Rich p Posted July 9, 2014 Share Posted July 9, 2014 Rated 50% PTSD and 0 sinusitis. Denial letter said due to the absences of suicidal ideas my rating is 50%. Due to no va treatment for sinus issues 0%. In my nod I detailed by line item in the progress notes, that i had several issues with this issue and had actually be admitted to a hospital by court order for same. All mentioned in the c&p. I ask that the va give me a fair rating. That I believed them responsible for gross negilance because the rater lowered my claim due to an existing condition documented in the original c&p and any reasonable person would disagree with them if they read my c&p, which I made clear was not done based on the raters comments and the info in the c&p. I also raised the issue that I had not be seen by the va for long before the c&p. That I had provided evidence of two radical surgeries and still fill a dish towel on a regular bases from sinus issues. Then I received notice of a second c&p. The dro actually sent a copy of my nod to the doctors telling them in writing that the veteran has in great detail accused us of gross negilance. I did get rated up on sinuses and 100% for PTSD. I'm very concerned that there is no way to report such grossly wrong actions. A dro review is intended to put a more experienced eye on the claim and regulations state a non adversarial view. Yet their comments on my c&p only served to bias the new c&p examiners. If the purpose was to get a fair report from a new set of eyes trained in their field then why would the providers need any other input except please review this veterans symptoms and provided.... Not sure, how but people like this DRO clearly allow their own biases to impact their decision making and may I point out that he is a senior employee. With people like this allowed to do as they please without conscience veterans will always be on the outside looking in. I'm screaming out my window " I'm as mad as hell and I'm not going to take it anymore. I'm finding a place to turn that chronic anger I have. Nice to have it directed somewhere. I understand I have a right to meet with the DRO. I plan to make that happen, show the individual why I have a problem with them and ask them to resign. Informing them I do not intend to go away or let go until they suffer the loss of income like the veterans they are providing a dis-service too. We need to find a way to require when appeals are rated in the veterans favor it generates an investigation and corrective action ( retraining, have employees sign off on their errors and release them based on performance. The only thing hard about this is someone might actually have to be qualified to do their job just like the va employees that are dedicated and have much lower rating issue problems. Wow! Sorry that's how civilian claims adjusters do their jobs without union protection. Once you have union you will always have those that do and those that get by. Kill this union and we will achieve control. Link to comment Share on other sites More sharing options...
rpowell01 Posted July 9, 2014 Share Posted July 9, 2014 Because you don't receive treatment from the VA doesn't mean they can and are allowed to deny a claim. There is not rule nor policy that states a person must be receiving treatment from the VA in order to have a diagnosis. This happened to me in a way. I have a diagnosis that I feel was so personal that I couldn't tell the VA doctors. But, I had a private doctor (specialist) diagnosis and link it to my service connected issues. So, the VA denied that claim for the same reason as yours. They are NOT allowed to do this and this is considered a CUE. You can are allowed to write a letter to the RO and ask them to CUE themselves even before the appeal deadline date. Most CUEs are filed after the appeal date has run out. In this case you can request a DE NEVO REVIEW with your appeal and ask the DRO to CUE themselves. This is what I would do. Link to comment Share on other sites More sharing options...
georgiapapa Posted July 9, 2014 Share Posted July 9, 2014 If the VA's justification for giving you 0% for sinus issues is because you did not receive VA treatment, the VA screwed up. A majority of the evidence I submitted with my claims was from private medical providers. About the only medical issue I know of that requires VA treatment is PTSD. Link to comment Share on other sites More sharing options...
Navy04 Posted July 9, 2014 Share Posted July 9, 2014 Welcome aboard and sorry to hear of your troubles. 100% PTSD 100% Back 60% Bladder Issues 50% Migraines 30% Crohn's Disease 30% R Shoulder 20% Radiculopathy, Left lower 10% Radiculopathy, Right lower 10% L Knee 10% R Knee Surgery 2005&2007 10% Asthma 10% Tinnitus 10% Damage of Cranial Nerve II 10% Scars SMC S SMC K OEF/OIF VET 100% VA P&T, Post 911 Caregiver, SSDI Link to comment Share on other sites More sharing options...
Notorious Kelly Posted July 10, 2014 Share Posted July 10, 2014 Welcome, Rich! That's wild they sent that info to C&P examiner; I'd call that a hostile environment. We need some reporters to do more than lip service and dig deep into the bowels of this corrupt mafia. Link to comment Share on other sites More sharing options...
rpowell01 Posted July 10, 2014 Share Posted July 10, 2014 I would send your decision letter to foxnews and them to report this type of behavior. Its nothing new but its now time for them to change and the VA needs an overhaul. Link to comment Share on other sites More sharing options...
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