V.A. disability Decision

[Jimmer]

I am not sure if I am on the right area, if not, please direct me.  I have followed you guys for almost a year, and really appreciate your help.  You guys have a wealth of knowledge, and I appreciate it.   My situation is, back in June 2015, I e-mailed a letter to Alison Hickey, because I felt the V.A.  was "stonewalling" me on my claim for a paralyzed left lung and my   lower back.  Two days later I received a call from a RO, who said she was handling my claim.  I fax to her exactly what she requested.   I had a "nexus" letter from three board certified Pulmonologists for my left lung, had one fill out a DBQ, also a medical opinion DBQ, also medical journal articles supporting my claim.   I had one board certified orthopedic surgeon do the same for my back.  I was told by the RO that I did NOT need a C & P exam.  ( I have e-mail to verify this).  She told me she received everything, and was working on my file.  Two weeks later, I received a phone call, and a letter for a scheduled C &  P exam.  I tried to contact the RO but to no avail.  ( Later found out she was transferred from Phoenix, Az., to San Diego, Ca.).  I went to the C & P exam, and the doctor said within five minutes, it looks like I am going to deny your claim.  He said hover "file a appeal, because you do have a strong case, and you should win on appeal". (His exact words.  He also indicate that the V.A likes him because  "I am very picky, every has to be dotted and t crossed".  My evidence supported a service connected disability.  I feel I was blindsided by the RO, and the doctor.   How should I appeal?  Contact "Bob"?  I also have contacted Senator McCain (I live in Arizona) and was told he has a big hearing on the VA next month and they would like to hear more from me.  Also I have just been contacted about IU, which I mailed the forms in.  I am 80% disability, one 60% one 50%.  Will any kind of appeal hold up the IU?  I know why they are stonewalling the lung, because that one is the biggie.  Sorry for the length, but any help is very much appreciated. 

[Navy04]

Jimmer, 

 

Sorry for what you are going thru, but it does not seem to ad up.  Were you treated for these conditions while Active?  The Sniff test is not as good as medical evidence as you think.  Do you have MRIs or Xrays on file of the Lung and Back?  Were you Diagnosed thru the VA, and currently Seeking Treatment?  For Example in my case I have SC Asthma, and with just the breathing test, anybody can fake that or affect the results. But I have had MRIs and X Rays of the Lungs that show the Black spots and Scar Tissue. I always say that Evidence is Evidence. The DBQs and Medical Evidence that you have is from the VA, Right? If not, then Why Not? Again anybody can pay some Doc off the street for the Services to See a Patient Once and Type up a Piece of Paper. You are well SC already, so make sure that you are Receiving all of your Treatment at the VA. I myself do not like to deal with Appeals, I just Reopened a bunch of Denied conditions, and went to the Next C&Ps with the Same Evidence, and mad the Docs actually read them and Talk To Me, Instead of At Me, and all but a few were granted SC.  Good luck and keep us posted. God Bless

[waccamawwild]

Broncovet you are so right!

[rootbeer22]

Folks:

 

Too Bad Ms. Hickey left and resigned as the head of the BVA? It's very unusual for a Senior Government Official like her to personnaly intervene for any one person or veteran whom has a claim for government benefits? At First, I was shocked that she was doing this last but year but based upon her background, she has a long history of making things happen as mentioned in this email string above . She did go out with a bang because under her leadership the VBA knocked down their case by the end of last fiscal year. I Know that Congress really was tough on her but she did a great deal of help for Veterans that has old cases and those that contacted her directly for help. I know folks would argue that more could and should be down to cut down on the case backlog but Ms. Hickey does deserve credit for her efforts. Jimmer, I'm really  sorry to hear about your issues and maybe Mr. McDonald can help you as instructed above by others...Good Luck and Godspeed...

[Jimmer]

Navy04,  The lung and back issues are the result of a fall I suffered in the military.  I also suffered damage to my left eye in which they awarded  SC disability.    My records indicated that I had "shooting pain" in my back, and trouble breathing, and pain in the left chest area.  Both the V.A. doctors and board certified specialists said I suffered "blunt Trauma", in the lung causing diaphragmatic paralysis, and only 10& usage of the left lung.   The doctors gave me a battery of extensive tests, (the snuff test was the one I remembered) along with COPD, which they indicated was consistent with diaphragmatic paralysis.   The FVC test,  FEV-1/FVC were the same, both V.A. and with my private specialists.  The C &P doctor (second one) stated that my medical records didn't specify the left lung, and it didn't say lower left back, specifically .   He said " I am a stickler, that is why the V.A. likes me".  The Ratings officer when contacted by Ms. Hickey, stated, if I could get a "detailed Nexus letter, have the Board certified specialist, fill out the DBQ's, and have then fill out another form called the DBQ medical opinion form,  a second C & P exam, would NOT be required.  I provided all that to her.  The doctors went into detail how my condition was service connected, provided the info.  The Ratings officer, told me "this is just what I need, I will finish up your case".   About three weeks later, I was called for an appointment for a C & P exam.  I tried on contact the ratings officer, but to no avail.   (I found out she was transferred from the Phoenix, Az.  V.A. to San Diego, Ca.  V.A.).    I went to the appointment. The C &P doctor told me flat out he was going to write "less likely then not"  as a decision.  Then he said  "You should appeal, because you do have a strong case for the appeal board".  Then as I was walking out he said, "you really are in bad shape".   I had a small writing tablet in my pocket, and immediately wrote down the exact wording of what he said.   I do plan on appealing this.   Would a CUE be possible?  I will definite contact "Bob" as well.  Thank you for all your help, you guys are really knowledgeable, and I wish I  contacted you guys when I got the notice for the second C &P exam.  I thought it was just  to have in their records.  Dumb me, I should have know better.  I do know now.

[Jimmer]

rootbeer22,  You are exactly right.  I had contacted Ms. Hickey in June 2015, because I felt the V.A. was "stonewalling" me on my lung/back issue, particularly the lung, because it is a biggie.  I am at 80%, and this one alone (lung) is equal to that or higher.  A  V.A. manager called me about two days after I submitted the e-mail to Ms. Hickey, saying he had is "butt chewed" by Ms. Hickey office.  A day later a Ratings Officer called me, and told me she was going to work on my case directly, and it would be expedited as quickly as possible.

[broncovet]

Its pretty much a sign of bad management that there is no one to replace Allison as the "go to" guy to get errors fixed.  

If I go to McDonalds, and order a hamburger, that is cold, dried out, or poor quality, there is someone there who will "fix" the problem pronto, and hand me a hot fresh burger that has not been under the heat lamp.  

It just amazes me that VA gets away, day after day, with worse service than McDonalds.  Every Mc Donalds has someone to take care of problems, I dont have to email Ray Croc's widow to get a replacement burger.  I can not figure out why the Va can not simply fix these problems when we call and complain and instead asks us to "email Bob McDonald".