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Fishing Expedition


Josephine

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  • HadIt.com Elder

Hi,

I received a letter from the AMC stating letter going to my Board Certified Internist of 30 years.

I did not receive any copy or information as to what they wanted from him.

He received his letter this past Tuesday.

I saw him on Wednesday for my usual appointment and he told me bits and pieces. This is the jist of what they wanted to know.

Why in your opinion as an Internist are you qualifed or more qualifed than a psychiatrist to treat this patient and what is her current diagnosis and past diagnosis and what are your credentials to treat her?

He went into depth about my diagnosis and his credentials. He read me bits and pieces of his letter,and mailed it immediately.

I am not sure that anyone knows the answer to this question, but thought that I would ask?

My question is The AMC sent me another " Statement in Support of Claim to file out.

Here we go:

I filed for benefits in 1978 denied.

I filed again in 2001 - denied

2004 - I acquired the Psychiatric records from the Archives. New and Material evidence to re-opened all claims.

The DRO had all of my post medical records from 1965 - 2004

The DRO had letter from my private doctor.

The DRO had the " New and Material Evidence"

The DRO sent me for a C&P October 18, 2004

Diagnosis - Generalized Anxiety not otherwise Specifed with Depression.

More likely than not or possibly the result this veterans anxiety with depression began in service with

Complete rationale for decision.

When the DRO ignored this information and chose to seek another C&P 5 months later for same and never found fault with the first C&P.

Does this come into play.

Mariano V Principi Vet. App 305, 312

Cautioning against seeking addtitional medical evidence where favorable evidence in the record is un-rebutted?

Thanks.

Josephine

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I look forward to seeing how this is resolved. Although I do not have a service-connected disability for

depression, I am curious about the VA's decision to question your internist. My internist also prescribes

anti-depressants.

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  • HadIt.com Elder
I look forward to seeing how this is resolved. Although I do not have a service-connected disability for

depression, I am curious about the VA's decision to question your internist. My internist also prescribes

anti-depressants.

Thanks Manitou Sprgs,

I am sure that you feel confident in taking this medicine from your doctor, as I have for the last 30 years.

Being that it is the " Rating Supervisor" asking these questions, this shall be decided very shortly.

Always,

Joephine

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x

x

x

I believe the 'Statement in Support of Claim' is a Standard Form, sent out routinely. It's an opportunity to send additional evidence - if you have anything to add - but it's not a requirement at this stage of your claim. If you have additional evidence, send it; if not, ask them to decide on the current evidence. Is the weight of the evidence in equipose?

*The basic three requirements for prevailing on a claim for service connection:

(1) medical evidence of a current disability;

(2) medical or, in certain circumstances, lay evidence of in-service aggravation of a disease or injury; and

(3) medical evidence of a nexus between the claimed in-service injury or disease and a current disability.

I certainly do not understand why your Internist would refuse you a copy of his letter. You are certainly, and most lawfully enntitled to a copy. Use the FOIA to obtain a copy. Hopefully, your Internist had something to add to the weight of your claim.

If you are going to cite case law, I would use a shotgun approach: list all laws and regulations that support your claim; just like the VA does when they deny a claim.

Remember "the veteran is not required to plead his/her claim with such [legal or medical] specificity, but VA is obligated to apply all relevant law and regulation regardless of how the claim is identified". See for example Roberson v. Principi, 251 F.3d 1378, 1383-84 (Fed. Cir. 2001). http://www.va.gov/vetapp04/files/0404870.txt

A disability may be service-connected if it results from an

injury or disease incurred in, or aggravated by, military

service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303

(2003).

When all the evidence is assembled, VA is responsible for

determining whether the evidence supports the claim or is in

relative equipoise, with the appellant prevailing in either

event, or whether a preponderance of the evidence is against

a claim, in which case, the claim is denied. Gilbert v.

Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. §§ 3.102, 4.3

(2003).

The Secretary shall consider all information and lay and

medical evidence of record in a case before the Secretary

with respect to benefits under laws administered by the

Secretary. When there is an approximate balance of positive

and negative evidence regarding any issue material to the

determination of a matter, the Secretary shall give the

benefit of the doubt to the claimant. 38 U.S.C.A. § 5107.

Following the point at which it is determined that all

relevant evidence has been obtained, it is the Board's

principal responsibility to assess the credibility, and

therefore the probative value of proffered evidence of record

in its whole. Owens v. Brown, 7 Vet. App. 429, 433 (1995);

see Elkins v. Gober, 229 F.3d 1369 (Fed. Cir. 2000); Madden

v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997) (and cases

cited therein); Guimond v. Brown, 6 Vet. App. 69, 72 (1993);

Hensley v. Brown, 5 Vet. App. 155, 161 (1993).

AND SO ON !!

ROCK ON !! ~Wings

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Josephine

I think one reason the VA is playing hardball with you is the potential for a large retro they do not want to pay. You still have to beat them based on the regs, however. That is all that you as a vet have to work with is the regs and the way you use them.

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  • HadIt.com Elder
x

x

x

I believe the 'Statement in Support of Claim' is a Standard Form, sent out routinely. It's an opportunity to send additional evidence - if you have anything to add - but it's not a requirement at this stage of your claim. If you have additional evidence, send it; if not, ask them to decide on the current evidence. Is the weight of the evidence in equipose?

*The basic three requirements for prevailing on a claim for service connection:

(1) medical evidence of a current disability;

(2) medical or, in certain circumstances, lay evidence of in-service aggravation of a disease or injury; and

(3) medical evidence of a nexus between the claimed in-service injury or disease and a current disability.

I certainly do not understand why your Internist would refuse you a copy of his letter. You are certainly, and most lawfully enntitled to a copy. Use the FOIA to obtain a copy. Hopefully, your Internist had something to add to the weight of your claim.

If you are going to cite case law, I would use a shotgun approach: list all laws and regulations that support your claim; just like the VA does when they deny a claim.

Remember "the veteran is not required to plead his/her claim with such [legal or medical] specificity, but VA is obligated to apply all relevant law and regulation regardless of how the claim is identified". See for example Roberson v. Principi, 251 F.3d 1378, 1383-84 (Fed. Cir. 2001). http://www.va.gov/vetapp04/files/0404870.txt

A disability may be service-connected if it results from an

injury or disease incurred in, or aggravated by, military

service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303

(2003).

When all the evidence is assembled, VA is responsible for

determining whether the evidence supports the claim or is in

relative equipoise, with the appellant prevailing in either

event, or whether a preponderance of the evidence is against

a claim, in which case, the claim is denied. Gilbert v.

Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. §§ 3.102, 4.3

(2003).

The Secretary shall consider all information and lay and

medical evidence of record in a case before the Secretary

with respect to benefits under laws administered by the

Secretary. When there is an approximate balance of positive

and negative evidence regarding any issue material to the

determination of a matter, the Secretary shall give the

benefit of the doubt to the claimant. 38 U.S.C.A. § 5107.

Following the point at which it is determined that all

relevant evidence has been obtained, it is the Board's

principal responsibility to assess the credibility, and

therefore the probative value of proffered evidence of record

in its whole. Owens v. Brown, 7 Vet. App. 429, 433 (1995);

see Elkins v. Gober, 229 F.3d 1369 (Fed. Cir. 2000); Madden

v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997) (and cases

cited therein); Guimond v. Brown, 6 Vet. App. 69, 72 (1993);

Hensley v. Brown, 5 Vet. App. 155, 161 (1993).

AND SO ON !!

ROCK ON !! ~Wings

Wings,

I think it is time for them to decide this claim. I don't understand too much of what is going on.

My representative received a letter, which I did not receive. I may be going for another C&P.

I called and ask the Supervisor, what next and she said, " If your doctor can produce" you will not be going for another one, so we have not sent you a letter.

I don't know how and what is going on.

Thanks for your time,

Josephine

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Did the DRO have a current written letter (form) that you signed giving permission for them to obtain medical information and records? I have seen forms "gundecked" that contain a photocopied signature from an older letter/form giving consent. (The VA didn't do it, a state VRO did.)

I suppose it might be possible to get a copy of the letter from the Dr., and depending on what it says, go further with it.

If the information in your file dates back to 2004, The VA is obviously using the "current medical information" scheme to see if any newer info might affect you claim, and an excuse to further delay resolution. It also sounds like they are obviously trying to rebut your Drs. previous medical opinion.

I'd be tempted to ask for the credentials of the VA psychiatrist involved.

Just remember "fighting city hall" is an uphill battle.

Hi,

I received a letter from the AMC stating letter going to my Board Certified Internist of 30 years.

I did not receive any copy or information as to what they wanted from him.

He received his letter this past Tuesday.

I saw him on Wednesday for my usual appointment and he told me bits and pieces. This is the jist of what they wanted to know.

Why in your opinion as an Internist are you qualifed or more qualifed than a psychiatrist to treat this patient and what is her current diagnosis and past diagnosis and what are your credentials to treat her?

He went into depth about my diagnosis and his credentials. He read me bits and pieces of his letter,and mailed it immediately.

I am not sure that anyone knows the answer to this question, but thought that I would ask?

My question is The AMC sent me another " Statement in Support of Claim to file out.

Here we go:

I filed for benefits in 1978 denied.

I filed again in 2001 - denied

2004 - I acquired the Psychiatric records from the Archives. New and Material evidence to re-opened all claims.

The DRO had all of my post medical records from 1965 - 2004

The DRO had letter from my private doctor.

The DRO had the " New and Material Evidence"

The DRO sent me for a C&P October 18, 2004

Diagnosis - Generalized Anxiety not otherwise Specifed with Depression.

More likely than not or possibly the result this veterans anxiety with depression began in service with

Complete rationale for decision.

When the DRO ignored this information and chose to seek another C&P 5 months later for same and never found fault with the first C&P.

Does this come into play.

Mariano V Principi Vet. App 305, 312

Cautioning against seeking addtitional medical evidence where favorable evidence in the record is un-rebutted?

Thanks.

Josephine

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  • HadIt.com Elder
Josephine

I think one reason the VA is playing hardball with you is the potential for a large retro they do not want to pay. You still have to beat them based on the regs, however. That is all that you as a vet have to work with is the regs and the way you use them.

John999,

I am too confused anymore to know what is even going on. Being that the " Rating Supervisor" sent the letter to my doctor, she has taken over for some reason. I know that the " Rating Specialist" kept my claims file for 14 days before turning it over to her boss.

As I was telling Wings, my Service Officer received a letter that I may be going for another C&P. I call and ask the Supervisor and I am told it depends on what my doctor has to say.

She said no letter has been mailed to me.

thanks

Josephine

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  • HadIt.com Elder

and, yes, to answer your question, Mariano V Principi Vet. App 305, 312

does apply to your case. They cannot "go doctor shopping" trying to find a diagonsis to suit them and harm you.

'sides dat, it jist ain't right, I tell ya, it jist ain't right!

Have a really good weekend, Betty.

P.S. I took Lola, the 20 lb. Norwegian Forest Cat to the Vet today for her annual vacinations and for her yearly checkup (new vet). The little vet assistant gal comes out to the lobby and says that she'll take Lola back in the back to get her weight and trim her claws and that the doc will be out for me and then I can come on back to the exam room. She bends over to pick up the carrier that Lola is in and tries to lift it, turns to me and says "Is there REALLY a CAT in there?", to which I replied, "No darlin, there is a REAL CAT in there." Of course, before we left the vet's office I had to pry all the girls, including the vet, off of Lola so we could leave. She's a real sweety. To bad I'm so old and ugly, 'cause that cat is a real chick magnet.

She likes to ride in the front seat so the A/C blows in her face. People will see her sitting in the front seat and they almost have wrecks doin a double-take.

post-1306-1192243338_thumb.jpg

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Did the DRO have a current written letter (form) that you signed giving permission for them to obtain medical information and records? I have seen forms "gundecked" that contain a photocopied signature from an older letter/form giving consent. (The VA didn't do it, a state VRO did.)

I suppose it might be possible to get a copy of the letter from the Dr., and depending on what it says, go further with it.

If the information in your file dates back to 2004, The VA is obviously using the "current medical information" scheme to see if any newer info might affect you claim, and an excuse to further delay resolution. It also sounds like they are obviously trying to rebut your Drs. previous medical opinion.

I'd be tempted to ask for the credentials of the VA psychiatrist involved.

Just remember "fighting city hall" is an uphill battle.

Chuck 75,

At the time that I filed in 1978, I did not have a representative and the counslor filled out all the papers and I signed them.

When I re-filed, again, I did not have a rep. I wrote a letter to the Va.

I don't think at this time, that my doctor would consider given me a copy of the letter. He read it to me and he was quite to the point on his diagnosis and he was talking in words that I have never heard.

He did write a letter that the two psychiatrist were patently incorrect in their facts. This was sent to the BVA.

He would be the one to know if I had self-inflicted injuries, eating disorder and a crap of lies.

The second C&P gave me an Axis 1 of Anxiety not otherwise specified with a GAF of 40.

They threw in that Axis 11 of Personality disorder not otherwise specifed with borderline, dependent and histronian traits.

This Axis 11 does not conform to the DSM- 1V.

They threw in it was their opinion it appeared that my symptoms were primary consistent with a personality disorder and that I was discharged for things that I considered indicative of abuse. Anxiety did not begin or worsen in service.

I still don't understand why two psychiatrist up to any good, would not allow my husband to be present. Makes no sense. None of this makes any sense. Why I can't remember what happened in that room makes no sense either and why I had to see the nurse on duty afterwards due to memory loss makes no sense either. I do have a statement from this nurse.

One Psychiatist was Drug Abuse and one was Geriatrics.

I do not know why when I placed a formal written complaint to the patient advocate about this C&P at the VAMC. The psychiatrist went in and placed a PRIVAVY AMENDMENT NOTE. You can not VIEW THIS.

They already knew that I had a copy in order to write a letter of complaint by means of which the examination was conducted and its contents.

How will they get around my treating military doctor that gave me the librium for my nerves and the cafergot for my headaches and referred me to the two military psychiatrist?

How will they get around my commanding officer that stated I was no longer of any use to the service as I could not perform the least menial task, thus leading to my discharge.

Dr. C, has them all beat in credentials. He wrote the letter May 12, 2005.

Thanks so much,

Josephine

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  • HadIt.com Elder
and, yes, to answer your question, Mariano V Principi Vet. App 305, 312

does apply to your case. They cannot "go doctor shopping" trying to find a diagonsis to suit them and harm you.

'sides dat, it jist ain't right, I tell ya, it jist ain't right!

Have a really good weekend, Betty.

P.S. I took Lola, the 20 lb. Norwegian Forest Cat to the Vet today for her annual vacinations and for her yearly checkup (new vet). The little vet assistant gal comes out to the lobby and says that she'll take Lola back in the back to get her weight and trim her claws and that the doc will be out for me and then I can come on back to the exam room. She bends over to pick up the carrier that Lola is in and tries to lift it, turns to me and says "Is there REALLY a CAT in there?", to which I replied, "No darlin, there is a REAL CAT in there." Of course, before we left the vet's office I had to pry all the girls, including the vet, off of Lola so we could leave. She's a real sweety. To bad I'm so old and ugly, 'cause that cat is a real chick magnet.

She likes to ride in the front seat so the A/C blows in her face. People will see her sitting in the front seat and they almost have wrecks doin a double-take.

post-1306-1192243338_thumb.jpg

Larry,

Lola is adorable and I see that we have something in common, Lola likes quilts like I do. Very nice picture!

Then you may be old enough to know that old song, " What ever Lola wants, Lola Gets. I think that is true in this case.

Thanks so much and have a great weekend. I got to figure out this darn case and I will try to apply some rules and regulations.

If they should sent me for another C&P, things won't change. Same old. Same old!

Always,

Betty

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Lola,

This sounds like a song by the Kinks.

Chuck made an interesting point. I guess at some point you allowed the VA to contact this doctor. If not, I think the doctor would only be able to answer questions as to his qualifiactions. If he only answers questions about his qualifications I do not see the correlation to doctor shopping. He probably signed evidence you submitted and they are verifying his credentials. I think the doctor needs to answer the letter because it sounds like they are not asking any new questions about your condition. They are just trying to go through the motions to give him a chance to establish a reason why they should listen to him rather than a psychiatrist. If he does not give them a good answer they will go with the psychiatrist. One thing to keep in mind is that the reason you do not get your meds from a psychiatrist is because you chose to see the internist. A psychiatrist could easily prescibe the same meds if you saw one. ASk the internest for a copy of the letter. There is no reason why he should not give you a copy. Your SO might have a copy of the letter the VA sent to the doctor.

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Betty, just think - this time when they reel in the line maybe a big whale will be on the hook and it will swallow them all hahahahaha. Hey, a guy has gotta dream a little.

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Lola,

This sounds like a song by the Kinks.

Chuck made an interesting point. I guess at some point you allowed the VA to contact this doctor. If not, I think the doctor would only be able to answer questions as to his qualifiactions. If he only answers questions about his qualifications I do not see the correlation to doctor shopping. He probably signed evidence you submitted and they are verifying his credentials. I think the doctor needs to answer the letter because it sounds like they are not asking any new questions about your condition. They are just trying to go through the motions to give him a chance to establish a reason why they should listen to him rather than a psychiatrist. If he does not give them a good answer they will go with the psychiatrist. One thing to keep in mind is that the reason you do not get your meds from a psychiatrist is because you chose to see the internist. A psychiatrist could easily prescibe the same meds if you saw one. ASk the internest for a copy of the letter. There is no reason why he should not give you a copy. Your SO might have a copy of the letter the VA sent to the doctor.

Hoppy,

Thanks, to be honest with you I didn't insist on a copy the day that I was there, as when he briefly read the letter to me, I noticed in his anger that he transposed his dates. He stated, " He first diagnosed my chronic anxiety with depression in 1997. I ask him about this and he instantly saw what he did. I told him it was in 1979. He said that he would change it, but that the VA would have to contact him to do it. I knew that they would never do this.

I waited until the next day and wrote him a letter and my husband delivered it to him, to please change the date. He ask me to contact the AMC for their Fax number and Station. I did this and he changed the date and sent the corrected letter, to which the Supervisor has confirmed is in their possession.

Hoppy, I left a Board Certified Psychiatrist to go to him and never went back the other way. He treats my diabetes, thyroid, blood pressure, heart disease, COPD, anxiety and depresssion and inner ear disease He is an excellent doctor and I refuse to change.

My question, is how did I get in this mess to begin with?

Why did the DRO not rate the Claim after the First C&P?

When the DRO went for the second C&P within 5 months of the first one, " Was he doctor shopping."

This is all that I am trying to find out. Should I have received benefits after the first C&P? No one to date has found fault with the first C&P.

Thanks,

Josephine

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Betty, just think - this time when they reel in the line maybe a big whale will be on the hook and it will swallow them all hahahahaha. Hey, a guy has gotta dream a little.

Ricky,

Would I be so lucky?

Always,

Betty

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The AMC wanted his full medical rationale and expertise for the opinion he already gave them Josephine.

He had to give your present diagnosis, link it to an inservice event that in his opinion "more than likely" caused it, and then state his medical background and credentials that support his being able to opine on your psychiatric disability.

I think the remand required that the AMC do this.

They are going step by the step by the wording of the remand.

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The AMC wanted his full medical rationale and expertise for the opinion he already gave them Josephine.

He had to give your present diagnosis, link it to an inservice event that in his opinion "more than likely" caused it, and then state his medical background and credentials that support his being able to opine on your psychiatric disability.

I think the remand required that the AMC do this.

They are going step by the step by the wording of the remand.

Berta,

I appreciate your assistance with my claim. Everyone has complied with the remand, except the two psychiatrist.

They refuse to provide their etiology, rationale for their decision or to reconcile their differnce.

I think the AMC is going to have to go around them.

I shall post my completed Statement in Support of claim, just as soon as I have it finished and would apreciate everyones comments.

Thanks as always,

Josephine

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Berta,

I appreciate your assistance with my claim. Everyone has complied with the remand, except the two psychiatrist.

They refuse to provide their etiology, rationale for their decision or to reconcile their differnce.

I think the AMC is going to have to go around them.

I shall post my completed Statement in Support of claim, just as soon as I have it finished and would apreciate everyones comments. Thanks as always,

Josephine

I have sit and pondered what you said. About the remand and all. I know now why Dr. P was so upset, he answered the remand request April 26, 2007.

Does anyone have any ideal of how I can safely get these records to the AMC? I may sound crazy, but someone is destroying my records. It took me 3 times to get my personnel records into the log and into my claims.

thanks,

Josephine

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Okay, somebody help us out here. My memory is blank, which is, not necessarily, a NEW condition..

But, what is the name of the really nice supervisor gal at the AMC? Heck, half of us here that have dealt with the AMC, have wound up dealing with her.

Betty, if someone here comes up with her name....send the stuff to HER, at the AMC. She's straight up, and won't mess ya up.

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Okay, somebody help us out here. My memory is blank, which is, not necessarily, a NEW condition..

But, what is the name of the really nice supervisor gal at the AMC? Heck, half of us here that have dealt with the AMC, have wound up dealing with her.

Betty, if someone here comes up with her name....send the stuff to HER, at the AMC. She's straight up, and won't mess ya up.

Larry,

I went back and looked at my papers and it was April 2006,when my doctor answered the remand. No wonder he is fit to be tied.

I know that I have spoken to a Ms Dunlap and somehow I managed to speak to a lady by the name of Rachelle Binder. She would not give me her position.

I have problems as my claim is a Sensitive 6, because of my niece, and no one has the clearance to open it.

I sure need some help.

Anyone??

Thanks

Josephine

Betty

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Josephine:

I am in agreement with one other member, can't remember who just now. However, it appears to me, and I don't know all that's going on. But reading what they are trying to do, or maybe trying to "wear you down", it seems like they are just trying to delay you the "big fish". This seems like their one last shot at denying you your long awaited benefits. I wish you the best of success, you will succeed. You deserve it.

jmack

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