Berta:

[lu12]

Berta, hope you are doing fine.

To my questions?

1. How do you Challenge a sour C&P evaluation or even a Review Officer SSOC. Are there any guidelines or any recommendation on how u can write in some form of a formal request or inquiry letter as for this issuesss?

2. Also will u provide or explain a bit more about the IIRIS and Fast Track Letters definitions and their purpose?

Thank u,

lu12

[Berta]

Iris is the VA "contact Us" button at the VA web site.

You go through the email menu ,fill it out, and then state your inquery and submit it- it can take a few hours or a few days for reply

I am still waiting for a reply to an Iris email I sent them in November.

I suggested dont ask for phone call- only email or letter (hard copy)

that way you have documented evidence of what they say.

I think you mean Fast letters- they are here and also at the VA web site-

which one are you looking for?

"1. How do you Challenge a sour C&P evaluation or even a Review Officer SSOC. Are there any guidelines or any recommendation on how u can write in some form of a formal request or inquiry letter as for this issuesss?"

If you received a legal VCAA letter and fully complied with the evidence they requested and then sent them back the VCAA election form-

you can rebutt the SSOC by putting RESPONSE TO SSOC DATED ___ at the top of a letter with your c file etc- and then tell them exactly what statements you disagree with and why the medical evidence you have reveals that the SSOC statements and their decision is wrong.

If they failed to comply with evidentiary requirements of 38 CFR and thus-failed to consider your medical evidence- tell them that and cite 38 CFR 4.3 and 4.6-

If the C & P performed the C & P incorrectly per the C & P blank worksheet (all worksheets for C & Ps are available here at hadit)tell VA what they failed to do.

If the C & P examiner did not provide an adequate medical rationale- pounce on that with whatever you can use from a good medical web source-

example- say the C & P doc in a claim for heart disease secondary to SC diabetes- says there is no medical connection between the veteran's SC DMII and his NSC heart atherosclerotic disease-and cannot state that the heart disease preceded the DMII-

you can easily whip out print outs from the American Diabetes Assoc , the VBM from NVLSP, and the VA's own DMII training letter and prove that atherosclerotic heart disease in a diabetic is medically associated to and more then likely (per the standard medical community)directly due to the SC diabetes and the VA doctor has not provided sufficient or appropriate medical rationale for their opinion to attempt to rule out that medical fact.

If they failed to consider an private medical records or any IMO you sent them pounce on that too-

I posted this here before -might help you- this is from my response to a VCAA letter I got in August:

I will list the evidence I am again enclosing , to include the signed Election Notice,

And I cite the following established VA case laws and regulations and ask that they be properly applied to my claims:

§4.6 Evaluation of evidence.

The element of the weight to be accorded the character of the veteran’s service is but one factor entering into the considerations of the rating boards in arriving at determinations of the evaluation of disability. Every element in any way affecting the probative value to be assigned to the evidence in each individual claim must be thoroughly and conscientiously studied by each member of the rating board in the light of the established policies of the Department of Veterans Affairs to the end that decisions will be equitable and just as contemplated by the requirements of the law

“b. Review of Evidence. Concisely cite and evaluate all evidence that is relevant and necessary to the determination. Rating decisions must evaluate all the evidence, including oral testimony given under oath and certified statements submitted by claimants, and must clearly explain why that evidence is found to be persuasive or unpersuasive. Decisions must address all pertinent evidence and all of the claimant's contentions. “

Source: September 23, 2004 M21-1, Part VI

CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS

PART 3_ADJUDICATION--Table of Contents

Subpart A_Pension, Compensation, and Dependency and Indemnity

Compensation

Sec. 3.159 Department of Veterans Affairs assistance in developing

claims. (XC 24 884 978 Page 4 of 5)

(a) Definitions. For purposes of this section, the following

definitions apply:

(1) Competent medical evidence means evidence provided by a person

who is qualified through education, training, or experience to offer

medical diagnoses, statements, or opinions. Competent medical evidence

may also mean statements conveying sound medical principles found in

medical treatises. It would also include statements contained in

authoritative writings such as medical and scientific articles and

research reports or analyses.

(2) Competent lay evidence means any evidence not requiring that the

proponent have specialized education, training, or experience. Lay

evidence is competent if it is provided by a person who has knowledge of

facts or circumstances and conveys matters that can be observed and

described by a lay person.

I remind VA that I proved the VA killed my husband without any background in medicine. My lay statements and the clinical record proved that the VA had committed malpractice and caused Rod’s death. I proved numerous VA doctors had been wrong in their assessment of the veteran’s disabilities and diagnoses.

I also cite Mariano V. Principi regarding the value of probative competent medical evidence thus:

“Additional development by the Veterans Benefits

Administration Appeals Management Center (VBA AMC) would only

serve to further delay resolution of the claim. Bernard,

supra. See also Mariano v. Principi, 17 Vet. App. 305, 312

(2003) cautioning against seeking additional medical opinion

where favorable evidence in the record is unrebutted.”

As defined in BVA decision http://www.va.gov/vetapp04/files/0404870.txt

The evidence in my C file of ALL past submissions since 2003 I have made - to include the IMOs from Dr. Craig C, Bash are preponderant and competent and unrebutted.

I also cite:

“The probative value of a medical opinion is generally based on the scope of the examination and review, as well as the relative merits of the expert’s qualifications and analytical findings.”

Guerrieri V. Brown, 4 Vet App 467 (1993)

---------------------------------------------------------

(in my case the VA doc used only 3 or 4 medical records- the whole clinical record -they say 5 volumes0 were sent here to the Bath VA (to give a deceased vet a C & P exam !)and remained here for months- and during the VA medical review-only 3-4 records were faxed to the VA doc in Buffalo.Via Iris I got VA documentation in an inquery as to that fact.The VA doctor did not know I had already won malpractice claim (FTCA)nor did she know that the veteran's high glucose readings all occurred while he was on a feeding tube-for many weeks-and there was evidence of the true etiology of his actual disability from AO in 6 years of medical records-but undiagnosed and untreated and covered up)

My 2nd IMO from Dr. BAsh totally knocked down her defective opinion in an SSOC.

Also I knocked her down too in another way- using numerous other medical documents from the clinical record and from the VA OGC malpractice report.

You must rebutt what you do not agree with in a SSOC.

Have you elected DRO review or traditional appeal process?

Edited January 10, 2008 by Berta

[lu12]

Iris is the VA "contact Us" button at the VA web site.

You go through the email menu ,fill it out, and then state your inquiry and submit it- it can take a few hours or a few days for reply

I am still waiting for a reply to an Iris email I sent them in November.

I suggested dont ask for phone call- only email or letter (hard copy)

that way you have documented evidence of what they say.

You must rebutt what you do not agree with in a SSOC.

Have you elected DRO review or traditional appeal process?

Berta, my case went already to the BVA on 2005, they remanded my case, re-routed through the AMC. Since August 2007 I been on 3 c&p evaluation one for my GI condition, one for my cervical spine disorder and the last one Dec 27, 2007 for my Psy disorders. so that leave me in a position that I have to wait for the Psy. c&p evaluation and the Social Worker report to finalize in order to request copies of all 3 c&p examination including the (SW) report.

I guess that all I can do at this time is to wait and to let my c-file to arrive back to the AMC and wait for the AMC decision.

I have prewar a new set of records one for my spine and one for my Psy disorders. They are chronologically organized with material evidence, new evidence since active service. I mean all evidence related to my cervical spine are in one file as well as the Psy. disorder every thing about this issue is all in one file. I dont care if there are duplicate document as you "cited."

a) Definitions. For purposes of this section, the following

definitions apply:

(1) Competent medical evidence means evidence provided by a person

who is qualified through education, training, or experience to offer

medical diagnoses, statements, or opinions. Competent medical evidence

may also mean statements conveying sound medical principles found in

medical treatises. It would also include statements contained in

authoritative writings such as medical and scientific articles and

research reports or analyses.

(2) Competent lay evidence means any evidence not requiring that the

proponent have specialized education, training, or experience. Lay

evidence is competent if it is provided by a person who has knowledge of

facts or circumstances and conveys matters that can be observed and

described by a lay person.

“Additional development by the Veterans Benefits

Administration Appeals Management Center (VBA AMC) would only

serve to further delay resolution of the claim. Bernard,

supra. See also Mariano v. Principi, 17 Vet. App. 305, 312

(2003) cautioning against seeking additional medical opinion

where favorable evidence in the record is unrebutted.”

§4.6 Evaluation of evidence.

The element of the weight to be accorded the character of the veteran’s service is but one factor entering into the considerations of the rating boards in arriving at determinations of the evaluation of disability. Every element in any way affecting the probative value to be assigned to the evidence in each individual claim must be thoroughly and conscientiously studied by each member of the rating board in the light of the established policies of the Department of Veterans Affairs to the end that decisions will be equitable and just as contemplated by the requirements of the law

“b. Review of Evidence. Concisely cite and evaluate all evidence that is relevant and necessary to the determination. Rating decisions must evaluate all the evidence, including oral testimony given under oath and certified statements submitted by claimants, and must clearly explain why that evidence is found to be persuasive or unpersuasive. Decisions must address all pertinent evidence and all of the claimant's contentions. “

And just in case I am working on a third file, this one is for a possible CUE.

thank,

lu12

[lu12]

Have you elected DRO review or traditional appeal process?

[Berta]

They seem to be holding you to the wording of the original claims-it would help if you had a service officer with an office in the same RO building as your claim is in who could clarify these issues.

Also- this could help- the VARO was mixing up two of my caims-I asked the VSM to clarify the issues and she did in writing.

I copied that last phrase from part of my own personal response - got a VCAA letter and also a DRO election form for another claim-all the same week-but anyone can cite 38 CFR 4.3 and 4.6

[lu12]

They seem to be holding you to the wording of the original claims-it would help if you had a service officer with an office in the same RO building as your claim is in who could clarify these issues.

WITH EVIDENCE OF CERTIFIED MAIL // DOMESTIC RETURN RECEIPT.

This is a letter I sent to the BVA; again they never responded to it. I know this b/c the way the board addressed all 3 issues on their decision.

Claim Number:

Claimant Name:

Supplemental Statement in Support of Claim

Substantive Appeal

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

I will be able to send to the Board of Veterans` Appeals, more information and medical evidence to substantiate my claims with in the next 90 days.

_______________ ___________

Claimant Signature Date

What should I do, write to the BVA about this matter now with a copy to the AMC or the other way around and wait for the AMC decision.

Also the Puerto Rico, VARO is no longer able to handle this case since the AMC, Washington, DC claimed jurisdiction over it.

Any comment please,

lu12

Edited January 11, 2008 by lu12