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

[hp1030]

Berta:

I agree they have not considered even half of the information provided. If we went by the Schedule of Ratings for my skin disability I would have to be rated at 60%. My private doctors states that the skin involvement is over 60% with constant corticosteroids treatment according to this info, It should be rated at 60% disabling. Correct?

My main diagnosis is Mycosis Fungoides a type of T cell lymphoma,but VA call's it Dermatitis.????

7806 Dermatitis or eczema.

More than 40 percent of the entire body or more than 40 percent of exposed areas affected, or; constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period 60%

20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or; systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly, during the past 12-month period 30%

So I do not think there was a scheduling error. Just a contrary to law rating reduction.

Thanks in advance.

[Jay Johnson]

Have your private doctor write up a medical history with a current diagnosis and future prognosis in great detail. With that, it should be an open and shut case. Also, request to use your civilian doctor as your C&P instead of the one they assigned, or, at least, get them to assign a different MD because this one is obviously using bias in his/her decision making process.

Also, I think you have grounds for a CUE here based on what you've said. The VA cannot simply send your C-file to any random doctor to reevaluate it without new and material evidence (3.156). Also, under 3.105 it clearly states that, "(:P Difference of opinion. Whenever an adjudicative agency is of the opinion that a revision or an amendment of a previous decision is warranted, a difference of opinion being involved rather than a clear and unmistakable error, the proposed revision will be recommended to Central Office. However, a decision may be revised under §3.2600 without being recommended to Central Office.". I had the same issues with my wife's case in which one RO tried to supersede another RO without ANY new evidence to the contrary.

I feel this is a tactic by the VA to get you into a C&P in order to take a "legal" look into a particular case.....by giving some lame excuse (in your case a "review), they get you into a C&P before your C&P date and once you take that C&P you have provided them with "new and material evidence" in which they can now justifiably alter your claim. But, based on solely that MD's "review" they cannot lower your compensation...it stands in stark contrast to the regs I listed (and several others).

Hang in there; you'll be fine.

[hp1030]

Thank you guys:

I think I am ready now for this C&P eval.

I will bring progress notes, psych progress notes an IMO and the last evaluation by my private dermatologist.

I will also bring the last blotched C&P exam by the dermatologist who reduced my benefits (soon to retire!!!) and copies of previous C&P exams and determinations which granted SC and 50% disability rating since 1994.

I will hand deliver this info to the RO with a statement of the case. I do not think any of this info was ever considered appropriately.

Berta,,,, Jay,,,,Vike,,, any new advice?

Am I on thwe righ path?????

Thank you so much.

[Berta]

Isn;t it illegal to have the same doctor do it again?

Not sure --Vike would know-

I hope the C & P doctor is recetive to your information-

especially the IMO- at least the doctor will know you have an IMO-

And copies of all that you have should also be sent to the VA - Do you mean the 21-4138 form-

Statement in SUpport of Claim---

available at the VA web site-

Always a good cover letter to use when submitting additional evidence.

(I always forget to use it- my vet reps never used one for 3 years re my claim evidence.)