I Think The Md Blew The C&p. What Can I Do?

[blazer1996]

Had a C&P exam at a VA hospital in connection with a request for increase based on worsening condition. (Heart Disease) The doctor took all of about 15 minutes to do the "exam" and appears to have based most of his findings on evidence provided by two cardiologists that have treated me in the past. Most significant evidence is a echocardiogram done by my MD that reports that I have an ejection fraction in the low 20's. C&P doc had that report and quoted from it using the date of the report and my doctor's name. Then he said that my e-fraction was in the 30-35 range. I went to the RO a spoke to them as soon as I saw the report. They were less than helpful. The VSO at the DAV was useless and just mouthed the company line about how long "things" are taking, please be patient, etc. Patient advocate at the VA hospital was also less than helpful and passed my inquiry to the FOIA officer. FOIA sent me a letter explaining that my request for a correction has been "forwarded". All that happened in June and July...Its August 15 now. Anything else I can do? I'm looking for advice. Thanks

[jbasser]

You may have jumped he gun. You really dont know what he is going to write down.

Get a copy in a week or so and then post about it.

J

[blazer1996]

You may have jumped he gun. You really dont know what he is going to write down.

Get a copy in a week or so and then post about it.

J

Got my letter back this week...Appeal denied. Tech who did the test estimated EF at 30-35. Cardiologist viewed results of the same test and estimated EF at 24. Guess which opinion they decided to believe? They did invite me to appeal to the Counsel General's Office in DC. How thoughtful of them...

[jbasser]

That sucks. Get ready for battle.

J

[Berta]

Can you scan and attach here the actual Reasons and Bases for the denial?

"They did invite me to appeal to the Counsel General's Office in DC. How thoughtful of them..."

Yeah, however no one appeals a rating denial to the VA General Counsel.

"Most significant evidence is a echocardiogram done by my MD that reports that I have an ejection fraction in the low 20's. C&P doc had that report and quoted from it using the date of the report and my doctor's name. Then he said that my e-fraction was in the 30-35 range."

Did you send the RO the MD's report for consideration of evidence or just show it to the C & P doc.

Was the C & P doc a real doc? I dont see how he could use 2 past C & Ps that might have reflected a past ratings but obviously wouldn't affect a more recent ECHO result.

If I were you I would ask the VA to go CUE themselves.

They have committed a clear and unmistakable error by violating 38 CFR 4.6,if they are aware of the private MD ECHO results but used instead

a C & P report that held no medical rationale.

"Tech who did the test estimated EF at 30-35. Cardiologist viewed results of the same test and estimated EF at 24.

Guess which opinion they decided to believe?"

The one from whoever the VA pays.

I have much info here as to how to get VA to CUE themselves.During the appellate period,prior to filing the NOD.

That battle tactic has sure worked for me.

I got them to CUE a DRO decision years ago via IRIS .I also faxed the request to my RO but I dont think they even read faxes.

And I got them to CUE themselves more recently on my original AO IHD denial in Nov 2011.

By Dec 2011 they did a re do and I got my proper award in January 2012

Peggy couldn't understand the status when I called the 800 for status on another pending claim I had..She read the AO IHD claim status first I was denied and then awarded in mere weeks for the same claim......

She though it was a mistake on their 800# PC.

I intend to use this battlefield maneuver, as I call it, as we ARE in battle, regarding every single award or denial I get in the future,if it applies.

I have an additional CUE yourself VA claim pending on the same AO IHD award letter regarding an additional legal error they made.to my detriment.

I intend to use this tactic in the future whenever I can.

The NOD must still be filed in time, if they don't fix the CUE and the NOD deadline looms close.

This is really good: I am stuck on this one.

"They did invite me to appeal to the Counsel General's Office in DC."

Who is "they"? .

"They" gave you absurd advise.

Edited August 25, 2013 by Berta

[iceturkee]

Had a C&P exam at a VA hospital in connection with a request for increase based on worsening condition. (Heart Disease) The doctor took all of about 15 minutes to do the "exam" and appears to have based most of his findings on evidence provided by two cardiologists that have treated me in the past. Most significant evidence is a echocardiogram done by my MD that reports that I have an ejection fraction in the low 20's. C&P doc had that report and quoted from it using the date of the report and my doctor's name. Then he said that my e-fraction was in the 30-35 range. I went to the RO a spoke to them as soon as I saw the report. They were less than helpful. The VSO at the DAV was useless and just mouthed the company line about how long "things" are taking, please be patient, etc. Patient advocate at the VA hospital was also less than helpful and passed my inquiry to the FOIA officer. FOIA sent me a letter explaining that my request for a correction has been "forwarded". All that happened in June and July...Its August 15 now. Anything else I can do? I'm looking for advice. Thanks

my c&p ortho exam for my unemployability didn't even last 15 minutes. he asked me a few questions, looked at my charts and apologized for wasting my time, as there was no way i could ever work again because of my back. he stated it on the report too.

[blazer1996]

Thanks Berta...sounds like good advice. The "they" in my post is the Administrator of the VA Hospital where the C&P was done. The MD who did the exam is a cardiologist...That is the part that makes me wonder what is happening. We'll start tomorrow lining up our ducks for the skirmish to come...