Flash- Va Told Not To Order Exams

[harleyman]

This is an informational post. I hope it gets into the proper hands, as this will most likely result in many confirmed and continued or denials of claims over the next 4 to 5 months.

As a VA Regional Office employee who processes claims for Veteran’s, I want you all to know I am appalled and EXTREMLY upset about the following information, I am passing on to the HADIT members. This is not B.S., and you will note I have been a HADIT follower for quite some time.

AS MOST OF YOU ARE AWARE:

1. There was a Mandate from VA (spurred by our US Congress to process all claims files older than July 1, 2011 by June 18^th 2013. Basically all other claims stopped being work except high priority special claims unitl these old claims were processed, (there are always exceptions for one reason or another but even the Special Ops team was processing all their older claims.) Basically, the RO’s succeeded in this mandate.(Please remember these were very old claims and most of them had exams in the file already and we were waiting for other information in processing these claims, or the Veteran had added new issues that needed due process be sent to the veteran before a decision could be made.)A lot of technical issues, more than lack of evidence and these claims also took a back seat to the RVN Agent Orange Mandate.

YOU MAY NOT BE AWARE:

1. Approximately the first of July, VA Corporate Offices came out with another Mandate to further reduce the backlog of pending claims. They instructed the Regional Offices to have their VSRs and RVSRs review all pending claims with dates of claim from July 1, 2011 to November 30, 2012, for necessary C&P exams. The exam reviews were required to be done prior to July 15, 2013. (In effect one month to review 1 ½ years’ worth of pending claims). A monumental task to say the least, and I guarantee not all these c-files with pending claims were reviewed). Nonetheless….

THIS PAST WEDNESDAY, OUR REGIONAL OFFICE EMPLOYEES WERE TOLD TO STOP ORDERING EXAMS. RATERS ARE TOLD TO RATE THESE CLAIMS ON THE EVIDENCE OF RECORD OR COMPLETE PROVISIONAL RATINGS.

THIS IS SIMPLY UNACCEPTABLE MY HADIT FRIENDS. WITHOUT EXAMS TO ESTABLISH A NEXUS YOUR CLAIMS WILL BE DENIED. AND YOUR CLAIMS FOR INCREASE WILL BE CONFIRMED AND CONTINUED BECAUSE YOUR TREATING DOCTORS AT VA DO NOT DO RANGE OF MOTION TESTING AND FILL OUT MANDATORY DBQ EXAM FORMS TO DOCUMENT WORSENING CONDITIONS. THEY WRITE SCRIPTS!

I predict from now through December you will see an unprecedented amount of DENIED and CONFIRMED AND CONTINUED claims. I also believe, this to be an opportunity for those Veteran’s who have private insurance or who can afford it, to get their IMO and IMEs to VA , BECAUSE once the word is out that VA is not doing exams, your evidence from your private doctors will be even more important, AND WILL PREVAIL greatly in the INEVITABLE CLAIMS APPEALS process.

I know this is a lot to take in right now. And there is a lot of crazy rationale from Corporate Offices on this, but Veteran’s deserve better than this from our Government.

This in my opinion is an attemp by VA, to manipulate the stats and make it appear to the public Veterans are being served. This is truely an injustice, I pray those of you who have the ability to contact your Congressmen and let them know you deserve opinion and increase exams to support your service related conditions and disbilities. Thank you for reading this.

Edited July 20, 2013 by harleyman

[harleyman]

Boomer, Amen! and Thank you! Please do it.-

Edited July 21, 2013 by harleyman

[jcolwell]

The examination policy currently being applied to claims that have a date of claim filed July 1, 2011 through November 30, 2012, are already being affected. I guess the only way to judge will be by the number of denials, c&c, "0" grants we see over the next 5 months. I believe if this policy is allowed to stand, it will become the standard, rather than a temporary policy to clear pending claims.

Alot of Veterans will not re-file thier denied claims because they figure whats the use. It's certainly will save the government alot, by not having to pay compensation payments to deserving Veterans.

If this policy continues, Veterans trying to become service connected for service related conditions will have to hire and pay for private exams and reports in support of thier claim. Usually, Veterans do not have the income for that kind of medical evidence and usually Veterans are "ill" and cannot work to pay for such evidence, such reports of findings with medical opinion can cost upwards of 2, 3, 4 thousand dollars.

And don't be fooled by one minute and think the government officials don't already know Veteran's incomes are limited.

Thanks. I fall in this window of time you mention . I have never had a C and P exam, I am lucky to see private physicians. I have waited 20 months on an appeal at RO and 11 months for new claim. I haved used DBQs. I will let group know if by some miracle something happens.

[harleyman]

If your private doctors have filled out the DBQs the Raters should be able to use them to plug into the evaluation builder and rate with the evidence your private doctors provided. Let us know what happens. The problem is the Nexus. Did your private doctors provide a link between your service and your new condition?

Even though they used the DBQ you still need a nexus unless it has been less than 1 year since you were discharged. Please keep us posted.

[jcolwell]

If your private doctors have filled out the DBQs the Raters should be able to use them to plug into the evaluation builder and rate with the evidence your private doctors provided. Let us know what happens. The problem is the Nexus. Did your private doctors provide a link between your service and your new condition?

Even though they used the DBQ you still need a nexus unless it has been less than 1 year since you were discharged. Please keep us posted.

I fall in the Oct 2010 approved Thailand group for herbicide exposure in Udorn for 1970 ( Vietnam Era Veterans, not boots on ground ) I have IHD and other secondard diagnosis for direct exposure. I have completed my DRO interview 4 months ago for IHD with ICD and DM 2 filed 9/2012. It will all depend on if they accept my perimeter evidence as a perimeter security guard. I was able to locate my colonel from Udorn who signed my evaluations while I was there and he gave me a buddy letter to that effect . If they accept his statement and mind , then nexus wont be an issue as I understand things. I have a boat load of secondary to the IHD . And I wait.

[harleyman]

Jcowell,

Back in the 60's and 70's (Vietnam era) didn't just about everyone have to pull some kind of perimader guard duty? If you have a buddy letter from your Colonel that is enough for the JSRRC (the specialist at VA to research your unit), if they can confirm you were in the unit at the time allowed for the Udon hebicide exposure, then exposure to AO should be conceded and you would fall in the presumptive category.

Alot will depend on your "personnel" records and what that shows as your unit assignment. If you were assigned there during the VA acknowleged time period. In my opinion, the buddy statement should swing this over in your favor. If they deny you for exposure, I would Appeal, as the decisions for exposure for Koreas, Thailand, some Vietnam, can be subjective decisions. Meaning, two different people looking at the same information can come up with two different decisions, one favoable and one not favorable for rating purposes.

Did VA order any VA exams for you at all?

You said you had your DRO interview. Is this an Appeal?

How long ago did you send in your buddy letter and your medical evidence of diagnosed presumptive conditions?

[harleyman]

Just because a rater can rate a case on the evidence of record, or do a provisional rating, is not a sign that a Veteran's claimed conditions will be service-connected.

This simply means the rater is going to rate the case. Remember, the decisions are; denials; grants; defers.

Right now at our Regional Office they are not allowing defers (because the goal is to clear "old" claim dates), so most of the claims that in the past may have been deferred for more evidence (such as evidence that an exam provides), will be rated on the evidence of record. Under normal conditions the claim would be deferred pending exam,

is now DENIED for lack of evidence.

I hope this is making sense, how awful this is for Veterans. The VA can and will try to put a positive twist on this, but this is not a "pro Veteran" policy that is going on right now.

Edited July 21, 2013 by harleyman