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

[ardodd]

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?

[ardodd]

2 hours ago, Lemuel said:

They are under pressure to get the claims through VARO quickly.  In my case it was done quickly and quickly denied.

I am affraid that this is going to be the norm now days. Run um in - knock um down - Here comes the VARO bus.

[pwrslm]

You need the C File.  I dint note anywhere in this long thread where you asked the VARO for a copy of it..  They should have records going all the way back to the first time you filed a claim. You need to review the entire file, note every mistake the VA made, and see what you turn up. It is very possible that your original claim contained errors that you can win in an appeal which would give you back pay for the entire 25 year period, but you will never know without the CFile. You can take it to a VA Lawyer for the appeal, and if there are any grounds for you to appeal, I have little doubt that they will pick up and run with it for you because of the sizable back pay involved. They take something like 20 or 40% when you win and should pick you up on contingency.

 

The biggest mistake we make is that we get in over our heads in the appeals process. If the VA Lawyer at the VBA thinks that they can run over you, they will and get the appeal denied. If you have the lawyer on your side that knows the in's and out's of the legal process, it is much less likely to happen. I know that the first instinct for a vet is to follow the good will ad faith in the system, but sometimes when these claims get very complex, we need legal help. The VA will fight tooth and nail and use every dirty trick in the book to not pay you backpay for 25 years because THEY made a mistake from the start. My advice is get that legal representation on contingency, if they lose you wont lose a thing. If they win, you get 60-80% back for the last 25 years.

[Lemuel]

Good and bad.  The attorney is limited to 20% of back pay or time, which for a small back pay add up to a higher percentage.  They prefer the 20% contingency with a large back pay such as you will get, ardodd,  because they don't have to submit their time sheets for audit. 

When TDIU is involved delay means $5,000.00 plus per year for sitting and waiting thus no incentive to force the issue for the attorney.  With an attorney, you need to build a paper trail for reducing their fee with an appeal to force the attorney to get on the ball and force the issue.  I didn't and it was a mistake.  But it wasn't a mistake to get the attorney.

However, if one cannot get an attorney because of a short back pay up to the BVA, get the best you can with a VSO and then send a notice of appeal to the CAVC well within the 120 day appeal period.  Do it yourself.  All you have to do is go online to the CAVC, download the form and fill it out.  The next thing that will happen is you will be inundated with attorney solicitations to represent you.  Your back pay will be longer.  The attorneys will pursue diligently for fear of the CAVC cutting their fee on appeal from the VA GC and the fee won't come out of your back pay.  The VA GC  will move faster.  There are short time elements for processing at the CAVC.  The DRO BVA have open time for processing.

Up through the BVA the fee comes out of your money.  At the CAVC the government may have to pay the fee.  Hence the BVA gives you max that they can and not have the VA GC appeal to the CAVC.

On FTCA in District court the attorney can get a higher contingency fee.

That paper trail I was talking about is the letter to your attorney by certified mail to request the claim be moved on to the BVA because of DRO delay and your hardship circumstance.

[ardodd]

8 hours ago, pwrslm said:

You need the C File.  I dint note anywhere in this long thread where you asked the VARO for a copy of it.. 

I apologize as I did not mention that I did get a copy of my C-file in 2015 when I was Denied for the 2015 Claim. I apologize as I have been focused so much on the Errors of the 1999 Claim. And how my initial 1990 Claim has just completely disappeared. As I can not find where I filed in 1990 so I can not keep fighting myself looking for the record as lots of my paperwork got throwed away by my brother after my mother passed away.

On the same note a word of advise to anyone is to make every effort to go to their local courthouse and let them keep the original copy of any claim. Because we are human and they are human also and we do misplace or lose stuff.

Forgive me as I was finally able to get a pain medications from doctor to stop the throbbing pain from the total knee replacement 2 weeks ago. It is hard to cope with pain without any kind of way to distract the brain. The private doctor that did the surgery will not write me a prescription because the VA has a Pain contract for only 2 Lortab a day. Which is not enough to help.  

[Lemuel]

To get it keeps changing because of the try at integration of computer systems.

I received my last CD From this address:

Department of VA, Records Management Center

DEPARTMENT OF VETERANS AFFAIRS
Records Management Center
P.O. Box 5020
St. Louis, MO 63115

I would recommend sending it directly there.  It doesn't mean you'll get all you need.  I didn't as can be seen from my Motion to Correct the RBA at the CAVC.  Many of the things I received in the 3,157 page CD from them weren't in the 4,529 page CD received from GC as the RBA.  Plus additional VA medical records that should have been in both are missing from both.

You can also submit an FOIA request to the Evidence Intake Center.

I'm attaching a redacted copy of my request that got the 3,157 page CD when I discovered much was missing from the 1420 page CD sent to my attorney.  Mine is probably more complicated than yours needs to be.

 

Army	Discharged, retired, or separated from any component	10/16/1992 to 12/31/2013	Department of VA, Records Management Center
		on or after 01/01/2014	AMEDD Record Processing Center
Navy	Discharged, retired, or separated from any component	01/31/1994 to 12/31/2013	Department of VA, Records Management Center
		on or after 01/01/2014	BUMED Navy Medicine Records Activity
Air Force	Discharged, retired, or separated from any component	05/01/1994 to 12/31/2013	Department of VA, Records Management Center
		on or after 01/01/2014	AF STR Processing Center
	Discharged or retired from Reserves or National Guard	06/01/1994 to 12/31/2013	Department of VA, Records Management Center
		on or after 01/01/2014	AF STR Processing Center
Marine Corps	Discharged, retired, or separated from any component	05/01/1994 to 12/31/2013	Department of VA, Records Management Center
		on or after 01/01/2014	BUMED Navy Medicine Records Activity
Coast Guard	Discharged, retired, or separated from Active Duty - Reservists with 90 days active duty for training	04/01/1998 to 09/30/2014	Department of VA, Records Management Center

20160811 FOIA request_Redacted.pdf

[ardodd]

Thank Lamuel

15 minutes ago, Lemuel said:

To get it keeps changing because of the try at integration of computer systems.

I received my last CD From this address:

Department of VA, Records Management Center

I do need to get my hands on a updated version as i have had so many complications and doctor visits along with surgeries since last time. The one I received in 2015 took about 2 weeks from the RO in New Orleans. But was also a result of going over everybodies head and straight to the Under Secretary at that time. So yes one would think that I am not going to get anywhere now since I do not have any help. And probably right I will most likely be black balled by the VA.

Hopefully I can get help from Hill & Ponton as I ask if they would be able to help me in my Claim Denial this year. I sure hope so this way they can look over my whole Claim process from the beginning and identify and thing that is not correct or wrong.