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Analysis of Deferred Contentions--What I Found Today

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rootbeer22

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Folks:

Today I did a sort of "after action" review of my FDC claim. By trade, I'm a business and management  analyst that looks at organizational processes and procedures. So, I figure that I would analyze part of the  results of my initial FDC claims results and then the deferred contentions that  followed and became the phase II - up of my claim. Anyway, Originally,  I did 13 DBQ's  at a VA facility to speed up my claim  but the nurse who did them, did not follow the VA Exam Manual properly? In particular, she did not follow the procedures correctly to the ROM Measurements and guesstimated about half of them without a measuring device? So, I complained and was able to take  two of the most important exams over? As a matter of fact, the rater later commented that there was a big difference between the DBQ and the second CP Exam with a doctor doing the examination? Of course, the second time, a measuring device was used and the point of pain was considered--as it should have been originally. Frankly, I'm not sure I would have done the DBQ's again now based upon the bias that I saw with that nurse? She essentially told me when we first met that she was too busy to do the DBQ's and that her boss was making her do them due to a new policy? She also made a point to let me know that older vets coming into the system just now, were taking up resources? So, I think that clouded her measurements and my particular readings during the exams? I still got most of the sc for the initial contentions but most of them were in the 10% range and I'll have to go for increases via the NOD Process.

Anyway what I learned today, concerning my deferred part of my claims, was that most of the evidence that is "supposedly missing"  was on/in my handwritten smrs anyway that the VBA already has? On the deferred claims, I only went 1 for 7 and knew something was wrong then? So, when the A8 says, "no record of "groin injury" in service",  but it was right their black & white in the records, then I guess handwritten records don't go thru the word search parameters of the VBMS system very well? The good news is that I found it (the missing evidence), easily but the bad news is that the rater did not, so  it's going to be a couple of more years before I see the  results or a service connection now for these contentions? When I first reviewed the VBMS and how it works, I knew that from the Desert Storm Generation  back,  that hand \written records are going to be a major problem to contend with in terms of claims accuracy and getting the correct results. Frankly, unless the records are typewritten, there's a very  good chance that they may just be overlooked and not considered at all --like mine this time? Unfortunately, my current  civilian PCP does all of his notes handwritten and not one can hardly read them, but he's a great doctor?

 

Take Care..Rootbeer22

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You posted:

"She also made a point to let me know that older vets coming into the system just now, were taking up resources"
 

end of quote.  

This is like saying I should stop making my house payments as that is just taking up too many resources.  

There is no draft now, and people join the military voluntarily, many to serve, but many for the "benefits", to include Abe Lincoln's promise.  

Yea, Im sure we could save money by just euthanizing old people over 60, and throwing them away like an empty soda can, as she suggests.  We can also euthanize the unborn, the very young, those too weak to defend themselves, any with genetic abnormalities, and certainly any with "terminal" diseases.  We could also eliminate "undesirables", too.  But, then, who would grow that nurses food, build, insure, fix, sell that nurses car, and babysit her children while she is working.  Or, maybe we should euthanize VA nurses who "are too busy to do DBQ's", after all, maybe we should genetically engineer a superior nurse that could get more work done for efficiency, and then euthanize any that can not perform to standards, as those below standards certainly consume resources designed for Veterans, too.  

Sorry about the rant, but this is exactly the thing the Republicans were talking about with the health care.  We are providing so much health care for so many, that "choices" will need to be made.  For example, who gets the "new" hep C drug?  Some get it, and others die, so who decides.  I guess you need an RN degree to be able to decide that right?  Sorry for the rant.  

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If there were fact in the records they had when they made the decision that directly contradicted what the decision states, and if those facts would likely have changed the outcome of the decision, isn't that a CUE?  I am in the same boat with the lowballing of my rating.  Records that existed in the VBA's possession when they made their decision contradict the C&P exam.  It is their duty to go over this information, and if the higher rating and the lower rating are in equipoise, they must use the higher rating.  Their failure to acknowledge the facts in the rating decision would effectively be a clear error that a lay person can identify, especially if that information inconclusively demonstrates that the higher rating is justified.  A C&P exam done by a PA -vs- ongoing medical care by an orthopedic surgeon and a neurosurgeon shouldn't leave anything up for debate, but when there is something that is contradicting, shouldn't the PA take the backseat to the specialist?  (I think so.)

How do you make the VA CUE themselves?

 

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pwrslm:

 

Frankly, I was dumbfounded  by the fact that so much in my CP exams were either missed or ignored when the information was clearly provided. However, Vern2 went over with me what happened to him with his well-documented Cardiac issues and it's almost always a battle.  For my Cardiac CP Exam, I stated clearly that I had angina, right arm/shoulder pain, fatigue and chest pains and took medicines like nitro & lisinopril to help with the angina.  Frankly, it's been going on for almost 20 years too.  I also found out that no less than 3 QTC Cardiac Doctors evaluated the report over a 30 day period and it stated that the veteran specifically denies "all of the above"? Also, the angina med nitro was in my pharmacy listing that the VA already has? Also, there's a previous echocardiogram from 16 years ago to shows I have left ventricular heart valve. But none of that got into this report and they lowballed me at 10% for the generic Hypertensive Heart Disease because of the above.  What astounds me is that these are licensed doctors that are supposed to be very thorough with everything they do.  Frankly, there should be an investigation into the reasons, why this is happening to Vets when they go in for CP Exams and that they are so inaccurate.

Edited by rootbeer22
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i am dealing with a deferred claim as well.

i filed for headaches relating to tinnitus in SEP 2011, i had also filed for tinnitus.  tinnitus was defferred in the decision on june 2012 (no mention of headaches however i infer they deferred this as well since it was secondary).  they finally granted a 0% rating in january of 2015 for headaches and 10% for tinnitus, tinnitus was given a EED date of september 2011 and headaches secondary to tinnitus was given a eed date of september 2012 (where they got this number i have no idea it corresponds to NO claim date or decision date, has to be some obscure (we got the evidence at this time, but that wouldnt make sense either).

 

I have filed a NOD to appeal the 0% rating as i have symptoms of 30-50% but thats par for the course, i am also going to file to get a EED back to septmeber of 2011, so that when i finally come out the other end with 30% or 50% i will be retrod back to september 2011 and not september 2012.

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broncovet:

Thanks, the day I went to have my first DBQ with that nurse, I thought I was going into have exams like I'd had done for over 20 years in the military but was wrong? She actually made me feel bad about being a Vet, that I was somehow a burden to the system? I was a senior officer in the military and don't generally take things personally but that really stung? Also, when she took my blood pressure readings, she made a snide comment if I had been taking my blood pressure meds or not? My integrity has always been very important to me and her attitude was really bothersome. Some of my friends have said that these people are sometimes over-worked and  can become cynical but there's a lot to be said about being a professional. However, her boss was very nice and when I explained things to him, he was very helpful and nice. At this point, I'm over it but am on  my guard from now on with this kind of attitude. Frankly, I guess everyone has their good days and bad days and maybe that's the reason this happened to me? I decided long ago that I will not become cynical and will try to find the positives of these situations that I'm involved with?  Consequently, I finally submitted a claim for TBI, after the VBA Rater telling me to do so in their comments, so we'll see how those exams go....

Take Care and thanks for your comments....Rootbeer22

  

 

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QTC again fails a veteran. They sound more concerned with "flipping patients" than being accurate.

The comments about older veterans being a burden is total BS.

This would be a prime case of where recording a C&P exam should be justified. The VA claims it harms the honest relationship between the care provider and the patient, but it is more harmful when the examiner is dishonest.

I recommend contacting Allison Hickey about all of the problems you encountered.

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