procedures for my skin disease and also Independent Medical Opinions, should I bring those to be included with the C&P record?

This taking into consideration that my record was not taken in account at all for the last inaccurate decision.

Any advice or previous experience will be appreciated.

Thanks in Advance;

HP

[Berta]

Are these IMos that meet the VA's criteria posted here?

Have they ever been seen by the VA before?

I would bring them to the C & P- and also submit copies of them to the VARO right away.

[hp1030]

Berta:

Yes, I understand they all meet the criteria. They even state that they were performed in accordance to the "Physicians guide for disabilities"

Yes, they might have been seen by VA before. I have no idea or way of telling. But i am sure i can get at least one new IMO before Friday, these are all my long time attending physicians.

Most of the info comes from the VA medical record.

Thanks for your time and dedication.

HP

PS: Is this SOP... to reduce benefits like this???After all this time with the condition???is ok for the doctor to be judge and part???

[Jay Johnson]

The VA randomly reduces people despite not having the proper regs to back it up. Honestly, I feel it's simply a cat and mouse game to see if the veteran will fight for the money; if not they win. In your case, it does not sound as if the VA doc's opinion met the "New and material evidence" requirement needed to reopen or readjudicate a claim. In other words, a single doc cannot simply review your file and lead to a reduction. However, that doc could have reviewed the file and reopened the case citing a prior mistake, but it would take more than that single opinion to overturn the totallity of what appears to be a fairly significant medical file on your part.

So, either you've gotten better or you haven't; if not, then no one doctor can overturn the opinions of several others unless said doctor has far more knowledge of the disease (specialist) and the prior doctors didn't.

Basically, a claim is like a civil law suite.....you have to prove your side is more right then theirs and they cannot find in favor of 10% of the documentation over the advice of the other 90%. This is where reasonable doubt comes into play.

G'luck,

Jason

[Vike17]

"The VA randomly reduces people despite not having the proper regs to back it up. Honestly, I feel it's simply a cat and mouse game to see if the veteran will fight for the money; if not they win"

Nonsense! The VA isn't randomly reducing veterans just to be doing it. Hell, they have so much work to do now, they aren't going to go out on fishing expeditions just to create more of a workload!

When a veteran comes up for an review exam, it was either entered into the system way back when the prior rating was issued or the RO may have become aware of improvement in a veteran's condition either because the veteran was admitted to a VAMC and somehow their service-connected disability was brought to light, or the veteran himself submitt medical evidence of improvement (sounds far fetched but has happened before).

hp,

I'm not sure if any IMO's will help your situation. You just need to concentrate in getting the medical evidence to the RO of your disability not improving since your last rating decision.

Claims for increases/re-evaluation normally do not require a C-file to be present. The C&P examiner and the RVSR just needs to see treatment records from the last C&P exam/rating decision. You should bring any treatment records since your last exam/rating with you to the C&P exam AND then send them seperately to the RO to insure they receive them. Many times a veteran will bring treatment records to the exam and will rely on the doctor to forward them to the RO along with the exam write-up. DO NOT count on this to happen, especially if this is the same examiner you had last time!

Vike 17

[hp1030]

Vike 17:

Nothing random about my reduction, I agree. My Service connected disability was brought to light when we requested IU(2004). I received a C&P evaluation shortly after and the benefit was reduced; On a single examination, with evidence from my private doctors and VA doctors that my condition had not improved and continue to worsen. This is not correct. right Vike???

I contend that they did not follow procedure and never complied with 38 C.F.R. Section 3.344. We have appealed, that bring up this next C&P eval.Friday.Same doctor.(Juror and part???) We have submitted all available evidence , records, biopsies...etc,etc to the RO. Should we send again now? My prior C&P was done in 1994..!I have copies.

Jay:

The doctor did not meet ANY requirement, But they still went ahead and reduced my benefit from 50% to 10 % after over 10 year without improvement and the condition worsening. I have many medical opinions stating so. What else do you think I might need to do?

What else can I Do before Friday??

I thank you guys.

[Jay Johnson]

Nonsense! The VA isn't randomly reducing veterans just to be doing it. Hell, they have so much work to do now, they aren't going to go out on fishing expeditions just to create more of a workload!

When a veteran comes up for an review exam, it was either entered into the system way back when the prior rating was issued or the RO may have become aware of improvement in a veteran's condition either because the veteran was admitted to a VAMC and somehow their service-connected disability was brought to light, or the veteran himself submitt medical evidence of improvement (sounds far fetched but has happened before).

Vike 17

Believe what you want, but I've seen hundreds of cases reduced for completely inexplicable reasons. Whether or not it's just RO's being ignorant to regulations or intentional I really don't know; but the VA does it and does it often. Just as the VA will push one claim through quite easily while the exact same type of claim with the exact same type of evidence is denied or low-balled. To me, it's much like the IRS....most of the time your taxes are hassle free, but every once in awhile they pull your file and make your life a living hell, except in the VA's case they do so in the hopes that the veteran will not be knowledgeable enough to properly fight the claim (which many aren't).

My wife's claim of 100% PTSD with A&A AND P&T was reduced for no other reason then us switching regions (east coast to west coast). It took a year, a few CUEs and many calls to the director in order to "fix" it to the way it was...to top it off her 100% with A& and P&T was decided just 5 months before moving, so don't give me the "new evidence" stuff. The file was reviewed when it was shipped, they saw an opportunity to low-ball it and did so....had I not fought on her behalf she would be at 70% right now.

But, believe as you will.....

- Jason