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Need Help With Increase And C&p Exam


Bound4heaven

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Greetings,

I contacted my local RO over a year ago to ask if I could get a letter stating that I am T&P (I am currently rated at 90%IU with T&P with Chapter 35 benefits and no future exams) The ro informed my that I was not T&P (I was but was unaware at that time) and I would have to apply for increase. I do file for increase and I was sent to my 5th C&P exam. The examiner was a N.P and extremely rude to me. She asked me questions that had nothing to do with my exam (Why do my wife and I adopt special needs children, and was I drinking I havn't drank in over 10 years) I informed her that was not while I was there. I have many bi-lateral foot issues and she asked me to stand on my toes and I informed her I could not and she became furious at me telling me I was combatant and she would make sure that was known. I knew after that exam last July it ewas not going to go well.

I got a copy of the C&P exam from the mnedical records and I was floored with the distorations and lies that were in the exam. She said in the final report that I was missed dignosed and my disabilities were not as severe as my other doctors in the VA. She went on to say that I was able to stand on my toes so by doing that I had no foot problems. I files 7 complaints with the patients advocate at the VA Medical Center. I even met the pwrson in charge of the C&P exams. I sent all information to the RO. I also receive SSD. The question I have is because of her comments on the C&P reports will I loose the increase? However the big issue I have is will they reduce my current benefits I now receive?

I have one last issue. With this increase I brought into play secondary disabilities from side effects I now endure from the 21 different medications I now take. I had a medication evulation done outside the VA and all the current side effects I thought were due to my disabilities were because of my meds. I submitted this report to the RO. I also had a IME done by Dr. Bash , however he is not done with it as of yet. My American Leigon cso wants the RO to make a decison asap, and use the IME for an appeal if necessary. Can anyone give me some advice? God bless you all.

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Geez- this is awful-and this crap is starting to happen to too many vets at C & Ps- did you get any follow up at all from the person in charge of the C & P exams? or the PT Advocate? re: your complaints?

The VA cannot reduce you without some clear cut evidence of improvement-

do you get SSA for the same service connected conditions?

I think Dr. Bash is great and hope his opinion will overcome this lousy C & P you got.

You could submit a copy of it as soon as you get it- or use it to support a Notice of Disagreement if they do not give you a good decision.

By getting that C & P right from the git go- you see already what you might have to fight about-

Welcome aboard and by the way- do you feel comfortable telling us

what the C & P was for and what your SC disability is?

I am a little confused- you were already declared P & T but then they wanted to give you another C & P ?

Is Dr. Bash aware of the C & P results?

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Thank you for your response.

I am currently rated *40% for bi-lateral foot conditions (Flat Feet, Planter Fasiilis, ect)

*50% back condition (Osteoporosis, lumbar strain, degenerative disc desease)

*10 % Tinnitus

*20% Loss of motion in left arm

*20% Varicose Veins 20% Bi-lateral

*20 % Hearing loss

*10% loss on motion left finger

Yes After I filed my complaints with the RO and the Patients Advocates, local senators I received a call from the main person in charge of C&P. I was blessed I had a VA Med appt the same day so after my appt she sat down with me and we went through the entire issues. She was only concerned about the C&P examiners response concerning why we adopt specail needs children, and her telling me I appeared to have had a stroke which was out of her medical knowledge to give such a statement. She also informed me that they would be making a full investigation and would displine the C&P provider. My cso called me after that and told me that,"There were several complaints filed against this C&P examinier. I was also informed that if I did not like the results of the decision from the Ro that I could request an appeal. (All Veterans have that right) so she wasn't telling me anything new.

Yes Dr. Bash is aware of this issue he has the entire C&P exam along with 4 of my doctors with dignosis and prognosis which is against everything the C&P examiner said. Yes I am rated at 90% IU with T&P paid at the 100% rate. When I called the RO last December I knew I was 100%IU, but I did not know I was also rated at T&P due to I received chapter 35 benefits, and no future exam on my award letter. The guy at the Milwaukee RO had no clue to waht he was talking about when he told me I had to apply for an increase.

So when I applied for an increase for my feet, back and that I now use a cane to walk (Only 43 years old)(I took the word of the guy at the RO big mistake) and I filed for an increase and then they sent me to another C&P exam. I was contacted by another man from the RO who was confused by entire matter (Welcome aboard I told him) He sent me a letter about 6 months ago stating that I was 100% T&P signed by the head of Milwaukee's RO. So I thought I would cancel the claim, and when I did I got the same thing that I was not 100% T&P, but 90%IU with T&P he was unable to explain the difference. So I continued the increase. Then I got another call that said my claim was for SMC sence I maxed out my percentages. So that is where that stands.

The other question I had was reguarding service connection for side effects from medication. I take 21 meds per day and have 11 side effects and I filed secondary service connection for that as well. I also had a medication evulation done outside the VA and submitted that as addtional edivence. I appriciate any help. Thank you all. God bless

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Typical VARO smoke screens in order to get you in for a reduction. I would cancel the claim all together. If they are indeed looking into an increase for SMC you have a right to terminate your claim at any time. Now, since new evidence was presented, they CAN reopen the claim themselves, but at elast then you'll know what their original intentions were. They pulled the same thing with my wife...they try to trick you into C&P exam illegally, in order to get some evdience to open your P&T claim against your will (the only way to open a P&T claim is if NEW evidence is provided, hence them tricking you into a C&P).

I would also file a CUE under -

§ 3.327 Reexaminations.

(a) General. Reexaminations, including periods of hospital observation, will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability. Generally, reexaminations will be required if it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability or that the current rating may be incorrect. Individuals for whom reexaminations have been authorized and scheduled are required to report for such reexaminations. Paragraphs (B) and © of this section provide general guidelines for requesting reexaminations, but shall not be construed as limiting VA's authority to request reexaminations, or periods of hospital observation, at any time in order to ensure that a disability is accurately rated.

(Authority: 38 U.S.C. 501)

(:blink: Compensation cases—(1) Scheduling reexaminations. Assignment of a prestabilization rating requires reexamination within the second 6 months period following separation from service. Following initial Department of Veterans Affairs examination, or any scheduled future or other examination, reexamination, if in order, will be scheduled within not less than 2 years nor more than 5 years within the judgment of the rating board, unless another time period is elsewhere specified.

(2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled: (i) When the disability is established as static;

(ii) When the findings and symptoms are shown by examinations scheduled in paragraph (:huh:(2)(i) of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more;

(iii) Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement;

(iv) In cases of veterans over 55 years of age, except under unusual circumstances;

(v) When the rating is a prescribed scheduled minimum rating; or

(vi) Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions.

© Pension cases. In nonservice-connected cases in which the permanent total disability has been confirmed by reexamination or by the history of the case, or with obviously static disabilities, further reexaminations will not generally be requested. In other cases further examination will not be requested routinely and will be accomplished only if considered necessary based upon the particular facts of the individual case. In the cases of veterans over 55 years of age, reexamination will be requested only under unusual circumstances.

And a CUE under this regulation if/when they try to reduce you -

§ 3.343 Continuance of total disability ratings.

(a) General. Total disability ratings, when warranted by the severity of the condition and not granted purely because of hospital, surgical, or home treatment, or individual unemployability will not be reduced, in the absence of clear error, without examination showing material improvement in physical or mental condition. Examination reports showing material improvement must be evaluated in conjunction with all the facts of record, and consideration must be given particularly to whether the veteran attained improvement under the ordinary conditions of life, i.e., while working or actively seeking work or whether the symptoms have been brought under control by prolonged rest, or generally, by following a regimen which precludes work, and, if the latter, reduction from total disability ratings will not be considered pending reexamination after a period of employment (3 to 6 months).

(:D Tuberculosis; compensation. In service-connected cases, evaluations for active or inactive tuberculosis will be governed by the Schedule for Rating Disabilities (part 4 of this chapter). Where in the opinion of the rating board the veteran at the expiration of the period during which a total rating is provided will not be able to maintain inactivity of the disease process under the ordinary conditions of life, the case will be submitted under §3.321.

© Individual unemployability. (1) In reducing a rating of 100 percent service-connected disability based on individual unemployability, the provisions of §3.105(e) are for application but caution must be exercised in such a determination that actual employability is established by clear and convincing evidence. When in such a case the veteran is undergoing vocational rehabilitation, education or training, the rating will not be reduced by reason thereof unless there is received evidence of marked improvement or recovery in physical or mental conditions or of employment progress, income earned, and prospects of economic rehabilitation, which demonstrates affirmatively the veteran's capacity to pursue the vocation or occupation for which the training is intended to qualify him or her, or unless the physical or mental demands of the course are obviously incompatible with total disability. Neither participation in, nor the receipt of remuneration as a result of participation in, a therapeutic or rehabilitation activity under 38 U.S.C. 1718 shall be considered evidence of employability.

You can also use the second regulation as a basis for CUE because they reopened your claim and scheduled a reexamination without any new material evidence to suggest an improvement. I would also use these regulations to get your SO motivated and for your local senator's office. Make sure you make it clear that all you wanted was a letter stating that you were P&T and that the RO told you that you weren't and said you MUST report to a C&P.

I wouldn't worry too much as the requirements for lowering a P&T TDIU claim are quite difficult to prove. The doctor did say something to giev them a window though..essentially, he/she said that the prior decisions were false which can lead to a reduction based on the RO calling CUE on itself, but this will be quite difficult given the higher of two evaluations rule and the reasonable doubt rule (not to mention the preponderance of evidence rule). I would suggest that you use Bash's IME AND get a seperate civilian examination from a specialist (even if it's out of pocket costs..in fact out of pocket appointments are much quikcer then waiting on a insurance company and time is not your friend).

Basically, throw the book at everyone you can..this includes writing the regional director's office (or calling), writing your senator, getting your SO more involved (sounds like a bad one to me, you may want to change), contact your local newspaper with clear facts of your case and how they are tricking you, and many vets, into lowering your compensation because of the cost of this war (politics are your friend) and contact the secratary of the VA and file a complaint (but be sure to keep it in the context of "you just wanted a letter and the RO forced you into a C&P via a lie.....the secretary will not get involved in adjudication issues).

Hope some of this actually helps:-)

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Thank you Jay for you time responding to my issues.

My American L. Service officer wants the RO to make a decision asap, and use DR. Bash's IME for an appeal if needed. Would I be better to wait on DR. Bash's IME prior to the RO making a decision?

It is very confusing for me and I have been dealing with my local RO for 8 years. It amazes me how I have been treated over the years. Please do not misunderstand me. One of my 4 doctors is a blessing and went to bat for me when I applied for SSD and I got approved. In general I have had a bad time of it with the RO. It seems I have to prove and prove my-self all over again. The rudeness and boldness of my local RO is not on the side of the Veteran who thinks as once as I did they are.

I also brought into play an outside medication evulation of the 21 meds I now take. Do you or anyone else know if it will make a difference. I filed service connection for side effects from the all the meds. Thank you, and God bless.

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Thank you Jay for you time responding to my issues.

My American L. Service officer wants the RO to make a decision asap, and use DR. Bash's IME for an appeal if needed. Would I be better to wait on DR. Bash's IME prior to the RO making a decision?

It is very confusing for me and I have been dealing with my local RO for 8 years. It amazes me how I have been treated over the years. Please do not misunderstand me. One of my 4 doctors is a blessing and went to bat for me when I applied for SSD and I got approved. In general I have had a bad time of it with the RO. It seems I have to prove and prove my-self all over again. The rudeness and boldness of my local RO is not on the side of the Veteran who thinks as once as I did they are.

I also brought into play an outside medication evulation of the 21 meds I now take. Do you or anyone else know if it will make a difference. I filed service connection for side effects from the all the meds. Thank you, and God bless.

I don't understand how a fast decision is in your best interest. Once they make a decision you are fighting an uphill battle with, what could be, a lower amount of compensation. It's a lot less stressful to get a good first evaluation then trying to fight to get your old level back. Either way, it is VERY difficult for them to reduce a TDIU P&T claim....if you can't work and there is no evidence to suggest that you can, then they cannot lower you. To be safe I would seek another civilian evaluation of all of your disabilities, even if it takes a few visits to different specialists. The VA MUST take the civilian evaluation over the C&P if the civilian doctors are better qualified to make the decisions (IE - a cardiolist can better diagnos you then a primary C&P doctor). So, get some more evidence on your side, just in case, and do so as quickly a possible.....even if it costs you 100's of dollars to get the evals, it will be worth it when you save $1200 a month in lost compensation.

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Guest allanopie

>The examiner was a N.P and extremely rude to me. She asked me questions that had nothing to do with my exam (Why do my wife and I adopt special needs children, and was I drinking I havn't drank in over 10 years) I informed her that was not while I was there. I have many bi-lateral foot issues and she asked me to stand on my toes and I informed her I could not and she became furious at me telling me I was combatant and she would make sure that was known.

Hello Bound4heaven,

This is identical to what I experience & by a NP. It wasn't at the Spokane VAMC C&P dept, was it?

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Oh, I missed that it was an NP. There's NO WAY the RO should take a general NP diagnosis over your past doctor's opinion. In fact, the RO should know better then to send someone with specialized disorders to a general NP for an overall evaluation. As a nurse I can etll you that an NP is in now way traianed to deal with the issues you mentioned...they are, essentially, for medications and routine common problems like flu, colds and other common everyday disorders...in fact, an NP cannot even officially diagnose anything without the signature of a supervising MD.

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Just thought I would add a little note about our experience with C & P exams. My husband went for a C & P exam for his claim for an increase in his service connected skin condition. We thought things went well, at the time. He then was scheduled for another C & P exam for service connecttion for hypertension. While we were there, the doctor who gave him his C & P exam for his skin claim saw my husband and called him in, telling him that there were a few things he had forgot to ask him when he was there the week before for his skin and he needed to get those answered. Strange, huh. Well, the next thing we know, he is asking my husband questions about a claim he had in for ED, secondary to his meds for PTSD. We were not told that this was a C & P exam for ED. This is when he became very angry and beligerent with me because I insisted that he look at my husband's complete file which would have a bearing on his claim fir ED. When I finally got the results of the exam for ED, it went on and on about the ED being due to meds being given to my husband for prostrate problems, not his PTSD. My husband has never had nor does he now have any prostrate problems. He even quoted my husbands psychiatrist's name and stated "he was from the Urology Department and the records from that department backed up his findings". Number one, the doctor from the Urology Department that he referred to is not a urololgist, but his psychiatrist. Number two, this doctor is a she, not a he. Number three, my husbnd has never been treated in the Urology Department, so how could there be any records from this department stating anything and he also does not have a prostrate problem. The whole report was horrible and inaccurate. Then, when I called about the results of his C & P exam for his skin problems, I was told that the results of that exam was included in the same report for ED. The only thing stated in the ED report was that my husband was claiming an increase in his skin condition. That was it. When I stated this and wanted to know where the notes were that the examiner took whiole my husband was being examined for his skin, they couldn't tell me anything except that his file and everything had been released back to the VARO. Now the VARO has an incompetent C & P opinion for ED and nothing on his exam for his skin. I hit the ceiling. Sat down and wrote a 4 page letter taking each sentence the examiner wrote and disputed each one. Even told them where to go to get the documents to back up what I said. We hand carried this to the VARO and spoke with someone there about it. I then called the VAMC and filed a complaint with the examiner. I am still waiting to hear from them about a meeting that they indicated that they wanted to set up with the Chief of Staff for us. Not sure where this stands at this point. This probably will hurt my husbands claim in the end, but there was no since in this examiner doing this to any veteran who only wants a fair examintion and not a report based on inaccuracies. Someone has to step up to the bar and file complaints about the inaccuracies of the C & P exams that some veterans are receiving. The veteran only wants a fair shake and not a bunch of inaccuracies which would immediately get his claim denied. I took everything straight to the VARO before my husbands claim could get denied, based on this examiners reports. The first question the VARO ask me was how I managed to get a copy of the C & P exam before the claim decision had been made. I told him we went to the Release of Medical Records Depaqrtment and asked for it.

Well. this is where we stand on this. Any input from anyone on whether or not I took the right road on this and whether or not my husbands claim may get negatively affected?

Thanks

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Guest allanopie

The BVA or the VARO "may" request a specialist or MD perform the C&P examination, but the VA medical centers are the ones that decide who there going to pay and what for. I believe the regs state, the examiner needs to be trained to give the examination, but thats about it.

My first C&P was performed by an NP for neurological & spinal disorders. I think I've had 4 or 5 C&P examinations since & they were all, internal medicine, none were neurological.

If you get a favorable C&P, you can expect the VARO to refuse to give it any weight as evidence. They will likely say they're not experienced enough. If it's denied, they will stand by their examiners opinions until your at COVA. If your looking for compensation for exposure to bio- hazards, forget the VA NP's, PA's or internal med doctors. There not going to know as much as your third graders science class.

If you get to see leading Neurologists at a VAMC, you can expect them to know absolutely nothing about "Agent Orange, Gulf War Illness, radiation or bio toxins you were "more than likely" exposed to as an occupational hazard of military service.

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I would call the Chief of Staff's office myself to see if an appointment has been set up- if not you could make one with them-

The points you brought out here as to the doctor referring to the ED from a condition that he doesn't have is just plain incompetence-actually it borders on negligence.

I have to tell you something- yesterday I went through files and medical records for a 6 year period of my dead husband's experience with the local VAMC.

Full of incompetence- we do have to step up to the plate-

I found one old C & P and 3 other "expert" VA medical opinions that I knocked down many years ago-

And of course a litany of misdiagnoses that, without medical backgrounds ourselves, we never picked up on or questioned until it was too late-

Regardless of the fact that Rod had filed 2 claims with the VA ,we still fought them for better care.

His claims, that I re-opened were not awarded until 3 years after he died.

But I dont think our battles with the local VAMC caused that-

The most significant medical evidence to award his claims had been continually lost or ignored by the VARO.

I would not worry about the effect on his claim-

as it stands now- the C & P results could have a very negative affect anyhow on it.

One suggestion- I had one or two meetings with the Chief of Staff here fighting over Rod's care and I asked him to note in the med recs what we discussed. He did that.

This and another notation became very important years later when the claims were resolved.

The Chief of Staff had also made a notation in the med recs that I called my Congressman in March 1994 and as soon as he got the congressional call the patient was admitted.

(they had denied admission) It was VA's documentation of a complaint which you might need too.

That C & P your husband got cannot stand as it is- you are quite right to question it.

The part about the 'hug'- between you and me- I would let that go-

just my opinion-

you could tell the Chief of Staff that you felt it was inappropriate behavior but would be willing not to pursue that issue if they give your husband a new and proper C & P.

Edited by Berta
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Guest allanopie

Hello mssoup1,

contact the "Patient Advocate" at the VAMC to file your complaint. I would suggest you discuss it with a team "Social Worker" as well & ask them to assist you with filing a "medical power of attorney".

You can also request a local hearing at the VARO with your SO & present evidence in person. This entitles you to be sworn in when you provide testimony. Sworn testimony goes in the record for consideration.

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Oh, I missed that it was an NP. There's NO WAY the RO should take a general NP diagnosis over your past doctor's opinion. In fact, the RO should know better then to send someone with specialized disorders to a general NP for an overall evaluation. As a nurse I can etll you that an NP is in now way traianed to deal with the issues you mentioned...they are, essentially, for medications and routine common problems like flu, colds and other common everyday disorders...in fact, an NP cannot even officially diagnose anything without the signature of a supervising MD.

Dear Jay,

I do thank you so much for your response. I have learned more from fellow veterans from this web site in 2 days then my entire expirence with my Americam L. Service officer. I have found out that dealing with the VA. It is the Veteran that must make and stay on top of the entire process. A veteran cannot rely on anyone else to the fact of making sure the RO gets all necessary information. I am very very dissapointed with my cso. I currently have a IME performed my DR. Bash who has a heart for veterans and their issues. My CSO did not even reccommened him to me till after I informed him I was using DR, Bash, and he knew (MY cso ) THat I needed an IME and I told him I was unable to find one until another CSO from a different origization informed me of DR. Bash.

Why do the RO send Veterans to NP at C&P exams? if they have such limits placed upon them why are they there? my expirence with this C&P examinier is on the line of incompentence, and she was no way able to address all my issues and then be able to make a decsion (Which they have not the medical knowledge of education). Many veterans don't know this and are again and again given wrong decisions which will effect them and their famlies for years on appeals. I asked this question to the RO when I started my complaints againt my C&P examiner and he had no response, and I informed him that was not good enough. It was then because of his disinterest on my complaints that I turned to the Medical Center patients advocates, and contacted all my senators, abd all reps both state and federal. It was time consuming, however I not only wanted attention to my case but to all veterans who feel they have no voice aginst a system (NOt all) but most of the time against them.

Majority of workers at the RO at college grads who never knew a veteran, and have little clue the issues we face and therefore have no sympthmy towads us. (I am not complainer at all, however justice is what I am after) I appriciate all you help Jay. God bless you.

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Thanks so much for your responses back to me. First, ouir Patient Advocate is of no help. Been that route before. She tells you to first try and resolve the problems yourself. When we told her that is why we were there speaking to her, because we couldn't resolve the problem, she basically said go away and try again. So much for their help.

As far as the question someone else had concerning PA's doing C & P's, our VAMC has one. She does the C & P, writes up the notes, gives her opinion and then states that it has ben reviewed by the C & P doctor and he agrees with her opinion. I think this is basically how they get around using PA's for C & P's. As long as the PA has a doctor who claims they reviewed what they did, the VARO accepts their opinion.

Also, I am giving the office of the Chief of Staff at the VAMC time to respond back to me before I contact them again. I just recently called them so they may be getting documentation together for a meeting. I explained quite a bit over the phone to them. They also stated that it was possible the Diretor himself may want to be involved in this issue.

I hope I haven't overstepped some bounds with this issue, but it is time that someone does something aboujt this doctor. When we walked into the exam my husband made a comment to him about he had heard that he was going to retire. His comment was that they would like to get rid of him, but he wasn't going anywhere and besides they had no one to replace him with.

As I stated before, we don't want anything that my husband is not entitled to. But his exams rquired by the VARO could at least be as honest and accurate as possible. It appears that this doctor goes out of his way to write up opinions which will automatically guarantee a denial at the VARO, regardless of what he has to put in them. That is not right for the veterans who are fighting so hard for what they rightfully deserve. Give an honest opinion and then let this and the evidence make or break your case.

I do believe that this doctor thinks that unless you are terminal or close to it, then you don't deserve anything.

Sorry for the ranting, but I do think it helps other veterans who are working their claims to see what other veterans are having to experience with their claims through the process. Of course, no two will be the same, but it doesn't hurt to know what others are experiencing.

Thanks

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NPs and PA's have, basically, the same level of training. They cannot, officially, diagnose anyone with anything unless they get authorization from a surpervisor (MD). The reason the VA uses them is quite simple, they are cheap! Also, most self-respecting doctors will not work under the contraints of the VA....no MD is going to make medical decisions based on "saving the VA money", but NP's/PA's are more willing to sell their soles (so to speek).

With that said, I hope you keep in mind that RO's are notorious for not following the regulations and you may be in for a long battle regardless of any favorable IMEs and/or outside help from senators, supervisors, etc.......It is still in your best interest to contact the people you have and prepare your case as best as you can, but be prepared for a war if/when the time comes.

You are 100% correct in that it is up to the VETERAN to WIN a claim and the vet MUST stay on top of things or he/she can easily be low-balled/denied. You should treat your case like a lawyer would presenting evidence in court......gether ALL the evidence you can from as many experts as you can and use the regulations to your advantage (here is a link to a website with the full list of regulations - VA REGS ). Also, try to highlite everything in your claim that best supports your percentage....in other words, present the case like your trying to talk to a 3 yr old. Make it as easy as possible for them to get the best picture in support of your claim.

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Jay,

Thanks for your response. I have responded back to the RO with a detailed letter I wrote up, cited the regs that applied to what I was talking about, sent them copies of these with the areas highlighted, copies of his medical records with the appropriate areas highlighted, along with copies of anything else which pertained to his case and highlighted those areas as well. Any 3 year old could have fully comprehended what I sent in, but they still cannot read or comprehend what you are trying to state. Then again, it may be that they just are not even bothering to read the evidence you send to them. Takes them too much time. Something is wrong when you get a denial and it doesn't come anywhere to making sense, based on the evidence that was sent in.

As to inadequate C & P exams, per another posting I had, you would think the BVA and Court of Veterans Appeals would get tired of remanding claims back based on inadequate exams being given. I think that they should weigh the other evidence that you have presented and if that pretty much gives them what they need to approve a claim, then they should be doing that. Instead, they remand it back so the veteran can undergo another inadequate C & P exam. No wonder there is such a backlog in the claims process. But then again, I guess this makes too much sense.

Again, thanks for your response.

Mssoup1

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As to inadequate C & P exams, per another posting I had, you would think the BVA and Court of Veterans Appeals would get tired of remanding claims back based on inadequate exams being given. I think that they should weigh the other evidence that you have presented and if that pretty much gives them what they need to approve a claim, then they should be doing that. Instead, they remand it back so the veteran can undergo another inadequate C & P exam. No wonder there is such a backlog in the claims process. But then again, I guess this makes too much sense.

Again, thanks for your response.

Mssoup1

Well, what they are hoping for is that the veteran will NOT appeal in the first place. Or that the veteran will not go above and beyond and get their own sources of medical evidence...this is where the IMEs help a bunch in my opinion. The VA is supposed to weigh evidence and rate based on a "preponderence" of the evidence (though RO's tend to go with the lower eval. regardless, the BVA and CoVA tend to follow the letter of the law). It's all a big circle in the hope that a veteran will either give up or die trying....I know it sounds horrible, but it is the truth. The VA puts up as many roadblocks as they legally can (or illegally...not like they have any oversight).

P.S. - If you already haven't, be sure to copy everything you send and ALL of your medical evidence...the VAROs are known to "misplace" key evidence in your favor:-)

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NPs and PA's have, basically, the same level of training. They cannot, officially, diagnose anyone with anything unless they get authorization from a surpervisor (MD). The reason the VA uses them is quite simple, they are cheap! Also, most self-respecting doctors will not work under the contraints of the VA....no MD is going to make medical decisions based on "saving the VA money", but NP's/PA's are more willing to sell their soles (so to speek).

With that said, I hope you keep in mind that RO's are notorious for not following the regulations and you may be in for a long battle regardless of any favorable IMEs and/or outside help from senators, supervisors, etc.......It is still in your best interest to contact the people you have and prepare your case as best as you can, but be prepared for a war if/when the time comes.

You are 100% correct in that it is up to the VETERAN to WIN a claim and the vet MUST stay on top of things or he/she can easily be low-balled/denied. You should treat your case like a lawyer would presenting evidence in court......gether ALL the evidence you can from as many experts as you can and use the regulations to your advantage (here is a link to a website with the full list of regulations - VA REGS ). Also, try to highlite everything in your claim that best supports your percentage....in other words, present the case like your trying to talk to a 3 yr old. Make it as easy as possible for them to get the best picture in support of your claim.

Jay,

Thank you again so much for your help. Can you ever considered helping out at a vet center? you have knowledge that many veterans need, and will not receive. God bless you.

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Jay,

Thank you again so much for your help. Can you ever considered helping out at a vet center? you have knowledge that many veterans need, and will not receive. God bless you.

My pleasure:-) Honestly, I would love to help vets on a more one to one basis and learn even more about the process myself, but my wife is very dependent on me to be home with her and she is agoraphobic, so leaving the house is quite difficult (she usually stays in the car when we go to the store and I leave one of the kids in the car with her so she doesn't have a panic attack). Perhaps in time she will grow more comfortable, at least at home, and I'll be able to do more, but, for now, I'm kinda stuck in the house:-(

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Jay,

Again thanks for your help. My husband has gotten an IMO on his eye problem before and the doctor stated that it was more likely than not that his eye condition is connected to his skin condition. With this being said, you would think his claim would go through fairly smooth. Well, the VARO wanted to know where this doctor got his opinion from, then denied the claim. We showed the denial to his doctor and he was floored. Had to go to the BVA and at that point he received an instant approval.

I do keep copies of everything. All correspondence to the VARO, documentation they send back to us and I have a complete copy of his SMR, medical records from the VAMC, including C & P exams and any IMO's. Each time he visits the VAMC, on our next trip we get a copy of any notes from his previous visits, unless we need them before hand. This way, we stay up to date. Can't get them the same day he goes as it takes them longer to get the information into the system. We are very fortunate because we only live about 25 miles from the nearest VAMC. I feel sorry for those veterans who have to travel so many miles just to get to the nearest VAMC facility. It's really sad.

By the way, I completely handle my husbands claims. I do read everything to him and explain it, then have him sign waht he needs to. It has been many years for me fighting the VAMC, but I'm too old to give up now. Guess I'll have a VARO denial plastered to my hand when they put me in the casket, but they can say at least I didn't give in or give up.

Anyway, thanks for your assistance and help.

Mssoup1

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