I Hate The Va! I Hate Them I Hate Them I Hate Them

[SouthernBelle]

So, I'm so mad I can't see straight right now. They denied the increase again. I can't believe it, I really just can't understand how a DOCTOR'S OPINION, the DOCTOR WHO TREATS MY HUSBAND TREATS HIM! can be ignored for a lower rating. RATERS ARE NOT DOCTORS! DAMN, I'm pissed. I am sitting here shaking I'm so mad.

Edited December 15, 2008 by SouthernBelle

[SouthernBelle]

Do I have to provide a reason for the request?

[Commander Bob]

"When it rains it pours"... then the sun shines again. Your washing machine picked a fine time to stop working. You are a kind soul and a blessing to those lives who you touch. My most positive thoughts are with you and your family this Christmas season and I wish you every success in the new year.

[tssnave]

Ok - at the risk of being shot by friendly fire, in the interest of giving SB the best advice possible by vetting all opinions through the board, let me take the opposing position on asking the VARO for a rater's qualifications and using that as basis for refutting the Decision because I do not see that as a viable option (unless someone has specifically used this defense before successfully - then it goes out the sphere of conjecture and into the sphere of experience which would make it more suitable to pursue).

Unless there is a regulation or court case where this has been done before I would not waste your time doing it. I would stick with the VA regs, which support you, and court cases, which, again, support you.

The VA rating manual, M21-1MR, Part III, Subpart iv, Chapter 5, states “the RSVR may not rely upon his/her own unsubstantiated medical conclusions to reject expert medical evidence”. So it doesn't matter what the rater's education is, he has to bow to expert medical evidence and rate accordingly (you may have to remind them of this fact). The VA reg already supports you without having to question the competency of the rater.

So, the question becomes what does the expert medical evidence state? At the end of the initial PTSD C&P exam in Section N the examiner states basically what percentage you are disabled. It is Section M on the review C&P exam. What did the examiner state in this section of your husband's C&P exam? If it is either the 100% or 70% (first two) statements, then you can quote the C&P exam as expert medical opinion and remind the VA that the rater can't use their own opinion over medical opinion.

Do any of the treatment reports or IMOs state clearly that your husband can't work due to symptoms of his PTSD? If so, quote them, verbatim and then quote M21-1MR, Part III, Subpart iv, Chapter 5.

I know you are upset right now, I understand that, I have been right in your shoes knowing that I am 100% disabled but not being able to get the VA to see that for years. It is maddening. But the only way to beat them is with the medical evidence, the regs, and the court cases - ALL of which favor the vet.

Please check your husband's C&P exams (sections N for initial exam and M for a review exam) and tell us what the examiners put in those sections. That will help your claim immensely. Also, quote the VA docs and private IMOs for language that speaks to his inability to work due to his PTSD.

Think long and hard before you start down a path questioning the VA's very right to adjudicate your claim. No matter how poorly they do it, they are authorized to do so. FTR, it was a 24 year old female history major who denied my claim in the first go round because "there is no evidence in your SMRs" despite a treament report and consult as well as letters from two shrinks who treated me on active duty. She never served in the military - I have kids older than she is. When I found out just how green the rater was I wanted to yank a knot on her little GS-7/9/11 head but it didn't matter. She had the authority to rate my claim and it wasn't until I got to the DRO and a senior rater that I was even able to get a C&P exam. I know the stats on my first rater because my VSO was disgusted and told me she was cranking out lousy Decisions left and right. It's called a learning curve and I got slaughtered in it. You may be in the same situation since the VA has hired a lot of new folks.

Either way, consider basing your NOD on the evidence, regs and court cases rather than going down a path that will cause you more frustration than it will be worth and continue to delay proper adjudication of your claim. Your rater could have been another 24 year old who never served in the military and has an art degree but even so, he/she has the authority to rate your claim - you simply have to show the VA through your evidence, their regulations, and court cases how they did it wrong.

I realize others may not agree with me, and I respect their right to have an opinion different than mine and I hope they will offer the same courtesy to me but either way, it is your claim and you need to figure out what is the best way for you to win your claim in the least amount of time possible.

Go back and read my earlier post - I gave you a NOD outline that worked for me to get 100% P&T. Look at his C&P exams and see what the examiner states in sections N/M about his functioning.

I hope this helps focus you in the right direction.

TS Snave

Edited December 19, 2008 by tssnave

[poolguy11550]

SouthernBelle- request the DRO hearing. Also in your cover letter state that the VA failed to apply the reasonable doubt. Also since your husband is no longer attending school, the longer the adjudication process plays out the stronger your claim will become- so continue to send the RO evidence of your husbands further worsting if that is the case.

Send in the FOIA request about the medical and legal background of the raters that worked the claim after you get the reply that the DRO will be handling your claim.

[tssnave]

Pool guy - if she gets a DRO review the background of the previous rater is moot because the DRO will be the one making a new Decision on his claim. Have you ever heard of anyone successfully winning a case because of the education/background of the rater? To me this is completely irrelevant as the VA has the authority to rate the claim no matter what the education/background is of the rater. I am concerned you are, with good intentions, steering SB down a blind alley that will just delay her claim further.

Thanks,

TS Snave

[SouthernBelle]

PoolGuy, I'll do the NOD/Hearing request first, then the FOIA thing after I hear back.

Is this okay?

I disagree with the decision dated 10 December 2008 as well as the decision dated 29 October 2008. In both Statements of the Case Department of Veterans’ Affairs failed to evaluate the Medical Records Evidence after 17 July 2008. I request reconsideration based on this fact. If reconsideration is not possible, please consider this my Notice of Disagreement. I am also requesting a Decision Review Officer Hearing. Please expedite the request for a DRO Hearing as well as the Notice of Disagreement and the Request for reconsideration.

**Should I put in why I am asking for this to be expedited? Our financial situation falls into the "dire" category. Also, I've filled out the TDIU form, should I enclose that as well?