Dro Conference

[Berta]

My claims are with a rater.

I have 2 detailed IMOs, and additional brief IMO statement, from former VA doctor, and also treatises that support my claim as to the clinical record of the veteran and standard known medical fact.

In 2005 my POA had a "conference" with the DRO who had sent me a sameo sameo -socalled de novo review which I raised hell over-and this produced the "conference"

My POA assured me that my initial IMO was in the c file.Yet it had been ignored for a year at that point.

It was his suggestion that the VA get a medical opinion.He told me the DRO could not understand my IM0 because she was new and that my IMO would be considered along with the VA expert opinion.

It never happened. I asked my POA's main office to cough up the documentation on this conference but they couldn't.

It states in the SSOC that a conference occured and it was determined that a VA medical opinion should be obtained.

They denied based on the VA opinion and stated that the evidence did not even rise to the level of Benefit of Doubt.????

Say what? I had initial IMO from Dr. BAsh and a brief IMO -as a recent documented statement from a former VA doctor who treated Rod.Dr. Bash liked the statement very much as it did support his findings too.

It was in email to me from this fprmer VA doctor and Dr. Bash called him and asked him to put this on his now=private practice Neurology letterheard for VA which he gladly did.

As you all know I have had to raise of sorts of hell with VA-just as I did in the 1990s to get them to read my evidence.

Due to the remand I got it seems they are forced to do that now.My vet reps- one at the local office and one at the VARO have been changed under the same POA.

Question-

I pulled out that Dec 2005 SSOC yesterday-

The VA ignored all of my medical evidence-to include the 2 IMOs yet-----

if that meant that the claim did not rise to the level of Benefit of Doubt -why did they even need to get the VA doctor's opinion?

My POA offered no reason at all that they did not address my medical evidence in 2005 ----he said he discussed it with them but there is no record of that at all.All I have is the DRO's statement and it was never discussed.

but still-why would a POA suggest getting a medical opinion and not insist that my opinions be considered too?

It just doesn't make sense.

This is Nehmer class action- a successful award could mean mega buck retro-

would a POA have any reason at all to prevent this type of award?

I THINK my claim evidence is being considered due to the remand and how I raised even more hell---at the illegal transfer to the BVA in July-

but still- something odd happened to my AO claim all along----Dr. Bash himself raised the Benefit of Doubt issue in his August 2006 additional IMO and now I realise what he meant-

His Nov 2004 IMO (I sent him the Dec 2005 SSOC etc that failed to address it) and the other doc's statement raised my claim- even with the VA med opinion that was deficient- to and beyond Benefit of Doubt. I would certainly say now that my evidence, in total is a preponderance of evidence.

If the VA stated that none of my evidence (which they didnt read anyhow and never addressed in any SOC) failed to raise to Benefit of Doubt would it have made sense to even get the VA opinion?

They shot themselves in the foot because maybe they didnt think I would get another IMO to knock it down.

In the 1990s when they kept fighting me over my claim- at least they addressed my evidence and then got a VA doctor to manipulate it all in SSOCs.I continued to rebutt them and at least they read the rebuttals. I won anyhow.

This time- I really think something odd happened at that DRO "conference" with my POA who seemed not to even care when he heard that the IMO from Dr. Bash had again been ignored and had not even been given to the VA doctor to read.

sorry for long post--------

this VARO based vet rep from my POA in Sept 2005 did not even know that I was represented by his POA.

all of my claims and evidence has disappeared from the POA files from Jan 2003 up to Sept 2005.

during that time I actually helped the local vet rep with some of his claims- thinking he was helping with mine---he never even told anyone I was a claimant under their POA.He told me to send everything to the VARO and didnt want my claims there. I gave them to him anyhow.They never got into my POA file.

Something strange has been happening to my claims all along.

I cannot understand why.

Any thoughts at all?

Edited October 26, 2006 by Berta (see edit history)

[john999]

Berta

I think they just don't want to grant your claims and you will probably end up having to go to the BVA. They know they can't beat you so they will delay you. When they start stonewalling you know you are on the right track but it just takes time. It is all a stall and incompetence. They don't respect vets and spouses because they know their are no consequences for ignoring evidence and losing things. The worst happens they have to pay eventually. I had one of those instant De Novo Reviews. I got the decison and ten days after I sent in the NOD I got the De Novo Review. It was just an rehash of the decision and pure BS. You have to get to that face to face meeting and that may have to go higher if it means money. You know what is going on! Maybe the POA traded you off for some other vets.

[Josephine]

I think they just don't want to grant your claims and you will probably end up having to go to the BVA. They know they can't beat you so they will delay you.

Berta,

I think that John may be right on your case, as I certainly do not have your knowledge of the system, but after 4 years at the R.O level, at least with the BVA I have moved from there and remanded to the AMC.

I spend 4 years wasting my time at the R.O.

Just one delay after the other. When my file was transferred from one state to the other, that was another year delay.

They just wouldn't give me a yes or a no. I was idle.

I had to write to Honorable Cooper Under Secretary of Veterans Benefits and he called Huntington himself and I had my No in 5 days.

At least now, my file has been read, and it is down with the two psychiastrist to review the record and to reconcile their difference. Give them a rationale for their decision and give them a new opinion

Perhaps this battle is soon to be over.

Just my thoughts,

Josephine

[Guest jstacy]

Beta, I think it is a personal issue. You called their bluff and hurt their feelings and now they are confused and must not have enough experience to do the next step. What they should do is to offer you a Job at the GS 13 level.

You have proven them to be wrong before and they are afraid their decision may backfire on them so they are just stalling. Kind of like a Kid who does not want to go to bed on time.

I cannot believe they are not consider ing the IMO evidence, That is in Violation of the M21 for evidence evaluation requirements. If it is not considered that also puts them in line for a later CUE.

You may want to consider filing a Writ to get them to make a decision, at least you can go to the next level, For I am fairly posative you can beat them at the BVA or Court level.

Anyhow, here is what they are instructed to do for rating a claim as per VA instruction but it does not always work this way.

http://www.warms.vba.va.gov/admin21/m21_1/...v/ch05/ch05.doc

Edited October 27, 2006 by jstacy (see edit history)

[Berta]

"Maybe the POA traded you off for some other vets.'

I think you might be right-

One vet at the local vet rep level-

my vet rep had made a terrible error on his claim around the time I filed my claims. The vet was pretty upset.

It seemed that the vet rep had promised him 100% SC for PD.The vet rep read the award wrong-it was for a VA pension.

The VA does not recognise personality disorder as a compensatable disability.

I even helped with this claim to see what other disability could possibly be SCed- there was some support for heart disease in the SMRs but it was very weak evidence.

I saw nothing in the SMRs that would support PTSD, depression, anxiety, any other compensatable mental disability.I talked to the vet many times about his service.There was nothing he said that was a stressor or anything that would lead to a different diagnosis.He mentioned incidents where he felt his superiors were too hard on him but nothing beyond normal service life and nothing that he had any evidence on.

I suggested to the vet rep that he get a strong psychiatric opinion with all the shrink testing to try to see if he had a compensatable disability because they wont pay for the PD.

Seems the vet rep didnt believe me and continued to try to get this vet SCed for PD.I think his focus was more on this claim than mine because if I brought up my claims, he would ask what other way could this vet be service connected.

The BVA denied this claim last year.I bet they filed it again.

I think the vet rep doesn't want anyone to find out the error he made in this claim and has put other claims to the side to concentrate on getting a 100% SC award for personality disorder for this vet.

[Berta]

I forgot to add- there have been many complaints from veterans against this same local vet rep-not just me- worse one I ever met-

I was not concerned however- until I got the DRO conference-where a more senior POA vet rep was at the conference (I think)???

There is a good possibility that my initial IMO was never even discussed-no record with the POA or the VA that it was even acknowledged- and a possibility that the POA sent in some lower level rep to handle this conference.

They have to do something (VARO)-I asked for the BVA to remand due to 3 reasons,lack of VCAA Notice,lack of consideration of my evidence in violation of VA regs and case law, and due to the 3rd IMO.

The BVA remand stated the claim needed additional development.They have been doing something with it since the day they got it back.

After I filed a formal complaint with my POA's boss,they changed my vet rep at local and regional level.

Actually the POA problems might have nothing to do with my claim.

This is exactly what I went though in the late 1990s with the same VARO.I filed an administrative review and

still they withheld important medical evidence from the VA Central Office.

All the evidence in the world does not matter if no one at the VA even reads it.

In the above situation I called VACO in DC every week to make sure they had what they needed.But only at the last minute, during a call to the Strategic Healh Care Team of cardiologists, did I realise that the most important evidence was not there. The head team doctor was shocked when I mentioned it and told me this evidence was never sent with the 5 volumes and the c file ---which they had gone through carefully- and asked how soon I could fax it directly to them.Within days after their receipt of this evidence by fax, they awarded my claim.

With the violations in the handling of my claim- the BVA would continue to remand it anyhow- so they have to do something-until those violations are corrected.

Edited October 27, 2006 by Berta (see edit history)

[john999]

Getting 100% for a personality disorder??? That shows the POA is just completely out of his depth. I did have the VFW argue that I should get a higher rating because on top of the fact of a compensable anxiety disorder I had a PD. That was absurd. That was years ago. With service officers like that the veteran is lost. These VSO's have over a million dues paying members and where is the money going I would like to know besides parties and conventions? Without hadit I think we would be lost. My VSO had never, ever told me about TDIU and even discouraged me from applying for it.

[Berta]

John-this is a state Veteran's Affairs division.

Alex assessed state vet reps ,in general , for me and it was not very complimentary.

I believe I am one of the first claimants they had here in Bath who ever produced an IMO.They never recommend that a vet get one.

They never even heard of Dr. Bash at the local office.

The remands they have at the BVA show how negligent they are.

I do not believe all the state vet reps are lousy here in NY but they sure are out of touch.

When they told me I could not send more evidence after I elected the DRO review- I sent them M21-1 where it said they were wrong.

Unfortunately many vets go to them for help because they are on the grounds of the local VAMC.

The one rep there is good but he is totally overwhelmed all the time.

But it is the evidence that prevails in spite of lousy vet reps.

It just bothers me how much these reps get paid by the state taxpayers and they really dont have a clue.

What goes around comes around, and the main problem rep there surely is not producing anything comparable to the other one as far as claims work goes. This will catch up with him.

[john999]

Berta

It seems that the first thing out of the service officers mouth ought to be for the vet to go get an IMO if he wants an increase in disability rating. I have never had a VSO tell me how to go about getting an increase.

[Ricky]

I think they are the same through out the COUNTRY. Here, when I went for assistance after I had my stroke my rep told me to forget it and that I should be happy with the 40 percent I was already receiving. I guess he was only getting 30 percent or something. I fired him on the spot and if I did not have to hold on to my walker as I left his office I would have took it out and pissed on the floor but I did not want to pee on my leg :) I think I will give up this VA stuff and go find me a job where I will be paid to be incompetent hahahhaha.