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C&p Results Ridiculous! Now What?


chriscshunter

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After waiting 18 months, and then an additional 4 months due to a scheduling error on the VA's part I finally got my C&P exam done. I thought it went very good and was a very thorough 4 hour examination. However, I was surprised to find that of the 12 items on my original claim, only 1 of them was approved. Also the 1 that was approved, was in direct relation to 2 other items.

To go into detail, I was approved for 'broken nose, deviated septum' which was from blunt trauma to the nose, and I had surgery on it while I was active duty, but it didn't resolve the blockage hence the disability. Since then I had additional issues in relation to the initial injury and post surgery. Before I checked out from active duty, I made sure they had these issues amongst others diagnosed, copied, and submitted these items to the VA. They stated that I had rhinitis and sinusitis. I explained all this to the examiner. Well apparently they can't put a 3 piece puzzle together because for those 2 items they stated "The evidence continues to show this condition was not incurred in or aggravated by military service". Which is complete BS as it is in complete relation to the other disability they said was in relation to my military service...

Of the 12 things I applied for, I felt the most serious of which was my post partial amputation which was also denied, which makes absolutely no sense to me, and just makes me sick to my stomach. Is this a normal practice of the VA C&P Process?

So what is my next move? Do I play with eBenefits for a few hours? Do I call and just keep appealing and waiting 6-18 months? At my next exam should I exaggerate the conditions? I don't know how you exaggerate a post partial amputation... Do I point at it and state "HEY, SOMETHING IS MISSING RIGHT HERE... WHERE THE HELL IS IT?"

Edited by chriscshunter
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What happened to you is not unusual. The VA examiners seem to have trouble connecting one condition to another unless you provide them with written documentation from a doctor stating the conditions are connected. They just find it easier to deny the secondary claims. In fact, many of the C & P examiners are not qualified to conduct the evaluations.

You need to get an IME and a IMO from a private doctor who specializes in diagnosing and treating the conditions you have. Provide the doctor with copies of your SMRs and any other records you have pertaining to your medical conditions.

After conducting a thorough Independent Medical Evaluation and reviewing the records you provide, the doctor will be able to provide you with a Independent Medical Opinion as to whether there is a nexus between your medical service and your medical conditions and/or whether your denied medical conditions were caused by and secondary to your service connected conditions. If the doctor's opinion supports your denied claims being service connected, he/she can provide you with a IMO letter you can use to countermand the opinion of the C & P examiner. The opinion of a specialist should trump the opinion of most C & P examiners who are usually NPs, PAs or general medicine doctors.

There is info on this website regarding how to prepare a good IMO letter. Provide the info to your private doctor.

Good luck to you and thank you for your service.

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Chris,

This whole process is a kangaroo court, at best.

If the IG really gave a damn, they'd take 5 veterans and process them thru The System at 5 different location in the US and compare results.

Then they could try to reconcile how they came up with 5 different awards/denials for those 5.

Fight it every way you can figure how from these forums and other resources.

Best start is to post the exact wording from the denials.

Good luck!

Edited by Notorious Kelly
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Take your C and P, and sit down and find all errors you feel are not correct. Then one-by-one quote the error and then provide evidence to correct the errors. Understand you are not a medical doctor, and generally their opinions hold hard and fast. However, if you have medical evidence contrary to the examiners findings, list this in your letter of corrections and then attach this medical evidence to your letter of corrections. Do not send it the C and P unit, but send it to the RO handling your claim. If they have a Claims Coach see that this information gets to this individual, then request once the CC has gone over it, to send it to the Supervisor over all the DROs in your Regional Office.

Here are three options you can also do:

Complain to the Patient Advocate at your VAMC (if they are good)

Send a complaint: via iris.va.gov

or send it to:

If your location of residence is:

  • AL, CT, DE, DC, FL, GA, IN, KY, ME, MA, MI, MS, NH, NJ, NY, NC, OH, PA, RI, SC, TN, VT, VA, WV

DVA, Evidence Intake Ctr, POB 4444, Newnan GA 30271-0020 or

fax toll free to 844-531-7818

or

All other States:

  • DVA, Evidence Intake Ctr, POB 4444, Janesville, WI, 53547-4444 or

  • Fax toll free to 844-822-5246

Patrick428

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