What Tricks Has Va Used To Deny You?

[NavyWife]

What tricks has VA used to deny you?

It seems that VA has a group of tricks they commonly use to deny claims. If you carefully read and reread the denial section of the rating decision you can break down word by word what they are saying.

1. Misdirection---they deny you based on something that has absolutely NOTHING to do with the rating schedule. Another vet here posted he was denied on migraines because he did not meet the "economic inadaptability" criteria to get to 50%, even though he had the required number of headaches for the rating. The denial said that because he was going to school, he did not qualify. Hello! Students don't make any money!!! economic inadaptability means you have difficulty holding a job.

In another example, a vet was denied because he still had his drivers license. having a drivers license is not in the rating schedule.

We need to carefully read the denial paragraph, and compare it to the rating schedule. Then cross reference both of those to the evidence listed in the rating letter and read EACH piece of evidence they used.

2. Pretend they can't get your records--in one of hubby's 4 denials, they denied his request for increase saying they could not get the records from the VA medical center he was treated at. I had NO PROBLEM getting those records a few months ago. Oh, and big surprise, the records had the proof that he needed for the increase!!!

3. Ignore their own VA C&P exam--they will disregard their own C&P exam and instead use a random note pulled from your medical file to deny the claim.

We should write up a big list of these common maneuvers VA uses, so other vets can recognize them and know that they need to appeal the incorrect denial. Or if we are feeling adventurous & bold, submit a "Go CUE Yourself" statement based on Berta's instructions in the CUE forum.

that saying, "you don't know, what you don't know" really applies to many of these denials. unless a vet knows every damned regulation and statute that applies to their case, they don't even know they have been wrongfully denied. They just accept the word of the VA. This makes me sad and pissed off at the same time!

Edited April 22, 2014 by NavyWife

[Jon1371]

Personally, I think it starts in the doctor's office. They down play what you say or stretch the truth and word things in such a way as to make it in the VA's favor. I've been reading my own notes and there's stuff in there that isn't what I said.

1. When asked if I drive I said not alone, I always go with someone. The Dr said that I said I don't drive, but that I drove my grandma to the Dr appointment. Makes me sound like a liar.

2. In the beginning I described a panic attack as racing heartbeat, sweating, nausea, fear, anxiety and shaking. I never said I had panic attacks because I didn't know what they were. The Dr wrote that I deny panic attacks.

3. Dr reports that I'm not suicidal when I tell them that I'm thinking of killing myself and that I and my family would be better of if I were dead.

4. Saying that I had moments of humor and didn't break into tears several times.

5. Says I have a good memory after saying I don't know I don't know how many times.

I think the shafting starts at VMAC and concludes at BVA. I'm really starting to understand why I keep getting advice to get IMO/IME. I'd like to be supportive of your thread because I'm going to need it, but I don't think I have anything to add other than angry noises.

[Berta]

Navywife, you have certainly brought up some of the most important things any claimant can do.

You said

"If you carefully read and reread the denial section of the rating decision you can break down word by word what they are saying."


"you don't know, what you don't know" really applies to many of these denials. unless a vet knows every damned regulation and statute that applies to their case, they don't even know they have been wrongfully denied. They just accept the word of the VA."

Many of us would be in the crapper by now if we didn't get educated on the regulations that apply to our specific claims.

I referred a new member here a few weeks ago to some regulations they needed to know of and they jumped all over me ,saying they don't have time to read regulations.

I regret that we have to practically become lawyers and doctors ourselves ,but this is what it often takes.

The VA denied my first DIC claim with a statement in the SOC that was not only completely false, but even slanderous in my opinion,to my husband.

Of course since he was dead (death by VA 1151 claim), he could not speak for himself to defend their statement.

His autopsy totally disproved the statement but the RO failed to give that to the C & P doctor who opined on his claim.

Then they had even denied the claim AFTER I succeeded under FTCA .

I called up the General Counsel right away and told them my settlement with the USA for my husband's wrongful death ,was now null and void and they could start adding a thousand a week to the settlement until the RO accepted their findings.

OGC set them straight right away.

This doesn't just happen to veterans, it happens to their survivors.

I am anxious to see how others reply here.

I have a folder full of past VA decisions I have gotten over the past 2 decades , and am saving , that indicate exactly how incompetent these people are, or sometimes smart enough and even willing to try to manipulate the regs or make some up ,in order to deny me, or on the other hand, just how hell bent they are ,at these ROs ,to do all they can to save the VA some cash.that is actually valid compensation they owe to the veteran.

The fact that, since many claimants do finally succeed on their claims, is proof to me that most of the denials they got ,from regional office levels , up to that point ,were bogus.

And ,it also means many of them took our advise and got an IMO/IMO from a real doctor.

Please everyone.....Ask your congresscritters to support HR 4031 :

"Department of Veterans Affairs Management Accountability Act of 2014 - Authorizes the Secretary of Veterans Affairs (VA) to: (1) remove any individual from the Senior Executive Service upon determining that such individual's performance warrants removal, and (2) remove such individual from federal service or transfer the individual to a General Schedule position at any grade that the Secretary deems appropriate.

Requires: (1) the Secretary to notify the House and Senate Veterans' Affairs committees within 30 days after removing such an individual, and (2) such removal to be done in the same manner as the removal of a professional staff member employed by a Member of Congress."

http://beta.congress.gov/bill/113th-congress/house-bill/4031

Jon said:

"Personally, I think it starts in the doctor's office"

I disagree, I think it starts with RO management.

None of this crap happens in a vacuum.

Take BVA transfers , for example.

Bad enough if you have a vet rep , they can sit on preparing the 646, adding time to the transfer , but there is an I-8 form that someone from VA must prepare prior to transfer to the BVA.

They seem to check Yes to all the questions,on the I-8 , some that often should have been checked No.

But by checking No, the claim goes back to the rater, and the prime goal of many ROs is to get the claim off their desks and on to the BVA,if the veteran appealed it.

That reduces the individual RO backlog numbers, and since there is no accountability at all, even for those I-8 forms, it increases the chances that the veteran's disability might get much worse,during the BVA process, and they might even die ,before the BVA gets to their claim, and they might have no one able to substitute themselves as the claimant.

They checked Yes to the VCAA question as well as the Evidence question on my I-8 of 2008 ??? forget when and I asked BVA for a remand.

My BVA award ,a few months after the remand, took note of my IMOs and other evidence they had never acknowledged (even on remand) and the fact that my VCAA letter was not legal.

Edited April 23, 2014 by Berta

[Slowlane]

The RO had a young lady call me on my cell phone and practically offer me IU. But, they needed physicians release papers and some forms filled out. They expedited me the forms and I turned them around in 3 days. Within 30 days they started severance of service connection proceedings and ignored everything I sent them including a 1000 mile round trip face to face with the DRO. They had me severed in less than 6 months. They can move very fast and be very cruel when they smell blood in the water.

By the mere presence of this forum there is enough proof that the VA is not on your side which means lying and cheating is fair game.

[71M10]

Berta,

You indicated you think it starts at the RO not the doctors office. I will disagree further, it starts at the SECRETARY, who they choose to head up the VBA and VHA. The attitude is established at the top and rolls down hill! If the Head of VHA was outraged at the errors and incompetancy they would start cleaning house, but they don't. Clearly, the average base level medical provider in the VHA is carfeul to minimize supportive statements about how disabled the veteran is. It is obvious they view their job as a service provider to you (working within generalized policies of the organization) and not an advocate for you and your health that requires the system to provide competant care! These base level providers are often bare MD's or MBBS's with no certification in general practice and spotty on what they do know.

I have taken to calling my PCP "doctor google" since he often is using google as the knowlege base to recomend treatment and understand my problems. Often I have already read some of the same pages from Merck, and Clevland Clinic that he is during my appointment. I often read the treatment notes and then have to request a correction of what is in them.

VBA. How can they continue to issue decisions that do not explicitly state what VASRD code they are using for the rating? How can not providing the actual code they are using ever comport/comply with the VCAA? Claims are not given a unique identifier, this allows them to play games about what they say you appealed vs what they have listed appealed. This problem comes up when you have multiple claim actions that get merged into one.

Not providing a copy of the C&P exam to the veteran as soon as it is released. How is it non-adversarial to develop evidence and not share it with all parties?

Why do they do things like tell you in your award letter that you have a bone disorder that is 0% disabling. In my case they knew I had arthritis and spondylosis and a medical history of thoracic strain, but they used "bone disorder" and I submit that calling it a bone disorder instead of ARTHRITIS, caused the 22 year old veteran to kind of nod his head and say OK. Wheras, if you tell a 22 year old they have Arthritis, the reaction is this is an old persons disease and they want to know more. When they want to know more, they would force additional exams and xrays that would have shown arthritis in the adjacent segments, which would REQUIRE a compensable rating. By doing this the VA saved about 200 bucks a month for 20 years.

How can the VA say an appeal is waiting on a 646 form when the veteran has NEVER been represented by a service org?

Why is the Veterans Benefits Adminsitration office not proactively addressing violations of law by Regional Offices?

Yes we should all support and request that congress approve the Management Accountability ACT, it is a start! but lets go one step further, we need a LAW that unequivically states any employee of the VA who breaks federal law, MUST be processed in the justice system - no administrative punishments. If convicted, they will be sentenced like any other criminal and their employment terminated. For those convicted of a felony they will loose all retirement benefits and be excluded form employment with any other federal agency or contractor. Furthermore it must be codified in federal law that any Veterans Adminstration employee who knowingly mis represents a material fact, destroys, alters, removes or purposefully misfiles evidence related to veteranas claim is guilty of a federal felony and subject to a seven year sentance and will pay restitution to any and all veterans who were denyed benefits due to their crime. The restitution will be seven times the value of the witheld/denied benefits and will not be subject to discharge under any state or federal bankruptcy proceeding!

I still chafe at the fact the VA is allowed to use the presumption of Administrative Regularity, The VA faces no deadlines, regularly violates law and policy which is documented in extensive BVA decisions (which are not precidental). They are continually allowed to play fast and lose with the rules and face no accountablility for errors, ommissions, or out right deceptions that are heaped upon veterans daily!

Edited April 23, 2014 by 71M10

[K9MAL]

The VA ignored my private gastro doc's DBQ he filled out and went solely off of the fabrications of the C&P doctor (general medicine). How is it possible they ignore a specialists opinion, who I've seen on multiple occasions, and go with the opinion of someone whom I've only had a very brief interview? The DBQ was filled out using VA verbiage and the way it was stated I should've received 60% but through the miracles of the VA C&P I received 10% instead.

It's a sad fact that the average, everyday veteran can't just put forth a straight forward claim and receive a straight forward answer. The archaic verbiage they hide behind is infuriating, to the say the least.

NavyWife - Good thread and thank you again for all the helpful advice.

[Slowlane]

71m10 I agree 100 percent. without accountability there will be no improvement. I think we should start a class action lawsuit against the VA. We could all pitch in what we could, and try to get civil and criminal actions taken against them. wheres the lawyers?

Sierra, I'm not sure that a class action lawsuit would work on such a broad base but, at least this thread is bringing forward the frustrations suffered by most Vets.

What we need to do is keep a thread going that suggests what to do until we come up with a plan that will work.

For Example:

1. Strongly campaign against anyone holding office now and before all the VA abuse. It happened on their watch.

2. Name names of your representatives and Regional Offices that are not helping.

3. I need help here.....I'm getting so pissed I can't think anymore.

4. _____________ fill in the blanks please.

Please keep this thread going