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C&p 10/27/12


maine2000

Question

I had a C&P exam on the 27th of October,the examiner stated that my numbness in my leg was unrelated to the gulf war.The sleep disturbances(insomnia) he linked to PTSD.The Plantar Fascitis he stated no service connection was found.The examiner did not even deal with the recent X-Rays that showed I have mild (left) and (right)hallux valgus and minimal first metatarsophalangel osteoarthorois(Bilateral.My left knee I have degenerative arthritis and this was not handled either.How should I handle this?

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  • HadIt.com Elder

Since you don't have a decision, you cannot formally appeal until you have a decision.

What you can do is write a letter to the VA stating that the C&P was, in your opinion, inaccurate, and incomplete,

how it was incomplete, etc. (Evidently it didn't fully address your claimed conditions.)

If you can obtain an IME (independent medical exam) and/or an IMO (independent medical opinion) by a doctor

that is board certified in the appropriate specialty, do so, and include it (or not) with the letter.

The doctor should be very familiar with the VA's requirements.

The argument for including it assumes that the VA is interested in correctly resolving your claim.

The argument against assumes that the VA intends to deny in part or all, and will attempt to preemptively rebut the IME/IMO.

Still, having the IME/IMO in the record, assuming it's favorable, helps setup documentation for an eventual appeal.

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maine2000, I went through something similar during my recent awarded claims for Ples Planus (bilateral) and knee pain/problems.the Va had consistently denied these items as service related or stated that I didn't have the claimed problems currently.I had a C&P exam that was a sham about 2 years ago where the C&P doc stated that there was nothing wrong with my knees......Fast forward 2 years, I resubmitted the claim with a copy of my MEB/PEB board results that list these items on the MEB exam conducted by my Orthepedic surgeon (which also served as my exit exam).The VA sent me to 2 C&P exams for these items, first with a contract doctor that said YES I did have Ples Planus and even had Hammer Toe caused by it.The second exam was done at my VAMC by the same doc from 2 years ago.She asked me some questions, referenced my medical records which she had and then examined both my feet and had me do range of motion tests on my knees (during which one of them loudly popped and she noticed it).Also sent me for Xrays for both feet and knees..In the time between exams EVERY TIME I saw my PC doc I complained about my flat feet and knee pain so that it was on my VA treatment record.About 6 weeks after the last C&P I was awarded 50% for ples planus bilateral and 10% for each knee for chondromalasia ( which was in my SMR's numerous times).They also rated me for 10% tinnitus which was also on my med board physical (and I hadn't even included it in the latest claim) and when I was sent to a contract audiologist I had some high range hearing loss.................. Important thing is to get a copy of your exit physical or MEB/PEB board results if you went through one.DO NOT assume that these are in your medical records even if you know they were when you turned over your records when getting out..Mine were in my medical records but when I requested a copy of my SMR from the VA they had magically disappeared.Once you have these records go through them and highlite every single time you went to sick call or sought medical help for the claimed issues,make copies of these highlited pages and send them in to support your claim (certified,return reciept)..Also VERY TIME you are seen by your VA PC doc complain about pain and problems from these issues.They WILL check your treatment records.........About the Insomnia they did the same thing with mine connected it with my PTSD, but part of my PTSD treatment includes meds for the insomnia and sleep problems.That is one of the reasons I think that my PTSD was awarded at 70%............If you get a denial letter for these items be sure to submit a NOD within the required time limit.Then get the documentation you need sent in ASAP............And always remember that the VA docs have the VA's interest first and foremost in their mind and not yours.And you will have to lay it out clearly and without doubt for the rater or they will overlook it...........................Good Luck and don't give up.They want you to give up.I gave up in the 90s and then started again about 4 years ago then stumbled on this site and learned sooo very much.I didn't even get a GULF WAR physical until 2008..............Keep fighting....................Grid

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  • HadIt.com Elder

When rated 0% for heart problems secondary to AO DMII I asked my PCP to refer me for some testing since no testing was done when I got the 0%. The NP that did the C&P exam just did an incompetent and incomplete C&P. After more testing and filing a NOD and appeal I got 60% rating which got me "S" smc. The VA has all the testing devices including CT scans and heart testing machines. I bet if you look up your exam schedule many things were left off the exam or were given routine negative answers (vet unfriendly) based just on guesses. To my mine the C&P exam is just round "one" in a ten round fight.

John

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