Any Ideas ?

[Justme1949]

Can anyone tell me if once your rated 100% P&T is there any reason why a Veterans record would be looked at by the VA????? :( IF there has been no new claims, not IU, no home address change, or any calls to the VA to ask a question? I can't for the life of me think of any reason why a veteran would be on the VA radar screen. The reason I ask this question is because this veteran is a friend of my husbands who just received a letter for a C&P exam and he is freaking out. I know anything is possible with the VA but can anyone think of why a veteran who is 100% permanent and total have to go through a C&P exam . Forgot to mention he is 58 years old and the 100% is not fora mental condition. I just assumed once you have been rated 100% P&T your file is filed away. :) Thanks for any help!

Justme

[ruby]

I can't remember where this is in the 38 cfr so you will have to look for it. There are several circumstances where they are not suppose to schedule a C&P, one of them is over the age of 55. Look for the rules that govern this subject and have the friend write a letter to the VA reminding them of the rules and ask them to cancel the exam. If they (probably won't) then he needs to go.

Whatever he is disabled for he needs to look at the criteria to keep that rating.

[Pete53]

He needs to get copies of all his VAMC records.Gueswork is not a good way to fix this problem.

If he does not know he should go to his VAMC and ask for directions to records department and ask for the computer copies of all his Medical records for last 2 years. They can print them on the spot.

Than someone should help him review till he finds out what and who wrote him up that would cause this outrage.

Once you know what you are dealing with you can defend yourself.

Knowledge is Power

[Justme1949]

Thanks Ruby, I've never heard of the 55 regulation and I will tell him about it. I'll also try

to find it in the 38 cfr regs. Grace

[Justme1949]

Thanks Pete! This is outrageous and I sure hope he can find some answers before his

C&P exam! :(

Grace

[jbasser]

Can anyone tell me if once your rated 100% P&T is there any reason why a Veterans record would be looked at by the VA????? :( IF there has been no new claims, not IU, no home address change, or any calls to the VA to ask a question? I can't for the life of me think of any reason why a veteran would be on the VA radar screen. The reason I ask this question is because this veteran is a friend of my husbands who just received a letter for a C&P exam and he is freaking out. I know anything is possible with the VA but can anyone think of why a veteran who is 100% permanent and total have to go through a C&P exam . Forgot to mention he is 58 years old and the 100% is not fora mental condition. I just assumed once you have been rated 100% P&T your file is filed away. :) Thanks for any help!

Justme

How long has be been 100 percent?

There are protection rules also.

10 year and 20 year.

J

[carlie]

Justme1949,

VA can request a re-examination at any time and at any age.

I would venture to say that something got this C&P going.

NEVER - NEVER - NEVER, miss a C&P - other than you being hospitalized

or the death of a close family member and even at that at least call the VA

and be ready to provide documentation of the above.

§ 3.326 Examinations.

For purposes of this section, the term examination includes periods of hospital observation when required by VA.

(a) Where there is a claim for disability compensation or pension but medical evidence accompanying the claim is not adequate for rating purposes, a Department of Veterans Affairs examination will be authorized. This paragraph applies to original and reopened claims as well as claims for increase submitted by a veteran, surviving spouse, parent, or child. Individuals for whom an examination has been scheduled are required to report for the examination.

(b) Provided that it is otherwise adequate for rating purposes, any hospital report, or any examination report, from any government or private institution may be accepted for rating a claim without further examination. However, monetary benefits to a former prisoner of war will not be denied unless the claimant has been offered a complete physical examination conducted at a Department of Veterans Affairs hospital or outpatient clinic.

© Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination.

(Authority: 38 U.S.C. 5107(a))

Cross Reference:

Failure to report for VA examination. See §3.655.

[60 FR 52864, Oct. 11, 1995, as amended at 66 FR 45632, Aug. 29, 2001]

§ 3.327 Reexaminations.

(a) General. Reexaminations, including periods of hospital observation, will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability.

Generally, reexaminations will be required if it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability or that the current rating may be incorrect. Individuals for whom reexaminations have been authorized and scheduled are required to report for such reexaminations.

Paragraphs (b) and © of this section provide general guidelines for requesting reexaminations, but shall not be construed as limiting VA's authority to request reexaminations, or periods of hospital observation, at any time in order to ensure that a disability is accurately rated.

(Authority: 38 U.S.C. 501)

(b) Compensation cases —

(1) Scheduling reexaminations. Assignment of a prestabilization rating requires reexamination within the second 6 months period following separation from service. Following initial Department of Veterans Affairs examination, or any scheduled future or other examination, reexamination, if in order, will be scheduled within not less than 2 years nor more than 5 years within the judgment of the rating board, unless another time period is elsewhere specified.

(2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled: (i) When the disability is established as static;

(ii) When the findings and symptoms are shown by examinations scheduled in paragraph (b)(2)(i) of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more;

(iii) Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement;

(iv) In cases of veterans over 55 years of age, except under unusual circumstances;

(v) When the rating is a prescribed scheduled minimum rating; or

(vi) Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions.

© Pension cases. In nonservice-connected cases in which the permanent total disability has been confirmed by reexamination or by the history of the case, or with obviously static disabilities, further reexaminations will not generally be requested. In other cases further examination will not be requested routinely and will be accomplished only if considered necessary based upon the particular facts of the individual case. In the cases of veterans over 55 years of age, reexamination will be requested only under unusual circumstances.

Cross Reference:

Failure to report for VA examination. See §3.655.

[26 FR 1585, Feb. 24, 1961, as amended at 30 FR 11855, Sept. 16, 1965; 36 FR 14467, Aug. 6, 1971; 55 FR 49521, Nov. 29, 1990; 60 FR 27409, May 24, 1995]

§ 3.655 Failure to report for Department of Veterans Affairs examination.

(a) General. When entitlement or continued entitlement to a benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination, or reexamination, action shall be taken in accordance with paragraph (b) or © of this section as appropriate.

Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, death of an immediate family member, etc. For purposes of this section, the terms examination and reexamination include periods of hospital observation when required by VA.

(b) Original or reopened claim, or claim for increase. When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. When the examination was scheduled in conjunction with any other original claim, a reopened claim for a benefit which was previously disallowed, or a claim for increase, the claim shall be denied.

© Running award.

(1) When a claimant fails to report for a reexamination and the issue is continuing entitlement, VA shall issue a pretermination notice advising the payee that payment for the disability or disabilities for which the reexamination was scheduled will be discontinued or, if a minimum evaluation is established in part 4 of this title or there is an evaluation protected under §3.951(b) of this part, reduced to the lower evaluation.

Such notice shall also include the prospective date of discontinuance or reduction, the reason therefor and a statement of the claimant's procedural and appellate rights. The claimant shall be allowed 60 days to indicate his or her willingness to report for a reexamination or to present evidence that payment for the disability or disabilities for which the reexamination was scheduled should not be discontinued or reduced.

(2) If there is no response within 60 days, or if the evidence submitted does not establish continued entitlement, payment for such disability or disabilities shall be discontinued or reduced as of the date indicated in the pretermination notice or the date of last payment, whichever is later.

(3) If notice is received that the claimant is willing to report for a reexamination before payment has been discontinued or reduced, action to adjust payment shall be deferred. The reexamination shall be rescheduled and the claimant notified that failure to report for the rescheduled examination shall be cause for immediate discontinuance or reduction of payment. When a claimant fails to report for such rescheduled examination, payment shall be reduced or discontinued as of the date of last payment and shall not be further adjusted until a VA examination has been conducted and the report reviewed.

(4) If within 30 days of a pretermination notice issued under paragraph ©(1) of this section the claimant requests a hearing, action to adjust payment shall be deferred as set forth in §3.105(h)

(1) of this part. If a hearing is requested more than 30 days after such pretermination notice but before the proposed date of discontinuance or reduction, a hearing shall be scheduled, but payment shall nevertheless be discontinued or reduced as of the date proposed in the pretermination notice or date of last payment, whichever is later, unless information is presented which warrants a different determination. When the claimant has also expressed willingness to report for an examination, however, the provisions of paragraph ©(3) of this section shall apply.

(Authority: 38 U.S.C. 501)

Cross References:

Procedural due process and appellate rights: See §3.103. Examinations: See §3.326. Reexaminations: See §3.327. Resumption of rating when veteran subsequently reports for VA examination: See §3.330.

[55 FR 49521, Nov. 29, 1990; 58 FR 46865, Sept. 3, 1993]