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DRO hearing

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rpowell01

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I have a hearing coming up on Thursday for Bowel Incontinence. Yesterday my POA stated that the DRO wanted me to have another C&P exam for the Bowel Incontinence. Here is the thing Dr. Bash diagnosed this back in 2012. Again in 2013 and I've had 2-3 C&P exams since 2012 for the same things.. The VA, a PA and GI Surgeon both diagnosed the same exact thing in July 2013, Bowel Incontinence secondary to my Lumbar DDD/DJD.

On the original decision the RO stated it was not diagnosed. This is wrong because they had in their hands Dr. Bash's IMO which showed the diagnosis then in 2013 whenever the VA Surgeon finally diagnosed it they still are denying me but the only reason they gave so far that it was not diagnosed. Everything Dr. Bash diagnosed has been diagnosed by the VA. As a matter of fact they approved me for IU based on the same Dr. Bash IMO!!!!! So how are they allowed to pick and choose what to believe on the report when the diagnosis has been proven by the VA? This is crazy.

I am going to refuse ANOTHER C&P exam on the grounds that they already did 2-3 exams, Dr. Bash did 2 exams and the VA (James A. Haley) did two of them (One from PA and One from the GI Surgeon). Am I correct to say they are just trying to low ball me severely knowing it would put me over the SMC and P&T threshold? I told my POA that I will in fact just send it to the BVA if the RO doesn't want to make a decision. They all know I have it so why are they low balling me? I am on SSDI all just for service connected issues, nothing else and I was just award my SSDI continuation. So what gives and how should I approach them at the hearing? I will try to keep my cool because the have sat on this too long.

Rob

Edited by rpowell01
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I mean, if they had the IMO and ignored it , that is a CUE ( 38 CFR 4.6)

but the Duty to Assist and BOD regs are not CUEable.

 

"Yes my POA finally asked his supervisor and they both agreed with me in stating that this is in fact a CUE. What he is going to do is ask the Rater to CUE himself " great because they see what I seemed to see here too. I would let the POA write the CUE up.

"and I told him to at least try to make a deal with him about the P&T."  I do not foresee VA making any type of deal even if it seemed to make sense.

Current C & Ps justify new decisions and they also provide enough info ( sometimes) for the correct rating %.

Your condition might have gotten worse since Dr Bash did that IMO.

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Berta the P&T was in fact my whole case I brought up to the DRO. I had the POA go over and asked them to approve the P&T and I would drop the bowel and bladder issues. They refused. So since they want to go that route then I am going to make them pay big time as in extra scheduling such as SMC. I gave them a chance to fix themselves but the DRO is dumb enough to refuse. Oh well the CUE will settle and fix everything because this should have been rated whenever they rated my legs during the De Novo Review back in Feb. They cannot pick and choose what and what not to rate when the evidence is overwhelming and I am not going to let them.

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How does a CUE work? Does the DRO have to CUE themselves or does a supervisor do it?

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The initials of the last person who decided your claim appear in the alphanumeric Re: part to the right of the decision, where they put the date.

Your Vet rep can fax the CUE to them , and I suggest putting "Attention to", then those initials on the CUE claim.

That worked for me. I would have to pull out my last award letter to see if it was the same rater or maybe someone else handled it instead.

I filed one of my CUES via IRIS and more recently directly with the Director, via email.

The vet rep will know the best approach.

CUE claims do not stop the NOD deadline, if VA does not reverse the CUE within that first year after the decision is made.

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Oh I am in the DRO hearing stage of the appeals. We just realized how bad of a mistake the rater made by rating my arms, legs but not my bowel and bladder issues. I uploaded the CUE letter and request on ebenefits as there is a way of doing this now. The request is about the P&T Status. I requested that if they approve the P&T I would drop all remaining appeals but if they didn't I would pursue the appeals and push the CUE. They know its a CUE, they just want to low-ball me.

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