tdiu The magic sentence in VA claims.

[broncovet]

Remember the show "Pee Wee Herman"?  My grandkids love it.  In the show, they always had a "magic word".  Whenver someone said the magic word, everyone screams and hollers.  

Well there is a magic sentence in VA claims.  Here it is, now to test it, every scream when you say the magic sentence:

"The VEterans condition is at least as likely as not caused by x event in military service".   (Now everyone scream that is the magic sentence.)  

So, when you read your file, look for the magic sentence.  

If you are seeking TDIU, then the magic sentence is a little different:

"The Veteran is unable to maintain substantial gainful employment due to service connected conditions"...(everyone scream).  

Finally, if you are seeking service connection for secondary condtions, here is YOUr Magic sentence:

"The VEterans xx condition, is at least as likely as not due to the influence of his (primary) condition".  

Now everyone scream when you hear any of these magic sentences.  Oh, yes..the doctor needs to say these.  

[brokensoldier244th]

The 4142/4142a comes to us (the auth to retrieve private records) and we send it to a centralized group that does the requests. DTA says 2 attempts in 30 days. If they get a response then the records are uploaded to VBMS. If they get a rejection (illegible 41421, unsigned, inaccurate contact info, whatever) then they upload the reason for the rejection and depending on what it is we are supposed to contact the veteran and let them know what to correct.

Sometimes providers just ignore us (PHP Non-Response), or charge for records retrieval. The VA doesn't pay for records retrieval so I send a letter to the veteran letting them know so they can do whatever they need to do on their end to get the records to send to us. If it is a non-response I usually send them a letter saying "hey, your provider didn't respond, or responded with "no record of the patient...." or "discrepancy with dates of treatment......" so they can contact the provider, or upload corrected 21-4142s with a more accurate date range or contact information. 

[Vync]

@Rattler Been there and had that happen. I wonder how the VA would define the term "current"... Is it this week, month, year, or something else? I remember receiving numerous denial letters back in the 90s. They would always say there was not a current diagnosis, the issue was noted just a few times in the service, or it was not chronic. And then when the C&P examiners used the opinion terms "possibly" or "probably", those were instant denials. And on top of that, having to go to the BVA just to get them to approve C&P exams was just a big waste of time.

@brokensoldier244th I recently helped another retired vet get their supplemental claim going. He mailed in the release of medical info forms for about a dozen different docs and facilities. He had already received the medical records so those were sent in. One of his providers had mailed him a letter saying they were closing their doors permanently because the doc was retiring. The VA sent him letters saying they were going to request records from each of those providers, including the one who had long since closed...

[Rattler]

21 hours ago, brokensoldier244th said:

The VA doesn't pay for records retrieval so I send a letter to the veteran letting them know so they can do whatever they need to do to get the records to send to us. I

In that is where the real rub is. A lot of medical providers have gone to a service that charges for the records. Although it's not supposed to affect you getting your records it does. the only way to be sure you get them is to go in person and request them. I know it's more work and some Vets may not be able to physically go. But the real question is do you want to win your claim? If so you will have to put in the work.

I am also helping a veteran who has Parkinson's and a list of other TERA issues. He has a Parkinson's diagnosis from a doctor that is top in the state. I had to go to his docs with him to get his records. This is after he requested them himself via the VA and in person.

Vync 

The 90's were no picnic.  The 70's and 80's were even worse. To me, it seemed like it deponed on what state, what regional office, and whose desk it landed on if you were going to get approved or not

[brokensoldier244th]

21 hours ago, Vync said:

I recently helped another retired vet get their supplemental claim going. He mailed in the release of medical info forms for about a dozen different docs and facilities. He had already received the medical records so those were sent in. One of his providers had mailed him a letter saying they were closing their doors permanently because the doc was retiring. The VA sent him letters saying they were going to request records from each of those providers, including the one who had long since closed...

Yes- He listed it on the request, so we sent for the requested records. Unless he said something to the effect of "this provider is no longer practicing"/ closed, whatever then we wouldn't know if they were closed or not. Veteran sends, we request. If its on the 4142/4142a we have to develop for it. Our PMR requestor would call/fax the request, get no answer, or get an answer of "take a hike, Im drinking mimosas on the beach...." and then would inform us that the provider is no longer practicing or "no response received from PHP". 

[brokensoldier244th]

32 minutes ago, Rattler said:

In that is where the real rub is. A lot of medical providers have gone to a service that charges for the records. Although it's not supposed to affect you getting your records it does. the only way to be sure you get them is to go in person and request them. I know it's more work and some Vets may not be able to physically go. But the real question is do you want to win your claim? If so you will have to put in the work.

I am also helping a veteran who has Parkinson's and a list of other TERA issues. He has a Parkinson's diagnosis from a doctor that is top in the state. I had to go to his docs with him to get his records. This is after he requested them himself via the VA and in person.

Vync 

The 90's were no picnic.  The 70's and 80's were even worse. To me, it seemed like it deponed on what state, what regional office, and whose desk it landed on if you were going to get approved or not

I agree, that sucks. I usually free text something in the letter that goes out to the veteran under "What we have done...." to the effect of "We have requested records from X,Y,Z but our request does not compel them or require them to release those records to us, or to respond. If you have any of the evidence listed on your submitted 21-4142/4142a please send it. Some providers respond faster to a direct request from the patient than they do for VA."

[stuart55]

16 hours ago, brokensoldier244th said:

Yes- He listed it on the request, so we sent for the requested records. Unless he said something to the effect of "this provider is no longer practicing"/ closed, whatever then we wouldn't know if they were closed or not. Veteran sends, we request. If its on the 4142/4142a we have to develop for it. Our PMR requestor would call/fax the request, get no answer, or get an answer of "take a hike, Im drinking mimosas on the beach...." and then would inform us that the provider is no longer practicing or "no response received from PHP". 

It seems that you adhere strictly to protocol. Until the physician medical record requestor certifies, you have no control over whether the provider is still in practice. You've mastered the procedure!