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Disability Process Got Me Down


rootbeer22

Question

Folks:

This whole disability process has got me down. I got some of my CP Results and they are lackluster at best? Just when I thought that the exams were done and I have been making progress...it looks gloomy at best?

I literally lived in a Tank, my first two years in the Army. My wife who was newly married to me then wanted to leave because we were not together much while I was in the field. I loved the Army and I wanted to be a Tank Commander since I was in the 6th grade. Early in my career, I was severally injured twice, once in a anti-tank ditch accident and then a year later in a tank main gun explosion. So, now as I filed my claim the doc says" how do we know that you were injured in the Army?" Well, how many civilian professions use Army Tanks to do their work...none that I know of? I actually was given a Class AI flight physical and passed it when I first came in because the Army needed helicopter pilots but I still got Tanks like I wanted. But with all of the injuries and sacrifices and with good SMRs, it's almost like I'm begging to get covered for the conditions that only could have occurred in the Army? I know other vets have been through this drill before and the lack of respect really stings...I know, it's not over yet and I'm a fighter and that we vets are a sturdy group...one thing is for sure..this site has taught me a lot....and I appreciate the advice about educating ones self about the process which is important if one wants to keep their sanity until the final letter comes...then one may still have to do a Nod or even worse an appeal. I guess I thought having my stuff together by learning everything about the FDC would make the difference..... but not always...?

Edited by rootbeer22 (see edit history)
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Was it a VA, or a VA-contracted C&P? You might need to go get a private Independent Medical Examination with a medical opinion to trump it. Also make sure you have all your records personnaly.

Mark

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Markintexas:

It was a part time contractor working at VA C & P Facility and seemed like a pretty good guy? I think he was just trying too be cautious but did not seem to look at the records that I gave him including very detailed evidence including CTs and MRI's? I' m finding that the Regional Offices are not sending SMRs for the examiners and when SMRs are provided , they don't seem to review them? I'm an analyst and thought that proving good SMR evidence would make the difference but it does not seem to? Certainly, on an appeal it would be compelling but why not do it right the first time? I don't know, maybe it's like Social Security where most get rejected at first and then after considerable effort, they start approving the claims...?

Edited by rootbeer22 (see edit history)
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It happens. They were missing most of my SMR's on my VA C&P's.....wasn't until I got my C-File that I noted they didn't even have them available. IME/IMO with the SMR's available should be helpful to your case. Keep on fighting!

Mark

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rootbeer22,

I agree with Mark. I would go ahead and try to line up some good specialists to conduct IMEs and prepare some strong IMOs for you as soon as you receive your rating decision. However, I would wait until you actually receive your rating decision before you go to the expense of actually hiring the specialists because your rating decision could be the opposite of what you expect. You really never know what will happen the VA. JMO

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rootbeer22

I certainly understand your frustration, unfortunately C&P's are not what we usually expect the results to be.

Even with good medical reports in your favor if the Dr's don't take the time to read them and base their report on just a few questions (during the C&P Exam) then any medical evidence you have is useless this is obvious!

I found in my experience with C&P its not always what we think,( the Doc some anyway) makes you feel the examination went good and your mind is at ease but to only be low-balled sorta-speak, they make you think everything is going to be fine...and get your hopes up, only to find they never read your evidence and medical reports that is so important in a C&P, and if a VA Examiner ever tells you I see your here for an increase in your compensation/or new comp claim and at the end of the examination he/she says ''its not me that makes the decision I will follow up on this report'' you can go check out now''.....you can bet your booty this examination will go south!

If you think you got a bad C&P you can request another one with a different examiner or if you ever have a DRO Hearing at your RO you can sit down with the DRO an explain about the unfavorable C&P As to how the VA Examiner was and how he/she never addressed your medical reports while examining you as well as any negative you observed during your exam.

I am so sorry all of this is happening to you but please realize your not alone!

Just keep hanging in there and keep on fighting you will win soon Bud!

...............Buck!

Edited by Buck52 (see edit history)
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rootbeer22

If you have good medical evidence in your favor and denied?

Request DRO Hearing at your RO.

DRO can expedite your claim if you have good medical evidence that is in your favor they usually will rebut the C&P Examiner.

Sometimes I think C&P is useless!

jmo

.............Buck!

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Sorry to hear of your troubles bud. When I was Medically retired from the Navy in Feb 2013, I was 30% from Navy, and 80% VA. My VSO in county said that I would not get 100% VA or SSDI, even though I had 15 surgeries while active and multiple health issues. Thanks to this site I was increased to 100% VA in Feb 14, and awarded SSDI in less than 10 weeks, which is permanent. The VA denied both knees, shoulder, back, asthma and a slew of secondary conditions with my first claim. Since I have completed 3 FDCs, and guess what, instead of NODs and APPEALS, I just kept reopening the denied conditions, and the VA has not only awarded all of them, but at high %s. VA thought I was stirring the pot or ungrateful with a filed my current FDC in NOV 14, and sent me for a bunch of C&Ps, and then decided to review all of my high %s including a 2hr PTSD Review, which was brutal. Guess what, not only is the VA continuing my SC, but it looks like a few of the Reviewed Conditions are actually going to be granted an Increase. Sorry for the long post and rambling, what I am trying to say, is that I kept going to over 30 C&Ps for the same conditions, and I just made the C&P Docs look at the same Medical Evidence, and I would not leave until they reviewed every note or MRI or Xray. Most Docs would not listen, and here and there I would get a really good Doc that was nice, but even then they would not review everything or they would get overwhelmed due to all my health problems. I promise that you will win in the end, and we are always here for you. Good luck and God Bless!!!!!

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Folks:

Thanks again to everyone....I'm a fighter and will continue to do so until this is done. In a few cases, the SMRs were there with all of the correct information...but they were never consider at all it seems? He even mentioned the extensive SMRs over a 20 year period for my back issues-over and over again on the report...but never looked at the extensive CT Scan and MRI Images that were right on top of the file and pointed the results out...The RO just sent my buddy statements to the examiners but not the SMRs. So, I provided the SMRs to the examiner during the examination but it looks like they were never considered? However, I get the same answer time and time again, "don't worry, the rater looks at your whole file..and they'll figure it out for you? I was floored that I have an SMR that says may hand was hurt on a specific day, time and place in service but there's only a 50/50 chance that it was hurt in service?

Edited by rootbeer22 (see edit history)
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I agree with you fellows. The process for a claim is made to tire you out and see if you will go the distance, rather that it gets so tiring and complicated that you just give up or make a deal. Department of labor is the same way. I seriously believe that these Agencies are out to get me. Reality is they are just trying to save a buck to get that new Bentley or pay some interest group or constituents. The process has me and has gotten me to the breaking point several times. But I realized something today. With my case specifically, both on VA and Federal Workers comp. Stick to your guns. Don't give up. Once you file stay the course and don't let anyone, not family, not attorneys, not even Chief of Staffs or Secretaries of the organization intimidate you to concede. quid pro quo. It's your life, the rest of your life. Don't let your sacrifices and those before you be shamed because these perpetrators want to make or keep a buck. The hell with them. The stakes are really that high, IMO and cases they are for me. " fight til your last breath"

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I was ten foot tall and bulletproof. I am nonthing more than a worn out old man with mental illnesses. But I like that song some days I'm as good as I ever was. That's what keeps me ticking. Never give up

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You are nearing the end of the beginning. Compensation claims are a lifetime ordeal. I filed my first claim in 1986 and will probably die before all is said and done. A few Vets get under the wire just to show the public that the VA claims process is viable when in fact it's a broken arrow. It's like a marathon race. The VA c&p exam process is a farce. Most Vets who have filed a claim understand it and how, why it happens that way. Frustrated and angry Vets tend not to prevail in the long run which is why the VAROs throw out so many errors. The system is designed this way with the approval from Congress who would just as soon sequester compensation. They want to reduce Vet benefits to zero so that their buddies can get earmarks. The best way to handle it (as you will soon find out) is to just shovel out the required paperwork and then walk away and let it take it's course. Easier said then done...I've been there

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I feel for you rootbeer2. The VA got a medical opinion after my husband died. It was used to deny my claim. It was so short and brief, and just scribbled on a Statement of Case form. It was like the doctor couldn't even be bothered with sitting down and writing a real opinion. I thought - my husband deserved MUCH better than that. He spent his life serving his country and the VA could dismiss him with a few scribbled sentences? Of course, such a pathetic medical opinion was easy to defeat at the BVA level, but still - it just seemed so disrespectful to me.

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My fellow veterans the problem is more than the VA, manpower, or process.

The problem is many veterans don't adequately understand the process and incorrectly file for compensation based on the wrong assumption of service connection.

There are several ways to garner service connection, but most claims (I imagine) are filed due to direct service injury/sickness.

Even though it is the most prevalent way to garner service connection (current diagnosis, diagnosis in SMR, and continuity of care/nexus). It is not the only way.

You should file a claim and seek service connection based on the circumstances of the injury or sickness.

Here area few examples:

1. aggravation of pre existing injury- injury documented in entrance exam or before active duty, documented aggravation of injury during military service, and current documented injury by medical professional.

This type of service connection is primarily shown by steps 1 and 2, which places a tremendous burden upon the VA to prove the aggravation during service was more likely attributable to wear and tear.

Often the VA cannot prove the burden.

No nexus is needed.

2. Chronicity- Veteran is cited during active duty or the presumptive period with a chronic condition.

If the condition is medically cited as being chronic after military service, then the condition is service connected.

The diagnosis of chronic is key in this type of claim.

Also, make sure the physician lists residuals of the chronic condition too.

No nexus needed.

3. Continuity of Symptomology- This type of service connection is based on complaints, medical diagnosis, and residuals which later manifest into a chronic condition.

The initial diagnosis or complaints can be underdiagnosed while on active duty; however a link (nexus) has to be shown how the current chronic condition is connected to the complaints on active duty.

The connection/nexus has to be skillfully wrote and supported by medical evidence.

These are several other ways to get service connection granted, but most veterans are unaware and led to believe direct service connection by injury and sickness is the only way.

VSO's have to carefully sit with veterans and go thru their medical documentation and see what service connection will often make the claim successful.

Don't depend on the VA to connect the dots, They send denials and let the veteran figure where they went wrong. Most veterans wont connect the dots and give up on a probably successful claim if developed more.

The act of acquiring service medical records is key and having a knowledgeable VSO to map out a game plan according to the event in the service records.

Don't allow a VSO to simply push you into filing 15-30 claims simply because the information is in your medical file.

Know what events where diagnosed on the entrance exam, were any injuries made worse (documented), where any of the issues noted to be chronic in nature, where any of the issues manifested during one year time period since leaving active duty, where any injuries cited on exit exam as having worsened (flat feet example), have any medical issues or complaints manifested themselves since leaving active duty, etc.

HADIT and just generally studying VA process has greatly helped my knowledge and better understand how the process works as a whole.

I would recommend any members whom are considering filing a claim to research the process of service connection and make sure your medical records are present when you speak with a VSO.

Have a game plan (gather/know your argument of service connection), know how conditions can be service connected, and get the medical documentation to cement the claim.

"NEVER GIVE UP"

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