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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

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AF_Comm_Vet

Need some guidance -scratching my head on a denial

Question

-  Filed a year ago for a lumbar spine condition caused by a severe auto accident in-service. After an initial denial, the claim was finally approved after doing a re-open and submitting an new IME.  The NEXUS was made between the Lumbar spine injury and accident based on civilian ER reports where I was transported.  Was scheduled for a C&P exam prior to decision, and the C&P physician actually rated higher than I expected (after doing X-rays) at 40%. 

-  Several years ago I started having headaches, neck stiffness, and occasional  Pins & needles in the arm, not severe or constant so blew it off.  Four months ago it became severe, started missing work left and right, and pain prevented even sleep without heavy meds. Was referred to an Orthopedic doc and later an Ortho Surgeon.  MRI's and X-rays were accomplished in Jan with bad news, severe degenerated discs and cervical bone structure.  The Surgeon said this was pretty severe for my age, and after describing the accident he agreed it was likely the cause of the damage which had been brewing for years. 

- Filed a FDC for Cervical  Spondylosis and degenerative cervical disease.  I referenced the earlier evidence of the accident in-service. I also had a thorough IMO done by one of the Physicians mentioned in the forums often (not including the name), the IMO was very thorough with a NEXUS statement and citing previous cases.  Submitted the FDC in Early Feb.

 

 Well, I after I saw the FDC move from Review to Decision process les than tend days after submitting I became concerned. Sure enough, it was returned denied as "Not Service Connected".    

 

OK, I get it....an IMO doesn't guarantee anything, but based on my evidence and previous related injury  I thought I would at least be granted a C&P before the case would be tossed back in my face.    Any thoughts?? 

 

Thanks

 

 

Edited by AF_Comm_Vet
qeqweqww

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Muskogee RO as of June 2015

Director jason.mcclellan@va.gov

No Fax or phone# listed for him

VSCM Tim Clark  918-781-7606   

AVSCM Paul Altman 918-781-7614

AVSCM Callie Beavers-Fillman 9180-781-7680

AVSCM Sandy Psomas 918 781 7600

 

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5 hours ago, Berta said:

Muskogee RO as of June 2015

Director jason.mcclellan@va.gov

No Fax or phone# listed for him

VSCM Tim Clark  918-781-7606   

AVSCM Paul Altman 918-781-7614

AVSCM Callie Beavers-Fillman 9180-781-7680

AVSCM Sandy Psomas 918 781 7600

 

Berta:

 

My Apologies...but not quite sure what I am going to say when I call these people?     Not trying to have you hold my hand, and I'm fairly savvy with Federal Agencies, but am a bit nervous about calling some GM15 to discuss my personal case without an invite.  

Rather than beat around the bush, please help me clarify my options so there is no confusion on my part:

1.   Re-Open the case and explain that my IME was ignore don the first go-round, and therefore is "new" evidence.

2.   Re-submit the IRIS complaint, and hope that this time its read by someone that understands the  "CUE" process and takes appropriate action with the VARO

3. Actually contact the VARO (Again, need your help in what to say). I would prefer emailing them if possible as its less intrusive. The goal is to initiate the CUE, not to piss anyone off and make the situation worse.

4.  File a traditional NOD

 

My Preferences are from #1 to #4 in that order ......  I would like to move #3 to #1,  but definitely need some diplomatic guidance from you,

 

Thanks !!

 

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If I were you I would email Jason McClelland, who had no fax or phone listed in my source. I assume he is still there director there.

And I posted his email addy in the reply yesterday.

Do you use ebenefits? I have had little reason to use it but someone here could advise whether there is a way you download not only the CUE claim but also download anything they have ignored.

Others will have to advise on that.

You could also get a Vet rep, and hopefully they will see the error and have a better way to bring it to the VA's attention.I would seek one who has an office right in the same RO building or near it.

You also might try to email the Secretary ...his email addy is here somewhere

I am sure not the one here to provide any 'diplomatic' guidance....

In the 20 plus years since they caused my husband's death,  there was no room for diplomacy.

My most recent CUE was awarded a few months ago, because I contacted VACO with an  a IRIS complaint ( I filed  many CUEs that way)and also emailed the director of my VARO.

She called me and emailed me back many times during the course of that whole scenario.(multiple CUE issues) as they had ignored an IMO I had too, from the Chief Cardiologist at VA Central in DC.

I certainly am respectfully to anyone at the VA but I also know if I had not picked up the phone years ago and called the Regional Counsel as well as the General Counsel attorneys in DC (no email addys when I filed my SF 95 in 1995)

the VA could have easily gotten away with killing my husband due to malpractice.

 

 

 

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robert.mcdonald@va.gov

Secretary of the VA

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Thanks Berta...

 

I will try emailing the Sec of the VA...  His email would be read by a staffer that has authority to take action.  I don't want to involve the VARO Director (Yet), that will be my nuclear option.

 

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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 2 replies
    • Exams that were being sent strictly to contractors before, due to VAMCs not being open, are starting to be routed back to VAMCs. This is going forward from last Friday- not sure if prior scheduled exams will be re-created for VAMC vs vendor.
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    • Mere speculation in your VA C and P exam

      M21-1, Part III, Subpart iv, Chapter 3, Section D – Examination Reports III.iv.3.D.2.r. Examiner Statements that an Opinion Would be Speculative Pay careful attention to any conclusion by the examiner that an opinion could not be provided without resorting to mere speculation (or any similar language to that effect). VA may only accept a medical examiner’s … Continue reading
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      Fund HadIt.com Veteran to Veteran LLC


      Give a financial gift to help with the upkeep of HadIt.com. HadIt.com is NOT a non profit. Gifts are not tax deductible, they are just gifts. 
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