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Disability claim for cancer patient

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I am the primary caregiver for my father. He is a Vietnam Vet, recently diagnosed with a presumptive disease, multiple myeloma. I went through a VSO to file a disability claim on his behalf. She listed his myeloma, along with other health conditions on his application.  We faxed all requested health records and needed information. He has now been told he needs to go to two different C & P exams. My father is unable to complete these exams due to his physical condition and extremely compromised immune system. He is in the middle of an intense chemo cycle. It is extremely difficult to get him to his chemo appointment once a week in a cancer center. We can not risk him getting an illness from visiting one of these appointed sites. I believe these C & P exams are likely for the conditions listed by the VSO other than his cancer.  Can his claim possibly be approved , considering he has a presumptive disease, if we cancel these appointments? 

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The VA is a pain sometimes...

When you keep running into BS, and they can provide no solution,  go unconventional.

First off, I will assume that your father is under NON VA care? If so, ask his attending/primary physician to fill out a DBQ. DBQ is a big part of the C&P exam and if the VBA gets that up front, your VSO should be able to get the apt set aside. The Rating official must accept it, no option, unless the MD that filled it out screwed it up bad. Beyond that, they are also required to review the Vets record, because if there is enough info in the record, they do not need a DBQ. Did you provide them with your dads full medical record on the cancer and his treatment? They can do a C&P request from a qualified provider of their choosing to give them a qualified medical opinion in either case without your dad if they have the DBQ. You dont even need a NEXUS, just prove that he has the presumptive condition, and had boots on the ground in VN. (A lot of the time the moron at the bottom of the ladder is shuffling files mechanically and does not even open the Vets C File until after the C&P is complete.)

The VA guidelines that back this up:

M21-1, Part I, Chapter 1, Section C - Requesting Records

 

3.c.Reviewing Evidence of Record Prior to Requesting Examination

 

An examination or opinion is only necessary when there is not sufficient medical evidence of record to make a decision on the claim. 
  • Prior to requesting an examination or opinion, review the available medical evidence to determine if such evidence is sufficient to rate the claim.
  • If evidence, such as a disability benefits questionnaire (DBQ), a private physician’s report, or private medical opinion, is received and such records are fully sufficient to rate the claim then do not order an examination.  
References:  For more information on
Edited by pwrslm
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evaluating claims based on the evidence of record, see 38 CFR 3.326(b)

 

 

§3.326   Examinations.

For purposes of this section, the term examination includes periods of hospital observation when required by VA.

(a) Where there is a claim for disability compensation or pension but medical evidence accompanying the claim is not adequate for rating purposes, a Department of Veterans Affairs examination will be authorized. This paragraph applies to original and reopened claims as well as claims for increase submitted by a veteran, surviving spouse, parent, or child. Individuals for whom an examination has been scheduled are required to report for the examination.

(b) Provided that it is otherwise adequate for rating purposes, any hospital report, or any examination report, from any government or private institution may be accepted for rating a claim without further examination. However, monetary benefits to a former prisoner of war will not be denied unless the claimant has been offered a complete physical examination conducted at a Department of Veterans Affairs hospital or outpatient clinic.

(c) Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination.

(Authority: 38 U.S.C. 5107(a))

Just give them the evidence and they dont need that exam!!

Edited by pwrslm
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The possibility of winning service connection WITH a C&P is about a 50/50 shot in the dark.

The possibility of winning service connection without a C&P, especially your first C&P, well I doubt it would happen,

Missing a scheduled C&P, is a no no.  Don't do that.

But, I have been wrong before,

Hamslice

 

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Something else to consider, Special Monthly Compensation, Scheduler Housebound SMC S (additional $34?.00 per mos) if his other SC's have a CSC (Combined Service Conection) Rating of 60% independant of the (1) SC Rated at 100%.

If appropiate at this time, request that his Private Oncologist complete a VA Aid & Attendance Medical Questionair.

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Respectfully Vetquest- just because you have a diagnosis, does not mean you need extensive medical transport.

I understand the point.

If the debilitation is severe they would not be at home. 

21 years of experience in this area. 

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Have your Dad's Cancer Records been downloaded to his VMC?

If he's a Nam "Boots on the Ground Vet," he doesn't need a DBQ completed for the MM Cancer Claim. An MM Cancer DX by a Private or VA Oncologist is sufficient for the AO Presumptive Claim.   His DD214 does verify his Nam Boots on the Ground, right?

The MM is the BIG SC 100% Claim at this point and should be expedited due to the Nehmer Rule. The other Issues Claimed ar low hanging fruit and will be addressed in due course by the Rating Dept. These other Claimed conditions will not hold up the MM presumptive Award.

The one thing you might consider, ask his private Oncologist to address his C & P Exam Exposure to infection due to his compromised Immune System. A VMC Oncologists review of his MM DX and treatment notes should be adequate to order VMC Medical Transportation services.

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