Bva Granted Sc - Finally.....!

[pacmanx1]

Vetslady

Pete......you say "If they low ball" - I'm curious why you say that......?

Thanks....and Thanks for everyone for the support....it's much needed right now. Emotionally, I'm a wreck.

I was only commenting on Chuck75s' post, he said;

"The RO can possibly accomplish two goals with a C&P. Most important, DELAY when the evidence is irrefutable. Next, C&Ps are known as an attempt to minimize or give a countering opinion to favorable medical records.

The RO will automatically take the "unbiased" (Hah!) C&P results as definitive, even when the C&P examiner (Nurse, PA,etc) and possibly the "reviewing" doctor is/are not medically qualified in the appropriate specialty.

Frequently, the unfavorable C&P results will be used, and force a veteran into the appeals process.

This adds years of additional delay, and if the veteran makes any procedural mistakes, quite possibly eliminate compensation completely".

Your Vet is already 70% and should be granted at least 100% TDIU but no one can really say what VA will do or not do. I was trying to let Chuck75 know that"if" the RO gives your vet a low rating, due to the fact that this is a remand that his file will go straight back to BVA and you will get a BVA decision on the rating. If you agree with the rating then BVA will dismiss the appeal. If you disagree with the rating BVA can make a rating decision or they can remand it again to get the RO to redo the claim. It should not take that long now.

[VetsLady]

Thank you everyone for the replies. It's a roller coaster ride for sure and not much fun .

As for TDIU, that's a possibility - he applied a few years ago as he did meet the 70% however.....SSD gave him disability for a different condition even though all of his VA claimed

conditions were listed....they only need 1 so they only choose 1. Any of the conditions he filed SSD for would have given him SSD disability and he was approved the 1st time he

filed. VA denied the TDIU and life insurance because the remaining illness (the one that was just sc on appeal) was nsc at that time.

BTW, this is not a remanded decision. It's a grant by BVA for sc. Sent to the RO for a rating. It was remanded after the initial decision in early '09 for further development to the AMC

and AMC sent it back to BVA for a decision.....I sent in complete updated medrecs, Nexus', etc. and they had all they needed, and still let the BVA make the decision.

[Chuck75]

I see at least some of my postings are read carefully!

My original statement was perhaps too concise and pessimistic when it mentioned the possibility of an unfavorable outcome. Things are a bit different when the BVA gets involved.

I would expect that with the appropriate evidence, that the veteran will eventually receive 100% TDIU.

I was trying to point out that RO's have been known to do things that are not what you would expect, and may not make any sense, given the VA's stated duty and "mission".

What happens if the VA/BVA does something "off the wall" and completely unexpected? (It does happen!) It's a very good idea to have a backup plan or methodology waiting.

For instance, there is currently a complex active claim in front of the Atlanta VARO, with parts in the appeals process, parts denied that may very well involve a "CUE", with the majority of the denials impacted by the "new" presumptives.

A previous SSA SSDI decision cites only "SC presumptive" conditions as the cause of total disability.

The "CUE" involves a special schedule portion of a claim, and the stated reason for denial cites something that is not a cause for denial under the law.

Bilateral organs, etc are involved, and the denial logic is based upon the fact that one of the bi lateral organs is still functioning.

At one point in the claim The veteran was given only a phone call as "short" notice of a C&P.

The C&P was deliberately scheduled at a VA location far from the veteran, even though two VAMCs that do "general" C&Ps were closer and have access via "all weather" roads.

The scheduled location involved "shortest distance" travel over secondary two lane roads that are quite hazardous in bad winter weather.

A second C&P was later scheduled at a more appropriate location, but was a "limited" C&P. The veteran involved has "CAD", a known component of IHD. Yet, the C&P examiner jumped on the VA's favorite "essential" HBP classification, ignoring various authoritative medical references and records that tie the HBP to CAD, etc.

When HBP responds to treatment in specific ways, just about any primary care physician, VAs primary care physicians included, will likely conclude that the HBP is due and related to the CAD.

The C&P examiner totally ignored an opinion and medical records that are based upon a board certified cardiologist that is the "treating" physician.

A complication is that some hospital medical records over ten years old are inaccessible for various reasons.

Vetslady

I was only commenting on Chuck75s' post, he said;

"The RO can possibly accomplish two goals with a C&P. Most important, DELAY when the evidence is irrefutable. Next, C&Ps are known as an attempt to minimize or give a countering opinion to favorable medical records.

The RO will automatically take the "unbiased" (Hah!) C&P results as definitive, even when the C&P examiner (Nurse, PA,etc) and possibly the "reviewing" doctor is/are not medically qualified in the appropriate specialty.

Frequently, the unfavorable C&P results will be used, and force a veteran into the appeals process.

This adds years of additional delay, and if the veteran makes any procedural mistakes, quite possibly eliminate compensation completely".

Your Vet is already 70% and should be granted at least 100% TDIU but no one can really say what VA will do or not do. I was trying to let Chuck75 know that"if" the RO gives your vet a low rating, due to the fact that this is a remand that his file will go straight back to BVA and you will get a BVA decision on the rating. If you agree with the rating then BVA will dismiss the appeal. If you disagree with the rating BVA can make a rating decision or they can remand it again to get the RO to redo the claim. It should not take that long now.

Edited August 26, 2010 by Chuck75

[VetsLady]

I see at least some of my postings are read carefully!

My original statement was perhaps too concise and pessimistic when it mentioned the possibility of an unfavorable outcome. Things are a bit different when the BVA gets involved.

I would expect that with the appropriate evidence, that the veteran will eventually receive 100% TDIU.

I was trying to point out that RO's have been known to do things that are not what you would expect, and may not make any sense, given the VA's stated duty and "mission".

What happens if the VA/BVA does something "off the wall" and completely unexpected? (It does happen!) It's a very good idea to have a backup plan or methodology waiting.

For instance, there is currently a complex active claim in front of the Atlanta VARO, with parts in the appeals process, parts denied that may very well involve a "CUE", with the majority of the denials impacted by the "new" presumptives.

A previous SSA SSDI decision cites only "SC presumptive" conditions as the cause of total disability.

The "CUE" involves a special schedule portion of a claim, and the stated reason for denial cites something that is not a cause for denial under the law.

Bilateral organs, etc are involved, and the denial logic is based upon the fact that one of the bi lateral organs is still functioning.

At one point in the claim The veteran was given only a phone call as "short" notice of a C&P.

The C&P was deliberately scheduled at a VA location far from the veteran, even though two VAMCs that do "general" C&Ps were closer and have access via "all weather" roads.

The scheduled location involved "shortest distance" travel over secondary two lane roads that are quite hazardous in bad winter weather.

A second C&P was later scheduled at a more appropriate location, but was a "limited" C&P. The veteran involved has "CAD", a known component of IHD. Yet, the C&P examiner jumped on the VA's favorite "essential" HBP classification, ignoring various authoritative medical references and records that tie the HBP to CAD, etc.

When HBP responds to treatment in specific ways, just about any primary care physician, VAs primary care physicians included, will likely conclude that the HBP is due and related to the CAD.

The C&P examiner totally ignored an opinion and medical records that are based upon a board certified cardiologist that is the "treating" physician.

A complication is that some hospital medical records over ten years old are inaccessible for various reasons.

Chuck....

Thank you for the further explanation. What happens - happens. We go with the requests....its urks me to (and I'm certainly entitled to be urked - LOL) that with ALL of the medical evidence in the C-file

and it all being current, this exam "appears" to be a delay in rating....nothing more, nothing less. Realizing he has to do what they say, show up for the exam, etc. he will do just that. I don't have the two

letters at the end of my name but, what I do know is what his VA doc and his private doc say....."never going to get better, will stay the same if lucky but more likely than not, condition will get worse. His symptoms and

medical evidence support a 100% scheduler rating on their own merit.

Will keep everyone posted how this pans out....

[rjimenez]

keep fighting it will payoff at the end