hypertension No Comment - Please Read

[shag]

this may need to be read twice. It is from a vet's remand from the BVA. Accordingly, the case is REMANDED for the following action: 1. The AMC should send the Veteran's claims folder to the examiner who conducted the April 2004 and December 2004 VA heart examinations, or if the examiner is no longer available, a suitable replacement, to request that he prepare an addendum to his report. The Veteran need not be re-examined unless an examination is deemed necessary. If a physical examination is deemed necessary, all indicated testing should be accomplished. The claims files should be made available to and reviewed by the examiner. With reference to supporting data, the examiner is asked to offer a complete rationale for his opinions, expressed in the examinations referenced above, that it is less likely than not that the Veteran's hypertension or heart disease are related to or aggravated by the Veteran's service-connected PTSD. Hard to believe that one.

Edited March 26, 2010 by shag

[chr49]

OK...I'll bite. I read this over 4 times..then I looked up 'Remand' - An appeal returned to the regional office or medical facility where the claim originated - to be sure I wasn't completely crazy in my understanding.

Maybe I'm full of it but it sounds to me like BVA didn't like what they were looking at in this vet's claim. I know a remand means more waiting, but if the outcome is positive for the vet it could be worth it. In this case, let's say the claim had one or more IMO's stating that it was 'more likely than not' and this one examiner said it 'is less likely than not'. Isn't it possible that the BVA is sending it back to 'offer a complete rationale for his opinions, expressed in the examinations referenced above, that it is less likely than not that the Veteran's hypertension or heart disease are related to or aggravated by the Veteran's service-connected PTSD' because they think the examiner didn't offer proper documentation and his statement doesn't support the evidence in the rest of the claim? They say they want an addendum, which tells me the examiner didn't show or give proper rationale for his statement. I've read it and read it and it really sounds to me like they are giving this vet the benefit of the doubt on this one, as they are supposed to. Call me crazy...I can take it. Of course, one could say that they should simply weigh the positive IMO over the examiners....but maybe there were no IMO's and they are simply looking over the evidence...all food for thought.

Hey, I'm new at this!! I can think positive.

[shag]

Thank you Ch49 and you other guys.....There is more than one way to look at the situation... I have learned!!!!! Thank you again... It's just that there seems to be many on here that have mentioned VA games,,,I thought this might be one. But it could very easily be as you have stated. Glad I learned to put the question forward, hush, wait, and listen (read)...

OK...I'll bite. I read this over 4 times..then I looked up 'Remand' - An appeal returned to the regional office or medical facility where the claim originated - to be sure I wasn't completely crazy in my understanding.

Maybe I'm full of it but it sounds to me like BVA didn't like what they were looking at in this vet's claim. I know a remand means more waiting, but if the outcome is positive for the vet it could be worth it. In this case, let's say the claim had one or more IMO's stating that it was 'more likely than not' and this one examiner said it 'is less likely than not'. Isn't it possible that the BVA is sending it back to 'offer a complete rationale for his opinions, expressed in the examinations referenced above, that it is less likely than not that the Veteran's hypertension or heart disease are related to or aggravated by the Veteran's service-connected PTSD' because they think the examiner didn't offer proper documentation and his statement doesn't support the evidence in the rest of the claim? They say they want an addendum, which tells me the examiner didn't show or give proper rationale for his statement. I've read it and read it and it really sounds to me like they are giving this vet the benefit of the doubt on this one, as they are supposed to. Call me crazy...I can take it. Of course, one could say that they should simply weigh the positive IMO over the examiners....but maybe there were no IMO's and they are simply looking over the evidence...all food for thought.

Hey, I'm new at this!! I can think positive.

[chr49]

Shag,

MY VRO representative phoned me today to tell me where things were with my claim. No, I didn't phone him. I was really surprised. When I checked the mail I had one of the VA 'we care about you' letters that others are getting waiting for me. There's lots of work to be done to put the trust back but they seem to be trying. Just being treating us with respect will make a difference.

So...I'm thinking positive tonight.

[deltaj]

this may need to be read twice. It is from a vet's remand from the BVA. Accordingly, the case is REMANDED for the following action: 1. The AMC should send the Veteran's claims folder to the examiner who conducted the April 2004 and December 2004 VA heart examinations, or if the examiner is no longer available, a suitable replacement, to request that he prepare an addendum to his report. The Veteran need not be re-examined unless an examination is deemed necessary. If a physical examination is deemed necessary, all indicated testing should be accomplished. The claims files should be made available to and reviewed by the examiner. With reference to supporting data, the examiner is asked to offer a complete rationale for his opinions, expressed in the examinations referenced above, that it is less likely than not that the Veteran's hypertension or heart disease are related to or aggravated by the Veteran's service-connected PTSD. Hard to believe that one.

Am I imagining it or are they implying in their discussion about the claims folder that the claims folder was not available to the examiner during one or both of these 2 aforementioned V.A. rating examinations? I make this inference because BVA twice mentions the claims folder: (1) The AMC should send the Veteran's claims folder to the examination who conducted the April 2004 and December 2004 V.A. heart examinations . . . The claims files should be made available to complete rationale for his opinions . . ." If the claims folder was unavailable during one or both of these V.A. rating examinations then BVA has disregarded 38 CFR 4.1 Essentials of Evaluative Rating which states, " . . . It is thus essential, both in the examination and in the evaluation of disability, that each disability be viewed in relation to its history" and BVA has also disregarded the provisions of 38 CFR 4.2 which states, " . . . If a diagnosis is not supported by the findings on the examination report or if the report does not contain sufficient detail, it is incumbent upon the rating board to return the report as inadequate for evaluation purposes."

[broncovet]

Very well, I wont say a word..oops too late. These darn "untrained" and uneducated fingers of mine are to blame. Of course, it is not the fingers "management" that could possibly be the problem, according to the VA.

Your post points out 2 disturbing facts:

1. The BVA is pressuring the medical examiner to give evidence to deny. Very disturbing, and quite contrary to the "favor the Veteran" "non adversarial" nature of the VA claims system.

2. It is clear this is a "spanking" to the claims examiner, telling him to do this all the time, if he wants to keep his job. It demonstrates that claims examiners are being manipulated by the VA to save money at the expense of Veterans. Further, I see this claims examiner copying this letter and giving it to his coworkers, explaining if they want to keep their job, they need to give evidence to deny. Of course, the VA knows this will "spread" and all C and P examiners can and will do the same. The VA's motto, is "Saving money at the expense of Veterans in order to preserve VA executive bonuses, and lucrative contractor contracts."

[Berta]

I agree with Hawkfire-I think the C & P examiner gave no medical rationale for their statement.

However-

please post the hyperlink to this decision as it cannot be opined on out of the whole context.