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Denied On One Part Of Claim But Approved On Another


ammodad

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ok friends , as i mentioned before my wife and i are fighting these guys over my asbestos exposure claim .

they denied me saying that i needed to have the exam and they are giving me 60 days to have it and they will will revisit my claim pray for us and my health while awaiting this to come about .

i have a question which is troubling me , i just reieved a letter from the va national service office , i had already been awarded 20% for a previous ailment . during the course of preparing for my asbestos claim they awarded me 50% for another service connected illness . now in my calculations this totals 70% yet according to there letter this newly awarded 50% with my combined evaluation for service connected disabilities is 60% .

are they in the habbit of dissreguarding . previosu awarded amounts , or was it a missunderstanding . on the first of my claims i was awarded 10% which was increased to 20% . a year later which is now they award me the 50 for another illness wouldnt that total 70 or can they just ignor the previous decision like that .

should i call them to inform them that i am nolonger at the 10% and that my rating prior to the previous decision was 20% which would put me at 70% ..

i need some advice as to how to handle this , please any advice anyone can offer will be greatly appreciated .

i am adding a copy of the letter to show what i am refering to with my already 20% wouldnt this kick me up to 70% or am i not figuring things the way they are ???????

thanking you all for your concern and support you guys are the greatest i figured i was one out of alot of guys who were just going this thing alone . your being there has made this mean alot more . there is so much more i would like to say , but all i can say is thank you ..

Edited by ammodad
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Guest elizabeth
ok friends , as i mentioned before my wife and i are fighting these guys over my asbestos exposure claim .

they denied me saying that i needed to have the exam and they are giving me 60 days to have it and they will will revisit my claim pray for us and my health while awaiting this to come about .

i have a question which is troubling me , i just reieved a letter from the va national service office , i had already been awarded 20% for a previous ailment . during the course of preparing for my asbestos claim they awarded me 50% for another service connected illness . now in my calculations this totals 70% yet according to there letter this newly awarded 50% with my combined evaluation for service connected disabilities is 60% .

are they in the habbit of dissreguarding . previosu awarded amounts , or was it a missunderstanding . on the first of my claims i was awarded 10% which was increased to 20% . a year later which is now they award me the 50 for another illness wouldnt that total 70 or can they just ignor the previous decision like that .

should i call them to inform them that i am nolonger at the 10% and that my rating prior to the previous decision was 20% which would put me at 70% ..

i need some advice as to how to handle this , please any advice anyone can offer will be greatly appreciated .

i am adding a copy of the letter to show what i am refering to with my already 20% wouldnt this kick me up to 70% or am i not figuring things the way they are ???????

thanking you all for your concern and support you guys are the greatest i figured i was one out of alot of guys who were just going this thing alone . your being there has made this mean alot more . there is so much more i would like to say , but all i can say is thank you ..

FROM your you guys i think tou may be in nj.If so you can fax MIKE BLAZIS at1-973-3314 mike is the supervistor in claims .Now if you are not from nj try to get the fax number of your ro ;i always fax to va NOW go to the va home page look under benifits i am sure i saw rates start at 10% i may be wrong but you can always go to va home page and ask HOW DOES VA RATE this should open more pages you might need to find a answer. ELIZABETH
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Ammodad, VA math does not follow the rules that were taught to you in school. Your award letter is correct.

50% leaves you with 50% capable. The 20 % is then applied against the 50% capable which is 10%. The 10% added to the 50% equals a total disability rating of 60%. You can not simply add 50+20. Look around on Vet sites and you will find a calculator that will do the math for you.

Ricky

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Ammodad, VA math does not follow the rules that were taught to you in school. Your award letter is correct.

50% leaves you with 50% capable. The 20 % is then applied against the 50% capable which is 10%. The 10% added to the 50% equals a total disability rating of 60%. You can not simply add 50+20. Look around on Vet sites and you will find a calculator that will do the math for you.

Ricky

thanks guys once again for being correct , ricky you were correct our way of figuring isnt the va`s way of figuring they do everything their way which means ur gettig ripped one . thanks for being there with the answers godbless

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Ammodad-

Have they checked your inservice occupation for possible or probable asbestos exposure yet?

Is the VA telling you that you yourself have to have this "exam" in 60 days?

It sounds like they are saying you yourself have to get an IMO- did they ever give you a C & P on the asbestos?

It sounds like they might be sending you retro- maybe a good time to think of paying for a good IMO.

The Independent examiner should know of your military exposure and-if I were you I would bring anything from the net that shows your disability has already been associated to asbestos.

Yeah- the guys are correct-VA math - I think it is somehow one more way the VA snookers vets-best thing to do- if your evidence meets a higher rating on this for either of the disabilities they 'combined' -is to NOD this part of the decision.

IMOs- I have noticed lately that the VA will sometimes deny a claim with an IMO if the private doc didnt examine the vet in person- I am sure it all depends on the disability-

but that bothers me to see this in VA decisions-

Seems to me a good IMO doctor like Dr. Bash- takes a lot more time with the med recs from a vet who might live far from him ,unable to see him in person, then these VA docs do in these 15 minute C & Ps.

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Ammodad-

Have they checked your inservice occupation for possible or probable asbestos exposure yet?

Is the VA telling you that you yourself have to have this "exam" in 60 days?

It sounds like they are saying you yourself have to get an IMO- did they ever give you a C & P on the asbestos?

It sounds like they might be sending you retro- maybe a good time to think of paying for a good IMO.

The Independent examiner should know of your military exposure and-if I were you I would bring anything from the net that shows your disability has already been associated to asbestos.

Yeah- the guys are correct-VA math - I think it is somehow one more way the VA snookers vets-best thing to do- if your evidence meets a higher rating on this for either of the disabilities they 'combined' -is to NOD this part of the decision.

IMOs- I have noticed lately that the VA will sometimes deny a claim with an IMO if the private doc didnt examine the vet in person- I am sure it all depends on the disability-

but that bothers me to see this in VA decisions-

Seems to me a good IMO doctor like Dr. Bash- takes a lot more time with the med recs from a vet who might live far from him ,unable to see him in person, then these VA docs do in these 15 minute C & Ps.

ok ,

i found out today i have an exam sceduled for the 23rd of this month with pulmonary function .

from what i found out they are giving me the 60 days to bring in new evidence ,

now the first time around they refused to take my exrays and after scheduling me a biopsy they canceled that appointment saying they had all they needed to decide my claim .

i am submitting the exrays now , and the new pulmonary test which will directly link my being exposed to my condition . that should do it .

the last time i was there the doctor diagnosed me as having restrictive lung disease , and stated it was directly do to my being exposed to asbestos .

after speaking with the pulmonary function doctor he stated to me that that should have been enough evidene along with my service reords, which listed the career field i worked in which was boiler maint.

he told me they should have approved my claim without question , so now i am scheduled to go for another exam he said just bring my records and dont worry he will take care of everything .

the whole ordeal was they had no problem diagnosing m with the disease , they just didnt have a doctor there with the balls to put in writing that the disease was directly do to me being exposed .

i found out that the doctor who diagnosed me as having the disaese , during an exam they sent me to was let go not long after doing so .

but the thing is that in doing so he didnt put in my records that the cause of me having it was do to being exposed . which was just like he had did nothing at all.

the pulmonary function doctor told me that , he had no problem doing just that and that.

so i guess we will have to just wait and see .

the letter from my supervisor whih stated that all the buildings we worked in were filled with asbestos , and that the boilers were covered with it aswell as the adjoining pipes .

our career field is listed among the ones which they list as heavy exposure ...

i have been fighting with these guys scence 1991 when i first got out i filed for lung condition do to asbestos exposure they denied me . i have appealed and kept it going , until now and now that its finaly starting to catch up with me , i need to find an end to this real soon .

the thing which i find strange is they approved a claim just a month ago that i had no evidence on what so ever , less than i have with the asbestos claim .

doesnt make any sence to me it would seem they are trying to put it off until i cant file anymore ..

thank you for your advice and being there continue to pray for us as we will do for all of you god bless and never give up the fight ...

Edited by ammodad
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You just said a mouthful-

I believe you are extremely on point!- some of the VA docs have no goonyats whatsoever-

I get the impression that the Varos have changed internally over the last ten years-

It used to be the VA doc's word was like the Holy Grail and no one questioned it- even if it supported the claim to the git to-( they used it to award or somehow ignored it) but that has changed-

I know for a fact that two VA docs who worked on my past claim and the present one were under pressure to say what VA wanted them to say when they reviewed my claims.

I almost forgot- someone here mentioned this today-many

years ago out of sheer frustration I told some VA doc I would write to the AMA about them-but I was just popping smoke-

Boy did they suddenly turn around-in an opinion - this was long ago-

I forgot all about that because when I said it to this VA doctor I didn't think they came under any guidelines from the AMA-and certainly I never did write to the AMA-

they were willing to rewrite their opinion- and I found out that the VA had not given them what they needed anyhow so it was not their fault at all- the first opinion-

Now I am thinking maybe they do have to answer to complaints to the AMA ???

Some of the medical statements in SOCs are ludicrous-just to deny claims- maybe if vets suggested sending these opinions to the AMA it would change the way C & Ps are done-

As a matter of fact- if I get another SSOC that ignores Dr. Bash's opinion I had and the other brief IMO I had too- in favor of the SSOC VA "expert" one they got- which I knocked down with evidence - it was ridiculous-

I am sending this doctor's complete report to the AMA- and filing a complaint to see what they can actually do.

Her report showed that she felt , with all of the significant medical entries,blood chems, etc and MRIs etc, the VA docs could not diagnose my husband properly in 1992 with diabetes.

She made the point however ( I was able to manipulate her statements into what I wanted here-learned how to do that from the VA) that (had the VA not killed him) he would be classified as diabetic today-that's nice.

She based her entire opinion on a "few" as she stated, medical records, yet Dr. Bash used them all. I have absolute documented proof that the veteran's med recs never left the local VAMC and never went to Buffalo for her "expert" opinion.Her sec called this local VAMC, said they were under pressure and just fax a few chem reports to her so she could get this "expert" VA medical report done fast.

I never considered ever really calling any VA doctor on what they say wth the AMA- but if I have too-

I will do that and let you all know how that goes-

In essense she was saying that, like the VA docs who were busy covering up my husband's heart disease -and prior malpractice screw ups-so we would never find out-Documented-in 1992- she too would have been one of many VA doctors at that time- if he was in her care-

who would have lent to his death by incompetence and malpractice.

Forget who made this AMA point - but I now have another way to combat them.

In 2004 they had all the evidence they needed to award my claim.My vet rep at the VARO was astonished at their denial. But they were so afraid when they saw Dr. Bash's report and Curriculum Vitae- I think they hide his IMO in a drawer and hoped I would die. I think they did finally read it 2 months ago- dont know the results though-

Maybe we should start dropping the dime on these C & P docs-with the AMA- if their reports are medically deficient in regards to their medical assessment of your disabilities-in my mind they-as medical professionals- must be deficient too.

Edited by Berta
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You just said a mouthful-

I believe you are extremely on point!- some of the VA docs have no goonyats whatsoever-

I get the impression that the Varos have changed internally over the last ten years-

It used to be the VA doc's word was like the Holy Grail and no one questioned it- even if it supported the claim to the git to-( they used it to award or somehow ignored it) but that has changed-

I know for a fact that two VA docs who worked on my past claim and the present one were under pressure to say what VA wanted them to say when they reviewed my claims.

I almost forgot- someone here mentioned this today-many

years ago out of sheer frustration I told some VA doc I would write to the AMA about them-but I was just popping smoke-

Boy did they suddenly turn around-in an opinion - this was long ago-

I forgot all about that because when I said it to this VA doctor I didn't think they came under any guidelines from the AMA-and certainly I never did write to the AMA-

they were willing to rewrite their opinion- and I found out that the VA had not given them what they needed anyhow so it was not their fault at all- the first opinion-

Now I am thinking maybe they do have to answer to complaints to the AMA ???

Some of the medical statements in SOCs are ludicrous-just to deny claims- maybe if vets suggested sending these opinions to the AMA it would change the way C & Ps are done-

As a matter of fact- if I get another SSOC that ignores Dr. Bash's opinion I had and the other brief IMO I had too- in favor of the SSOC VA "expert" one they got- which I knocked down with evidence - it was ridiculous-

I am sending this doctor's complete report to the AMA- and filing a complaint to see what they can actually do.

Her report showed that she felt , with all of the significant medical entries,blood chems, etc and MRIs etc, the VA docs could not diagnose my husband properly in 1992 with diabetes.

She made the point however ( I was able to manipulate her statements into what I wanted here-learned how to do that from the VA) that (had the VA not killed him) he would be classified as diabetic today-that's nice.

She based her entire opinion on a "few" as she stated, medical records, yet Dr. Bash used them all. I have absolute documented proof that the veteran's med recs never left the local VAMC and never went to Buffalo for her "expert" opinion.Her sec called this local VAMC, said they were under pressure and just fax a few chem reports to her so she could get this "expert" VA medical report done fast.

I never considered ever really calling any VA doctor on what they say wth the AMA- but if I have too-

I will do that and let you all know how that goes-

In essense she was saying that, like the VA docs who were busy covering up my husband's heart disease -and prior malpractice screw ups-so we would never find out-Documented-in 1992- she too would have been one of many VA doctors at that time- if he was in her care-

who would have lent to his death by incompetence and malpractice.

Forget who made this AMA point - but I now have another way to combat them.

In 2004 they had all the evidence they needed to award my claim.My vet rep at the VARO was astonished at their denial. But they were so afraid when they saw Dr. Bash's report and Curriculum Vitae- I think they hide his IMO in a drawer and hoped I would die. I think they did finally read it 2 months ago- dont know the results though-

Maybe we should start dropping the dime on these C & P docs-with the AMA- if their reports are medically deficient in regards to their medical assessment of your disabilities-in my mind they-as medical professionals- must be deficient too.

thanks for reading and really understanding , i didnt think anyone else got that,

i was searching through my records trying to gather up the info they say i missed . i found in my medical records from c&p exams this one dating back to 1999 this is chest 2 views pa&lat what ever this means , now i didnt know this until i read this last night the report says there are abnormalities some 1.5cm and larger calified right hilar nodes but no infiltrates .. and another c&p exam where they say they cant find any signs i have been expposed to asbestos the it says findings chronic obstructive pulmonary disease ... and they put down this

job34875 mt154 /BM

WHAT DOES TIS MEANS

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