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Va Primary Care Team Is Helping Out.


Guest Morgan

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We got good news today. My husband's new primary care team is cooperating with him in writing a letter to the RO confirming his conditions. That will be three doctors saying it's so. B)

The PVA said a letter from a VA doctor confirming the conditions (since he couldn't go for the exam) could very well reverse the denial. The PVA SO thinks he should be at the R2 level, as do we. At first, they were just going to put a statement in his medical record, but today they said they are working on a letter and will mail it to us. Sure hope this turns it around. At least, it's not in the pile for a long appeal just yet.

The PVA said BVA appeals are five years out now. Anyone else heard that?

Carrie

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That should help a lot.

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Carrie -that is just great news------and it supports that fact that we truly need to ask for what we need---

5 years on BVA appeals? that seems very high- I though it was about a year and a half- then again-

there are so many many BVA remands- this is just awful-

A claim sits at VARO for a year or two- then goes to BVA for a year or two- and then -if remanded- back to VARO- even though the BVA requests "expeditious treatment" of the remand and it can collect dust at the VARO level again.

Claims need to be supported from the git go with medical evidence-if possible-

and if the VA says they will get your private med recs or your SSA records, you have to track this yourself.

Remanded claims at the BVA often upset me greatly because I see that the remand is for information that the vet rep could have advised the vet years ago to get or the veteran could have gotten without a vet rep's advise.

And by the time a remanded claim gets back to VARO and hopefully is rated and awarded- the vet then has to file a NOD often because their disability has increased since filing it-and this medical information has not caught up with the BVA remand.

I scream when I see a Remand that says something like- 'the veteran states she is on SSDI and the VARO should contact the SSA for the veteran's SSA records.'

DUH- years have gone by and the VARO should have gotten them already!

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VARO sat on my husbands claims for 4 years. This included my appeals back to them. Went to BVA. A couple were instantly approved by the BVA. The BVA took 6 months to send the remanded claims back to the VARO for reevaluation. This included getting new C & P exams since the claims were so old. Well, it has now been a year that these have been sitting again at the VARO. The C & P exams were completed several months ago. A couple of the exams were more than inadequate. The rest of the exams were written that it was as least likely as not that these conditions were a result of his military service or as seondary to an already existing service connected condition. I have already sent in my rebuttal to the inadequate exams before they had time to deny the claims based on these inadequate exams. Still have not heard anything, even on the ones that definitely showed they are service connected. When my husband calls, he gets the same message that it is with the raters. The last person we talked to was not very nice and acted as though we were wasting his time. I was on the other phone extension with my husband and I got so frustrated with this person that I just hung the phone up. He then asked my husband if there was anything else he could help him with. I'm not sure why when he really didn't tell us anything to begin with and acted as though he really didn't wanted want to assist us. Apparently the fact that Congress is getting involved with the VARO service calls being inadequate has not filtered down through the system, yet. Or maybe it has and they still don't care about helping you. I don't intend to bash all of the people who work the phones. I'm sure there are a lot that truly want to help the veteran with his call, but we don't seem to ever get any of those. This guy was actually very rude with us and once he made a statement, he didn't want to explain anything further.

My husbands claim went through the BVA process fairly quick, based on what I have heard from others. I guess we were lucky at that point. It has been the VARO that seems to be the bottleneck.

Anyway, just thought our story on my husbands claims might help some others to understand how the process can be.

mssoup

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Berta,

You are so right. We need to ask. All they can do is say no or just not do it. I explained the situation to one of my husband's nurses, and he understood completely. He said he had had a similar problem himself with a claim. He gave an example of how during his medical training he learned that one cancer had sixteen names, but the VARO needs a specific name of that cancer. He was very kind and helpful. The nurse who came to see my husband at home also said he was asking for confirmation of only what was true, and they would be glad to help.

The first thing I had to get clear in my thinking was that the two entities--the medical side and the RO side--split in Washington. At first, I thought they communicated on a regular basis. I thought a rater could pick up the phone and talk to one of the veteran's doctors. I'm sure most veterans or their representatives are not as uninformed as I was, but it helped me to work the maze after I figured that out. And it helped me to be bold enough to ask for help from his doctor.

I encourage everyone, ask for what you need from your doctor. And tell them the wording you need if you think it would help.

Carrie

Edited by Morgan (see edit history)
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