Als Claim

[mom24]

Hello,

I posted a question before I believe in wrong place because I didn't get any response. So, I'll post here and try to be brief. I filed claim for ALS on 9/24/08. Had to get a VSO with PVA to get ball rolling for me. He did. I was scheduled for a C&P exam on 2/23/09. The dr who did the exam had me scheduled for an EMG to confirm the diagnosis. I wasn't happy with how exam went and let my VSO know about. On 2/27/09 I received an award letter being rated 60% for ALS for a combined 70% with my knee disability from before. I immediately called my VSO because the rating decision was made on 2/23/09, the day I had my C&P exam, which wasn't even concluded. AFter a couple of days, he got back with me to let me know the rater told him she rated me just so I could start getting some compensation because it would be 20-30 days before she got results from exam back, and when she got the results from C&P exam, she would rate me again. Fast forward to last week. On Tuesday, I emailed my VSO for an update. Didn't hear back from him by Thursday, so I called the 800# and was told my claim was closed with no further action pending unless I appealed. I then left another email for my VSO and and a voice mail message. On monday morning I got email from VSO saying he would pull my file and see what was going on. I then, that same day, went to VAMC to request a copy of C&P exam and was told it wasn't done! The lady at release of information office could only pull off a progress note dated 3/13/09 from the Dr. who did my exam stating that a C&P exam was scheduled by VARO on 2/3/09, but then cancelled before the date I had it which was 2/23/09. Nobody notified me or the VAMC of this since I had my exam as scheduled. The dr's note from 3/13/09 also gave results of EMG. The lady at release of information called down to C&P office to see what was going on. I was able to go down there and actually speak to the Dr. who did my exam. I had my award letter with him and explained to him how I was rated based on medical records from my dr that I submitted and why they were not sufficient for VA rating purposes. I asked him if he still had notes from my claim and he did. He said that after he got results from EMG and went to enter his findings in the computer, the screen for him to enter it wasn't there. HE then saw where the exam had been cancelled citing adequate medical evidence already received as the reason. He read over my notes again and actually examined me again. We talked some more and then he called the rater while I was in his office and let her know that he still had his notes from my C&P exam and he could type them up if they would be of some use to her. He told her that medical records I submitted from my dr. contained more diagnostic information about my condition than functional. I know the exam would have either brought me to 100% or the claim I filed for IU at same time I submitted back in Sept would have been approved based on his notes. Rater had also denied my claim for IU because I homeschool my children. Now, on Friday, I also submitted a IRIS inquiry and they answered me on Monday to say that they reviewed my file but needed clarification from the Regional Office before they could give me a status. I was able to update them with the information I got from the Dr. who did my exam on Monday. So, now it is Wednesday, and I still have not heard back from my VSO and still waiting to hear back from IRIS inquiry. Right now, I'm just giving my VSO and IRIS time to respond before I do anything else like a Congressional Inquiry or something. Any advice?

[Berta]

20 NY lawyers told me my FTCA case would never succeed.

They sure lost money.

An SSA lawyer would not support my husband's reconsideration of his CVA award for a PTSD award.

I called the lawyer up 4 months later to tell him he just lost 1/4th of the PTSD retro.

Of course if you dont want to pursue this-that is OK too.

Sometimes one needs a second opinion when it comes to lawyers as well as doctors.

20 NY lawyers told me my FTCA case would never succeed.

They sure lost money.

An SSA lawyer would not support my husband's reconsideration of his CVA award for a PTSD award.

I called the lawyer up 4 months later to tell him he just lost 1/4th of the PTSD retro.

Of course if you dont want to pursue this-that is OK too.

Sometimes one needs a second opinion when it comes to lawyers as well as doctors.

[Pete53]

Berta:

I have not understood why more Lawyers are not interested in the gold mine that is sitting right in front of them. The way the VA drags out they would get a much better payout than Social Security.Besides that VA has violated all kinds of Laws and Regulation by the time it ready for NOD after all the VARO turn down hoping that BVA will fix it. Now that Lawyers are ready to pluck dollars from them maybe the VARO will have to do a better job.

I don't know why but this is not rocket science. It seems like a real team with a senior person could crank out dozens of claims every day.

[boblandstar]

Mom24,

Dump your VSO and find one that wants to help YOU.

I am aware of the diagnosis errors that are common with ALS. There is no single test for diagnosis,but rather a battery of tests. All to often this disease is misdiagnosed.

Please be aware that even with a proper diagnosis and a fair C+P your rating % is going to be based on your current disabilities. Although ALS is presumptive the base rating is only 30%. The rapid onset and unpredictable nature of ALS can be a nightmare when dealing with the slow pace of the VA and getting the rating you deserve. If I can help in any way or advise you based on my experience with the VA concerning needed equipment,and shortcuts to help you please contact me at boblandstar@att.net.

I have been fortunate in my dealings with the VA. Here is my story.

Amyotrophic Lateral Sclerosis

SEPT 23,08 FILED CLAIM WITH ASSIST OF PVA VSO.

CLAIM FILED AT MUSKOGEE OK. VARO

OCT, 27 LETTER GRANTING 30% INTERIM FOR ALS. C+P EXAM SCHEDULED FOR NOV 7.

NOV,7 C+P LASTED 30 MINUTES.

NOV,21 VSO CALLED. I HAVE BEEN GRANTED 100% P+T WITH SMC R2

THE ACTUAL COMBINED RATING ON MY APPROVAL LETTER% WAS 390% DISABLED.

I was fortunate to find a VSO whos office is in the same building as the VARO. He knows the personnel and can walk in and get answers. If the VARO is aware the claim is for a condition considered "terminal" they make every effort to expedite that claim. I live in Tahlequah OK. about 25 miles from the Muskogee VARO. I filed for SC in 05 but was denied so all the necessary paperwork was already in my file. My VSO is Lawrence Walker of the Paralized Veterans of America.

I owned a successful business but had to quit when my speech and mobility became affected. Eventually I had to sell or transfer my assets in order to qualify for SSI. But I waited too long and was denied SSDI because I hadn't worked enough "recent quarters". I had already turned my business over to my sister. I am Indian so I had to live in Cherokee public housing. I had to live on $605 a month SSI and food stamps. Oklahoma provided a home health aid 2 hours a day to cook and clean for me. The VA provided hospice care for bathing and feeding.

In Sept 08 I decided after a bad fall that I could no longer live alone and reluctantly moved into a Medicaid funded Nursing home. WHAT AN AWFUL PLACE! Thank the good lord the VA finally designated ALS as service connected! I am now SMC R2 I receive $7650 per month. I moved to a 3bd 2ba rental house and hired a live in caregiver for eves/nights and my old home aid came to work for me working days.

Oklahoma exempts me from sales and property tax. The VA gave me $11,000 to buy a wheelchair accessable van. The VA will pay $60,000 towards building me a handicapped accessible home. I chose a 1 acre lot and a house plan last week. Building begins in April. God willing I'll live to see it built.

Happy ending? No. But thank God for all the "HEROES" that worked so tirelessly to get this devastating disease on the Service Connected list. No other vet should have to walk my path.

[mom24]

Thanks to everyone for information SSD. I just got off the phone with SSA and was told I have good cause to reopen my claim from 2005 due to misdiagnosis. YEA! I have contacted an attorney who is supposed to contact me early this week. If they do, I'll let them handle it so I dont have the hassle of going it alone. If they don't get back with me, though, I'll be like the little red hen and I'll do it myself. As for VA claim, still waiting for more word from VSO. If he doesn't get with me this week with an update, I think I'll be looking for a new one.

[Pete53]

That's the ticket

[Berta]

Pete said:

"I have not understood why more Lawyers are not interested in the gold mine that is sitting right in front of them"

Indeed Well said- and the amount of money they could make in Negligence and malpractice claims-in my opinion- is quite a tidy sum too-

As Dr Phil says ( gee my old psychology professor would spin in his grave on this quote)

"Past behavior predicts future behavior"

VA medical care had harmed vets in the past and it continues to- but this is the case for private doctors and Hospitals too-

I fully believe VA saves countless lives every day- (I thought maybe they even saved my life when I was sick in December)

but the reality is many vets die and no one takes the time to really look into their medical care and how it could have compromised them to point of their death.

They might be shocked.

Unfortunately I think VA and lawyers should have agreed to stipulate to something in the lawyer for vet regs.

To stipulate that the claim, under an attorneys POA, would have to be resolved by a certain time period.

As it is -lawyers certainly have the duty to fully prosecute the claims they handle but it is beneficial for a lawyer to continually appeal a decision without really helping the veteran support the claim, because their fee grows by the month.

I would rather pay 20% on 10,000 reto for example-

instead of 20 % on 100,000 retro-to a lawyer-

which bulit as retro because the claim stayed in appeals process yet could have been resolved.

These lawyers should be requiring the vet get IMOS from the git go in many cases-

Rich Cohen Director of NOVA told me they (NOVA) can often get the IMO by advancing the cost of one and I understood this fee would be paid from the retro.

But this is only done case by case when they know they have a winner I think-

Yesterday Medical Associates called me- regarding my IMO request- it (IMO) is not done yet but they complimented me on the statements and the way I had prepared the evidence.

It took me 4 weeks to do this.They asked if I had formalmedical background-

which I dont-

This shows that when we request an IMO ourselves it pays to prepare cover letter and then tab the Med recs carefully as to what the IMO doctor needs to focus on.

An IMO doc reads it all- they have ethica obligation to do that but some are not familiar with the VA legal and medical criteria for SC and it helps when we are able to help an IMO doc follow the IMO guideline here.

Many like Dr BAsh need no help at all as to VA guidelines- still I prepared my IMO requests for Dr. BAsh so well that my IMOs took a few days instead of weeks when he got the records.He called me the day after he received my forst IMO request and said he agreed with it so far after reading only a few records.

We have to ,in essence, lay a foundation as the lawyers say- to support the need for an IMO and why the evidence supports our claim.

If the VA raters were required to be lawyers- the VA could whip out proper and sensible decisions in a much more timely fashion too, using all of our evidence- lawyers love evidence-raters in some cases- just want to trash it-

and besides

Lawyers can Read.