What Does This Really Mean

[ruby]

RO stated your positive opinion was not considered because he did not have your complete claims file.

How do you fight that statement (anyone knw of any rules or regs to negate this statement)

What does it really mean? (is it just a cop out to deny when you have a positive opinion)

Thanks

Ruby

[Berta]

Do they mean they didn't consider a positive independent medical opinion (IMO)you got?

I dont know why they would question the lack of the doc having the claims file as long as the doc had the complete medical record and the SMRs if applicable.

If this was an IMO did the doctor give a full medical rationale for the opinion and refer directly to info in your medical records and/or SMRs to support their opinion?

[john999]

Ruby

I think this is a new tactic the VA is using to shoot down IMO's. If the claim is already established and you are just asking for an increase why would your doctor need the entire claims file? Is this a original claim or an increase on an existing claim? If the VA is claiming there c&p doctors read the vet's claim files that would be absurd. You are lucky if they even read your SMR's. I know the VA will shoot down an IMO if the doctor does not refer to the SMR's. This is the kind of crap that turns people into VA warriors.

[LarryJ]

RO stated your positive opinion was not considered because he did not have your complete claims file.

How do you fight that statement (anyone knw of any rules or regs to negate this statement)

What does it really mean? (is it just a cop out to deny when you have a positive opinion)

Thanks

Ruby

My question:

How the heck do THEY know that he didn't have your claims file? Did it state in his report that he did indeed NOT have your claims file?

Regardless, I find some of the fancy footwork that occurrs in the "rating" stage of your claims, astounding! Better than Emmet Smith on "Dancing With The Stars"!

[jbasser]

Ruby they cant dismisss your opinion either as you are also a Medical Professional.

They will try anything to add lead to the negative evidence which includes dismissing posative evidence.

J

[ruby]

To All:

I had one IME that stated he reviewed my smr's-he gave a positive opinion that the cyst in service was actually HS they accepted his opinion and sc the HS (previous sc for cyst)

That same doctor wrote in his opinion more likely then not the HS was the causative factor of my arthritis and the literature supported this opinion and he included medical treatise to this efect-he also stated he saw no other know causes for this arthritis. THIS PORTION OF HIS IME WAS NEVER ADDRESSED IN THE DENIAL.

My primary Rheum doctor wrote probaly the causative agent and he also review pertient smr. They said his opinion lacked crediblity since he DID NOT HAVE MY COMPLETE CLAIMS FILE

He left the VA and my new Rheum has stated many times that I clearly have this problem and the HS is more then likely (sometimes he says probably) the cause of my arthritis. THIS OPINION WAS NEVER MENTIONED IN THE DENIAL.

My opinion has never been addressed as a medical professional and I have signed all my claims as RN BSN.

How do I fight that no one has my c-file any bva,cav,opinions on this subject.

Hope this clarifies and some one can tell me how to attack this statement.

[ruby]

Here is a court opinion that all vets should be aware of as they can't say "claims file not reviewed" as the sole reason.

http://www.uscourts.cavc.gov/orders_and_op...s4thQuarter.cfm

Nieves-Rodriquez v Peake 12/2008