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What To Do?


rdnkjeeper
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Question

I have had an appeal in for over 2 years now. I have a new DAV rep and he said that my appeal is weak. Two C&Ps and one says I am ok, but the other clearly states that I fall into the 40% bracket. The one that says I fall in the 40% bracket was the latest one and done by the head of the C&P department. My first C&P was done by someone that was NOT local and had a lot of complaints against him. (I was not one of them) My rep said that I should get my doctors to write a letter stating that they agree with this latest C&P. Now here is the real kick in the ass......NONE of them will write one. I get ALL my care at the VA. Any advice, all the wise ones here have for me?

Thanks

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Get an outside IMO from a Specialist. An Occupational Specilist woulf be the best as t hey can compare your issues with the working economy and give you a breakdown oif what you cna or cant do.

J

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The appeal is for an increase of my back. I am currently rated at 20% for Lumbar strain. After 15 years they finally gave me an MRI and I have a bunch of herniated discs and a bunch of bulging discs. I know I should have gone out to a private doctor and gotten it taken care of. I will give the Dav rep a call and see if he has a doctor for the IMO.

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Get an outside IMO from a Specialist. An Occupational Specilist woulf be the best as t hey can compare your issues with the working economy and give you a breakdown oif what you cna or cant do.

J

I totally agree with getting an Occupational Therapist to do an Physically Assessment of your current condition(s). This will help with getting an increase and/or TDIU!

Good Luck

B6

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Do not listen to your DAV. I have heard many others have their VSO basically tell them to give up or forget it, and they persisted and won.

Your DAV has shown he is not doing his job. If you think you are entitled to benefits, then you know much more about your medical history than the DAV could ever know. Your VSO is supposed to be YOUR advocate, and that is not much of an advocate to suggest you quit.

DAV reps are rarely Doctors, they almost never rate claims, and many of them are neither experienced nor trained in VA law. Did he show you a Veterans Benefits manual where similar claimants denials were upheld by the courts?

Frankly it is appaling to me the DAV essentially is suggesting you quit. Quitters never win, and winners never quit.

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I would also point out there are regulations in your favor. That is, when there is conflicting medical opinions, the VA is supposed to use the one "most favorable" to the Veteran. Further, if there is one favorable, and two non favorable, remember this:

1. First, there is no guarntee the rater will read your entire file. It is possible he reads only one or two opinions and awards your benefits.

2. Even so, you have an opportunity to see other doctors, both in and out of the VA, who are more "Veteran friendly". You may find another doc side with you..you may just need to keep looking. You can ask the docs who gave you an unfavorable opinion why he did so, when doc......differed. Maybe its a misunderstanding, or maybe your unfavorable doc did not read your entire history and did not know what the other doc opined. Even if you get denied, you/your lawyer may be able to argue that the doc who offered the favorable opinion did a more thorough exam..reading your entire record, while the unfavorable doc, shot from the hip.

3. You can change docs! I changed docs, and the doc called me and asked my why. I told the doc that I was not pleased, and why. (I also happen to know other Vets did not like that doc either and complained). Well, now my doc pretty much gives me what I want. Frankly, I think she was under some sort of probation and maybe even fired if I persisted with my complaint, which I dropped.

Edited by broncovet
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Your DAV has shown he is not doing his job. If you think you are entitled to benefits, then you know much more about your medical history than the DAV could ever know. Your VSO is supposed to be YOUR advocate, and that is not much of an advocate to suggest you quit.

DAV reps are rarely Doctors, they almost never rate claims, and many of them are neither experienced nor trained in VA law. Did he show you a Veterans Benefits manual where similar claimants denials were upheld by the courts?

The DAV rep certainly could be doing his job by informing the vet their appeal is weak.

Not all claims are winners - no matter how much we may want them to be.

Personally - I think when a rep tells a claimant their claim / appeal is weak and then lets them know

what they need to strengthen the claim / appeal - that rep IS doing a good job.

I've met several loud-mouth, beat their chest types that will tell vets they can get any claim granted

and they wind up letting the vet down because the claim was crap - a pipe dream from the get - go.

For the record - DAV reps - NEVER, not "almost never" they NEVER, NEVER,NEVER - rate claims,

DAV reps have NEVER had the authority to do so.

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