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25 Year Long Service Connected Disability Denied After C/p Exam.

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ardodd

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This epic battle began 25 years ago when I was Discharged from USMC with a Medical Discharge for Bilateral Patello Femoral Syndrome in both knees. I filed when I got out in 1990, or so I thought I filed, according to the VA. I am not getting any help from VA on it at all. But I will move on and let that be my battle to prove.

All of this supposedly began in 1990, but it was not until 1999 when the VA said I filed a Claim. So I will just go from there, I supposedly submitted a Claim then. But in 1999 I was Denied my Claim for Disability and supposedly they sent me a letter telling me I was Denied. This was after signing the private hospital and doctor release forms. Of which to the knowledge of all these places they were never contacted.

So forward to 2010 when I Appealed that decision in 1990 stating they never Reviewed my Medical Records from the Military and from private hospitals and doctor's. Plus I signed the Release of Medical Records form again. And yet I was sent a Denial of Claim stating I had not provided any new material evidence. So in 2011 I Appealed that again and was told that after Review I had not provided new material evidence supporting my Claim. I was frustrated so I just dropped it and did my best to work until 2014 when I was struggling to keep employment and unable to perform daily task. And after being involved in automobile accident I tried in 2015 to go back and try to resolve this 25 year problem.

You may ask why are you know deciding to finally set down and try to resolve it?

Until now I did not understand all the laws and complications this process has. So after filing an Apeal for all the years I had been Denied and taking this matter to some Senior Board members in Washington,D.C for help and and guidance from the VBA. I was unclear of any of it. But my biggest Question has always been to the VA. First why was I not processed when I got out and was paid Severance for my Disbility. Second why have I been denied a C/P exam if they say I had no new material evidence if I signed the Forms for them to get the Medical Records. And the biggest clue for me was during this year when I filed an Appeal and was told that it would take between 2weeks to a,month for them to have my Service Medical Records scanned into the System.

Hello that is like handing me a Loaded Gun. Why would they need to send off to St. Louis for my Service Medical Records after Denying my Claim for over 25 years. I have been told by every VSO,RO and every VA rep that they have access to that file and it was used to Decide my Claim. Ok, if they had it then why did they need, more Importantly why did I send by email a scanned Certified copy of my Service Medical Records for them to use in my Claim this year. It was not until I sent them my certified copy did they let me have a C/P exam. And after 25 years do you honestly think that I would have the exact same symptoms and disabilities as I did 25 years ago. Why of course not, after all human,bodies and disabilities change.

But according to the C/P examiner in his Nurse Practioner wanting to play doctor said that my condition now was not what I was Discharged from the USMC for. And that what he diagnosed me for is not debilitating. Honestly where do they get these people from. He did not do a full exam,and his Non-Board Certified Orthopedic opinion is what 25 years of frustration has turned into. But I am Appealing this poponderous and unethical wisdom.

Sorry this so long but I felt it needed a merit of background, I have left out a lot of details to make it shorter. But my question is two things.

1) Did or does the VA have to grant or give a Veteran a C/P exam if they were Medically Discharged? This was in 1990

2) If the VA did not have to grant me exam even back in 1999,2010,2011 and it would of proved my Claim why would they still not give one and state I did not provide new material evidence even if I showed them records of not one but two arthroscopic knee surgeries as proof?

3) The biggest Question I have is how can the VA Board make any Decission without using my Service COnnected Medical Records and why would they not even acknowledge that I was Discharged from the Service with the Disability?

I would like to say that 2weeks ago I witnessed some VSO's shredding old folders from a filing cabinet. I asked what they were and they told me they were just old folders or files over 7 years old and they had to go. So I am,asking how is it that if someone like me wants to Appeal and old Denialxand might need the proof of the doctor's notes or something from it that was missing or not included. Why would they not scan and record all the information onto a CD or external type hard drive for cataloging. I am just asking has anyone known of this to happen and later the VA says,they never received anything. Kind of makes me wonder why the VA says they never got my 1990 Claim and says I did not try for Disability Compensation until 1999. What your thoughts on it?

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What the VA Rating Dept is required and supposed to do and what they actually do can and usually are, 2 different things. Just gave your post a early am 1st cup of coffee cursory read. It appears to me that your pretty much screwed, or not, regarding old 1st claim.

You may have done everything you should have in regards to being absolutely 100% positive that the VA rating Dept had all the Medical Evidence necessary to support your claim but I don't think so. As with so many Vets (Myself included) we rely on VSO-Reps and the VA to do all the work on our 1st claims. It's not until we get the DENIAL, that we realize the errors we made. It's YOUR claim, and YOU need to be Pro-Active, Trust but Verify everything. Have you requested and received a complete copy of both your Miltary Records & SMRs? By now I would think you would have located and obtained both of those. Do they support your claim? Have you obtained your complete VA C-File?

It's not uncommon for Denied Vets to just say Frack It and walk away. Then months or years later, to realize what they gave up on. At 1st read, that seems to be your situation. At this point, if you really want it, get busy tracking down all the Medical Evidence needed to support your claim. Sounds like you didn't get or keep copies of all your 1st claims VA filing documents, right.

If YOU can prove your VA Claim, the comp is there and you earned it. Get It!

Semper Fi

Gastone

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Ask the VA for a copy of the 1999 denial letter. After you get it, then see if your denial contains a page which explains your appealate rights. Check to see if your address is correct or if the VA had an "old address".

You need to rebut VA's "Presumption of Regularity" in your appeal. The VA is given a hall pass, and it is assumed they did everything they said, absent your rebuttal to the contrary.

If the VA can not come up with a copy of the 1999 denial, then its gonna be difficult for them. Your appeal time (one year) is tolled until AFTER you get your notice you have a right to appeal.

Get a copy of your cfile, if you have not already done so.

You definately have a fight on your hands. The VA is hoping you give up. If you have copies (either through your VSO or not) that you sent, especially certified mail return receipt requested, it will help.

Since you are service connected at 20 percent, are you trying to get an earlier date on the 20 percent, or are you tryiing for an increase, or both?

You can consider a CUE at some point, but if your decision is within the past year, right now you want to file a NOD, dispting the effective date, the disability percentage, or the denial of other conditions, or all 3 of these.

You want to go to Chris Attig's website, and put in your NOD the wording he cites which disputes the C and P examiners qualifications. The examiner is assumed to be compent, absent a rebuttal on your part. So, make it easier for your attorney, later, when he appeal this to the CAVC, by including in your NOD the wording Chris Attig states disputing the credentials of the C and P exam, if its an unfavorable exam. If the exam is fully favorable, then you dont want to dispute his credentials.

Edited by broncovet
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I feel your pain brother. Good advice by all, but this is what I would do.

True, get the denial letter. That will offer clues what they based their decision on 25 years ago.

Next, with documented medical discharge it seems you have satisfied the 2nd leg in the equation (in service injury or sickness).

Go get a current medical diagnosis. Make sure its by a verifiable means (X-Ray, CT-Scan, MRI, etc). This should satisfy the new & material evidence qualification to reopen the case and show you are still dealing with the issue.

Also, with the current diagnosis submit any medical records related to the discharge disability since leaving active duty.

If you are granted service connection, file a NOD for the earlier effective date.

"NEVER GIVE UP"

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i would suggest that contact Mary Ann Wentzel at VARMC at St. Louis via email and request a CD copy of your Claims file.

maryann.wentzel1@va.gov

MARY ANN WENTZEL

Management Analyst, Director’s Office

VA Records Management Center

St. Louis, MO

She has been very helpful to me. Just be polite and explain to her that been trying for 25 years and really need an electronic copy of your C-file (claims file). The CD is searchable and hopefully you may find what you are seeking in this file.

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Thank you all for your advice and it was all needed. As I did obtain a copy of my C-file from the New Orleans RO. First off the problem with proving that I filed a Claim in 1991 when I got is nearly impossible now. When I got I was told to make sure I had copies of all my records and any paperwork that would help when I got home. Admin made me copies of all Service Records, Medical Records, Dental Records and made sure each single piece of paper was certified and signed. They even made triplicates of the discharge paper work with the severance pay, travel pay, and VA forms for disability that were already filled out and signed to turn in. I even have the receipt and contract from Ryder where got it from and where I turned in at, along with the paperwork showing the exact weight of truck with all my stuff in it, and after unloading.

I am just going stop right here...

I have already put myself in a position where the VA thinks I am crazy for arguing with them. I went to the person in Washington with the VBA told her what was going on and she inquired at the Regional level. They granted me that exam and denied my claim for the original discharged disability. I filed a NOD they got it all confused and said all I disagreed with was the compensation rating of my knee's. I went back and the local VSO sent in another NOD disputing the rest of the conditions. Again I asked the person in Washington in between Christmas and New year's if she would please find out about why it is taking so long. She did and I was scheduled a hearing with the DRO. Went to hearing and the DRO told me go back home and file for a earlier effective date of claim. And please make claim for Depression, Anxiety and other Mental conditions.

The DRO scheduled a New C/P Exam for my knee's and C/P Exam for Mental conditions. I had to contact Washington again to ask if they would please add the report from the knee C/P Exam. And it finally showed up in my online access to medical. I used the Blue Button and downloaded it. It contained both C/P Exam reports for my knee's the 2015 and the New 2016. Not to my surprise the C/P examiner from this years exam went through alot of trouble in making statements about my physical findings. And when compared side-by-side neither C/P examiner could agree on some of the test performed. But in all the new examiner went out of her way to make legal statements about my claim in 1991 and then in closing she included that the RO had made a clear and mistakable error in service connecting my for Traumatic Arthritis in the first place. That in her opinion that from being overweight and not from any service connected disability.

So what I am saying is since I asked questions elsewhere and had involved other VA help outside my state and regional office. They seem to be on a road to make sure I am not granted any kind of disability. Right now I am awaiting the DRO decision on my case. Which is still setting at Ready for Decision stage. I have rocked the boat and they will get to it when they want to

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Please scan and attach here the DRO decision when you get it (Cover C file #, name, address first)

"They seem to be on a road to make sure I am not granted any kind of disability. "

I am sure many here have felt that way before.

I certainly have plenty of past VA decisions myself that , as a widow of a vet, proved to me they did not want to pay me a dime. Evidence overcame those denials..

The worse one regarded a manipulated C & P exam. I got the  actual exam from the C & P doc.

The actual exam opinion and their decision revealed that they will go as low as they can go.

It all worked out OK however. After a long battle.

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