I’m back- Being Re-Evauated for Neck

[rootbeer22]

Folks:

 

Its been a long time since I’ve been on this board and credit many of you with the help that I received when I was helped with my original ratings. Anyway, I came home after work about Wendesday, and noticed a message on my home phone. Apparently, it was QTC giving me a short notice message about the re-evaluation of my claim. Anyway, when I got my final ratings two years ago, it said that I would be re-checked about the two year mark- and it’s been almost 2 years. Of course, like most, my anxiety level went up because I have visions of going thru everything again as I’ve heard the stories, but it’s just for my neck only. During my Army career,  I was in a Tank accident and traumatic explosion so my neck got damaged pretty back and I suffer each and every day. Anyway, during my original claims processing and CP exams, I came across an article that said once a vet reaches 55 or older that these types of exams are limited or my not even  occur?  Since, I’m just shy of 57, I figured that that rule may have applied to me? But, it appears not? I do know that the VA CP folks can do just about whatever they want anyway?My condition has actually grown worse but I learned previously that a lot of the outcome has to do with the doctor doing the exams and how they operate.?  I spoke in an earlier post that for my Gulf War Syndrome CP, that when conducts, I clearly had 5 of the 7 of recognized cumulative conditions detailed in my medical records. But, my 4 hour scheduled CP exam lasted just 20 minutes, and the doctor started by telling me not to speak unless he spoke to me first? Then he never made eye contact with me and proceed to focus on his computer and type the entire time until he told me to leave? I was denied of course. But, that afternoon, I went in for the rest of the exams and the other doctor was very thorough, engaging and asked a lot of questions about what caused the injuries. Those exams turned out much differently.

I guess my question is that are the CP re-evaluation Or CP exams similar to the previous exams ones or are

there general differences

in how they are conducted and what they are looking for?

Goodspeed, Rootbeer22

 

[Carl the Engineer]

rootbeer22,

 

I have not had any reexaminations, but here is the reg, and it mentions age 55, but it also has language that says the VA can do what ever it wants.  As usual.

 

Hamslice

 

§ 3.327 Reexaminations.

(a)General. Reexaminations, including periods of hospital observation, will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability. Generally, reexaminations will be required if it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability or that the current rating may be incorrect. Individuals for whom reexaminations have been authorized and scheduled are required to report for such reexaminations. Paragraphs (b) and (c) of this section provide general guidelines for requesting reexaminations, but shall not be construed as limiting VA's authority to request reexaminations, or periods of hospital observation, at any time in order to ensure that a disability is accurately rated.

(Authority: 38 U.S.C. 501)

(b)Compensation cases -

(1)Scheduling reexaminations. Assignment of a prestabilization rating requires reexamination within the second 6 months period following separation from service. Following initial Department of Veterans Affairs examination, or any scheduled future or other examination, reexamination, if in order, will be scheduled within not less than 2 years nor more than 5 years within the judgment of the rating board, unless another time period is elsewhere specified.

(2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled: (i) When the disability is established as static;

(ii) When the findings and symptoms are shown by examinations scheduled in paragraph (b)(2)(i) of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more;

(iii) Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement;

(iv) In cases of veterans over 55 years of age, except under unusual circumstances;

(v) When the rating is a prescribed scheduled minimum rating; or

(vi) Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions.

(c)Pension cases. In nonservice-connected cases in which the permanent total disability has been confirmed by reexamination or by the history of the case, or with obviously static disabilities, further reexaminations will not generally be requested. In other cases further examination will not be requested routinely and will be accomplished only if considered necessary based upon the particular facts of the individual case. In the cases of veterans over 55 years of age, reexamination will be requested only under unusual circumstances.

[Buck52]

What I never understood is how do they come to the conclussion that a S.C. Disability has ''improved''?

 ''Generally, reexaminations will be required if it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability''.

 

ok if the veterans condition has not improved what constitute a examination?

just my opinion here but No Veteran is going to say his/her condition has improved or likely has improved or show evidence

that it has improved...

To the contrary  it has got worse and not improved.

[toddt]

I would think that a C&P re-evaluation would be the same as a regular C&P exam.  Reading your post it sounds like the doc that did your neck exam was only interested in filling out paper work.  It may be that he/she did many exams this way and the VA has had complaints about him/her and wants to make things right.  Did you get the notes that the doctor wrote about what he/she found during the neck exam?

[broncovet]

Welcome back, rootbeer.  Its great to hear from you.  

[EODCMC]

The VA can check on a veteran just as easy as insurance companies check on claimants nowadays. Drones can observe you in your yard or most places you go outside your home with little effort and cost. Or, am I looking under the bed for boogie men?

[rootbeer22]

Folks:

As always, thanks again for your comments. Frankly, I really appreciate and value your comments and sharing information helps just about everyone. Anyway, I wanted to follow up on my earlier posts regarding this neck issue and new re-evaluation exam. So, when I received the notice that I was being reevaluated for my neck injury issues and it was not a surprise. I have extensive  records relating to my neck injury issues so there was no debate on the service connection.  The basic problem was that there were two previous neck exams and during the earliest evaluation the nurse examiner did not use a goniometer. When I asked about it's absence  during the exam, she go irritated? The other issue with that exam is that it was more than obvious that she appeared not to fully review my records prior to the exam. So, then about 1.5 years later when I had another neck exam, the doctor used a goniometer which resulted in a higher rating. Although the VA honored the higher exam originally, they advised that they would visit it gain within 2 years later which they did.  Anyway, during the latest exam a few weeks ago, the CP doctor was actually a surgeon and seemed very thorough. He asked a lot of questions, used the goniometer and was professional.  As a result of the neck injuries, I cannot move my neck very much and have significant pain always, especially when I do computer work and have to lean over the key board for hours at a  time. The doctor asked my if I had considered surgery and I said although the pain is increasing each year and the pain is affecting my quality of life, the likelihood of a successful long-term surgical  outcome is minimal at best?  Anyway, as a result of my neck injuries, I was alt least 2-3 weeks behind in my work and it is getting worse. Anyway, the doctor of the re-evaluation exam ruled that my neck injuries were clear with significant mobility issues and nerve damage, but said the nerve damage was not "moderate' so they dropped the rating by 10%. The other relevant issue was that although I had reported debilitating instances during the last year and subsequent years, that was not considered in on the rating which I believe would have kept the rating at the same original level? Anyway, the good news is that my overall rating stayed the same due to some other injuries %.     

That all said,  as I get older these military related injuries are really making it tough for me. I knew and accepted the risks and would still do it all again. Frankly, I don't think the average American citizen knows what we vets like us  go thru long after our service is up. I read in the Sunday paper that the government wants to decrease our medial benefits via Tri-Care again and that does not seem fair at all...

 

Anyway, Godspeed and good luck to all of you....