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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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C&P Glass is Half Empty


Shake-n-Bake

Question

I just had two C&P exams this morning and am trying to keep a positive mindset, but the glass looks half empty to me. Maybe someone else can offer some insight on my situation.

Since April, I have been rated at 60%; 50% for PTSD and 10% for tinnitus. The claims process for those went pretty smoothly, really, and I was awarded my disability ratings in very short time. I have since then filed three additional claims. My intent to file was back in April, but I submitted the claims on July 25. These three claims are for hypertension secondary to PTSD, sleep apnea secondary to PTSD and for hearing loss. Today I had my C&P exams for the hearing loss and hypertension. I have heard nothing about scheduling a C&P for the sleep apnea.

My first exam this morning was for hypertension. I was diagnosed with hypertension, by a private doctor, about 4 years ago and have been on medication since then and am currently being treated by the VA for my hypertension. My hypertension isn't very severe, but it is outside of normal parameters and has been this way consistently for quite a few years. Even though I wasn't officially diagnosed until 2013, I have (and submitted) evidence of prior medical records that show high blood pressure readings well before my actual diagnosis. I don't think I meet the criteria for anything more than a 0% rating, but that's all I really want, or need. I believe I have bradycardia (abnormally low pulse), as a result of my high blood pressure. My blood pressure has always fluctuated and spiked in relation to my PTSD symptoms, so I certainly think the PTSD aggravates my blood pressure, but I don't feel good about my C&P exam from this morning. The doctor was one of the weirdest people I've come across at the VA, so it was hard to get a good read on him. All he did was take my blood pressure 3, or maybe 4, times, all from my right arm, while I was seated. He wanted to know when I was first diagnosed and how many times they had taken my blood pressure during the visit in which I was diagnosed. I told him it was in 2013 and, although I didn't recall how many times they took a blood pressure reading, I did remember how high it was when I was diagnosed. I tried to discuss the evidence I had submitted to support my having actually had high blood pressure before my 2013 diagnosis, but he shut me down. He said anything that I sent in with my claim wasn't his concern. All he was doing was "checking the boxes" on my blood pressure exam and someone else would look at everything that was submitted. This doesn't make sense to me. Isn't the purpose of the C&P exam to look at the evidence, as well render an opinion? I have already been diagnosed with hypertension and am receiving treatment. I'm guessing my blood pressure readings from the C&P exam are within normal parameters...that's what the medication is for. I don't understand the point of putting me through this dog and pony show, but I certainly didn't walk out of there feeling good about it.

Next, I had my audiology exam for my hearing loss claim. I just had a audiology exam a little less than 2 months ago from a VA contractor and was subsequently issued hearing aids from the VA about a month ago. As I mentioned earlier, I already receive compensation for tinnitus, so part of me feels like the VA has already conceded that I had sufficient noise exposure in-service to cause damage, but I have also heard of people winning on tinnitus and losing on hearing loss. Since I had just recently had an audiology exam, I was only given an abbreviated C&P exam for my hearing. The audiologist stated that the contractor had not "submitted a full report", or something to that effect, so she only needed to do a partial test today. She asked me a little about my in-service noise exposure, as well as about my civilian occupations. It was over pretty quickly. I didn't feel quite as bad, or confused about that one as the hypertension C&P, but both of them seemed rushed and indifferent. 

When I got home, I logged in to eBenefits to check on something unrelated and decided to look at my claim status. It had gone from Gathering Evidence to Preparation for Decision, since the last time I had checked on it. How could it be in Preparation for Decision? Mind you, I just had two C&P exams a couple of hours before. There is no way those reports had been sent in and considered already, so it had to have moved to Preparation for Decision a day, or more ago. Since I have not been scheduled for a C&P exam for my SA secondary to PTSD, I suspect now that they don't plan to give me an exam for the sleep apnea. The fact that they'd already moved my claim to Preparation for Decision before my exams leaves me with the impression that my claims are doomed to denial. Realistically, both the hypertension and hearing loss should each be rated at 0%, so that won't get me an increase in disability pay anyway, but a positive decision on the SA would. I also need the 0% ones, though, because of their relationship to other problems I have.

I'm a little confused by all of this and am certainly not feeling hopeful about my prospects at this point. Am I jumping to conclusion prematurely, or am I making a reasonable conclusion that things aren't going my way? It's been less than 30 days since my claims were filed and it's already been moved to Preparation for Decision before my C&P exams. I don't know what that means, but it doesn't seem good.

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I have 10 for tinnitus and 0 for hearing.  You need to be deaf to get anything higher than 0 for hearing.  Not really, but pretty close.

Deferred means that they are sending that part out to have experts in that area take a look at it, but wanted to get the results of the other two to you as soon as possible.  Both of my claims that were deferred service connected, one at 0 and one at 20%.

I too claimed hypertension, but I was service connected at 0%.  However, I learned much latter, (8 years) that I should have filed for heart disease.  I did just claim heart disease secondary to hypertension and was service connected at 30%.  I believe that if I had filed for heart disease at first, I would have been originally service connected at 30%.  Remember the VA will not connect the dots for you.

Hamslice

 

 

 

 

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Sometimes it jumps around just wait and see or call the office of case management before they are out of service on 9/11. (202) 530-9470 can't get through 17 minutes it hangs up just call back until you talk to someone they give you the answer your seeking.

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I just checked eBenefits this morning and it says my claim has now gone to "Preparation for Notification". So, they apparently have made their decision - right at a month from the date I filed the claims. Nothing is showing yet to indicate whether the claims were awarded or denied, but the way this all rolled out doesn't leave me with much confidence in a positive outcome.

My sleep apnea diagnosis was done by a VA contractor, but it was a home sleep study, not the full blown in-clinic study. I would think if they were serious about examining my case, they would have set up a C&P Exam for the sleep apnea. The only thread of hope I have for that claim, in my mind, is that in my PTSD C&P,  the examiner made some comments to the effect that my sleep apnea was "relevant" to my PTSD, or vice versa. 

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eBenefits now shows that I was sent a letter of notification, plus under my "disabilities" tab, it now lists a decision for my three latest claims. It appears that they have service connected my hearing loss at 0%, which was the most I could have expected on that one. Basically, I just wanted to go ahead and get it service connected to save the hassle down the road if/when my hearing deteriorates into the the compensable range of loss. 

My sleep apnea secondary to PTSD has been "deferred". I know what the word deferred means, but I don't understand what it means in this particular context. Does that mean they will schedule me for a C&P sleep study, just arbitrarily kick the can down the road, send it off to someone else for a decision, or what? Why do they defer decisions and what does that do to the process?

They have my hypertension, secondary to PTSD, as "not service connected". I'm pretty disappointed in this one. Although I was only hoping for a 0% rating, I feel this one was important to be service connected. I don't see how there's any way that my PTSD has not aggravated my hypertension, which I thought was all that needed to be proved, in an at least as likely as not manner. I am anxious to see the letter to learn their justification for denying this claim. I have an abnormally low pulse rate most of the time, as well as fairly frequent heart palpitations and chest pains, which are potentially connected to my years of hypertension. I will definitely reply to this decision with a NOD, but other than getting an IMO in support of my claim, I don't know what more I can do other than what I'd already submitted. I did not have high blood pressure while in service, so I'm not trying to claim that it was directly caused by my service, or even that my PTSD directly caused my hypertension (though I personally feel that it did). Aren't they supposed to automatically rule on whether it is aggravated by, not just caused by?

I wish I could file a claim for all the anxiety and depression caused by VA's disability claims process. On the one hand, they try to treat my symptoms and on the other hand, they are often the leading agitator of my symptoms.

 

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      or that further efforts to obtain those records would be futile.” 38 C.F.R. § 3.159(c)(2).
      “If VA . . . after continued efforts to obtain Federal records concludes that it is reasonably
      certain they do not exist or further efforts to obtain them would be futile, VA will provide the
      claimant with oral or written notice of that fact.” 38 C.F.R. § 3.159(e)(1). The notice must (1)
      identify the records VA was unable to obtain; (2) explain what efforts the VA took to obtain the
      records; (3) describe any further action VA will take regarding the claim; and (4) notify the
      claimant that he is ultimately responsible for providing the evidence. 38 C.F.R. § 3.159(e)(1)(i)-
      (iv).
      Negative evidence and mischaracterization of claims. The Board may not consider the
      absence of a medical notation to be negative evidence when there is no reason a medical
      examiner would have commented on a particular matter. Buczynski v. Shinseki, 24 Vet. App.
      221, 224 (2011). See Douglas v. Shinseki, 23 Vet. App. 19, 25–26 (2009) (“...the duty to gather
      evidence sufficient to render a decision is not a license to continue gathering evidence in the
      hopes of finding evidence against the claim”).
      The Board may not mischaracterize veteran’s claims. Mischaracterization of claims may
      lead to considering issues outside of “...the scope of the appeal, applying the wrong law, and
      engaging in the wrong analysis.” See Murphy v. Shinseki, 26 Vet. App. 510, 513 (2014) (the
      Murphy Court recognized mischaracterization of claims as the catalyst to improper reduction of
      claims, which the Court indicated has a “...’chilling effect’ in the administrative appeals
      process...”).
      Medical treatises. A medical article or treatise “...can provide important support when
      combined with an opinion of a medical professional” if the medical article or treatise evidences
      “...generic relationships with a degree of certainty such that, under the facts of a specific case,
      there is at least ‘plausible causality’ based upon objective facts rather than on an unsubstantiated
      lay medical opinion.” Sacks v. West, 11 Vet. App. 314, 317 (1998); see also Wallin v. West, 11
      Vet. App. 509 (1998).
      “A veteran with a competent medical diagnosis of a current disorder may invoke an
      accepted medical treatise in order to establish the required nexus; in an appropriate case it should
      not be necessary to obtain the services of medical personnel to show how the treatise applies to
      his case.” Hensley v. West, 212 F.3d 1255, 1265 (2000). “An ‘evaluation’ of treatise evidence
      should be made in the first instance by the BVA.” Timberlake v. Gober, 14 Vet. App. 122, 131
      (2000). If the Board fails to consider medical-treatise evidence by the veteran, the Court will
      remand the case to “...the Board to evaluate “that evidence” to see if it supports a nexus.” Id.
      Due process. Veteran also contends the Regional Office’s (RO) failures as expressly
      asserted in this Notice of Disagreement rise to the level of the Secretary’s denial of Veteran’s
      procedural due process protections, guaranteed to U.S. military veterans by the Fifth
      Amendment, U.S. Constitution. See Cushman v Shinseki, 576 F.3d 1290 (Fed. Cir. 2009).
    • By brokensoldier244th
      I was looking at Ebenefits under the 'disabilities' section, and I noticed that, with CPAP, my Sleep Apnea rating is listed as 20% rather than the expected 50. I had to appeal my sleep apnea 1 time to get SC. Has anyone ever seen this? It looks like it is numerically at 20, but they paying it at 50? Misprint? 
       

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    • I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even  reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and  nothing about stressor,
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      VA Compensation & Pension (C&P) Clinicians Guide 2 Final Corrected 20180719.pdf
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    • I don’t say thank you enough to all of you...
      You, yes you, are the reason HadIt.com has remained a resource-rich resource. Thousands come each month to read, ask questions, or to feel a sense of community.

      Last month June 2020, we over 50k visitors they viewed over 160k pages. Veterans and their advocates, spouses, children, and friends of veterans come looking for answers. Because we have posts dating back 15 years and articles on the home page, they usually can find an answer or at least get pointed in the right direction.

      You all made that possible. Thank you.
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