Please Help Explain These 2 Iris Responses

[usmc1114]

I really wish I would have found this site prior to going for my C&P exam. Anyway, I have submitted 2 IRIS in the past few months and these are the two responses I have received. I am correct in that it is my understanding that my file is sitting in a pile waiting for a rater to review it? Any help in terms of the next step and about how long it could take from until I receive a decision would be greatly appreciated. My claim is being processed through the Detroit, MI location. Thanks!

1. Your claim was sent to the rating board on May 20, 2009. The results of your examinations were recorded on your claim and your claim was sent to the rating board.

2. We show that as of June 8, 2009 your claim is ready for a decision. We are unable to give you a timeline when the rater will review your file as we do not know their caseload.

[usmc1114]

I have heard that Detroid does not hold the speed record for decisions. However, who knows if you will be an exception. If they are ready to make a decision by June 8th 2009 then they are flying. Maybe your rating will come soon. Do you have a veteran's service organization working for you? They will often know before you get the letter. You might call them and find out what is happening. Do what Berta says also about the C&P exam. You can usually tell from the C&P what kind of rating you will get in a ballpark sort of way. Post your C&P on here (take out your name, SS# and private stuff and just post the facts) and we can probably take a good guess at how you did at the exam.

HERE IS THE INFO THAT I GOT OFF THE LAST PAGE OF MY C&P EXAM REPORT....

formation consistent with mild degenerative changes of the tibiotalar joint. No other osseus abnormalities are identified.

Three-view of the left knee done on today's date show no significant osseus abnormalities. There is a 0-degree valgus attitude to the left knee.

Three-view of the lumbosacral spine show a mild right-sided thoracolumbar curvature with normal lumbar lordosis. No significant degenerative changes are noted throughout the lumbosacral spine. There is facet arthrosis noted at the L4- L5 level.

IMPRESSION: 1. Chronic low back strain with early age-related facet

arthrosis. 2. Chondromalacia patella left knee. 3. Left knee medial

meniscus tear. 4. Chronic Achilles tendonitis left ankle and posterior tibial tendon tendonitis.

MEDICAL OPINION: Based on the history obtained today by the veteran himself along with review of the veteran's C-file and objective physical and radiographic evidence reviewed on today's date, it is my opinion that the veteran's current low back condition and left knee condition and left ankle condition have documented onset while enlisted in active military service as described above. These are stable in nature with the exception of low back pain, which subjectively has been becoming more frequent with mild worsening. Also noted on radiographic imaging are age- related changes to the lumbar spine and possible underlying lumbar scoliosis. Therefore, it is my opinion that the veteran's current low back, left knee, and left ankle conditions are at least as likely as not due to injury sustained while in active military service. The exception of this is suspected medial meniscus tear on the left knee, which is different from military service- documented left knee pain, therefore it is felt to be a new condition arising after separation from military service.

[pacmanx1]

In reference to what Berta and airborne18 said, It depends on where you had your C & P exam. If you had your C & P exam at the VAMC (VA Hospital) then go to the release of information office at the hospital. The Release of Information Office (ROI) office can print a copy after you sign the form and it does not interfere with your claim being rated. If you had a QTC C & P Exam the only way you can get a copy is requesting it from the VA regional office and this could delay your claim decision because it would have to leave the rating area and go to the Release of Information Office at the VA Regional Office (VARO) and wait its turn to be copied and mailed to you. Then your claim would go back to the rating area and it may be put back in place to be rated or put your claim at the bottom of the pile. So the question is where did you have your C & P exam? Was it at the VA hospital or a private doctors office?

[airborne18]

Pete,

In 2007 when I tried to get medical records from ROI, ( as suggested ).. my VAMC would not release any records that were associated with a pending claim.. The reasone, which actually makes sense, is that people were disputing their claims before they were even decided. And submitting new evidence while they were in the process of being decided.. It is a contributing factor to the claims delays.. So they stopped it..

Once a claim is filed and you signed off on your VACC.. just let it be decided then plot your next move..

Everyone who is in the system knows the wait game, it sucks.. And reading the horror stories and the endless examples of suffering at the hand of the VA.

One reason to at least talk to a NSO at your VARO is to present your claim and see what they think.. They have seen thousands of claims and will at the least tell you if you have proven your nexus. And they will make sure you got all the evidence that you should have together. I don't trust them completely, because some are worthless, but it is a free opinion before you drop off your claim. Though you should not put your fate in anyone's hands.

Try the VAMC... not the VARO.

[pacmanx1]

airborne, I am very sorry for your experience but mine has been totally different. I recently had a bad C & P at the VA hospital but I had already collected my evidence and I did not send it in because I knew the doctor would not agree. I deliberately waited to send in my evidence to force VA to give me a new C & P exam that specifically address my issues and not just go by what the doctor stated in my exam. My claims are unique, I am asking for secondary to disorders that are grouped in to a service connection disability. The disability itself may or may not cause secondary problems but the grouped conditions would. They are ratable separately without pyramiding. I know that's hard to understand but just believe me, I feel I have legitimate claims. Even if VA denies my claims they must go back to the BVA because they are remands and they will see the evidence I submitted prior to my decision. They will then remand my claims back to address the new evidence I submitted after my C & P. I maybe wrong but someone can chime in but I believe it is part of the privacy act of 1974 see quote:

d) Access to records

Each agency that maintains a system of records shall:

(1) upon request by any individual to gain access to his record or to any information pertaining to him which is contained in the system, permit him and, upon his request, a person of his choosing to accompany him, to review the record and have a copy made of all or any portion thereof in a form comprehensible to him, except that the agency may require the individual to furnish a written statement authorizing discussion of that individual's record in the accompanying person's presence;

By law VA or any agency can not refuse your request. They can tell you it will take sometime to process but they can not deny the request. Mental health records may be different, they sometimes request that you get a mental health doctor to help you understand these records but they are suppose to release them. I get a copy of my records every time I go to the VAMC, it doesn't matter if I have a mental health, C & P, PCP, or rheumotology appointment. I just fill out the form and I get my copies or they mail them to me. It also doesn't matter if I have a pending claim. My claims have been pending since 2004 and I always get my records. No reason makes sense you are in a legal battle they must give you access to the information. I disagree after you sign your VCAA and you get new evidence you should submit it. It could change the raters decision, and you would not have to file a NOD which takes about two years. Sorry for the length

Edited July 2, 2009 by pacmanx1

[airborne18]

Pete,

I will check with my ROI again just for kicks. It was not an issue that I thought too much about.. there are bigger issues at the VAMC.. what I really needed at the time were MRI records, but they would not release any records that were even part of it..

I actually believe legally they can hold your records, that are part of evidence, until they decide the claim. After all a claim is a legal action against the VA. The FOIA and right to records exists at all levels of the federal government, but it is not instant access, nor unlimited.

. . You have split this point correctly, and it is a key point. I have seen it echoed on this board over and over that get your claim file and c&p results right away.. But really there is no point until after your decision comes back. People don't want delays, yet they do everything possible to create their own delays. ( I actually tried to get my claim file while it was being decided, and the VARO told me exactly what I needed to do.. But they warned me, it would add a 5 month delay. )

I understand you have a strategy, and you know the system.. I had a strategy even before I let my wife file the claim. And my strategy worked. I have not filed claims I should or could, but I will in a few years if I have too. Luckily at my VAMC they have some highly respected docs in a few areas, that diagnosed me, and the C&P docs just took their findings.

[usmc1114]

AS PER REQUESTED BY JOHN999, I AM POSTING THE SUMMARY OF MY C&P EXAM THAT I RECEVIED AT THE VAMC DETROIT. ANY & ALL COMMENTS ARE WELCOME. THANKS EVERYONE!

formation consistent with mild degenerative changes of the tibiotalar joint. No other osseus abnormalities are identified.

Three-view of the left knee done on today's date show no significant osseus abnormalities. There is a 0-degree valgus attitude to the left knee.

Three-view of the lumbosacral spine show a mild right-sided thoracolumbar curvature with normal lumbar lordosis. No significant degenerative changes are noted throughout the lumbosacral spine. There is facet arthrosis noted at the L4- L5 level.

IMPRESSION: 1. Chronic low back strain with early age-related facet

arthrosis. 2. Chondromalacia patella left knee. 3. Left knee medial

meniscus tear. 4. Chronic Achilles tendonitis left ankle and posterior tibial tendon tendonitis.

MEDICAL OPINION: Based on the history obtained today by the veteran himself along with review of the veteran's C-file and objective physical and radiographic evidence reviewed on today's date, it is my opinion that the veteran's current low back condition and left knee condition and left ankle condition have documented onset while enlisted in active military service as described above. These are stable in nature with the exception of low back pain, which subjectively has been becoming more frequent with mild worsening. Also noted on radiographic imaging are age- related changes to the lumbar spine and possible underlying lumbar scoliosis. Therefore, it is my opinion that the veteran's current low back, left knee, and left ankle conditions are at least as likely as not due to injury sustained while in active military service. The exception of this is suspected medial meniscus tear on the left knee, which is different from military service- documented left knee pain, therefore it is felt to be a new condition arising after separation from military service.