Question On Cue

[Rockhound]

I am needing anyone opinion on whether or not CUE can be shown, given that statutory and regulatory provisions extant at the time were not abhered to when a Claims officer at the VARO (AOJ) intergected his own unsubstantiated opinion that a C&P examiner had changed the diagnosis of a psychiatric nature, which was a disease subject to service connection and which was the reason for discharge from the service ,to that of a personality disorder, inadequate type, which is not a disease subject to service connection.

What I think I am saying is that the C&P examiner makes no reference that his diagnosis of a personality disorder, inadequate type is a change in the prior diagnosis of the psychiatric nature. The only mention of the psychiatric diagnosis, was that he could not fully support that diagnosis. the answer being ambiguous at best

I do not have any money for an independent evaluation of my medical history, so don't bother telling me to get one. I have no resources to draw from and i will not resort to theft. LOL

Thank, Rockhound

[jbasser]

Cue is an attack on a final non appealed decision. If it is not,than a request for reconsideration or a DRO appeal would be the next step. I would ask the RO to Clarify the statement and send a letter to the Service Center Manager and your Rep. Put them on the spot and let them tell you where the word Personality disorder came into play.

J

[Rockhound]

I'm afraid my appeal time has lapsed since my last denial. I would like nothing better than to have that question answered but I can not get an answer from anyone. That is why I am considering a CUE claim, only a change in diagnosis is not a basis for CUE, at least the way I read the rules for CUE

I was kind of hoping by claiming CUE that they failed to follow statutory and regulatory provisions extant at the time when a Claims officer at the VARO (AOJ) intergected his own unsubstantiated opinion that a C&P examiner had changed the diagnosis might be a way around this rule concerning a change of diagnosis.

Thanks for the reply, I hope their are more to come.

Rockhound

[Ricky]

If your C&P doc stated that he could not support the previous diagnosis (whatever that may be) then I am afraid you are kind of stuck without another opinion. I based this upon the RO being able to justify their actions by stating your disagreement is simply a difference of opinion on the medical evidence which is not cue. JMHO

[Rockhound]

Ricky: My understanding is that once a diagnosis is presented, such as the diagnosis the in-service Dr."s gave, must be either agreed upon and only the severity determined or that it must be dissproved to change it to another diagnosis. Since the VA C&P Dr could attest to niether, then how can they accept a seperate and present diagnosis as such a change. The Dr did not state in his diagnosis that his current diagnosis was such a change.

The C&P exam should have been sent back for clerification, not to have a claims officer made such a diagnostic leap and say their was a change. How could he interpret what the Dr was saying if the Dr didn't even say it was a change in the diagnosis.

sorry, starting to repeat myself, I get upset every time I think about this.

Maybe it is Cue for the Claims officer to make such a determination without proper documentation of the change to back his assertions, that Dr was making such a change.

rockhound

[Ricky]

I fully understand your feelings. And yes the appropriate way for the claim to be handled was for the RO to send the exam back and ask the doc to clarify or to have you undergo another exam.

However, the RO is famous for this type of action and in my opinion it is not a CUE. The stupid law allows them, eventhough they are only lay persons just as you and I are, to interpert, weigh and determine the probativeness of all evidence. I think this is what will kill the CUE issue but remember this is only my opinion. May Berta, Pete, or Bob will come along and provide a much clearer answer so we both can learn.

I fully understand your situation of not being able to afford an IME. However, when it comes to mental illness most states provide free services. At least I think they do. I know for sure that the state of Alabama does. Alabama has free clinics in which you can see a physc doc and it is well documented. Just and ideal that you may want to check out with your state.

Are you service connected for any other disability?

Just wanted to add. Maybe you could contact the patient rep at the hospital and file a complaint that the exam was not properly conducted and ask that another exam be given and a proper diagnosis be decided upon. Now this would not be a C&P exam but if it were in your favor it would give you the power to submit it as new and material evidence to have the claim reopened. I think that at this point the best opition for you is to somehow find a way to get the claim reopened. Once a proper decision is made then you could work on getting the effective date changed. Once again maybe someone else will come along with a better ideal.

How do you now obtain your normal medical care?

Edited January 4, 2008 by Ricky

[Ricky]

At the present time my preferred diagnosis would be that of a personality disorder, inadequate type associated with an inadequate educational experience. There is no evidence of any psychosis present curently. The patient does give a history of convincing visual perceptial distortions on several occasions which, by virtue of their being totally and completely visible, would suggest a toxic etiology,

Rocky - this is from your other post. The way I read this the doc did issue a diagnosis and at the bottom of the exam notes issued his opinion as to why this diagnosis was issued. You are going to have to get an IME someway or another to refute this diagnosis. jmho