hypertension Senseless Denial And Forced To Use An Attorney ! Unbelievable. !

[DocNyger]

Hello fellow vets, I hope all is well and still in the fight. I am new to the site and welcome any and all comments please... I served for 12 years , I've been involved in 3 wars. I separated in August 2003. In March 2005 I filled a claim for 4 contentions. I finally heard about my denial in Nov 2008. The reasoning that VA stated my denials were that even though the QTC doctors documented favorable statements , he didn't state it was from the military. ( I read the exact notes and he did state back issues, knee issues, hypertension, and depression were from my time in the military ). I also stated the locations on my original claims and sent in multiples documentation via hand delivery to my Regional office, faxing my VSO, and certified mail with Return Receipt. In the denial section the Va stated that there was nothing in my medical records. I filled a NOD in Feb 2009 and to date that appeal is still on phase 1...:(. I started to wonder if it's just me or does the Va really denies veterans for no reason..) So I'm waiting !!!!!

In Mar 2011 I filed for PTSD , and PFB (shaving). I've submitted documentation for both the same vehicles that I did before. I received countless messages from VA stating they need sudden information... The same info I sent.... So I called my VSO again, met with her and gave the same copies I sent in, she supposedly walked it up and personally put it in my C -file. Well later I finally got scheduled for a c and p for PTSD. Nothing for PFB. My initial exam was by a mental health doctor at the Va who verbally told my the she was new to the field and after the exam was over, she diagnosed me with major depression and hypertension, she stated that there were multiple symptom for ptsd but unsure if they meet criteria 1 for PTSD and referred me to a Va contracted mental doctor. My treatment started in the beginning of 2012. During his ignition evaluation, he diagnoses me with probable ptsd. He explained to me why, because he just met me and wanted to spend time with me. Well on Apr 25 2013 I was diagnoses with PTSD have severe symptoms. Now all my records were sent to Va and I once again hand delivered them and got the regional acceptance stamp. In the end of October I received a letter stating that the Va wanted me to go to another c and p for PTSD. I called my VSO and explained what was going on and she just stated " I guess you need to be there" ... Why do I have to go through four different evaluations.!!! I truly thought this was crazy. Well I reported to the c and p examination and I experience a very rude ,biased, and incompetent person I have ever dealt with in my 41 years of living. He asked me two question. Do I drink and how often? And how much do I spend on alcohol a month. That's it !!!! Nothing about PTSD symptoms or nothing. I filled out a form asking what are my symptoms which I stated everything from my treatment records. This guy didn't put anything that I verbally stated or written. He had this ( what ever attitude). Not even 10 min later he stated it's done. You probably won't get it... And left the room.

Well I finally left 5 minutes later when he didn't returned, later in Nov 2013 I received a denial letter stating I was denied because I don't have a current diagnosis of PTSD, even though my treatment notes states probable ptsd the recent ptsd exam did not diagnosis me with PTSD. I was floored !!! I ordered I copy of the exam to find out that the examiner diagnosis me with substance abuse... What !!! No one even looked at my records. I went to my regional office again and spoke to another VSO. I showed him the diagnosis from the contracted mental doctor for PTSD back in April and he supposedly walked it up to the raters. He came back and told me that they said there wasn't a signature from the doctor. I pointed out the electronically signature that many doctor uses, then the VSO stated that it does stated that it's a diagnosis, I stated and showed him in the right corner where it states Confirmed Diagnosis ptsd 309. Etc and severity of symptoms., then I was told that the raters said that they would challenge the diagnosis... At that point I said I'll get an attorney because this is not right and the VSO stated " why would you want to do that, they will take all your money" .. Of course I left and found a good attorney who took my case and was shocked how the Va handle my case. The attorney stated that the Va is famous for creating bad evidence to out way the good .. Is that true? What do you think about my case? I'm sorry for the long message .. Just need to vent and my wife is getting tired of the nightmares, isolation, and me talking about it... Thank all of you in advance for your comments and advice !!!

Edited May 19, 2014 by DocNyger

[K9MAL]

New and material evidence

I've written about this several times but allow me to reiterate it again. Look closely at 38 CFR § 3.156(b). At any time during the course of your claim at the Agency of Jurisdiction ( AOJ aka your Regional Office), a Veteran submits new and material evidence (NM&E) to the claim (such as a new IME/IMO), it requires a de novo (brand new) adjudication in conjunction with all the previously submitted evidence of record (EOR) in your c-file. The submitted information may also be EOR in that it is pertinent (material) to the claim and clarifies or enlightens/alerts the rater to a possible brain fart on his part. This graciously allows everyone to pat themselves on the back and right the wrong without anyone’s ego being bruised. I'm also sure it's why they invented yellow hi-lighter pens...

When you submit NM&E should a letter accompany it spelling out their errors or omissions? I had a DBQ and VA medical records that were blatantly ignored in my decision. I'd like to send them the highlighted records so that they can't be ignored and hopefully increase the percentage to the proper level. Would a letter similar to a NOD be appropriate where it spells out their errors?

My 1 year NOD date is in February so I thought I'd attempt this route prior to having to resort to the NOD. Thanks for all the great info!

Edited October 15, 2014 by K9MAL

[NavyWife]

At this point, anyone who has a fubar'ed claim should email Bob McDonald about it.

Robert.a.mcdonald@va.gov

[K9MAL]

At this point, anyone who has a fubar'ed claim should email Bob McDonald about it.

Robert.a.mcdonald@va.gov

What would constitute FUBAR? At the 1st denial stage or are you talking about a NOD and past that?

Hope you're doing well NavyWife. I had to take a brief hiatus from this VA stuff but I'm back in the swing of things now :)

[Berta]

I emailed him Monday...no reply yet.

If the VA has received (and your have proof of that from USPS) evidence that is Probative to your claim and not redundant nor cummulative, and has failed to consider it or list it as evidence in a SOC or SSOC or any written BS they come up with, that means the VA has snafued and fubared your claim by violating 38 , CFR 4.6.

BTW they have a new Intake address for Evidence as separate from claims intake.....

When submitting all claims:
U.S. Department of Veterans Affairs
Claims Intake Center
PO Box 5235
Janesville, WI 53547

When submitting evidence or anything other than a claim:
U.S. Department of Veterans Affairs
Evidence Intake Center
PO Box 4444
Janesville, WI 53547

Even if you sunmit via ebenefits, they seem to want 20 pages or more submitted this way.

Has anyone here used the new intake address?

Did they lose you stuff yet at the intake center?

I have been dealing with VA since 1981 and I think the Intake Center might become the Ultimate FUBAR.Hope not.

[NavyWife]

K9MAL--

Good to hear from you-- it's been a minute!

Yes I think your file definitely warrants an email to Uncle Bob! Maybe just something brief with your identifying information, your regional office and that they ignored evidence & what you would like done.

Since you've been gone, hubby's claim for increase was approved-went from 20% to 80%. Happy with that, except that the C&P examiner filled out the DBQ corresponding to a 100% rating, however the rater decided they only felt like awarding 80%.

Berta--The ultimate fubar-- ha ha

I can see some aspects of the centralized mail processing that could be really great, like freeing up the VAROs time & Making sure that documents are scanned into the system, Not left in a box in a back office.

But my main worry is that they will wrongly associate claims evidence with the wrong veterans electronic file. I guess we will see how it pans out. Every vet needs to be vigilant about putting their claims number or Social Security number on every single piece of paper they send in.

Edited October 15, 2014 by NavyWife

[K9MAL]

Since you've been gone, hubby's claim for increase was approved-went from 20% to 80%. Happy with that, except that the C&P examiner filled out the DBQ corresponding to a 100% rating, however the rater decided they only felt like awarding 80%.

Congrats! And this is exactly what happened to me. Private gastro fills out DBQ in accordance with a 60% rating and they gave me 10%! Same thing for my migraines... The fight continues and I'll be blasting off that email later today with the requisite evidence to support my claim.