ptsd Bva-amc 2 C&p Exam Same Day.

[lu12]

Berta thanks for u reply; first in regards to my cervical spine c&p exam the examiner never performed any kind of physical nor medical evaluation. What he did was just ask one question which it was related to my 1998 soc response to the varo. He did not even ask about all new ime`s = nexus opinions - and material evidence on record and ignored by the varo and by the 1998 first cervical spine c&p examiner evaluation. 1. smr evidence “back was not well evaluated to make a determination” did mean anything. 2. First 1989 vae and acknowledged later by another 1989 rd for voc-rehab, state that with in 12 mo. pp; etiology of the vet back pain at medical - discharge and at the First vae “were both un-clear”. But what really blow my mind was the fact that this c&p examiner did not wanted to reconciled or understood the BVA remanded instructions and actions to be specifically followed. Nor with the ime`s = nexus opinions He just said that b/c, I wrote that I claimed and sought medical treatment as chief complaint through the VHA for s-c for my cervical spine condition in 1996 there is nothing that he can do for me. Geeeeez, I can bet that this Dr. did not revise carefully enough my c-file.

If the 1996 claim decision is a final one there might be CUE potential- hard to say- How can I really know VARO from 1996 to 1997 they never answer me this claim in any type -form or shape. As for this matter I’ve submitted evidence of this in multiple occasions

Evidence of the record ignored in multiple occasions including when the issue was first claimed also ignored can be consider as CUE?????

at some point this claim was pending (I think)after the VCAA became law- did you ever get a VCAA letter? Yes, I did, I even claim assistance for my 1998 depression issue: they never gave me that assistance b/c they said that it seems that I was pretty knowledgeable when I cited and claimed my rights under the 2000 VCAA law. Then again I claimed for depression in 1998 and the VARO processed my claim for Dysthymia instead of Depression, could this fact also mean another reason to file a possible CUE???

BVA decision docket number: 98-17645A. I hope that this can help other veteran’s when it comes to any GI-ISSUES due to medications prescribed as “NSAID” for s-c conditions The AMC recently granted me a 30% for this issue. Decision date: Oct 30, 2007 and Effective date is: Jan29, 1998. Not considering intestinal problems such as: constipation (ibs) and hemorroids.

Double whammy: BVA-AMC 2 C&P Exam, same day.

First of, thank you for this site… it is truly helpful. It does make a difference, to every service member, especially for our guys coming out of Iraq and Afghanistan. I was set up for two C&P evaluations Dec 10^th 2007. 1st Exam for a cervical spine disorders the second evaluation for this issue, first done back in 1998. 2. Exam for an acquired psychiatric disorder the same as issue num. one - second C&P evaluation done since 1998 this means 9 years in this or-deal. These two C&P Evaluations were order by the (AMC) Washington, DC not by the Puerto Rico, VARO and remanded by the VBA 2006 decision where I was granted service-connection for a GI condition.

Now as for my 2007 cervical spine C&P exam, here is what happened: Attending Medical Examiner seems like a nice person I mean not like a (USMC) Drill Instructor type of a guy anyway, he went on and ask me the reason for me being there, I said I was set up for a cervical spine re-evaluation an issue claimed since 1996 as service-connected condition secondary to my lumbar spine and my right knee disabilities. Now here is what are the most interesting and an unusual part of this new cervical spine evaluation. First the Examiner did not perform any kind of physical evaluation on my cervical spine and upper extremities as directed by the (BVA). Second my c-file was there (ok), he told me that he reviewed my c-file and said to me that there is nothing that he can do for me b/c of an statement of the case response that I made to the VARO back in 1998 were I stated the fact that I did requested the VHA to medically treat my cervical spine as chief complaint for the fist time in 1996 apart from my lumbar and knee chief complaints, so first of we where debating about my 1998 (SOC) response to the VARO then he goes to said that b/c of that fact he could not relate this issue to my active service period and secondly b/c since I were medically discharge in 1989 there was no medical evidence of treatment until 1996.

Respectfully I said that most of the information that he referred was incorrect. I wet on to explain that during active service the medical attention was given to my lumbar spine and my knee conditions, that 1. From the SMR there is evidence that state that my "back condition were not adequately evaluated to make a determination" just low back pain. 2. Also and most important that from my c-file a 1990 Hawaii, VARO (rating decision) for (voc-rehab.) purpose; their statement also included this: "Although veteran was seen in service for low chronic back pain, complaints, a definite diagnosis of a back disability was not made on discharge; etiology of veteran's back pain on a VAE 12-7-89 was also unclear.

Also there is evidence that from my Social Security Disability Benefits were due b/c of my cervical-lumbar spine and knee conditions since 1994 that in 1995 there was an Private Independent Medical Evaluation performed that documented that there was pain radiating through back muscles to Nuchal Region. That in another C&P Evaluation in 1996 there is evidence of complaints of cervical pain and anxiety. But still C&P Examiner could not find a relationship to my active service period.

In Feb 1997 I was involved in a motor vehicle accident where my car was impact from behind, I said that maybe that was the reason for the VARO denied my claims and if that was the reason respectfully I reminded the C&P Examiner, that accordingly to the VBA decision; additional medical evidence treatment and complaints were submitted well before the 1997 motor vehicle accident (MVA). That the factual basis upon the June 1998 opinions were rendered has change, the BOARD finds that the claims must be remanded for additional examination and etiological opinion. Also base on medical evidence that demonstrates that the veteran complained of neck pain, in addition to pain and numbness radiating from his neck into his arms in September 1995. A September 2003 (IMexperts-IMopinions) relates the veteran's spine condition to his service-connected orthopedic disabilities. C&P Examiner seem like he did not care about it. I went on to show additional independent medical evidence and opinions not mentioned by the BVA in which there are various professional medical opinions relating my cervical-spine conditions that was as a result of the traumas and injuries suffered while on active service period. Again The C&P Examiner seem like he did not care about it; finally I reminded the Examiner that there is lots of objective evidence not taken in to account and that also accordingly to the BVA they ask for a 50% or grater probability that this issue is related to either: 1. Period of active service period or to 2. His service connected low back disability. C&P Examiner seem he did not understand these two facts. "Unless the (AMC) had requested the C&P Examiner to follow other actions – rather of the BVA remanded actions.

The BVA did ask from the Examiner to specifically address and reconcile this opinion with the various opinions of records finding that the veteran's cervical spine disorder is related to his low back disability and injuries he sustained in service. If the examiner feels that the requested opinion cannot be given without resort to speculation, the examiner should so state.

Now for the acquired psychiatric disorder issue and second C&P evaluation done since 1998 - 9 years in this or-deal. Went in to the examiners room, psychiatric (she) started asking questions, I did remembered this psychiatric an old lady that she had see me before for Psy treatment at an OPC back in 2000-2202. as the question continues she did remember me and started pretty much screaming, and complaining b/c she could not performed the Psy-Evaluation due to conflict of interest. Up until that point to be honest I was curious, pleased and at the same time I was getting pretty mad. I explain my self; first; I sense the possibility of trouble and it did happen. Second y 2001 I was refereed by a private psychiatric to VA Dr. Petersons b/c I could not continued the private-spy due to the b/c how expensive it was the tx: even though I had my Medicare coverage, any way the private Psy made a medical certificate and referral along with copies of my medical records that included: depression and ptsd; well guess what VA Psy.

Never revised nor discussed any off the private medical evidence that I gave to her to also make them part of my medical records at the VA clinic. Continued the tx: but it was like an empty feeling coming out of the VHA-Psy office every time. Back then all she cares was about wife, kids, living conditions and that he refer about his chief complaints. All she wrote was the same thing every time. One paragraph, 10 sentences. MDD-NOS GAF-60. Now b/c of this I was released that she never got to perform my evaluation. Any way I got reschedule for Dec 27, 2007. Don't know what is going to happen, maybe the same as my cervical evaluation.

As for my GI issue the (AMC) they first request a C&P evaluation for rating purpose it took from Aug 2006 to Oct 2007 got a 30%rating. And now early Dec 2007 they started working for these other issue. Why not all at the same time? My GI Disorders experience as well as my Psy. Disorders they are pretty much on the same, same and same track, hx and tx dates: and all evidence of sings and symptoms (S&S) can be trace from active service period and from the 12 mo. Presumptive Period. But the BVA decide to remand this issue.

For my cervical spine issue, what about when the board does not make reference to private medical evidence IME medical evaluation; like for example they mentioned a 2003 IME medical evaluation, but fail to weigh in on a 2004 new IME medical evaluation, evidence submitted to the RO.

I claimed s-c for my cervical spine conditions in 1996, no action from the VARO in 1997 went on with a copy of my 1996 claim, no action from the VARO. Finally by 1998 they started to work on my claim – but the effective date is 1998. Also for this issue: SMR, C-FILE and PRIVATE MEDICAL EVIDENCE that were surrendered as material evidence were not included on any of the following VARO document's 1) RD, 1) SOC and 2) SSOC; clear evidences as to the fact that the VARO fail to incorporate in the EVIDENCE AND REASON AND BASIS - SECTIONS; objective, substantial and persuasive evidence. VARO listed as evidence some Private (IM experts-IM opinions). But they fails to weigh in or discusses there opinions'. Are these probable or enough reasons to file for, CUE-NOD base on a NOVO-REVIEW if this case might still prevails as negative decision?

[Berta]

I could not access the BVA case at all-

are there any other citations numbers on it?

And I am confused here as to some of the questions-

A NOD- Notice of Disagreement MUST be filed within one after the denial decision.

A CUE claim can only be filed on a final decision(one never appealed) that involves legal error-Duty to assist violations dont clount as legal errors- they should but they dont-

there is considerable info under the search feature at top of page on CUE claims here at hadit.

A DRO denovo review is what you are given opportunity to election- they send you a form to sign, elect DRO review, and then return to them and then at some point you get a DRO review-it could takes well over a year or more to get this type of review-

what I do see is that there is the current C & P-

and if this does not produce an award -the SOC can be challenged by what you had stated here as to any medical fact or error regarding your SMRs etc.

Do you have a vet rep helping you on this?

There is so much here that it would help if a good rep could sort it all out and try to anticipate what you can expect next from the RO-

It doesnt help to give the clinic any private records or medical opinions- any C & P doctor should know you have them and might read and consider them- but the RO MUST account for them and if they were not considered -the RO must give a medical rationale as to why this private medical info did not support your claim.

Private medical opinions must comply with the VA's own criteria (under Getting an Independent Medical Opinion) in the search feature here- otherwise the VA can easily reject them.

I feel you do have good claims-

"My GI Disorders experience as well as my Psy. Disorders they are pretty much on the same, same and same track, hx and tx dates: and all evidence of sings and symptoms (S&S) can be trace from active service period and from the 12 mo. Presumptive Period. But the BVA decide to remand this issue"

Only certain disabilities are presumptive for the one year after service reg- still with signs and symptoms noted in your SMRs- that should certainly help a great deal there too-

I feel and hope others will give opinions too- that if you have a copy of the Dec 2007 C & P results and they are incorrect as to the evidence etc- you could challenge this now- by sending a letter to the RO- why wait for them to deny on basis of this C & P- if they could?

I did this for my husband - the C & P doc didnt have any of his records at all-he either got a new C & P exam-or the VA used his actual treatment records- I forget-and disregarded this faulty C & P.

I called the doctor as soon as we got home and asked him how he was going to account for the missing records-to properly prepare his C & P report - he didnt know I had been in the waiting room during the exam listening to VA employees look all over for Rod's files.The claim this C & P was for was VA's attempt to lower Rods comp-

AMVETS who was his rep then called me about 6 months after he got the proposed reduction and told me my NOD turned it all around- his % stayed the same.

But I still think this faulty C & P had something to do with all that too.

[lu12]

I could not access the BVA case at all-

are there any other citations numbers on it?

And I am confused here as to some of the questions-

A NOD- Notice of Disagreement MUST be filed within one after the denial decision.

A CUE claim can only be filed on a final decision(one never appealed) that involves legal error-Duty to assist violations dint clount as legal errors- they should but they dont-

there is considerable info under the search feature at top of page on CUE claims here at hadit.

A DRO denovo review is what you are given opportunity to election- they send you a form to sign, elect DRO review, and then return to them and then at some point you get a DRO review-it could takes well over a year or more to get this type of review-

what I do see is that there is the current C & P-

and if this does not produce an award -the SOC can be challenged by what you had stated here as to any medical fact or error regarding your SMRs etc.

Do you have a vet rep helping you on this?

There is so much here that it would help if a good rep could sort it all out and try to anticipate what you can expect next from the RO-

It doesnt help to give the clinic any private records or medical opinions- any C & P doctor should know you have them and might read and consider them- but the RO MUST account for them and if they were not considered -the RO must give a medical rationale as to why this private medical info did not support your claim.

Private medical opinions must comply with the VA's own criteria (under Getting an Independent Medical Opinion) in the search feature here- otherwise the VA can easily reject them.

I feel you do have good claims-

"My GI Disorders experience as well as my Psy. Disorders they are pretty much on the same, same and same track, hx and tx dates: and all evidence of sings and symptoms (S&S) can be trace from active service period and from the 12 mo. Presumptive Period. But the BVA decide to remand this issue"

Only certain disabilities are presumptive for the one year after service reg- still with signs and symptoms noted in your SMRs- that should certainly help a great deal there too-

I feel and hope others will give opinions too- that if you have a copy of the Dec 2007 C & P results and they are incorrect as to the evidence etc- you could challenge this now- by sending a letter to the RO- why wait for them to deny on basis of this C & P- if they could?

I did this for my husband - the C & P doc didnt have any of his records at all-he either got a new C & P exam-or the VA used his actual treatment records- I forget-and disregarded this faulty C & P.

I called the doctor as soon as we got home and asked him how he was going to account for the missing records-to properly prepare his C & P report - he didnt know I had been in the waiting room during the exam listening to VA employees look all over for Rod's files.The claim this C & P was for was VA's attempt to lower Rods comp-

AMVETS who was his rep then called me about 6 months after he got the proposed reduction and told me my NOD turned it all around- his % stayed the same.

But I still think this faulty C & P had something to do with all that too.

Berta, good day.

How can I appeal a claim or a final decision that they started working on 2 years later? The varo ignored my 1996 claim in addition to the 1997 soc filed in support of the 1996 first cervical spine claim. In 1998 the varo finally with the help of the dav rep. 3rd cervical spine claim attempt finally was answered. But the varo-bva-amc, they all together dint recognized my 1996 first claim for my cervical spine disorders.

As of a serve. rep. I do have a state government local rep. I dint Know I have seen vet posting and replies that state that the best serve. rep. it is you - agree - others will suggest the use of an sro, I have to - agree on that too - but in my experience I have not been pretty lucky with some of them.

For the docket no. 98-17 645A this is it. And it appears on the bva remand decision, maybe because there are 2 pending issues that are with in the amc there is no citation no. assigned for it yet.

As for the c&p examiners, now, I can objectively said that they favor the use of negative medical evidence that is most likely favorable to the va in oder to denied your claim. I have been there...

I sent to the BVA an soc requesting to the boar to allow me to characterize and perfect my claim and appeal before the board. The board never replayed; all 3 issues descriptions are addressed in the same way with the appeal management center.

SSOC-RESPONSE

Hereby request the DVA; Board of Veterans` Appeals Washington DC 20420 to re-characterized the following Issues and allows me to amend and perfect the appeal on all Issues.

1. Entitlement to service connection for cervical HNP disorder to include C2-C3 Radioculopathy to shoulders, elbows and arms, bilateral factor of both upper and lower extremities as either on a Primary or Secondary Basis to my Service-Connected Conditions, Lumbar Spine & Right knee, Permanent and Total Disabilities. 2. The effective day of the claim for this issue should be 08/19/96. 3. Entitlement to an evaluation in excess of 50 percent. 5. Entitlement Service Connection on a scheduler or extra scheduler basis.

1. Entitlement to Service Connection for Major and (Recurrent), Depression; as either on a Primary or Secondary Basis to my Service-Connected Conditions; Lumbar Spine & Right Knee Permanent and Total Disabilities. 2. Entitlement to Service Connection for Generalized Anxiety as either on a Primary or on Secondary Basis, to my Service-Connected conditions; Lumbar Spine & Right Knee, Permanent and Total Disabilities. 3. Entitlement service connection for PTSD; because of Personal Trauma; as either on a Primary or, on Secondary Basis to my Service-Connected Conditions; Lumbar Spine & Right Knee, Permanent and Total Disabilities. 4. Also the medical evidence clearly demonstrates that I sought and began medical treatment (within the one year presumptive period) following my medical discharge from service. 5. Entitlement to an evaluation in excess of 50 percent; on a scheduler or extra scheduler basis. 6. The effective day of the claim for this issue should be 01/29/98.

1. Entitlement to service connection for Hiatal Hernia and Gastro Esophageal Reflux as either on a Primary and or a Secondary Basis, to my Service-Connected Conditions; Lumbar Spine & Right Knee, Permanent and Total Disabilities, to include as secondary for the use of NSAID Medication taken for the Service-Connected Conditions; Lumbar Spine, Right Knee, Permanent and Total Disabilities. 2. Entitlement to service connection for Gastritis and Duodenal Ulcer, secondary to the related use of NSAID medications. 3. Entitlement to service connection for the Helicobacter Pylori Infection, secondary to the Hiatal Hernia and Gastro Esophageal Reflux secondary to the use of NSAID medications for the service connected disabilities, Lumbar spine & Right knee, Permanent and Total Disabilities. 4. Also the medical evidence clearly demonstrates that I sought and began medical treatment (within the one year presumptive period) following my medical discharge from service. 5. Entitlement to an evaluation in excess of 50 percent; on a scheduler or extra scheduler basis. 6. The effective day of the claim for this issue should be 01/29/98

Date sent 04-22-2006 PS FORMS 3800, 3811 CERTIFIED MAIL & USPS DOMESTIC RETURN RECEIPT.

THANK,

Lg

[Berta]

OK- I am printing out the BVA decision even as we 'speak' I was using a small a instead of A

There might be a CUE here- not sure yet-

I hope I didnt misunderstand what you posted- for many years I thought my state vet reps were excellent-

until I found out how a few of them buggered my claims- long story- I filed a complaint with General COunsel on them under 38 USC 14.633.

However this org DOES have good reps and many state and county offices do too- we just cannot tell or find out years down the road when our representation has not been appropriate-

This is puzzling to me:

"The varo ignored my 1996 claim in addition to the 1997 soc filed in support of the 1996 first cervical spine claim." If that is still an open issue----

they still have to address that claim-

do you have a complete copy of your C file?

did you ever move since you first filed that claim?

I will read the BVA remand carefully and get back to you on all this-

did the vet rep support a challenge to the faulty C & P?

Edited December 18, 2007 by Berta

[lu12]

OK- I am printing out the BVA decision even as we 'speak' I was using a small a instead of A

There might be a CUE here- not sure yet-

I hope I didnt misunderstand what you posted- for many years I thought my state vet reps were excellent-

until I found out how a few of them buggered my claims- long story- I filed a complaint with General COunsel on them under 38 USC 14.633.

However this org DOES have good reps and many state and county offices do too- we just cannot tell or find out years down the road when our representation has not been appropriate-

This is puzzling to me:

"The varo ignored my 1996 claim in addition to the 1997 soc filed in support of the 1996 first cervical spine claim." If that is still an open issue----

they still have to address that claim-

do you have a complete copy of your C file?

did you ever move since you first filed that claim?

I will read the BVA remand carefully and get back to you on all this-

did the vet rep support a challenge to the faulty C & P?

Berta,

In regards to my cervical spine issue, I sent to the varo copies of my 96 claim & my 97 soc in more than 6 axions; that when I addressed the varo: ratting decision the soc and 2 ssoc and still the board and now the amc - have done nothing about this matter...

vet rep never have challenged any of my c&p examinations. also I will appreciate any comment on my request to re characterize and perfect all claimed issues and my appeal address to the board in 2006 in which I also state that my claim for cervical spine issue effective date should be from 1996.

thank,

Lg

[lu12]

Berta,

In regards to my cervical spine issue, I sent to the varo copies of my 96 claim & my 97 soc in more than 6 axions; that when I addressed the varo: ratting decision the soc and 2 ssoc and still the board and now the amc - have done nothing about this matter...

vet rep never have challenged any of my c&p examinations. also I will appreciate any comment on my request to re characterize and perfect all claimed issues and my appeal address to the board in 2006 in which I also state that my claim for cervical spine issue effective date should be from 1996.

thank,

Lg

Also the board raised a concern in regards to a claimed tmj disorder and requested the varo to take action on this too. But since the amc claimed jurisdiction on the bva remanded decisions are they (amc) are obligated or supposed to take action on the TMJ issue???

[Berta]

What I seem to get here is that the BVA is saying that the earlier claims were for sc for gastrointestinal disability and denied- yet the newer claim for GERD due to the meds is in the remand and granted.

"1. The claim for service connection for a gastrointestinal

disability was previously denied in an April 1993 rating

decision; the veteran did not appeal that decision.

2. Evidence received since the April 1993 decision includes

some evidence which is not cumulative or redundant, and which

is so significant that it must be considered in order to

fairly decide the merits of the claim.

3. The veteran's gastrointestinal disability

(gastroesophageal reflux disease and hiatal hernia) is a

result of the use of medications prescribed for his service-

connected orthopedic disabilities."

In essense they are saying (my take on this -hope others will help)that the first claim was for direct SC and denied but this newer re-opened claim is for SC on a completely different basis-

secondary SC due to the meds for your "orthopedic disabilities" page 2 of 9 BVA decision.And granted-on page 6-

I feel you presented your argument and rationale VERY well to them in your above post-on the other issues-

has the AMC or the BVA acknowledged receipt of your SOC response?

BVA has an email addy for thei ombudsman at the VA web site in the BVA link and Josephine has posted some phone numbers for the AMC.

I am really not familiar with the MOS of the AMC-

But I do know they have to follow the Remand to the letter-

what condition is the Dec 27th C & P actually for?

Orthopedic exam or the psychiatric exam?

Do you have any other C & P exam results since getting this remand?

I commend you for the way you prepare your SOC respone here-

nothing wrong with telling them exactly why THEY are wrong and why and what you expect as a proper resolve.

I dont know how they would go back to the EED prior to the GERD due to Meds claim date- because that claim was stated on a different basis-

then again- were you taken the same meds at that time too? and therefore- they were causing the GERD then too?

Hope others offer opinions on all this and take note of how well you presented your SOC rebuttal.

Edited December 18, 2007 by Berta