hypertension C & P Exam, (review with fine tooth and comb)

[Palma114]

C & P Exam

AS soon as you can, request a copy of the exam, and go over it with a fine tooth and comb.

Whether you thought that he did a good job or not. You get a copy and check everything. For example, in my case, I had a C & P Exam done on 10/21/2015 for chronic kidney diseases stage III secondary to sc hypertension, and when I looked at the exam I was happy that he did connect them together and his rationale was good also. So I was just waiting on a rating decision to come down in Dec 2015. But instead, I got a letter from the VARO saying that my DRO hearing will be in Jan 2016. I put in for the hearing about 18 months ago. So apparently they are not going to rate me until after the hearing, the hearing is in about 14 days.

So I decide to review my c & p exam, one more time, as I reviewed the exam, I noticed on the history of this disability, the only thing he mentioned about my kidney disease was the date it first began, which was in 2003. Everything else was within the last couple of yrs 2012-2015. Why is this important? Because in 2003, when my kidney problem was failing rapidly my creatinine fail to 4.5mg% stage 4, so they had to immediately get me on some high blood pressure medication to get this problem under control. GFR 39. Medication: Atenolol, furosemide, simvastatin. So, in Jan 2004, my creatinine dropped to 3.7mg% and stage III, and today it remains at stage III, and the creatinine is 1.9, GFR 43, in which it has gotten a little better. All of this is clearly in my VAMC medical records.

The importance to me is the damage has already been done, and as I look at the rating for renal dysfunction: Creatinine of 4 to 8mg%--rating 80%;  and a markedly decreased function of kidney or other organs systems--rating 100%.

Also didn't mentioned, that in 2004, VAMC Renal did a mag 3 scan to find out the functioning of my kidneys, test indicated left kidney function a 94% uptake and right kidney atrophy at 6% uptake minimumly functioning. Assessment:  Markedly asymmetric kidney function with minimal function in the right side. He did not mention my anemia, or secondary hyperparathyroidism. I was a little shocked, that all of this pertinent information was not put in the exam findings. Which should have a bearing on the ratings! 

Your thought and opinions

Edited January 8, 2016 by Palma114

[broncovet]

Yes.  As JG Wentworth says, "It your money spend it when you want it".  Not paying attention to your c and p exam is like giving a stranger your credit card and car keys and telling them to go buy you groceries.  

Assuming that the examiner is competent or did a good job can be very costly.  The sooner you notice a defective exam, the better off you are. 

Again, after your BVA decsion, you can not challenge the competency of the examiner.  Its too late.  

YOu need to challenge at the RO level, or the BVA level.  By the time it gets to the CAVC, the RBA is sealed and now new evidence can NOT be added, and you can not challenge the competency of the examiner in the first instance at the cavc level.  You must do it at the RO or board level.   If the Board ignores your challenge, then yes, you can bring it up at the CAVC.  

Edited January 8, 2016 by broncovet

[Palma114]

2 hours ago, broncovet said:

Yes.  As JG Wentworth says, "It your money spend it when you want it".  Not paying attention to your c and p exam is like giving a stranger your credit card and car keys and telling them to go buy you groceries.  

Assuming that the examiner is competent or did a good job can be very costly.  The sooner you notice a defective exam, the better off you are. 

Again, after your BVA decsion, you can not challenge the competency of the examiner.  Its too late.  

YOu need to challenge at the RO level, or the BVA level.  By the time it gets to the CAVC, the RBA is sealed and now new evidence can NOT be added, and you can not challenge the competency of the examiner in the first instance at the cavc level.  You must do it at the RO or board level.   If the Board ignores your challenge, then yes, you can bring it up at the CAVC.  

Well, it was denied by the bva in 2013 for direct service connection, and then the bva remanded it to AOJ, and order that the RO allow me to present my claim as kidney disease secondary to hypertension.

But, what is a little different for me is, the RO sent me to a C & P Exam 10/21/2015, and then in Dec 2015 I'm looking for a decision, but I get a letter in the mail, telling me I have my DRO hearing in Jan 2016, and I just happen to get a copy of the C & P Exam in Nov 2015. Even though I have 2 other disabilities pending. The letter they sent, said the Veteran will be able to bring any evidence he has. So my plan is to argue the recently C & P Exam, since they have not sent me a decision.

Edited January 8, 2016 by Palma114