Based On What They Said They Didnt Have

[63SIERRA]

if u read the reasons they denied my claims at the bottom, it looks like they didnt even look in my medical records for the records that were all surely there.

many times on ebennifits they said evidence requested is past due. I would ask my DAV service rep abt it and he would always say, dont worry abt it, they got it. well he never told me that if we never gave them a specific date range to look in, they could just blow my claim off. Copy the medical records and send them in with your claims. Dont trust that they will look thru your records to find what they need to approve your claim. It is EXHAUSTING looking thru, and reading everypage in a medical file that id 450 pages. I wish I could go back in time, and start over again. I would have done things so different. now im playing catch up, in a system that doesnt care how long it takes.

see attached file

CLAIMS.txt

[jbasser]

thanks basser, I will check him out. the link is broke, I s he out of battle creek michigan?

also being the VA is a federal entity, shouldnt the state tort laws be a moot point?

I wish they were but it is not the case.

[71M10]

63Sierra, From what you are relating about your initial file and interactions with the DAV. I have one quesiton, why are they still your POA?

You indicated they needed date for the medical records. I believe the dates they are collecting on the claim form are the dates of treatment and the facility. Yes they are very important, not only to identify where the records might be, but to substantiate that you have a chronic condition. If the DAV didn't collect that data and put it on the claim form you were doomed from the start (see first line of this message again...WHY).

You don't want to move this to a CUE contention unless you have incontravertable proof that an error was committed.

If you truly think Malpractice has occured, get a lawyer involved ASAP. If you keep sending communications forward that have not been vetted for their effect on a malpractice filling you may damage that claim/process.

Hang in there.

[63SIERRA]

I kind of feel like im in it too deep to drop the DAV. I believe the VA will see me dropping them as, " trouble in paradise", and use that against me ,, thinking things arent going well . (even though they really arent going well ).. In other words, I dont want to let the enemy know, that im low on water (poor representation).

As far as the possible malpractice claim, the VA dont know, that I know they screwed up. I dont think that they even know, that they screwed up. (changing doctors like drawers at the va its likely hard to get to know patients)

when my claims were filled out, we did not put the date range of the claimed contentions. we sent in the form that gives them access to med recs, maybe a privacy act notice release, and that was it.

Like I said it was a" write down the claimed condition " and ship it manuever.

Edited November 25, 2013 by 63SIERRA

[63SIERRA]

I called battle creek, hopefully he calls back and we can get this battle raging. its time.

[free_spirit_etc]

IMOs are what helps you prove your claim. If their doctor says the medical evidence shows it is not service connected, you need to find a doctor to refute that. If the VA relies on the doctor's interpretation of the medical evidence, then you need to give them something to work with to approve the claim.

no,l went to a outside doc to prove my back condition, but didnt ask him to write an imo as to if he thought it was service connected.

I look at IMO S this way.. they are like references, ... who is going to bring them an UNFAVORABLE imo. The medical evidence should stand on its own. Im trying not to get into the " lets see who can get the best IMO game" especially if IM paying for it. I believe the CP docs give unfavorable reports for the sole purpose of giving the va ammunition to deny claims. The va is the ones who employ them to perform the task,. If your part of " the quota" that month, then u must grin and bear it, and fight it. I was recently screwed by a CP doc, who measured a 13 inch scar, and never once asked if it was painful or not, and wrote in my report, that the scar was not painful and measured 0.01 mm. I called bs, and got another CP exam. I believe the doc who tried to screw me knew exactly what he was doing, and didnt think I was smart enough to follow up. T he second cp doc who examined me, told me that they get QC ed, but evidently no QC takes place, unless they get caught by the veteran. I also got denied for another contention that this same va doc examined me for, that Im reviewing the CP exam. If he goofed that one up to, I will get a redo.

[free_spirit_etc]

I am not sure that C&P exams have to be totally independent and unbiased. If the VA seeks an IMO on your claim (which is different than the C&P exam) those are supposed to be independent and unbiased. But those are usually done at the BVA level if the BVA says there is conflicting medical evidence and they need to seek another opinion to decide the claim.

According to the rules, The CP exam is totally independant and unbiased and payed for by the government, so rightfully and legally so, if they screw up the exam, you have the right to have it redone. If it was protocol for them to ask you a question, and they didnt ask, call Bs and call the VA regional office, and tell them, and write a letter and tell them.