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Question On C.u.e.

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Rockhound

Question

I'm pretty sure that I have figured out how to present a CUE claim, except when it comes to where, for CUE to prevail, it must manifestly change the outcome.

I can prove that the VA Claims Adjudicator failed to apply pertinate statutory and regulatory provision extent at the time that caused the clear and unmistakable error,

But I am having trouble understanding what "Manifestly change the outcome" means. what types of outcomes are we talking about?

In my case, although it concerns a change in the original diagnosis to an alternate diagnosis. The adjudicator failed to follow statutory and regulatory provisions extent at the time, i.e.

1. He did not get cirtification from the examining physicain to support the change of a diagnosis

(a) certification must contain a summery of the facts,findings, and reasons that support the

change in the diagnosis.

2. Their is nothing in the records that Adjudicator then considered what the change ment,

since he did not have the cirtification from the physician to guide him.

3. Their is nothing in the records that once the Adjudicator considered that severance of

service connection was warrented, a rating was prepared setting forth all material facts and

reasons, and submitted it to the Central Office for review.

4. and lastly, if it had gone to the Central Office, although their is no indication it did, and was

approved, the claimant was supposed to be given 60 days for presentation of additional

evidence to show that service connection should be continued.

Since the VA Examiners report did not have the certification that the original diagnosis was clearly and unmistakably in error and that his new diagnosis was the correct one, the VA Adjudicator could not make a determination or a medical opinion of his own and use this new diagnosis as an alternate one. Since the VA Adjudicator failed to send the report back to the VA Examiner for clarification, the report can only be interpreted that his diagnosis was a new and seperate diagnosis.

How do you show, how all this would Manifestly change the outcome of my claim.

I know that the evidence by the conferance of Naval Dr.'s and Psychiatrists would outway the VA Examiner's ambiguous report, at best, with his present diagnosis, since he states in his report that he could not solidly support the original diagnosis based solely on the history and not on any tests, exams or observations any longer than the exam itself, that he conducted, to support his opinion. Again, he based his whole opinion on the history, that it would be difficult to substantiae, in his opinion a solid diagnosis of schizophrenia. Not with standing or consideration, that the disorder was in remission, at the time of the examination.

It appears to me that the VA Examiner's report was insufficiant for rating purposes, so how do I prove that my claim would have manifestly changed if the report was so lacking. They can't go back and ask for clarification from the VA Examiner, or for that matter, the VA Adjudicatior either. It's almost as if the claim remains open, since the question of service connection of the original diagnosis from which service connection was predicated upon was never legally adjudicated.

Anyone want to run with this and give me their opinions and/or questions?

Rockhound :blink:

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  • HadIt.com Elder

Rockhound,

I am not even sure if I am dealing with cue. This is my long ordeal.

I filed in 1978 for benefits, denied. Filed again and again and

finally after I wrote to the St. Louis Archives for my " Psychiatric

Records", which had been stored there for 40 years and the VA never

once ask for them.

The VA knows I told them countless times to get my " Compentency

Review "Psychiatric Records".

Each counselor always said, there is nothing there.

Now I am at the BVA back from the AMC.

Why did this happen. I don't know.

After I turned in copies of the long lost Psychiatric Records I was

given my first C&P by means of, "Both New and Both Material Evidence

never acquired by the VA and all claims re-opened to 1978.

Doctor's diagnosis- generalized anxiety disorder with depression with

a " More likely than not and Perhaps and Result of service with

treatment in service and each day since discharge.

Had the DRO rated the claim at that time, Would I have most likely

received SC?

Did minds differ, when I located the " long lost psychiatric records".

According to my first C&P.

They sure did.

What do we call this, but a long hard road to travel.

Five months later, I have another C&P with an AXIS 1 of Anxiety

AXIS 11 of Personality Disorder not otherwise Specified.

R.O ruling Personality Disorder.

BVA remanded to AMC and now AMC denied and back to BVA.

The judge has my claims file on his desk right at this moment and I

have sent countless faxes of my on-coming IME. Never associated with

the claims file.

I finally thought to call Senator Warner's Office and now he has

faxed the letter to the Judge of the IME from Dr. Crowley. The Judge

is waiting for the IME before decision.

Dr. Crowley IME: Absolutely no Personality Disorder with complete

rationale as to why not.

Diagnosis: 300.00 Generalized Anxiety Disorder not otherwise

specified with depression.

This is the only diagnosis the medical and treatment records of the

US. Navy and post treatment records of 43 years, with treatment

within one year of discharge with complete rationale

for his decision.

By the way, I am starting my eighth year.

I have been around the block and back.

Always,

Betty

Edited by Josephine
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The VA have my Navy medical board findings with a diagnosis and if they had DSM III or IV at the time my axis I would have been acute schizophrenic episode, in remission demonstating moderate impairment to social and industrial adaptability assonciated with depression and anxiety. Axis II would have been a severely schizoid obsessional and womewhat withdrawn personality But the VA just wants to see the personality disorder that their examiner diagnosed and deny, deny and deny.

I am desperate at this point, but I will try tomarrow to see if I can get any help from the state run Adult Mental Health Services Clinic. If they don't, I might just go off my meds and have myself commited, cause I am fed up with it all. I live in a box and barely functioning as it is.

bad day, AMVET looked at my file and saw that personality disorder and said sorry can't help you their, you'll have to get me some new and material evidence to file a claim on that matter. Didn't think much of my CUE claim either, but said he would file it when I was ready.

He also said if I sent anything directly to the VA without going through him first, he would drop me like a hot potatoe. I don't know what that was all about. Why wouldn't I want to do otherwise, if he doesn't know what I am doing or what the VA might have sent me, how can he help me when needed?

By the way, our VA office moved and before they were on a bus route, now they are about a mile from it. Glad I have a good electric chair with strong batteries. I hadn't planned on them being so far out and hard to access by someone like me who has to schedule rides three days in advance. I got their OK, but I didn't think I would need a ride from their. Was I ever ticked off, I even told the guy I was in a wheel chair and had to schedule my ride. he should have told me their was no bus route close by.

Got to go take my meds before I forget again and it will be to late to take my sleep meds and I will be up again most of the night.

Rockhound :)

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Thanks to everyone who has been helping me find 1974 era M21-1 procedures 38 CFR regulations, and 38 USC Codes. Found everything at our local University, seems they are a federal depository of such things. Their nearly right down town and easy for me to get to. Once I am downtown, their is a free bus that goes up and down the main drag of town and has a stop with in a block of the University Library. The people their were realy nice and helpfull. almost as nice and helpfull you all have been putting up with my rants and raves. LoL

Chill pill time.

Rockhound :)

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  • HadIt.com Elder

Am still processing your post 'title' of manifested ..... I am trying to connect the dots the way I see it. I prefer things to keep moving myself, my vso advised reconsideration in that train of thought. Maybe you could get this NSC to SC diagnosis corrected with a reconsideration first, then CUE or EED afterwards. The way I understand if one goes for reconsideration of issue it goes to DRO. But I am not sure if NSC is handled the same way.

By the way, I did submit something before I gave my VSO a copy, no big deal, wasnt intentional to avoid vso, just got anxious to get it in and off my back. May wann, give that vso a peice of sorbitol sugar free candy next time round, could help disposition. Any way, your vso sounds a bit micromanaging, imho, but like he wants to do right by ya. the best to ya, cg

Thanks to everyone who has been helping me find 1974 era M21-1 procedures 38 CFR regulations, and 38 USC Codes. Found everything at our local University, seems they are a federal depository of such things. Their nearly right down town and easy for me to get to. Once I am downtown, their is a free bus that goes up and down the main drag of town and has a stop with in a block of the University Library. The people their were realy nice and helpfull. almost as nice and helpfull you all have been putting up with my rants and raves. LoL

Chill pill time.

Rockhound :)

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  • HadIt.com Elder

RIcky, thanks, not sure whats exactly new for me, first time ever requesting tdiu, been without work since discharge near decade ago? also requested increase for mdd same time. Staying positive here, feeling good, dr statement looked strong, ssa data backs it up, in new eval with psych for possible meds, etc.... sure need the tdiu, been years tryin to make do.

Sure good job with DOD, state or somewher would be nice, but oh its just so beyond what I can deal with mentally, let alone physically. Meanwhile, my former mil coworkers have moved up the corporate ladder (big $ for mil contracts, imagine!) we lunch sometimes, I stress, polish up, arrive late, eat small bite and listen to class A motor home gripes, latest business trip flight stories, then agree we are all looking good and promise to meet for lunch again soon. Family and I are gonna make it, so far ok, the full stop in my working wasn't planned. Guess I am glad I dont have class A gripes!

Again, thanks for thinking good thoughts on my behalf, lifes good here at Hadit, 'we may not like what we hear but we didnt write the reg's now did we?' best to ya, from determined cg

cg - keep in mind that a reconsideration will require new evidence in order to have the VA entertain it.
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