Claims File (C File.)

[IconicX]

I am going through a review. I am nervous as heck. I was homeless before getting my benefits. In 2009 I went into a VA homeless per diem program and stumbled on that I had a possible service connected disability. And I was awarded it in 2010. I was 52 at the time. Pure luck knowing about it and I had a really decent pyschiatrist and counselor. Why hadn't I sought this option before?   Someone told me when I was in the Army that post Vietnam vets (i served 1976-80) didn't have medical benefits and I believed them and never inquired about them for myself at the VA. (I know now… not very smart.)

The upcoming review is very stressful and stress triggers my symptoms. I am obsessing on being homeless again even though the review is (as far as I can figure) a normal request... my paranoia and anxiety is off the charts. I have been reading and things should be fine. Even though VA does some outlandish stuff I have stayed in treatment and have a paper trail of that. My highest and last GAF was 51and that was done in the States. (I have been living in Thailand.) But I just keep having these conspiracy thoughts and feelings. (Yes I am taking my meds.) 

I have found what works for me under stress like this is to try to stay rational and use sane and real information to combat my voices, thoughts and feelings. I came across in my research info about the 'claims file' and how we should under the freedom of information act have access to our own C Files. But it is hard to get. VA don't want you to have this info.  My questions are …"Do my VSO have computerized access to my Claims File?" The other is... "Do my VSO work for the VA?" I ask this because their email ends with VA.gov. 

 

[rhoe]

You have a few things going on here, so we'll go point by point from easiest to not so easy - 

1. Your VSO does not work for the VA. They are a separate organization that represents you. If you have authorized them to have access to your electronic file, then they have access. This requires a properly executed VAF 21-22 (older forms are not compatible and a newer version is required to give computerized access). Here is the forms site if you need to give them a new form.

2. The VA has no preference as to whether you have a copy of your claims folder or not. The claims process is not an adversarial procedure (i.e. they are not a court trying to prove you guilty of something). If you send in a letter or a VAF 21-4138 (Statement in Support of Claim) requesting a copy of your claims folder, they will send it to you under FOIA. It may not come as quickly as you want it to, as there are many requests and only so many employees to process them. This does not mean they are trying to "keep" things from you. Please do not send your file (or portions of your file to "prove" things) back to the VA, as, well, they're the people that just printed off what you have in your hands (i.e. they already have it, and duplicate evidence just make things more annoying, not better). 

3. If you were awarded service connection in 2010, then more than five years have passed since your last evaluation (unless you claimed an increase in there somewhere or for some other reason caused them to examine you). This means your disability % for whatever they're reviewing is "static," and they are entirely unlikely to reduce it based on the results of one review examination. Proposing to reduce an evaluation is much more work than continuing the evaluation - no one wants to do that unless the evidence on exam and in treatment records overwhelmingly shows that you're actually better. 

4. If you're not better, don't act like you're better at your exam. Be honest with the examiner about your worst days and symptoms. Bring any pertinent private treatment records with you (the examiner will already have access to your VA records if you're going to a VAMC). 

I am telling you three times - the rater that reviews your case does not want to reduce your evaluation. It is a worse outcome for you, more work for them, and extra work down the line to finalize the proposal. It's fine if you want to worry about conspiracy and clandestine actions, but these thoughts have no basis in reality, so only bother with them if it actually helps you deal with life. It's certainly not going to do anything for your review exam for good or for ill.

Edited February 3, 2017 by rhoe
Missed a question, added link to forms site

[broncovet]

Calm down.  Its not as bad as you think.  Once you have been rated 5 years or more, you have "protections".  

The VA can not reduce you UNLESS they go through a special procedure which includes a PROPOSED reduction letter and 60 days notice.  If you get this letter, you can dispute the proposed reduction with a hearing, so you can tell your side.  IF VA does not follow the required procedure, you can get a lawyer and the reduction wont stand.  

If you like reading regulations, then here it is:

 3.344 Stabilization of disability evaluations.

(a)Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of VeteransAffairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b)Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c)Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

NOTE:  "ORDINARY CONDITIONS OF LIFE" means, in part, you are working. If you are not working its very difficult for VA to reduce you.