Comp & Pen Exam

[theo]

Berta.. I recently had my C&P examination in December 06 just before Christmas.

Type : Respiratory (obstructive, Restrictive and Interstitial)

Pulmonary Tubersulosis and Mycobacterial Diseases

Compensation and pension examination

Instructions from the AMC to the examiner: "In particular, the examiner should discuss the manifestations of associated with the veteran's service-connected emphysema and allergic rhinitis and, to the extent possible, render an opinion as to the level of impairment caused by these disorders. The examiner is specifically asked to render an opinion as to the effect of the service-connected disabilities on the veteran's ability to procure, and to maintain, gainful employment (in rendering this opinion, the examiner should, to the extent possible, distinguish between the manifestation of the veteran's service-connected emphysema and service-connected allergic rhinitis and the manifestations of any non-service connected respiratory disorders."

The examiner's opinion:

1. Inactive tuberculosis

2. Bronchial asthma

3. Allergic rhinitis

OPINION:

1. The level of impairment caused by the veteran's allergic rhinitis is mild to moderate.

2. the level of impairment caused by the veteran's bronchial asthma is moderate. The veteran has been engaged in vocational rehabilitation in computer work. If he Veteran is able to be trained and to perform this work, he should be able to do this kind of work without too much interference due to the above service-connected conditions.

"While it should be granted that the allergic rhinitis and bronchial asthma are somewhat disabling, they should not severely impair the ability of the veteran to perform sedentary work. That being said, should the veteran be obliged to do a lot of talking on his job, he might find it more difficult to main employment due to shortness of breath, and chronic allergic rhinitis.

If there is a primary reason that the veteran would have great difficulty in obtaining and maintaining gainful employment, it is secondary to the nonservice-connected problems, such as chronic back pain, depression, and left flank pain secondary to incisional hernia."

The examiner's opinion regarding his C&P statement stated: "The veteran has been engaged in vocational rehabilitation in computer work. If the veteran is able to be trained and to perform this work, he should be able to do this kind of work without too much interference due to the above service-connected conditions."

My concern about this statement in that the examiner did not read the file / Vocational Rehabilitation Report. Which stated that the veteran was placed in the Independent Living Program, a computer was purchased from him communicate with family. And the report has stated that the veteran is unable to vocational rehabilitation.

REHABILATION CLOSURE STATEMENT. I won't go into specific information. "The Veteran completed an initial orientation and intial vocational interview on date indicated. The Veteran has a services connected disability combined rating of 60% for Pulmonary issue and other zero percent issue that are service connected. The veteran has an imparment to employability. He has not worked for the past five years, he is 60 years old and hs multiple medical problems with regards to his pulmonary condition. Furtermore, he has difficulties in terms of depression and is being treadted for this condition. Moveover, the Veteran has not overcome the effects of impairments to employability. The veteran was determined to have an employment handicap. Conditions for a serious employment handicap were also identified. The vertan is being treated for multiple condition and taking several medications. His Dr.indicated that the veteran was entitled to the Chapter 31 vocational rehabilitation benefits. However, he determined that the veteran was not feasible for competitive employment and would benefit from and Independent Living Plan."The Independent was written and since... I went through, now I have the file. The document is closes with comments of case managers closing statement."

Question, is the C&P examiner trumping the VOC Rehab people with his what if statement about being trained on computers and sedentary work? And do doctors statement's really matter anymore?

All of the Doctors letters included in the file and some referenced in the C&P

I'm trying to get a read on this comp and pen...

Your opinion please

Theo

[Berta]

Theo- sometimes it might come up with the citation number-

I am glad you found Dr. Bash helpful. I fully feel the money I spent on his IMOs was well worth it and he knows how to shape these IMos for exactly what the VA needs.

Has the VA considered his opinion at all yet?

[theo]

Berta:

"Has the VA considered his opinion at all yet?"

Yes the C&P Examiner quotes Dr. Bash in detail regarding his IMO, also my primary care Dr. is quoted as well, as he wrote:

The Veteran has been followed at the VA medical Center for a number of years for the following problems: Asthma, Lumbar Radiculopathym Depression, Chronic Rhinitis ad history of kidney removal for Cancer. In addition to the above problems, he is service connected for Pulmonary TB, Major Depressive Disorder, Disgestive Disorder, Hearing loss and Hypertension.

He has been under my care for this period of time and has followed all arecommendations and precedures as prescribed. He takes his medications as orderred.

These medical conditions has caused him to be unemployable.

The doctors statement added in some items in the S-C that are not S-C. However, when he wrote the letter he advised me to go to the federal building and re file the TDIU since they lumped the 1151 and the TDIU together.

I filed a separate TDIU.

Theo

[theo]

Berta, theo here again after a year or so since our last communication. I've been patiently walking my post.

I recently got a verbal from the DAV in Washington that the VA will grant the IU regarding my claim, plus 30% for Rhinitis. Someone finally wrote the right letter regarding my service connected disability as it relates to my inability to work, to include sedentary work.

My initial claim was filed in 2000, denied 1151, and TDIU, granted 60% from 10%. Appealed 1151 and TDIU.

The issue was remanded by the court of appeals in 2003 to the BVA.

The DAV argued the case before the court.

I understand from speaking with the DAV, the 1151 will be denied, the IU granted, however the rep said the retro pay for the IU will not go back to the date of the claim. The DAV Rep said it may go back a year.

In my records, I noticed that the Issue stated on the Docket No:

1. Entitlement to compensation under U.S.C.A. § 1151 (West 2002) for an incisional hernia based upon VA treatment in October 1994.

2. Entitlement to total disability evaluation base on individual unemployability.

In a Transmittal of Decision of Board of Veterans' Appeals, a paragraph stated: "Further, the veteran's representative argued in a March 2003 statement that the veteran's lung condition was of such severity, depth and pesistence to warrant a total evaluation based on individual unemployability in and of itself. The record show that the veteran's service-connective emphysema with inactive pulmonary tuberculosis and restrictive abnormality and asthma."

The restrictive abnormality was noted in 1996, however due to the incisional hernia, I've only be able to do spirometer.

Over the years the incisional hernia and other issue was clouding the ability to work issue with other issues other than the service connected disability.

Finally a doctor at the VA wrote the correct letter that acknowledged the statement quoted above. dated 2008 "The Veteran is unable to have a job that requires physical exertion due to his asthema, or any sedentary labor that would make it difficult for him to use his medications including his inhalers and nebulizer machine."

I had a similar letter last year from the same Department with different language but really says the same: dated 2007 "The Veteran is unable to be employed in any joy that requires physical exertion due to his breathing limitations. In addition he is unable to do sedentary labor that would take him away from is medications, inhalers and nebulizer machine."

FYI: The initial claim or increase, TDIU, and 1151, the effective date for the increase from 10% to 60%, denial for TDIU, 1151 is Feb 1, 2000.

The DAV rep said for me to get the IU in place and then appeal the effective date of the retro pay. Is that wise?

If I repeated myself, please excuse.

Thanks Berta!

Theo