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NOD, New C&P Exams, I'm Confused--Please help!!

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bcnandprn

Question

I'm super confused about where I am in the appeal process and what I need to do at this point.  Unfortunately, the DAV hasn't been very helpful with explaining things to me either, so I really feel lost in the mud right now.  I'm hoping some of you can help me or at least tell me who I should be contacting and/or what questions I need to be asking.

I filed a NOD that was received on 11/27/2013 and then the VA went MIA for two years.  Last month (November 2015), I received a call from the C&P department at the Kansas City VA Hospital to schedule new C&P exams and have now completed all of the new exams.  The exam notes have been completed in eBenefits and eBenefits still shows 11/27/2013--Appeal Pending-Notice of Disagreement--The VA will notify you of the next steps.  I'm guessing that the "next steps" were attending the new C&P exams and that there hasn't been enough time to update eBenefits yet.  I also realize that I probably won't get a decision any time soon, but what are the next steps after the C&P exams are complete?

In both exams, the examiner notes state that the conditions were just as likely as not service connected with further annotation of civilian doctor visits, frequency of flare-ups, severity, etc.  While I would love to know what level, if any, that each condition will ultimately rate out at, I know there is a lot of room for interpretation, so I'm not even going to ask for guesses on that.  I just want to know what the next steps are to try and understand where I'm at in line for a decision and what type of questions I should be asking when I call the 800-827-1000 number.

I've also moved since filing my original claim and eBenefits will not let me update my address online, so I've tried calling the 800 number but the system hung up on me after telling me that they had high call volumes right now.  While I do not receive compensation right now, eBenefits also shows an old bank account that I no longer use and I honestly do not remember the account numbers for it either, so I'm not sure how to get anything fixed.

I am feeling extremely overwhelmed and exhausted by all of this because I had no idea what to even begin to ask.  Thank you in advance for any suggestions you have.

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  • Content Curator/HadIt.com Elder

Vync--that's what I'm assuming and hoping for as well.  I know that I have service records for CFS.  The chest pains I was actually going to just roll over and die with since it seems to have mostly disappeared at this point and it's not worth the fight.  The CFS I'll probably fight later since my civilian doctor has run every test under the sun and has now diagnosed Fibromyalgia since all the tests came back normal.  I've been hesitent to even mention it because it makes me feel like a hypochondriac and I HATE that feeling.  Then again, I also hate feeling tired, having tingling hands and legs, getting dizzy, etc. too.  Sometimes I feel like it's a lose-lose battle and this girl is flat exhausted.    

I absolutely agree that a lot of us tend to play the tough card or risk being recycled or seen as weak, but then the VA "punishes" folks for this.  My last C&P examiner mentioned that she sees that type of thing all of the time.  In her own words, she stated, "You're all the same" and she wasn't being derogatory toward the service members. She also mentioned that it was insane that even though I marked all of the same problems on two separate post-deployment health assessments, the military never referred me to any doctors for any of it.  I was young and dumb and didn't know any better either.

Furthermore, I asked her about the back problem not being on the exam and while she couldn't add it, she essentially said that the reason they denied it as being service connected was bogus.  My back x-ray completed by the VA in 2012 showed mild osteoarthritis; however, they denied it by stating that it had been caused from riding horses when I was younger.  The examiner said, "if you didn't have it when you entered the service or they failed to find it, then it's service connected".  I may be crazy, but I can't imagine why carrying full battle rattle in Iraq for 15 months would cause osteoarthritis in my back (full sarcasm intended).

Based on what you described, I had a feeling you had fibromyalgia. I was diagnosed with it over a year ago. Aside from the usual medications, they also gave me a CPAP machine. It actually does help reduce the symptoms a bit, but only works when I am able to keep the mask on my face all night.

Regarding your back, did the C&P examiner or the VA rater make the decision to deny because you rode horses when you were younger? If the C&P examiner said it was "least as likely as not" or better, the rater is supposed to go with it. When you entered service, you had an entrance exam consisting of two parts. The first part was when you answered a lot of "do you or have you ever had" questions. The second part was the doc's assessment and examination based on what you filled out. If the doc said everything was normal, then that should be the end of that. Sometimes people have old injuries before they join, but are not severe enough to prevent service. If they are obvious, like surgical scars, etc... the doc can make a deduction and note it. However, if you merely mentioned you rode horses, that should not be a factor unless they have objective proof and/or medical treatment records to prove a pre-existing condition. Even if you had a provable pre-existing condition, the VA is not supposed to deny because of it. They are supposed to evaluate and determine if military service aggravated or worsened it. If it did, they can still SC you, but might do so with a slightly reduced rating % for that condition.

"If it's stupid but works, then it isn't stupid."
- From Murphy's Laws of Combat

Disclaimer: I am not a legal expert, so use at own risk and/or consult a qualified professional representative. Please refer to existing VA laws, regulations, and policies for the most up to date information.

 

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