Qtc Exam Question

[Berta]

On Wednesdays SVR show Dr. Bash discussed the problems some vets have had in obtaining copies of their QTC C & P exam results from the VA before any RO decision has been made on their claim.He had another serious concern as to QTC reports that could reveal additional medical issues which might need immediate medical care. We are trying to find out why this is a problem.

Yesterday QTC told me that, once the exam is done by QTC and approved, it is sent to “ ExamTrack” (probably a VA PC program) and then uploaded to VA and this often takes only 3-4 weeks.At that point the exam is owned by the VA and QTC has no ability to release it themselves to any claimant.

Question:

Has anyone here had problems getting a copy of their QTC exam from the VA?

If so can you tell me what VA sent to you -as far as indicating a reason why they could not release the report?

Were you able, only after a decision had been made on your claim, to then obtain a copy of it?

Has anyone's vet rep here been able to obtain the QTC exam copy directly from VA for you?

[Hoppy]

Berta and others,

“We must argue with medical evidence in responses to SOCs, SSOCs, to anything we disagree with as to disparaities between the SOC and the actual exam results.

And rebutt the exam results as well if they are speculative or medically inaccurate.

Or get a real doctor to do that for us ,with an IMO.”

This is how I won my claim. The denials made no sense at all and were based on misinformation and unsupported by any medical evidence. I was awarded by a DRO without submitting any new evidence. It was just a question of properly interpreting the evidence of record

I was recently helping a veteran who provided me with the medical reports used by the rater as evidence against his claim. The claim was for a secondary condition to a previously service connected condition. There is known statistical research that establishes a statistical linkage between the service connected condition and the secondary condition. The veteran submitted his own IMO referring to the statistical linkage. However, the rater gave greater weight to the VA examiners report that the secondary condition was due to post service intercurrent events.The doctors statements that the veterans condition was due to post service events were arbitrary and did not explain in any detail how the statistically known linkage was over ridden by the post service events. The fact that the post service events could have caused the veterans disability was plausible. However, the determination the condition was caused by post service events was speculative and unsupported. The doctor could only make a bare determination without supporting logic. This, is due to the fact that there was no road map establishing the post service events as the cause of the veterans secondary condition.

The thing that bothered me most in this case is I have seen BVA cases in which the raters remand the case back to the doctors and require that the doctors read each other reports and comment on each other reports before they decide the claim. I thought that given the complexity of this claim such a remand would have been appropriate in this claim.

The veteran was at a loss as to what to do next. So I gave him the exact advice you mentioned above. I told him the minimum he can do is write it up explaining in detail how the reports used as evidence against his claim lacked support and were bare conclusion without supporting logic and that the claim should have been remanded in order for the doctors to comment on each other reports. I told him the best thing to do is get yet another doctor to read all the evidence and comment on the reports used as evidence against the claim.

Long story short I told him to do exactly as you suggested above.

A bare conclusion, even when reached by a health care professional is not probative without a factual predicate in the record. Miler v. West,

11 Vet. App. 345, 348 (1998).

[Berta]

Hoppy said:

"The thing that bothered me most in this case is I have seen BVA cases in which the raters remand the case back to the doctors and require that the doctors read each other reports and comment on each other reports before they decide the claim. I thought that given the complexity of this claim such a remand would have been appropriate in this claim."

Yes- I even asked the BVA to remand my 2003 claim.They remanded in 2008 and awarded in 2009 due to the fact that none of my 3 IMOs had been even mentioned by the RO as evidence from 2004 to BVA transfer in 2006 and their opining doctors didn't mention my IMOs.

Plus I had a major VCAA problem and this too is why I asked for remand.

The VA agreed with me,in the remand, but that was years ago and I certainly would have handled this differently if it happened to me today.

I even got 2 DRO reviews because I asked VA to CUE itself on their initial DRO decision in 2005.The second review happened very fast and my former vet rep stood in for me at that review.

He called me up after it and said although he presented the IMOs to the DRO formally, she said she didnt know how to read them.

He was surprised that he asked her for another C & P opinion and she agreed.He thought he had done a great job doing that-

I asked him-wait a minute----if she cant read my 3 IMOs how the hell can she read a VA opinion?

He didnt answer that one but assured me the IMOs were put into my C file for their next C & P doctor to consider-but that never happened. He has been demoted.

Hoppy- you work hard for veterans and will surely agree that this stuff can truly become a war game.

Oddly enough this above all began when I started courses in tactical warfare at AMU in 2003 and being the only civilian these USMC profs had ever taught, I had to prove myself to them as well as prove myself to the VA, as a claimant because of the wording of the initial denial of that specific claim

.I think I lost focus on my claim as the courses were quite tough but it has helped me immensely in playing their war of the words game -when I made them CUE themselves this past Dec 2012 for my IHD claim and I got my award in January 2012. One month after I asked for them to CUE themselves.

When I say we need to be aggressive, I sure mean that- I dont mean getting angry or nasty,I mean hitting them with their own regs and all the evidence you have and demanding that they read it.

Often even attaching highlighted M21-1MR excerpts to our stuff can help remind the VA what they are supposed to do.

PS this is funny now but I was furious at the time-

It took me almost 8 months to get my money from VA on my 2003 claim.I had an usual situation not noted in any past VA claims at BVA or CAVC.

It might have been the first of it's kind.

However 38 USC and 38 CFR explicitely stated why the payment I expected was a valid ,legal request, in some old regs that VA doesn't use much at all.

I ended up dealing with emails to the Regional Counsel up here and making multiple phone calls andsending letters to the General Counsel and when they saw I would not go away some big deal at OGC finally sent the RO the same regs I had been sending them and told them to pay me.

I know I gripe about my past VA problems a lot here- but they are were resolved to my satisfaction.

If I had not taken aggressive actions, ALL of my claims would have ended up in the crapper.

38 USC,CFR and M21-1MR gives us as many tools to success as they give the VA tools to deny.

What is the actual current status of this vet's claim you mentioned?

Was his VCAA letter fully concise as to what evidence they needed for the secondary?