C & P Make Sure They Do It Right

[maxwell18]

This may help in processing and getting your claims through the the system. After submiting claims and receiving denials I started reviewing how the C&P should have been conducted and found in a lot of cases the person did not follow the VA requirements for C&P exminations. Example, for my back problems no range of motions measurements were taken. A requirement for ratings. The guide is called "Clinician's Guide" March 2002. I found this on the internet and printed the whole guide off and put in a binder. It covers every detail and guidence for them to follow in all C&P. I think you will find if you check this out you will much better armed for your actual C&P examnations on what they should be checking and doing and give a heads

up what to reply to. As you already know when they ask how you feel your response should be your worse day because you say OK they will turn it around that you said you don't have any problems.This has happened to me severals times. Pain rating one to ten, if you feel good you say 4, they will say no problem on your C&P. Another note, on my Social Security claim, turned down three times. I went to the office that handled my claim and reviewed my claim records,about 80% of the records was blank. I appealed again asking how a determention could be made with all information missing? Came back in about three weeks approved. Botttom line..100% schedule P&T and Security Security.

[rentalguy1]

good post maxwell...i printed the guide off several weeks ago and stuck it in a binder myself. When the time came for my back C&P, I took out the appropriate one and brought it to the exam with me. Since he let my wife intot he exam room also, I had her follow the step by step instructions to the dr., and take notes. It was very helpful. I already have 2 CUE's if I need them from this last exam, and I have one CUE for the one done in 2003, where they took away the 10% for my back. I went from 30% down to 20% for ROM that wasn't measured with a goniometer...go figure. It also stated in the C&P findings that I still had pain on ROM, which is an automatic 10%, but I guess they forgot that part..haha.

[spike]

If anyone wants to self educate them about the VA Rating System and Adjudication process and laws that govern the VARO, go out and get yourself from a Barnes and Noble or GSA website the full copy of the Title 38 CFR. It has all the rules, regulations, ratings percentages guidelines, etc.....best $60.00 investment I have ever made.

[Berta]

The Blank C & Ps are all here:

http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

Here is the whole Book C 38 CFR Rating schedule:

http://www.warms.vba.va.gov/bookc.html

The M21-1MR guidelines that the VA uses for adjudicating claims is at:

http://www.warms.vba.va.gov/M21_1.html

I dont use 38 USC much-I prefer 38 CFR-

Also the best investment in my opinion that any veteran can make- who might have numerous issues or a complex claim (and of course ANYONE who does claims advocacy needs this book)

is the Veterans Benefits Manual pubished annually by NVLSP (National Veterans Legal Service Program)

All that a vet needs is here at hadit-too- under searches-lots of the regs and links to them-

also BVA decisions (while the VA wont accept them usually to support a similiar claim) are a wealth of claims info, and also the General Counsel Precedent Opinions at their web site and of course the CAVC on line.

You are right- a faulty C & P exam can be challenged if the vet knows what the C & P should have covered but didnt.

I commend you for bringing this up- as maybe many dont know how much info is actually here at hadit-

and also available at the VA web site itself.(an excellent source itself)

The advocates rate for the VBM is about $130.00 (maybe less if you have low state tax) and I have purchased them since 1991,I keep in contact with the NVLSP lawyers,and the NVLSP web site for anything new in the regs etc, and won not only an FTCA settlement but my other past claims due primarily to their excellent information.My vet rep at that time saw no potential at all in my claims.This was before the internet provided all we need.

My former DAV rep found out I won them all in the DAV lawyer's office.

The internet and the easy access we all now have to everything that VA uses in the claims process( as well as units for buddy statements, medical info,the wealth of veterans sites etc) is the ultimate weapon in the War of the words that a VA claim is.

[Josephine]

The Blank C & Ps are all here:

http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

Here is the whole Book C 38 CFR Rating schedule:

http://www.warms.vba.va.gov/bookc.html

The M21-1MR guidelines that the VA uses for adjudicating claims is at:

http://www.warms.vba.va.gov/M21_1.html

I dont use 38 USC much-I prefer 38 CFR-

Also the best investment in my opinion that any veteran can make- who might have numerous issues or a complex claim (and of course ANYONE who does claims advocacy needs this book)

is the Veterans Benefits Manual pubished annually by NVLSP (National Veterans Legal Service Program)

All that a vet needs is here at hadit-too- under searches-lots of the regs and links to them-

also BVA decisions (while the VA wont accept them usually to support a similiar claim) are a wealth of claims info, and also the General Counsel Precedent Opinions at their web site and of course the CAVC on line.

You are right- a faulty C & P exam can be challenged if the vet knows what the C & P should have covered but didnt.

I commend you for bringing this up- as maybe many dont know how much info is actually here at hadit-

and also available at the VA web site itself.(an excellent source itself)

The advocates rate for the VBM is about $130.00 (maybe less if you have low state tax) and I have purchased them since 1991,I keep in contact with the NVLSP lawyers,and the NVLSP web site for anything new in the regs etc, and won not only an FTCA settlement but my other past claims due primarily to their excellent information.My vet rep at that time saw no potential at all in my claims.This was before the internet provided all we need.

My former DAV rep found out I won them all in the DAV lawyer's office.

The internet and the easy access we all now have to everything that VA uses in the claims process( as well as units for buddy statements, medical info,the wealth of veterans sites etc) is the ultimate weapon in the War of the words that a VA claim is.

What do you do when the examiner bases all of his conclusions on the

word, " Appears"?

Appears to have symptoms of a personality disorder.

Appears she did not acquire a chronic psychiatric disability in service.

The preponderance of the evidence suggest that the etiology of her

anxiety appears to have preceded service.

Anyone, where is this word " APPEARS" located in the regulations or

codes?

Thanks.

Betty

Edited December 11, 2007 by Josephine

[attack_boat_vet]

What you say is indeed critical when you meet the Doc for your C&P. My award letter included the C&P examiners findings and right there in quotation marks was exactly what I said when asked "How are you doing today"...I replied "not very good at all". Be honest, but be careful because what you say can and probably will be used against you.

[john999]

Betty

"Appears is very weak language and is not up to standard of "more likely than not". "Appears" is just not a diagnosis. It leaves it open to debate and conjecture.