tdiu Vamc Reversal ? Is This A Clue

[KennyJ]

Back in December 2004 I went to my Local hospital emergency room about 3 times. I filed the claims with my local VAMC and in April 2005 I received a letter from the Salem Va. VAMC saying that my claims for payments for my Emergency visits had been denied. I have had 5 C&P exams in the lasr 2 months and is currently awaiting to be rated on them. This week I recieved letters again from the Salem Va. VAMC saying that the calims from 2004 has now been authorized for payment. Is it possible that my current VA claims could have something to do with this reversal. I also have an Appeal for TDIU on file.

[Josephine]

Josephine,

If you have a standard C & P exam that does not fit into the specialized category, you will probably end up with an inadequate C & P exam. I think that every C & P exam that my husband had that was not a specialized exam was inadequate and filled with errors. After each exam, I gave them about a week to get the results of the exam into the system. We then went to the Release of Information Department and got a copy of it. I then turned around and sent a copy of the exam results, along with a letter explaining all of the wrong information in the report and sent it to the VARO before a decision was made on my husbands claim. I then requested that he be given another exam, by another examiner, due to the exam he just had as being totally inadequate. I explained that there was no way that a fair decision could be made based on these inadequate exams.

The specialized departments giving C & P exams seem to be fairly good, as far as what my husband received. On the last two standard exams he had, the examiner was in the process of going on vacation and my husband happened to be his last exam to do that day. The results of one of the exams was never even written up and sent to the VARO. The second exam he did was so full of errors and misinformation that you would have thought that he was doing the report without actually looking at his C-file or medical records. If he had, there is no way the report could have been written up the way it was. He was given new C & P exams and in the end he got those claims approved.

Hope things go well for you. If I can be of any help, let me know as I have been dealing with the local VARO and VAMC for many years.

mssoup1

Edited September 15, 2006 by Josephine

[mssoup1]

My husband had big time problems with one C & P that he had. I got a copy of the C & P and wrote a letter to the RO explaining all of the errors in the report and I requested that he be given another C & P exam due to the one he had being inadequate for use in making a decision. In the past, if we stated a C & P was inadequate, he was given another one. But, on this particular claim, after writing the letter requesting another C & P exam, we heard nothing on the claim. It seemed it just kinda died. He was never scheduled for another C & P exam and as far as I know, unless our POA signed off on dropping it, the claim would essentially still be active. With all of the other claims he had getting approved, which gave him a 100% rating IU P & T, we didn't bring this issue up because it was a SMK claim and would not have actually affected his rating pay other than to give him an extra amount each month. I didn't want to do anything that could have possibly reopened his file now that he had the full rating. I guess that since he was given his 100% rating IU P & T, then the RO felt this claim was moot and just dropped it.

I don't have a problem with my husband being given C & P exams. But, if he is, the least the examiner could do is read the medical evidence available to him/her and render a sound decision based on the facts. There is no reason to have a C & P exam report filled with so many errors when this report is such a big factor used in either approving or denying your claim.

I guess I am dumb on this, but what is Sensitive 6?

Wishing you much luck.

mssoup1

[Josephine]

mssoup1

One of my biggest problems is that I am a Sensitive 6 and have no contact with my file or the R.O in West Virginia.

I started this mess in 2002 with The Roanoke Regional Office and went through the rating board with a denial, but a pension.

In 2004, when I wrote to the archives and gathered up my psychiatric records, to which the Va had never seen, all of these strange things starting happening.

One of the counslors placed me in appeals.

I immediately received a C&P and Dr. M was really good and read my C file and diagnosis of anxiety disorder not otherwise specified with depression with a more likely than not.

I had always thought that my DRO niece had signed off my claim, but she hadn't. She waited until this C&P came in and hurried and signed off.

I was immediately shipped off to West Virginia

5 months later I had the strange lying C&P by the Board of Two. One refused to sign the report.

It is all slanderous lies.

I raised H to the Salem Medical Center and also the West Virginia R. O. I took the complete examination sentence by sentence and pointed out her lies with my medical records.

I called Dr. C. my treating physician to clairfy his records and how he helped me to received an early discharge. He thought that I had been receiving benefits all these years. He thought that I was issued a medical discharge. Not true.

I ask for another C&P for one year. I even involved Honorable Admiral Cooper into it. He called Huntington for me and told them to give me an answer.

They issued a denial and stated, although, I didn't agree with the last C&P, it was good enough for rating and that they placed their weight with the Board.

I went to the BVA, as I had had a form 9 in for almost 2 year, don't know how that happened either.

Three months into the BVA and I was remanded to The Appeals Mangement Center.

Now my file is to go back to the two Psychaitrist for them to come to some agreement about the last C&P examination or if they are not available to decide if I need another C&P.

I wasn't lucky enought to receive another C&P as the Huntington office wanted an examination to state, nothing bothered her in service.

They got it and I was out.

Thanks bunches!

Josephine

[Josephine]

My husband had big time problems with one C & P that he had. I got a copy of the C & P and wrote a letter to the RO explaining all of the errors in the report and I requested that he be given another C & P exam due to the one he had being inadequate for use in making a decision. In the past, if we stated a C & P was inadequate, he was given another one. But, on this particular claim, after writing the letter requesting another C & P exam, we heard nothing on the claim. It seemed it just kinda died. He was never scheduled for another C & P exam and as far as I know, unless our POA signed off on dropping it, the claim would essentially still be active. With all of the other claims he had getting approved, which gave him a 100% rating IU P & T, we didn't bring this issue up because it was a SMK claim and would not have actually affected his rating pay other than to give him an extra amount each month. I didn't want to do anything that could have possibly reopened his file now that he had the full rating. I guess that since he was given his 100% rating IU P & T, then the RO felt this claim was moot and just dropped it.

I don't have a problem with my husband being given C & P exams. But, if he is, the least the examiner could do is read the medical evidence available to him/her and render a sound decision based on the facts. There is no reason to have a C & P exam report filled with so many errors when this report is such a big factor used in either approving or denying your claim.

I guess I am dumb on this, but what is Sensitive 6?

Wishing you much luck.

mssoup1

Edited September 15, 2006 by Josephine

[Josephine]

mssoup,

I am not sure if this is a way to hinder a veteran or protect your claims file. After I received my first C&P with a more likely than not.

My intelligent niece, being supervisor of the DRO's In Roanoke, signed off on my claim. She should have done this when I was in the rating board, but she didn't.

I was immediately transferred to Huntington West Virginia and that is when I received that stupid slanderous C&P examination.

My claims file means that only those with special clearance can open my claims file, even at BVA and The Management Team Level.

Just about everyone that I call about my claim, say they do not have the clearance to open it.

This keeps the veteran in the dark as to what is going on and with my having been in West Virginia, there was no way that I could call them as the toll free number took me right back to Roaonoke.

You also cannot have a rep in the State of Virginia also, for they will not be responsible for your file in another state.

Thanks bunches!!

Josephine

[KennyJ]

I didn't have any C&Ps done at Salem VAMC I had mine done in NC through QTC. Had 4 done July 7, 2006 and one done in August. Heres the twist the ones done in July nine weeks ago in Zebulon N.C. hasn't been forwarded to QTC as of yet. The one done 3 weeks ago at Greenville NC is completed. I swear the ones done at Zebulon were for knee, ankle, and periheral neuropathy conditions were the first time doctor ever done any C&Ps and She was an internal medicine doctor. I don't see why they were not done at the VAMC in Durham N.C.