Claim Question

[Guest jangrin]

I was just wondering when the RO recieves a claim that has multiple conditions (sent all on the initial claim), do they make a determination on the ones they know are service connected first and send out notification, or do they go ahead and send out a notice on each condition as they make their determination? OR do they hold back everything on the initial claim until they have made a determination on all issues and then send out notice. Also how long before a C & P exam is scheduled following filing the initial claim? Do they always schedule C & P exams? Thanks

Jangrin :D

[Berta]

Rocky-

"Yep, this is not a spectator sport"--- excellent advise!!!!! vets have to realise how proactive they must be-

I like the way you put this-

the DMII vet-this will take time- as others have said-

Rocky is in a final stage and I am too- my claims were filed in January 2003.One has been decided (decided this past Jan)-but they are putting both into the decision- they said in 2 more weeks I should know results.

My past main claims at this VARO both took at least three years-

A vet can have absolutely bonafide evidence right from the git go- but still can have a long wait for a decision-

As an incountry Vietnam vet the DMII is presumptive- however-they like to lowball at 20% or 40%-and if he had secondary conditions that stem from the DMII- they like to try to see if those conditions preceeded the DMII diagnosis-

to deny them-

Example- vet has heart disease diagnosed in 2001. Then vet is diagnosed with DMII in 2002.

The VA might say the heart disease preceeded the DMII and is not due to DMII (yeah right) and wont service connect the heart disease.

In cases like this- since DMII is known to often be misdiagnosed or underdiagnosed, the vet needs a good IMO to show the heart disease is secondary to the DMII- which it "as least as likely" as not would probably be-

Also I have seen vets get a DMII diagnose during a C & P and then the VA tries to give them the C & P date as retro date-

that should be questioned too-

A vet gets a glucose reading only at periodic exams-

many never get the HBIAC test and the glucose reading at a normal exam can be misleading-

especially if the vet ate a small breakfast, hurried to the VAMC, and then sat around for hours waiting and maybe missing lunch. The Glucose could be low and then hours later shoot up to a diabetic reading.

[Guest jangrin]

Thanks Berta and Rocky,

This is the advice we were needing, I've been reading the past forum about appeals and NOD, etc., but we are in the very first stages in the application process and other than filing the claim there wasn't much advice in how to respond to the initial letters from VA and what we should be doing right away. We were being reactive with VA when we should have been being PROACTIVE.

We recieved a copy of my husbands medical records from the clinic. I noticed that there are no ECG strips in his record. They took his ECG on at least 3 times in the last 8 months. Also no records of seeing the clinic psychologist for his "stress related gastroentinology" (according to the VA doc). Any suggestions?

The SO told us that the VA would have copies of all records that the VA doc had a part in ordering or that we brought to the VA doc for review. I noticed there are no records like that in the copies they sent. Do they only send VA records or are they supposed to send ALL records that qare in the file?

This is probably a dumb question, but when sending evidense to VA, if they already have the medical report or history in their file but you want to reference a certain point on the record, do you re-send that particular piece of the records or do you just reference it (page number-date, etc.).

Also, SS just did a mental exam on my husband, DX PTSD and depression. WHen the report is ready should be in about a week, do we send it in or do we wait and have SS send it to the VA? This is the first of two exams with SS, the next one is in two weeks. I was planning on getting copies of the SS file all at once but now I'm thinking it might be better to send a little at a time. Any suggestions?

Thank you all very much, I'm sure once I get a plan here of how to proceed it will keep us really busy.

Thanks again,

Jangrin

[Berta]

"if they already have the medical report or history in their file but you want to reference a certain point on the record, do you re-send that particular piece of the records or do you just reference it (page number-date, etc.)."

Jangrin-I always send them another copy of the specific record and use magic markers or highlighters - so they dont miss the part they need.

The psychologist records as well as those ECGS should be there-

Sometimes the shrinks keep their records separate and you might need to ask the shrink for copies.

The ECGS and any ECHO (if they did this- Doppler image of heart and report) should have been with what you got- I would asend the Records Access Officer a letter saying they were missing and you are again requesting them.

"Do they only send VA records or are they supposed to send ALL records that qare in the file?"

It definitely pays to check and see if they send ALL-

I could write a book about that-

VA is very good at manipulating some records to set up a denial rather than getting a good picture with ALL records-

I would send them a copy of the SSA report myself if I were you and again state that your husband has applied for SSA and wants these records considered by the VA.

[carlie]

jargrin,

Here's some study info for you.

38 CFR

http://ecfr.gpoaccess.gov/cgi/t/text/text-.../38cfrv1_02.tpl

M-21

http://www.warms.vba.va.gov/M21_1MR.html

carlie

[Guest jangrin]

Thanks Berta,

You guys have no idea how much you have helped us today. I know we have alot of work to do, but to be honest, at least we will feel like we are doing something and that is a great feeling.

I'm sure we'll have more questions as we move forward in this process, but now we have a starting point. Thanks again.

Jangrin

[Guest jangrin]

jargrin,

Here's some study info for you.

38 CFR

http://ecfr.gpoaccess.gov/cgi/t/text/text-.../38cfrv1_02.tpl

M-21

http://www.warms.vba.va.gov/M21_1MR.html

carlie

Carli,

Thank you very much this is most useful. I don't know why I haven't seen this before. It is now bookmarked.

Jangrin