Received 5103 Notice For Remand - Questions....

[justrluk]

Good afternoon,

Well, I finally received the notice to respond with more support for remanded items from my appeal. I started digging through my copy of my c-file to see if there were any documents the VA asked for that were already in the file. Much to my surprise, I found reports from my STRs that were from the '80s (which the VARO said did not exist in previous decisions, this appeal, etc...) that support my issue that a condition started surfacing while on my initial enlistment. This supports my contention that the issue did NOT pre-exist service, but brings something else to light: if the records are in my hands as part of my c-file, is it a CUE that the VARO never saw/used them?

Also, the latest documents needed by one treating physician are not in my c-file. She is also currently claiming that I owe her $$ from a claim she didn't file timely with TRICARE and was therefore not reimbursed. I assume she will not release the requested treatment records until I pay her the $400.00 she claims I owe. Do I try to get the VA to get the records knowing it will take months, or try to get them myself? I cannot afford to pay her the cash she is demanding (we've been going around and around since 2011), but the remand mentions her by name as having records that will support my claim. HELP!!! I want this over with, but not so much as to sacrifice all the years of work to get to this point only to have things denied because of one doctor's bad billing practices/claims filing.

[Berta]

Boy I sure can relate to that.

“This supports my contention that the issue did NOT pre-exist service, but brings something else to light: if the records are in my hands as part of my c-file, is it a CUE that the VARO never saw/used them? “

Certainly, it is a violation of 38 USC 4.6:

However, as Broncovet and Carlie are always correct to quickly to remind us, 38 USC 3.156 (b) should always be considered first ,prior to considering CUE, if the newly discovered evidence involves STRs.

Here it is:

“the latest documents needed by one treating physician are not in my c-file “

and not in your VA med rec file?

I don't think any doctor can hold a medical document as hostage for a payment screw up.

Is this what the remand was for?

“I'm not arguing for service connection or even disputing the rating. I just wanted the original 40% returned (bilateral) from the reduced 20%. Just a recap: the original decision stated that the condition pre-existed military service. I argued that the condition did NOT pre-exist and therefore should be restored to 40% (44% bilateral). Heck, at this point I don't even care if there's any retro. “

Justrluk

from:

Could this remand possibly be yours?

http://www.va.gov/vetapp13/Files2/1313261.txt

[justrluk]

Ms. Berta,

Thank you for responding. Yes, this other post was in reference to proving the condition did NOT pre-exist service and therefore should not have been reduced. I didn't know if I should tag another issue to it, or start a new post (so I did the second).

What I found in reading through my c-file was by no means complete STRs, but certainly records from dates the VARO said were not available. I will submit the forms to the VARO per the request, plus copies of the medical reports regarding the first outbreaks of psoriasis. I will also try to get the Dr. to send me a copy as well. I only mentioned that I went to see her as my VA rheum appointment had to get postponed due to a work issue - for six months - during the hearing and the judge picked up on it. Six months with no meds and I was in agony so I went back to an old treating rheum from years before going to the VA. Copies of those records are not in my VA file on hand, so I need to get them ASAP. I'll get what I can, and will hope for the best. I'll also take a look at the link you posted to see what can be done about their claim (and I believe it has been in every decision I have received) that no STRs existed for review. Maybe I'm getting just a bit closer to the end of this issue.

[justrluk]

Ms. Berta,

This was the correct docket number as well.

[carlie]

just,

I sure liked reading this portion below, in the remand instructions.

"The examiner must provide reasons for each opinion given.

The examiner is advised that the Veteran is competent to report his symptoms and history,

and such statements by the Veteran must be specifically acknowledged and considered in formulating any opinions.

If the examiner rejects the Veteran's reports regarding symptoms, the examiner must provide a reason for doing so."

[justrluk]

Carlie,

Thanks so much for helping me through this. I've been really ill for the past several days (immune system is shot) and was really feeling depressed that I was back to the bottom of the stack for this appeal. Does this tell me that even though the symptoms are reduced due to taking three systemic treatments, I should provide a verbal (read) statement when the C&P comes along?

[justrluk]

UPDATE: I received a call for the C&P exams to be held Sept 7th (a Saturday). It will prove difficult to gather other records by then from outside docs but I have to try. Have to prove thought I'm well controlled but it takes three immunosuppressive drugs keeps my ROM and ability to walk. Also the VAMC in Augusta did an MRI of my neck. The report says nerve inclusion and some spinal cord pressure. I am wondering if this is a separate issue or will be treated as combined with the overall psoriatic arthritis. - Nervous and excited!

just,

I sure liked reading this portion below, in the remand instructions.

"The examiner must provide reasons for each opinion given.

The examiner is advised that the Veteran is competent to report his symptoms and history,

and such statements by the Veteran must be specifically acknowledged and considered in formulating any opinions.

If the examiner rejects the Veteran's reports regarding symptoms, the examiner must provide a reason for doing so."

Carlie,

Do you think I should write a script to read when asked to make verbal inputs?

EDIT: This was for GERD as part of the remand order. Still waiting for a C&P for psoriatic arthritis/psoriasis start time and type of treatment required.

Edited April 4, 2014 by justrluk