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To: Berta. Amc Rating Decision

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lu12

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Feb 22, 2008 AMC RD: Entitlement for a Cervical Spine disability (DENIED); Entitlement for a Psy. Disorder (30%)

For the cervical spine issue: C&P examiner opinion was based on the fact that I suffer a motor vehicle accident (MVA) on 1997, the examiner never got to reconcile with various IMO nor considered the BVA assertions and statements relating the following facts, Evidence of the record clearly showed that I got medical treatment for this condition well before the 1997 (MVA) nor considered the fact that the BVA related to an IME, Nexus Opinion from 2003.

filed for cervical spine, service connection in 1996 and re-filed in 1997, because the VRO never responded, I re-submitted a 21-4138 in 1998 in which I requested to amend my claim in order to add serv. conn. for a Psy & GI disorders secondary to the s-c disabilities.

The VRO & the AMC both have ignored the fact and existences and evidence of the 1996-1997 claims.Could this be sufficient or good enough to consider a NOD base on a CUE action for this issue?

For the Psychiatric Issue: The AMC decision is base on the following facts: C&P Examiner provided an opinion that the current chronic dysthymic disorder was more likely than not related to the s-c disabilities. an evaluation of 30% is assigned for moderate symptoms of depression, anxiety, social isolation and lack of energy. Here is one contradiction - Examiner opinion of Chronic dysthymic disorder and from the AMC rating decision makers: opinion and evaluation for a decision was based on a 30% for moderate symptoms of depression, anxiety, social isolation and lack of energy.

Private IME-IMNO's and Diagnosis for the Psy. Disorder have been assigned before 1996 as Chronic, Recurrent, Major Depressive Disorders to present, with similar Diagnosis from VHA Psychiatric Doc. with Recurrent and Major Chronic depression and anxiety due to s-c disabilities, and pain.

Medical evidence of treatment and Diagnosis since 1996 to 2008 from Private and VHA Psychiatrist's records notes have been consistence with a Dx. of Recurrent, MDD, anxiety and sleep impairments and ED. In addition to the fact that I requested in 2006 before the BVA to allow me to perfect and to re-characterized my appeal, because I wanted to emphasized the fact that my claim was submitted for depression and that I wanted to have the anxiety and Dysthymia to be rated separately.

Obviously the AMC not only minimized this Issue but also did not considered my request to be have all mental disorder evaluated separately. Could this also be sufficient grounds to file a NOD base CUE claim, or a Reconsideration?

Your advise will be appreciated

lu12

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Did the AMC decision give you any appellate rights?

I think you can ask for reconsideration- you did raise very good points here why this is wrong-

but I think the dysthymia will be lumped into any mental disability rating.

No basis for CUE as long as you have appeal rights.

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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Did the AMC decision give you any appellate rights?

For the Cervical spine issue: I don't understand quiet well, the AMC (SSOC) said that it is not a decision on any new issues, but is intended to inform you of any material changes in, or addition to the information contained in the (SSOC) that we previously send you. the following information will help to help you decide how to respond.

Your appeal was previously remanded by the BVA for further development, which has been completed. Before returning your appeal to the board we are giving you a period of time to respond with additional evidence. Please note that a response at this time is optional and it is not required to continue your appeal.

they give me 60 days to either respond and the same if I don't want to do so; also if Don't respond, the board will consider what you have already submitted in deciding your appeal.

Entitlement to service connection for a cervical spine disability, to include secondary to a service connected low back disability.

For the Psy. Disorder: if I disagree with their decision. you have one yr from the date of this letter to appeal the decision. Enclosed VA form 4107 rights to appeal their decision; appeal issues not covered in a statement of the case SOC, SSOC or a BVA decision.

I got lost here since there is one issue denied and one issue granted.

any comment please,,,

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If you have complied with the remand as to anything the BVA wanted or needed- and if they complied with the remand on their end- I would if I were you clearly tell them- in response- what you told us here as to the physical disability.

I think their 30% might be correct on the mental disabilty, disabilities.

"because I wanted to emphasized the fact that my claim was submitted for depression and that I wanted to have the anxiety and Dysthymia to be rated separately"

I dont see them doing that-

If your medical evidence warrants higher then the 30%

as per the Schedule of RAtings for the mental condition-by all means tell them-

"The VRO & the AMC both have ignored the fact and existences and evidence of the 1996-1997 claims.Could this be sufficient or good enough to consider a NOD base on a CUE action for this issue"

NO- if you have a final and Unappealed decision for those older claims-

and they made legal errors in them and this cost you retro and award at the time-that is basis for CUE claim.

Everything you need to know about CUE is found here in the search feature.I know because I posted a lot of that info.

A mental disability rating covers all mental disability issues.

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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hummm just a thought...

lu12 wrote: "For the cervical spine issue: C&P examiner opinion was based on the fact that I suffer a motor vehicle accident (MVA) on 1997, the examiner never got to reconcile with various IMO nor considered the BVA assertions and statements relating the following facts, Evidence of the record clearly showed that I got medical treatment for this condition well before the 1997 (MVA) nor considered the fact that the BVA related to an IME, Nexus Opinion from 2003."

If the C/p examiner is eluding that your condition deteriated due to the MVA on 1997...yet your condition for your spine was well documented prior to the MVA...wouldn't that be morelike.. THAT DUE TO THE MVA YOUR PRE-EXISTING CONDITION WAS AGGRAVATED BY THE 1997 MVA...(sounds like the nexus as to why your pre-existing condition has kicked in to cause you to file a claim for increase) but just my thought.

MT

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hummm just a thought...

lu12 wrote: "For the cervical spine issue: C&P examiner opinion was based on the fact that I suffer a motor vehicle accident (MVA) on 1997, the examiner never got to reconcile with various IMO nor considered the BVA assertions and statements relating the following facts, Evidence of the record clearly showed that I got medical treatment for this condition well before the 1997 (MVA) nor considered the fact that the BVA related to an IME, Nexus Opinion from 2003."

If the C/p examiner is eluding that your condition deteriated due to the MVA on 1997...yet your condition for your spine was well documented prior to the MVA...wouldn't that be morelike.. THAT DUE TO THE MVA YOUR PRE-EXISTING CONDITION WAS AGGRAVATED BY THE 1997 MVA...(sounds like the nexus as to why your pre-existing condition has kicked in to cause you to file a claim for increase) but just my thought.

MT

MT

To my understanding from 1989 to 1994 when I got medical treatment and complain about the pain on my back, I was under the perception that the back was only one body part and not the three part as they are. I'm already s-c'ed 60% for my lower back with out considering DJD nor the bilateral factor due to the radiculopathy to le's.

I claimed for s-c for my cervical condition on 1996 and complained privately on 1995. My argument for this issue is that the VARO nor the AMC rating decision makers did not considered my 1.) 1996 claim for s-c, 2.)1995 Private Examination, 3.) 1996 VA Out patient clinic, various dates of medical treatment and evidence of the record, before the MVA, 4.)1996 C&P for my Rt. Knee examination in which I complained about the cervical pain and discomfort, before the MVA, 5.) SS disability award letter date 1997 but effective on 1994 in which it is clearly established that my SS disability and benefits was granted because the cervical-lumbar and knee disability in addition that the SS award letter could be consider as another IMO.

The AMC, rating decision makers did not included as evidence nor reviewed none of the 3 IME linking medical reports nor reconcile with all of the private medial nexus opinions part of my medical evidence submitted to the VA.

So, should I go ahead with a NOD or a Request for a Reconsideration?

Edited by lu12
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lu12...

Depending when you received your decision letter would have a great impact on what to do.

No matter if you do a reconsideration or a NOD YOU HAVE ONE YEAR TO appeal...even if you submit a reconsideration the clock is still ticking.

I will give you a personal example I received a decision on my claim and I was awared 50% in which I did not agree due to the fact that my condition warreneted a 70% rating. I took my decision to my doctor along with the VA rating schedual to ask him if he felt my condition warrented the higher eval. based on factual medical evidence. He said my condition warrented the higher evaluation and he wrote me a letter explaining why my condition warrented the higher evaluaion based on my medical condition and how it effected my quality of life.

I submitted a letter for reconsideration noting the time frame I had...on my calander at home I put a big circle around the one year mark and a black circle around the day that was 3 months prior to that deadline date...if I did not hear anything before that black circle I had my NOD already made out ready to mail certified with receit...and besides mailing my NOD I brought it down to my POA and had him submit it...this was I knew they had my NOD.

NOW HERE IS A PITFALL TO DOING A RECONSIDERATION...to do a reconsideration you can look at the evidence that they used if you do not see the documents you have submitted that supports your claims that were sent prior to there decision you can gather that information Highlignt it and state that you would like a reconsideration on your condition and due to these facts were not noted in your decision...

IF YOU SUBMIT new evidence which is another reason to do a reconsideration like the letter I sent from my doctor (by the way I did prevail in this reconsideration) within the year deadline...the VA will more likely then not deem that as new material evidence and they will make your effective date to the date on that letter of new material evidence...so keep that in mind that may happen...yet you still may come out favorable...

ANOTHER FACTOR TO KEEP IN MIND...when you do a reconsideration...the rater that rated your claim in the first place more then likly and I MEAN MORE THEN LIKELY will be the one who will do the reconsideration....and since there performance evauation for there position is rated in part on there decisions it does not look good if they made a mistake...so sometime the rater will just kick it back or hold it....

where in a NOD a new rater will get your packet and review it...and will pick it apart to see what other mistake the original rater made...and of course that is all office politic!

I am a believer in good faith...that if you do a reconsideration the rater will be fair they know they are back logged and mistakes do happen...and like in my case the rater did the right thing on my reconsideration...

but I can not speak for all raters because I do know there are more good ole boys rating that want to look good...and keep the claim awards lowballed...

but there is what I think I know others will chime in...

SO RECONSIDERATION OR NOT...

well if you have the time go ahead and do the reconsideration...if the time is running out do THE NOD..and ask for a FACE TO FACE MEETING with the VARO...very important.

just my thoughts

MT

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