I can't find your post. I was hoping you would post more detailed information as to what the decision and medical reports actually said.
My point about raters was to show that you need to understand that they have specific training and that your doctors reports need to align with their type of training. You could have a valid claim that was wriiten by the doctor in a manner that did not meet the criteria of their training. Thus, all you need to do is get the doctor to change some wording or clarify how a diagnosis was made.
I do not expect that the raters would tell you how to advance your claim and advise you to have the doctor address a specif test or explain something in more detail. They would just write a vague denial that will confuse you. They did it to me. In fact they said that my doctor based his decision on my subjective history of the disease. This was complete BS. The doctor specifically put in his report that his decision was based on review of the SMR and numerous post service ER reports and a lifetime of blood studies. Thus, it is not only a question of their training. It involves the possibility that the rater is just being advisarial.
I won on appeal without submitting any new evidence. The denial I recieved was vague and had did not advise me as to what I needed to do to advance the claim. In my opinion winning without any additional evidence proves that the rater became advisarial. It also shows that my SO (ex rating specialist) who assisted me in preparing a position paper that was presented to the doctor addressed the issues in a way that the DRO could make the award. We did explain to the doctor that we wanted him list the reports he reviewed and to specifically write in his report that his decison was based on review of the SMR and all blood studies. That is what the doctor did and it had notning to do with my subjective history of the disease.
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Hoppy
Ricky,
I can't find your post. I was hoping you would post more detailed information as to what the decision and medical reports actually said.
My point about raters was to show that you need to understand that they have specific training and that your doctors reports need to align with their type of training. You could have a valid claim that was wriiten by the doctor in a manner that did not meet the criteria of their training. Thus, all you need to do is get the doctor to change some wording or clarify how a diagnosis was made.
I do not expect that the raters would tell you how to advance your claim and advise you to have the doctor address a specif test or explain something in more detail. They would just write a vague denial that will confuse you. They did it to me. In fact they said that my doctor based his decision on my subjective history of the disease. This was complete BS. The doctor specifically put in his report that his decision was based on review of the SMR and numerous post service ER reports and a lifetime of blood studies. Thus, it is not only a question of their training. It involves the possibility that the rater is just being advisarial.
I won on appeal without submitting any new evidence. The denial I recieved was vague and had did not advise me as to what I needed to do to advance the claim. In my opinion winning without any additional evidence proves that the rater became advisarial. It also shows that my SO (ex rating specialist) who assisted me in preparing a position paper that was presented to the doctor addressed the issues in a way that the DRO could make the award. We did explain to the doctor that we wanted him list the reports he reviewed and to specifically write in his report that his decison was based on review of the SMR and all blood studies. That is what the doctor did and it had notning to do with my subjective history of the disease.
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