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.

[FormerMember]

Danger. Danger Justrluk. Nobody who is tightly screwed down should ever be telling you to go off your meds to provoke the disease/injury you seek a rating or increase on. Better to show disease controlled by medication and have a documented medical record showing symptomatology and chronicity/continuity. The potential for this to backfire on you is phenomenal. By law, you would be required to inform them of what meds. you are on---or aren't. By either lying or omitting the truth, you have endangered your claim by fraud. That a VSO would suggest it is unsavory. The idea is to win legitimately, not by subterfuge or deceit. We won't discuss the danger to you personally (and medically) for doing it. That's a no brainer. If that is Mr. Service rep's secret weapon, your legal strategy is in deep doo doo.

I recommend my guys take copies of all the medrecs they can assemble with them to the C&P. I know full well VA says not to but note that they do not forbid it. Doctors are inherently self-critical and insecure. If there is anything about you s/he can read about to inform them about your illness/ injury, trust me they will gobble it up. They, too, know they are supposed to do it by Braille, but none of them can look away when an opportunity to plagiarize comes along. They reason that a hippocratic mind must, by doctor law, use anything to get to the bottom of an etiology. If it means peeking, so be it. Doctors hate to be wrong.

I "cheated" and did this on my AO porphyria claim C&P. The QTC doctor didn't even blink. All he did was ask if he could keep the records.

Edited August 28, 2013 by asknod

[justrluk]

asknod,

I hear you and thought this was a stretch. I WILL NOT do this dishonestly because the least I can do form myself is keep whatever dignity I have left. I have diaries that show periods of flare up that occurred when the VA stopped my Humira (three times since 2010) and the inability to walk without a cain from the car to my building. Horrible... no sleep either due to pain from arthritis. I just don't know how much I will be able to present, but I can narrate a summary I'm sure. I have tallied numbers of days, but since they don't all occur within the same one-year period, don't know how much I'll be able to use. I can only show the pattern and let the rest takes it's course.

Thanks for shedding some light on my integrity!

[justrluk]

Also (just thought of this question), I thought when I filed a waiver of VARO consideration this applied to the new evidence I would submit in support of my appeal. My VSO told me this only applied to material I submitted at the time of the hearing. Which is correct?

[justrluk]

Just for follow up: I was notified of a pending C&P exam for last Saturday. I show up prepared and with documents for psoriatic arthritis and neck, but when the C&P NP starts to interview me, she asked questions re: GERD. I filed a claim in 2010 which was denied, then filed an appeal but asked it be dropped. The VLJ brought the issue up during my hearing and in the remand ordered the VARO to issue a SOC. I thought they would just write the document, but a C&P for something already denied??? Now I'm really confused. Also, this wasn't the C&P for the REAL issue, so now what??? Wait some more for the PsA C&P! What a mess. I figure the best I'll get is 10% (if I'm lucky). I guess you can't push a wet noodle that far...

[justrluk]

Rating was included in the colon resection rating, but still acknowledged as service connected. This is at least a positive outcome. No C&P for the remanded issues yet, though. No SSOC for GERD either.