Withdrawal Of Claims

[blanco63]

On 10/3/09 i recieved my 50% rating(great c and p with a real doctor on 6/30) for sc migraine headaches, no exam until after 10/3/11. On 11/16/09 i filed two claims - chronic pain and chronic fatigue syndromes secondary to migraines. On 12/5 I received varo letter dated 12/3 acknowledging my two claims and that they also added a claim for an increase of my sc migraines(note - already at the highest rating of 50%). On 12/7 I sent an iris and 21-4138 statement to my varo saying that i wanted to withdraw my claims. On 12/8 i received vamc letter dated 12/7 saying that i have a c and p exam on 12/29. On 12/14 a va rater called me and said that they cannot withdraw my claims at this time and that i must attend my c and p on 12/29. i said that the c and p is with the same physicians assistant who denied me(well, wrote terrible reports) for both 10 and 30% so what do you think he's going to do now? she said don't worry about it, just go to the c and p, i am the rater not him. so i went to the c and p on 12/29 with the same physician's asst. i got a copy of it today. he states three times that my migraines should not be service connected. wow, the real doctor approved me for 50% but this p.a. denied me for 10,30, and now serv conn altogether. there also is a note that he discussed this c and p with a rater(not the one i talked with). what's that all about? anyway, i sure don't want to see this decision. i want to withdraw these claims before a decision is made(i guess that the 12/7 withdrawals are invalid and were trashed?) so, can these claims still be withdrawn? if so, how(iris, 21-4138, and a call to the rater?) please respond with advice. i am so afraid that they are planning to reduce me or take away my sc altogether. is that possible since the va put in the claim for an increase(to what i don't know) for my sc migraines? thanks in advance for your help!

[Josephine]

blanco63:

I am sorry this happen to you, and sorry that I do not know the answer.

My prayers are with you.

[broncovet]

blanco

I will take a "guess" at this, but maybe someone else can find the regulations. Your rating can not be reduced without the VA taking some very specific steps. First, they have to give you 60 days notice of a proposed reduction, giving you a chance to appeal the proposed reduction. Then, if your decision granting SC has been more than a year, they have to either show you committed fraud to obtain benefits OR that you have had "material improvement" and this has to be sustained..feeling better one day at a c and p exam is not "sustained improvement".

I think, frankly, it is very difficult for them to "un service connect you".

Many of the decisions the VA makes are judgement calls..and someone else could easily call it another way. If doc 1 says you are SC and doc 2 says you should NOT be SC, with everything else being equal, the law says the document of equipose applies, that is that it would need to be resolved in favor of the Veteran.

There does enter into it time. In other words, if my regular doc saw me once every 2 months for 5 years, and decided that I had a SC connected depression, a doc who has seen me ONE time could say that he does not think my condition is SC, but the law would favor the longer term docs opinion over the doc making a single exam.

Pretty much, they cant reduce your rating over a single C and P exam..they have to show longer term improvement, and a difference in judgement from the other doc should not hurt you.

Many Vets eventually win benefits even when one doc opines unfavorably against the Veteran. Others can chime in, but I am pretty sure I have this about right.

[Berta]

are you saying the VA awarded 50% for migraines based on a C & P doctor's report and then another C & P doctor has opined against the SC status?

Why would you get 2 C & Ps for the same disability?

Are you able to scan any of this and attach here ( cover the personal stuff)

[Wings]

x

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IMO, The PA's exam doesn't hold a candle to the exam provided by a VA medical doctor which granted your service-connection. ~Wings

[broncovet]

Wings is right. Just go to a hospital. Are the PA's, nursing assistants, janitors, etc, writing orders for the doctors to obey? I think it is the other way around..a doctors opinion easily over rides a conflicting PA's opinion.

[blanco63]

Hello everybody , thank you very much for your responses. I am going to give you some more info about my sc and how it got to this point. please bear with me if it gets too long. I really need help and advice on this claim. this physicians asst has wanted to destroy me for awhile now. he believes that if a veteran gets money due to his c and p that it is coming out of his own pocket. march 2007, I applied for sc for migraines with a nexus letter from my private doctor. On 10/31/07 i was granted 0% by the varo without having a c and p exam. On 11/27/07 i requested an increase. On 12/18/07 i had my first c and p exam with THE physicians assistant. On 6/30/08 va decision kept me at 0%. on 7/1/08 i sent a reconsideration and my doctor's letter to the varo and lo and behold i got a decision on 7/21/08 giving me 10%. On 8/20/08 i requested an increase. On 9/9/08 i had my second c and p with THE SAME physicians asst. i remember how it started. he said, you again, what do you want, you already get 10%, you think you deserve more than that. i know he was mad that i somehow got that 10%. anyway, on 11/10/08 va decision kept me at 10%. On 11/21/08 i sent a reconsideration and my doctor's letter to the varo and lo and behold i got a decision on 3/28/09 giving me 30%.so it seems that after you have a c and p with this p.a., the va gives you nothing until you send them a letter from your own doctor, hmmm. I cannot believe that the same va doctor cosigns all these c and p's. i am sure that they cosign anything, right. On 4/17/09 I requested an increase. On 6/30/09 i had my c and p with a va doctor, yes, a doctor. On 10/7/09 va decision granted me 50%. did you notice that when i had a c and p with a doctor, there was no va denial, recon with my doctor's letter, just an increase, but twice after seeing that same p.a. the va gave me denials. i know that p.a.'s are not supposed to be the most qualified people doing exams but look at what happens to me everytime i see him. anyway, i have the va doctor's june c and p and it is great. i have the 12/29/09 SAME p.a.'s exam and it is horrible. it seems like the whole thing is about migraines and serv conn. now i am in fear that the va will try to reduce my 50% or take away my sc altogether because of this same p.a. see what happened last 2 times with him? i was there because on 11/5/09 i applied for both chronic pain and fatigue syndromes secondary to migraines, but as i mentioned the va had requested an increase for my migraines(already at the max). so here is a little of that c and p. He says that i said that i am the same since my last appt on 6/3/0/09. i said something like that and that is ok with me because that got me 50% from the doctor, but immediately under that it says headaches should not be service connected. also said he only found one entry of headaches in my smr's and that headaches were not listed on my sep phys. so, how many entries must be in your smr and must every sc condition be on your sep phys? wow, this guy is great, doesn't miss a thing, don't you think? but check this out, at the exam he is asking me about acne and syphilis, what? yes, i have acne on my back now and in the navy and had syp in the navy and that it stays in your blood forever. he didn't see any of them in my records(that's in his report). I said there are about 5 entries for each. i have the records, but he can find one entry for headaches but not 10, great p.a. also states no mental health condition or treatment in navy but i was discharged for schizoid/sshizotypal personality disorder in 1983, which tha va also called adjustment disorder in 1985 and 2000. then that my doctors(pcp and mh) do not have access or the advantage of my records to make sc. i showed them my records and they copied a lot of them when i first began seeing them. right after this he states that this was discussed with a rater at the varo. what? why? Next part - headaches, date of onset, 1983 or 1984(what, after i got out). patient treated for headaches 1-2 years after aug 1983 navy treatment. i denie chronic fatigue. what? what is this claim and c and p for? Course since onset - improved. cur treat - medication, tylenol 4 and dilaudid. response to treat - good. side effects - yes. describe side eff - none. treated with continuous medication - no. list meds - tyl 4 and dilaud. headaches occur approx 4x a week, only one may be bad enough to be considered prostrating. no effect on work, unemployed since 10/2001. yes, on ssdi(he knows, va knows) for migraines, bipolar do, and mitral valve prolapse. headache severity - attacks are not prostrating, ordinary activity is possible, duration - hours. WHAT? june exam w/doctor had 4 prostrating weekly, three at 10 hours, one at 30 hours to 2 days. wow, this p.a. is good. again says headaches are not sc. end of report - no chr pain or chr fat syn, migraines not treated in military and started after leaving mil and should not be sc, not caused by or result of the one mention of it in his mil records. Sorry for the book. please help. is it too late to do anything? i know i am denied for the 2 chronics but are they going to take away my sc because of this P.A.? please respond soon. i am so afraid right now as to what the va is planning to do because of this one p.a. thank you!