Fight Now Or Wait

[Guest jangrin]

Question:

If you receive a copy of the exam findings and report that was done for a RECENT C&P exam, and you don't agree with the medical opinion or findings, should you send in documentation right away (even if the file is a the rating board) or should you wait until the claim is rated and then appeal the findings?

Husbands recent C&P was lacking on the findings for PN in hands and also incorrect statements regarding legs and feet (not accurate).

Thanks for you imput,

Jangrin B)

[Guest terrysturgis]

Jangrin, As you know my claim is a lot like your's. I did the same thing as you and requested copies of my C&P's after each exam. I waited for the decision because the rater should look at all the evidence (private Doctor et all) before giving a decision. One C&P is not the complete factor. The good news is the Effective Date is protected by filing a NOD. John999 has a lower rating for his PN than I did and his symptoms sound like mine. When I went from 20% bilaterial to 40% on lower extremeties it seemed to be based on range of motion and pain.

It's your call but maybe the rater will see it diffrent and award the higher rating. Don't ever give up your quest for evidence till you get the 100% P&T you'all deserve. Take care. Terry Sturgis

[Guest jstacy]

In addition, your IMO carries more weight than the VA examiner. The NP cannot override a Licsened MD.

I wonder if Dr Bash would bash the credentials of a NP for you.

Edited November 9, 2006 by jstacy

[sixthscents]

This is a good question. It depend though upon how much you trust your VARO and are you willing to hand carry the statement to them? I would submit it, in person at the regional office if it were me. Getting a signed receipt at the time. You can explain to the counselor that you packet is at the board and if possible you'd like it added before a decision is made. If it doesnt get there, then file the NOD, but if its only an hour or so to the office...heck even 2, I'd still go in person and see if they can add it now. Try to avoind complicating the NOD, because you will be filing a NOD right? I mean just expect that. Now you could hold the exam as new and substantial evidence, but thats not necessairy in your case, so...I'd try to get it included if you can.

Personally I have been to several regional offices and the ting I noticed most was the fact that there was almnost never anyone there in the waiting area but me. Think about it, how many of you have ever been to the regional office where you send your claim? You can go and talk in person to a claims rep.. the same people who answer the 1-800-827-1000 number you dial since it automatically routes your call to the VARO closest to you.

An example was my adaptive vehicle grant application. I submitted it, (return receipted of course) and waited 60 days. When I had heard nothing I called. Heck the rating decision specifically established entitlement to it in their statement of case. I got so many different answers I lost count. Finally they said that they didn't have any such form from me. I went in person with the form filled out, and they pulled my file...guess what was rubber banded to the top of the file? I walked out with a signed and approved adaptive vehicle grant.

So, always remember, if you are getting 50 different answers, you can ALWAYS go to the source and see what they have. Take all your records and ask do you have this etc. If you give them something get a receipt...type up a couple blank ones.

Anyway food for thought.

[Guest jangrin]

Jangrin, As you know my claim is a lot like your's. I did the same thing as you and requested copies of my C&P's after each exam. I waited for the decision because the rater should look at all the evidence (private Doctor et all) before giving a decision. One C&P is not the complete factor. The good news is the Effective Date is protected by filing a NOD. John999 has a lower rating for his PN than I did and his symptoms sound like mine. When I went from 20% bilaterial to 40% on lower extremeties it seemed to be based on range of motion and pain.

It's your call but maybe the rater will see it diffrent and award the higher rating. Don't ever give up your quest for evidence till you get the 100% P&T you'all deserve. Take care. Terry Sturgis

Thank you Terry,

Chuckles and I appreciate all your imput. We feel the NP really lowballed the PN. For one she didn't include the PN of his hands in her diagnosis section at all. Thats why he was no longer able to work. He lost his grip strength ahd droped stuff all the time.

And for his feet she got it half correct but left out the part about drop foot, unable the extend or flex foot and walks with abnormal gait. ALso she said hair pattern were well distributed. He has absolutely no hair on his legs due to circulation problems. All of this is of course is covered in Dr. Bash's exam findings and report as well as the SSD doctors findings.

Personally I think she will take a back seat as far as credibility when compared to the MD. But I was thinking about writing a letter addressing the inconsistancies and talking photographs of my husband's swollen legs and feet without hair. She stated his feet were pink and warm to the touch.

We are not looking at the same feet and legs.

Also she said no exercise restrictions, but I was sitting there when the VA PCP told my husband no exercise becasue of his heart, did not want him to stress. Also MD wanted to start insulin because of high sugar. Husband asked to wait and see if he could wait until we relocated to our new home. So I think that will be low also.

I am getting ready to start the appeals process because I can see it being low balled as Berta and You and John999 predicted.

Oh well, time will tell. I'm up to it.

Jangrin B)

Edited November 9, 2006 by jangrin

[mssoup1]

Just thought I would add a few comments based on my experiences I had. The statement "The NP cannot override a Licsened MD" is not always true. A NP gave my husband an exam, but there was the doctor who oversaw her that signed that he agreed with her assessment. This, even though he had not even looked at my husband. We also had an IMO and was written in my husbands favor. The VARO denied the claim, based primarily on the NP's C & P.

Also, as far as getting C & P exam results and finding out that they are inadequate. I would get my husbands C & P exam results as soon as they were put into the system and go over every word in it. I found some to be so inadequate, I felt that they must have written my husbands results based on another veteran they had seen the same day. I would immediately write a letter and dispute word for word everything in the C & P results that were not correct. I would then send this to the VARO. I didn't want to waste time on the VARO making a decision based on what I knew to be an inadequate C & P exam. To me, this saved everyone time all the way around. A new C & P exam was then requested based on the previous one being inadequate. Funny how the second time around that the results of a C & P exam could change so much and in my husbands favor. They knew they messed up the first time around.

Just thought I would add something to the post on some experiences we had.

mssoup

[Guest jangrin]

sixth scents & mssoup1,

Thanks for the imput. I believe if chuckles and my life were going along in the normal way we would start sending in documentation countering the NP C&P exam. Unfortunately, we are currently living in a different area than where the rating for initial claim is being done. Claim= CA - WE are now living in Texas. With that being the case we are in the waiting zone, but I have begun getting together our ammo to appeal the RO decision.

I would do it now but I'm afraid they will want to do another C&P exam and that means a trip or two to California and like all other veterans, money is a very big issue. So we will have to wait for the decision and then go after them after we transfer the file closer to where we live.

But we will go after them. Yee ha! B)