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Does The Va Give A Medical Exam For A Claim Appeal?


retiredat44

Question

I never got an exam for my claim, then it was denied, now I am in the appeal process. I have never gotten an exam notice for my appeal. I have already posted lots of info, and have read lots of info,, but I am still unclear whether or not the VA will have me go for a medical exam.

I have been under medical care by the VA for many years, so they don't need any medical records from any ourtside sources. The only outside sources I had hospitalization and treatment was from Kaiser many years ago after my active duty. I had those records sent to the VA so the VA has copies of my medical records from all sources. I then went full time to the VA hospital for a long term illness. I have been under a doctors care at the VA hospital for illness for 15 years.

But, since I filed this claim, I was never sent for an exam. many years ago, I filed a claim, and was sent to a doctor. I got 50% rating back then. I also have SSDI. I am trying to get the full 100%. Should I expect to be sent for any exams?

My VA Disability Claim appeal started in November 2009.

Last letter I got was asking if I had any more evidence (February 2010).

note: I also sent them an IMO/IME report I got from an outside doctor who specializes in IMO/IME's

I have a Veteran's Serice Officer helping me with al my claim and appeal papaerwork.

Thanx..

(I know this process can go on for many years.. from reading lots of stories here..)

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"(I know this process can go on for many years.. from reading lots of stories here..)"

Yes and this is why they have not scheduled you for a C & P exam -yet-

are you sure the IMO is part of your record?

Is the SSDI for what is or could become a SC disability? If so do they know that.

Did you formally apply for TDIU with a 21-8940?

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1) Just saying that I sent my IMO/IME in with my appeal, after the denial..

2) I don't understand about the SSDI question, I only said that I am on SSDI (maybe I should not post that as it makes no difference about anything for a VA disability claim as far as I know.. and it was a convaluted decision..too much of a frakkin nightmare and hell I went through (20 years ago..) when I got that after I went through appeals..) SSDI for intestinal disease and depression.. They fought me with denials and appeals.. Back then I could not get a decent medical opininion, SSDI treated me as an animal..It makes me angry everytime I think about the abuse I took during the SSDI process.

I have no clue if they know about it (it's in my VA records..), I don't know if they even asked... if was asked, I answered..

3)TDIU ? I haven't been employable for 20 years and can never work again.. (if that what TDIU means..).

No sure if I ever filled out whatever a TDIU form is..

It has been an unblelievable amount of paperwork and records I have had to go through,,, I could not even imagine anyone able to go through all my records, not sure if it's humanly possible..

Ok, so for my question and answer, I will be getting an exam by some VA doctor for my appeal?

I have been having exams and operations and treatment for 20 years.. if they want one more exam on top of the truckload of medical records...

"(I know this process can go on for many years.. from reading lots of stories here..)"

Yes and this is why they have not scheduled you for a C & P exam -yet-

are you sure the IMO is part of your record?

Is the SSDI for what is or could become a SC disability? If so do they know that.

Did you formally apply for TDIU with a 21-8940?

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  • Content Curator/HadIt.com Elder

Some conditions can be rated based directly on what they see in your treatment records with no need for a C&P exam.

Sending in the IMO/IME was a good idea, but did it use the VA's jargon like 'is due to' or 'least as likely as not' and also include some medical rationale?

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  • HadIt.com Elder

retiredat the questions people ask are for a reason, not just to be nosy if your SSD is based on the same comditions that you are asking for SC for then your SSD decision becomes very relevant to the discussion if it is for other than claimed military related conditions then it is a moot point other than substantiation for a TDIU claim, and in some cases if the conditions that SSD has you disabled for are not SC then the VARO will fixate on those issues to deny veterans the TDIU rating based on the fact the medical problems that prevent them from working are NOT SC, you have veterans here with many decades of experience in dealing with the VA claims system we have heard almost anything you can imagine, we also have a pretty good handle on how to counter the VARO arguments and what is necessary to help veterans navigate the process and get the benefits they have earned instead of just being told no over and over again regardless of how many exams VA doctors have given you over the years when it comes to wanting a check from the VA then they usually want at least one more exam from a doctor who specializes in compensation claims exams, who knows how to write the words the raters want, not normal doctor speak, the terms they look for is it is not related, it might be possibly linked, "it is more likely than not" caused by military service. The VARO is looking for specific language to approve or deny the claim no one is here looking at giving you a hard time they need info to give you their best advice Berta is one of the best there is I value her advice over many lawyers she has beaten many of the VA's own lawyers on her own. The claims process is bad enough, it gets worse when they start the "hamster wheel" and you are the one caught on it, no one warned us about the second war we would have to fight with the VA to get them to keep the PROMISE what we think should be simple the regional office manages to turn into an Olympic event and if it gets bad enough consider hiring a NOVA lawyer they know their business and they help each other have constant ongoing educational seminars and they are an e mail or a phone call away from each other they have a lot of legal years combined in fighting the VA and from my point of view I would much rather have 80% of an award than 100% of nothing after another denial.

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  • HadIt.com Elder

Consider posting on this Board as having a conversation that takes awhile. New Members usually don't know what to ask so we have to ask them a few questions but it works and has been working for a long time.

I ask questions just to make sure I understand or to try and let the poster know what is needed.

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I appreciate the help here, and don't mind giving out needed info..

I think I already said this, in a post a while back.

My IMO/IME was from a doctor who once worked for the VA. She now specialiazes in Medical exams and claims for insurance companies. She did my exam and I gave her medical records. I got back a package the size of two phone books. My VSO (veterans service officer) said what she wrote was exactly what I needed. She included some language stating it was likely my condition was likely a result of injuries and illness from my active duty service. This doctor knows her stuff. She specializes in toxic chemical injuries for those that worked with chemicals used in both petroleum industries and. and jobs that use petroleum chemicals, and chemicals made from petroleum chemicals. These chemicals are used in many industries and jobs.

It is huge and at this time I really don't feel like reading through it... I just don't feel well...

I have so many papers, I wish I could find everything I need faster to show different statements.

If I put all my records together (they are close to each other, but hard to get through them..)..they would fill a file cabinet.

If my health record was not so convoluted, I would be able to put down something easy to write and read. It is not. If I had, say one or two problems, like a heart and leg problem, that would be easy to write. (I don't mean this in a mean way, I am just trying to say that I wish... it was easy to put down my problems in an easy way..) I am a mess.

Sussing out what/where/how is very difficult.

I know earlier someone asked my record and the number for my hypertension readings (while I was on active duty), I still have not found the papers.. I should go look. again.. they are buried in huge stacks.. plus it depresses me to look through them.

I still have unopened records I got copies from my stay in the hospital and they are the size of two phone books (no joke,, two large yellow pages). I am afraid to read them. I went through absolute horrific hell.. From what I have seen on the doctor's computer, I am in deep crap for my long term outlook.. that's more of what I saw when they look up your records during an appointment.. It had information that freaked me out.. I just want this nigthmare to be over..

I know some more info is always wanted..

I really just wanted to know if I will need go for an exam for my appeal.. they never asked me to go for an exam before they denied me.. This time my records will make all those VA claim people work their asses off..

They will need a team of many, and my records alone will make them work overtime for a very long time..

My father, a Navy disabled vet (now deceased, smoked and drank) they gave him 100% without question, the first time. He smoked cigs and drank (beer), never spent one day in a hospital until he died.

I did not smoke and had very few beers, spent a long time in the hospital, yet they are putting me through the ringer..

It's not like I got to pick which diseases I would suffer from,, and chose a nightmare of diseases form some list...

If so, I would have chosen :

1)none..

2nd choice, some disease that the VA would not use to make my life more of a HELL !

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I really just wanted to know if I will need go for an exam for my appeal.. they never asked me to go for an exam before they denied me.. This time my records will make all those VA claim people work their asses off..

They will need a team of many, and my records alone will make them work overtime for a very long time..

retired,

If I understand right, you have a disabling condition that has been denied SC and you have appealed.

Your question is - will a C&P examination be ordered.

The best answer I can provide is:

If in the appeal, during a re-look at the rating decision that denied the claim - the decision maker decides that there is medical evidence

of a condition that may possibly be related to active duty (or a condition related secondary to an already SC'd disability),

then that decision maker would have the authority to do additional development and order a C&P examination

and/or take into consideration the additional medical evidence you are submitting.

I can state with confidence that I believe no one in adjudication will be going through enough of the medical records

that are the size of two phone books.

Hope this helps a vet.

jmho,

carlie

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