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Duty To Assist? Is This Still Required?

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10thFO

Question

I had the reg for VHA Directive 2000-29 which was the directive mandating that VA dr's had to give a written opinion if asked on your disability effects on employability and such. I noticed in my research to print said directive out that it expired in November of 2005. Is there a new Reg ?

I've got an appointment with my PTSD psych on Thursday and was going to request that she give me this, as I'm getting ready to finally follow through with my TDIU. I was SC with PTSD at 50% in the spring of '05. I have yet to NOD or CUE as I had a claim in Voc Rehab, and they want my dr's to state on my employability. I'm 70% total with PTSD and DDD.

Currently I'm in a lurch financially and need some good advice on which route to go that will get me the money the fastest. I need to file for an increase now, as DDD and Nueropathy have worsened and I have MRI's and EEG tests to prove this. I don't know whether to NOD, or file for an Increase, or just file for TDIU. My SO is an idiot so I need to have all this stuff layed out when I take it to the VARO. I'm gonna give my SO a copy, but the VARO is only 30 minutes from my house, so I'm dropping it off their as well. I stopped by Voc. Rehab today and saw my counselor, who would never return my calls for 4 weeks, and she told me that she thought I was already getting TDIU, and that's why she hadn't done anything with my file.

Ughhhhhhhh. These people are gonna kill me yet. I really need to get a statement from my Psych though as the lady that did the testing for Voc Rehab, outside contractor, told me that she didn't think I was employable but she was sending for letters from my docs. Evidently she didn't or they didn't respond. I plan on using the Psychs statement at the same time this week when I apply for SSDI.

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10thFO: You write, "I'm in a lurch financially and need some good advice on which route to go that will get me the money the fastest"

Probably given the record of the VA verses SSDI claims awards, your best route would probably be the SSDI claim. You should provide all the evidence of your VAMC records, your C-File, any Medications you are taking and their side effects, any Records from Privet Dr's or Psychologists or Psychiatrists, personal statements from friends and family that are clsoe to you, of course about what they have observed that effect your daily living and how you relate with others. If they should ask for additional information or clarification, don't hesitate to do so, even if it is only the latest visits to your VA DR's or Psychatrist. I would also let it be known that you are also asking the VA for a TDIU claim and if for some miricle you should be approved for TDIU, I would get that award letter to the SSDI claims officer as soon as possible.

Otherwise you can use the award for SSDI to help your claim for TDIU.

Good Luck

Jim S. B)

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10th FO-

I am using this directive to try to get a local vet an opinion-

I wrote a letter for him to give to his doctors for a linkage but so far- he has been turned down by two VA doctors- one said they didn't want to do it, they felt uncomfortable with it and the other doc said he was not allowed to give a vet a med opinion-

well this vet has two more VA doctors to go-

however I am waiting a call from his vet rep- might have to meet him there today-

we need the vet rep to check out a few other things- he might not even need the med opinion---but

I have found nothing whatsoever that extends this reg or prohibits this reg from continuing so I am still going by what it says-

It is also spelled out in addition to the VCAA of 2000 as an additional directive

If anyone wants to copy and attach President Clinton's actual press sec report on the VCAA and Duty to Assist dated Nov 9,2000 it is at:

http://harrisonheritage.com/adbc/benefits5.htm

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Guest Namvet6567

I know the original was extended, once and I'm thinking it was until 2006 or 2007, but I'm not sure. Haven't been able to locate the original VHA Directive 2000-29, on the web yet.

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http://www1.va.gov/vhapublications/index.cfm

Department of Veterans Affairs

VHA DIRECTIVE 2000-029

Veterans Health Administration

Washington, DC 20420

September 22, 2000

PROVISION OF MEDICAL OPINIONS BY VA HEALTH CARE PRACTITIONERS

1. PURPOSE: This Veterans Health Administration (VHA) Directive establishes nationwide policy requiring VHA health care providers, when requested, and under certain limited circumstances, to provide descriptive statements and opinions for Department of Veterans Affairs (VA) patients with respect to patients’ medical condition, employability, and degree of disability.

2. BACKGROUND: This policy rescinds all restrictions on VA physicians and other medical practitioners, defined in M-1, Part I, Chapter 9, section 9.50. Restrictions on the ability of VA health care providers to provide statements and opinions for VA patients are inconsistent with the goal of VHA to provide comprehensive care and place a serious burden on veterans who depend on VHA for their care. This policy must, however, be implemented in a way that avoids inappropriate VHA participation in the claims adjudication process that determines eligibility for VA disability benefits. It is anticipated that this policy area will be the subject of future notice and comment rulemaking.

3. POLICY: It is VHA policy to remove restrictions on the ability of VA health care providers to provide statements and opinions for VA patients.

4. ACTION: Medical facility Directors are to implement this directive immediately. Use the following guidelines:

a. Support by Treating VA Practitioners of VA Benefits Claims

(1) Veteran patients may request descriptive statements regarding their medical conditions and/or opinions concerning the “possible cause(s)” of an existing medical condition for VA disability claims purposes. VHA health care providers shall provide a statement or opinion describing a patient’s medical condition. If the health care provider is the veteran’s treating physician, and is unable, or deems it inappropriate, to provide an opinion or statement, such physician shall refer the veteran’s request to another health care provider for the opinion or statement.

NOTE: For purposes of this policy, a note in the consolidated health record containing a statement such as, “in my medical opinion the currently existing medical condition is ‘related to,’ ‘possibly related to,’ or ‘at least as likely as not related to’ an injury, disease, or event occurring during the veteran’s military service” constitutes a sufficient supportive statement. The injury, disease, or event can be something described by the veteran or shown in other records, but should be identified as such by the health care practitioner in the health care practitioner’s statement. A statement to the effect of, “I am unable to determine whether a relationship exists” between the present disability and a described injury, disease, or event occurring during military service, is also acceptable.

(2) When providing medical statements and opinions, the veteran patient must be informed that decisions concerning VA compensation and/or pension benefits are:

(a) Decided by VA regional office adjudication officials based upon the law, regulations, and the totality of medical evidence pertaining to the disability claimed, and

(b) Not controlled by the physician providing the veteran’s care or the medical facility furnishing treatment.

b. Medical Opinions for Non-VA Purposes. Veterans may also ask VA health care professionals for medical opinions to assist them in filing claims with other agencies, e.g., the Social Security Administration (SSA). These opinions may be provided in the same manner and under the same restrictions as opinions furnished for Veterans Benefits Administration (VBA) claims processing purposes. NOTE: This does not include completion of Social Security Administration (SSA) forms for examinations where SSA would pay a private practitioner, but is prohibited from paying other Federal agencies such as VA (see Title 38 Code of Federal Regulations (CFR) 17.38 (a)(1)(xiv)).

c. Requirement for Disclaimer. In all instances involving VA determinations, the veteran patient must be asked to sign a statement indicating the veteran’s understanding that the opinions of the VA physician do not constitute an official VA determination of service connection, degree of disability, or eligibility for VA benefits. The disclaimer documented below is being added to VA Form 10-5345, Request for and Consent to Release of Medical Records Protected by Title 38 United States Code (U.S.C.) 7332, to facilitate its use. In the meantime, for releases of information covered by this directive, incorporate a statement like the following, signed by the veteran, in the Consolidated Health Record:

“I understand that the VA health care practitioner’s opinions and statements are not

official VA decisions regarding whether I will receive other VA benefits or, if I receive

VA benefits, their amount. They may, however, be considered with other evidence when

these decisions are made at a VA Regional Office that specializes in benefit decisions.”

5. REFERENCE: None.

6. FOLLOW-UP RESPONSIBILITY: The Office of Patient Care Services, Forensic Medicine Strategic Healthcare Group (11F) is responsible for the contents of this directive.

7. RESCISSIONS: M-1, Part I, Chapter 9, section 9.50 and VHA Directive 98-052 are rescinded.

This VHA Directive expires September 31, 2005.

S/ Frances Murphy, M.D. for

Thomas L. Garthwaite, M.D.

Under Secretary for Health

DISTRIBUTION:

CO:

E-mailed 9/22/2000

FLD:

VISN, MA, DO, OC, OCRO, and 200 - FAX 9/22/2000

EX:

Boxes 104, 88, 63, 60, 54, 52, 47 and 44 - FAX 9/22/2000

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Guest Namvet6567

Wings, I found something on the web that states VHA Directive 98-052 was essentially codified but unable to find where. I'm thinking probably in VCAA 2000.

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