C&p Pending, Surgery Outside Va?

[chriscshunter]

So I'm currently waiting to get my C&P exam (been waiting for almost 2 years), however my wife is in the military and I have doctors outside the VA system. Today I was looked by an ENT doctor concerning my nose issues, which is also something on my claim. I had surgery on my ship to open up my nasal passage due to an injury in relation to my service, however I have noticed its closing up again. Today they found that I have a 70% airway blockage and I have had closed nasal bone fracture for quite some time and they recommended me for surgery. I went ahead and collected their paperwork on this. So I have a few questions concerning this situation.

Is this paperwork worth anything to the VA? Will it help my claim? How do I submit it to the VA?

If I receive surgery before my exam and the issue is resolved will I get back pay for the last 2 years I've been living with this?

If I wait and they award me with the 10% due to the blockage, and reconstructive surgery fixes the issue, will/when will they remove the 10%?

When I do surgeries and stuff outside the VA how does it work? Do they have access to the documents or do I have to inform them?

How frequently after my initial C&P do you get examined?

Sorry I know its a lot of questions, but I would really appreciate some incite and try to understand how this works...

[Vync]

I responded inline:

So I'm currently waiting to get my C&P exam (been waiting for almost 2 years), however my wife is in the military and I have doctors outside the VA system. Today I was looked by an ENT doctor concerning my nose issues, which is also something on my claim. I had surgery on my ship to open up my nasal passage due to an injury in relation to my service, however I have noticed its closing up again. Today they found that I have a 70% airway blockage and I have had closed nasal bone fracture for quite some time and they recommended me for surgery. I went ahead and collected their paperwork on this. So I have a few questions concerning this situation.

Is this paperwork worth anything to the VA? Will it help my claim? How do I submit it to the VA?

It depends on what you are claiming. If you are claiming sinusitis or allergic rhinitis, it might be beneficial. If it indicates the presence of nasal polyps, it could be very helpful. You can have polyps removed, but remember that they can always grow back.

If I receive surgery before my exam and the issue is resolved will I get back pay for the last 2 years I've been living with this?

If it results in an increase of your combined rating, then you likely will get retro. They might also stage your ratings. For example, if your evidence proves that you qualified for a 30% rating prior to the surgery, but 10% after surgery, then the retro could be 30% prior to surgery and 10% after. There is no way to tell if they will stage ratings, unless you are requesting staged ratings based on increases over time. Some raters dig in, some don't.

If I wait and they award me with the 10% due to the blockage, and reconstructive surgery fixes the issue, will/when will they remove the 10%?
You might consider holding out for not only the C&P exam, but also the award letter. The reason why I recommend this is because I had a C&P exam in one month, but was brought back the following month because the doc lost the results. That was back when they were taking notes on paper, not entering them directly in computers. If you can manage the time with medication and rinses, it might be worth a shot. Having a surgeon recommend surgery and actually having surgery are two different things. If your claim is still active and they see you had surgery, they might bring you back in or use those records to possibly reduce your rating.

When I do surgeries and stuff outside the VA how does it work? Do they have access to the documents or do I have to inform them?

The VA only has access to what you provide. They cannot go snooping around your non-VA records without permission. That's what HIPPA is for. Also, keep in mind that if you do sign the release of information, keep the dates they are allowed to access limited to only the records you want them to see.

How frequently after my initial C&P do you get examined?
It could vary. Keep in mind there is a difference between a C&P exam and a regular exam. The VA considers a condition stable after 5 years, service connection is protected after 10 years, and the rating percentage is protected after 20 years. Until you reach the 20 year window or become full P&T 100%, the VA could request you come back in at any time. I have been involved with the VA for about 20 years. I was only brought in twice for a new C&P. Once was when the doc lost the records. The other time was when I was given a 'temporary' rating, where they 'expected my condition would improve'.

Sorry I know its a lot of questions, but I would really appreciate some incite and try to understand how this works...

No problem at all. We all start out kinda green and need to learn how the VA operated. I do recommend you search through this site via the main page and forums. There is a wealth of helpful information. You can learn a lot from reading about how other people handled things. Also please be aware that the laws that govern the VA do change over time. If you look at really old posts, it might not be as relevant as newer posts.