Seeking Guidance: C&P Re-examination and Processing Claims

[Ocean]

Good Evening,

At the beginning of September, I opened a claim for ED which I have been actively working to get organized with medical notes and a DBQ. Three days later, the VA issued a C&P Re-examination appointment for my lower back; which I understand is normal. The concern that I have is that the estimated time for the re-examination claim to be completed is October 5th, with the VA appointment on 9/25. This seems incredibly fast. The concern I have is, will the VA complete a RE claim individually or does everything get processed together; like any other claim?

I have a few other items of concern (Sleep Apnea, Unstable Scars, Tinnitus, Voiding Dysfunction) that I intend to submit and have been just keeping them in a file cabinet as I was already rated 100%. I was considering just submitting everything that has accumulated over the past few years with their related DBQs and ongoing treatments. Any thoughts?

 

[Buck52]

Ocean

Its very complicate process   the more server your s.c. disability are the higher up the SMC Latter   so-to-speak  VA makes these hard to understand  So Basically you need a qualified  Dr Opine on all your server S.C. disability's that meets the criteria for the correct SMC .

SPECIAL MONTHLY COMPENSATION EXPLAINED

FRIDAY MAY 19, 2017  Source : CCK -LTD

The Department of Veterans Affairs (VA) pays Special Monthly Compensation (SMC) to qualifying veterans with especially serious disabilities or combinations of disabilities. The idea is that certain disabilities and combinations of disabilities are more debilitating than regular disability compensation rates account for, so VA pays a higher rate of compensation if you have them.

VA should automatically give you Special Monthly Compensation if you qualify for it. You do not have to apply. If, however, you believe you qualify for SMC but are not receiving it, you can call your VA regional office or contact an attorney.

There are several ways to qualify for Special Monthly Compensation. The different types of compensation are split into levels:

Levels L through O list specific conditions and combinations of conditions that qualify a veteran to receive SMC. Level L contains the least severe of these conditions (and therefore, the lowest SMC rates) and Level O contains the most severe (and the highest SMC rates).

Level K provides SMC for veterans who have, for example, experienced the loss (amputation) or loss of use of an extremity or organ.

Level S provides for veterans who cannot leave the house. Level R provides for veterans who need daily aid and attendance from another person.

All Special Monthly Compensation rates are given instead of the standard VA Disability Compensation rates, except for Level K. Level K is given in addition to your standard disability pay.

Once you know which SMC level you qualify for, you can look up the exact amount you should be receiving with the VA’s Special Monthly Compensation Rates.

To be eligible for any level of SMC, the disability you are claiming must be service-connected. The other eligibility requirements for each level can be complicated, especially if you qualify for multiple levels. In the rest of this post, we’ll cover the basics of each level and some of the special cases you might encounter when receiving Special Monthly Compensation.

LEVELS L THROUGH O

Levels L through O — that is, Levels L, L ½ (i.e. “L and a half”) M, M ½, N, N ½, and O — list specific conditions and combinations of conditions that qualify a veteran for that level of compensation.

Level L, for example, lists “amputation of both feet” as a qualifying combination of disabilities. Level N ½, a higher level of Special Monthly Compensation, lists “Loss of use of one elbow and amputation of one arm so close to the shoulder that it is impossible to wear a prosthesis” as a qualifying combination of disabilities.

[Ocean]

On 9/28/2018 at 3:44 AM, Buck52 said:

Normally if it was done by the VA then you only need to wait 3 days then go to medical records release of information and request a copy.

 

My VA C&P was a week ago, still nothing is showing on HealtheVet, I called the Regional Records and they stated the release of information has a turn around of 20 days. Am I able to go directly to the C&P check in area and request a copy of the exam?

 

The rater working my case submitted an increase on Migraines and I have a C&P for that tomorrow. I am curious if something was forgotten on 9/27/2018, during my back C&P and they are waiting for me to be in the clinic again. Can they do that? Or are they just being slow?

 

[Buck52]

2 hours ago, Ocean said:

My VA C&P was a week ago, still nothing is showing on HealtheVet, I called the Regional Records and they stated the release of information has a turn around of 20 days. Am I able to go directly to the C&P check in area and request a copy of the exam?

 

The rater working my case submitted an increase on Migraines and I have a C&P for that tomorrow. I am curious if something was forgotten on 9/27/2018, during my back C&P and they are waiting for me to be in the clinic again. Can they do that? Or are they just being slow?

 

you may need to wait until all you C&P are done. usually it only takes 3 days to check with the release of information office on any medical records that you want...you could go to the VBA (Veterans Benefits Administration ) and request the C&P EXAM report you want/need on certain date  ect,,ect,,,.  they can pull it up on the computer.

but if its not showing up they maybe waiting to record it with all your current C&P??. Normally after 3 days it should show up in the release of information office .

you might check with the VAMC Hospital director  because your certainly entitled to your records when you want them. (after 3 days) of the report.  remind the director of that.

[GeekySquid]

On 10/4/2018 at 3:07 AM, Ocean said:

My VA C&P was a week ago,

@Ocean

I am sure you know this, but just in case someone doesn't.

VA C&P's show up in MyHealthyVet, but those from outside contractors don't.

The search I suggest you do is to check ALL but limit the date range to the last 2 or three months. This will capture everything in that time frame and save a lot of other searching through the full file or not checking the right box to download.

I will respectfully restate a slightly different version of what Buck52 said in one of his responses.

In terms of filing all those other claims. It is not totally a myth that your claims and payments can get held up by subsequent claims.

I know as I am in  hold hell right now because of a recent claim approved, a recent C&P that  says service connected and the filing of additional claims. They are all tied up together.

I did get paid my monthly increase form 70% to 100% P&T what is tangled up is the retro pay on that claim as well as the SMC pay form the second C&P, any possible retro pay on the SMC, and the other claims I filed before I got the rating determination on the 100% P&T

I followed advice similar to what buck said instead of doing what seems to be the smartest option, which is Intent To File.

An ItF sets the effective date just like actually filing a claim does. But since there is no actual claim at that moment, anything in the pipeline gets processed completely and totally unfettered from any other possible claim.

Once you get the pipeline clear, assuming it is less than a year from your ItF date, then file the new claims.

Buck and other may be correct that they are not supposed to interfere with each other, but my experience right now is that getting paid can get tangled up with non-related claims.

Had I known that ItF's set the Effective Date, I would have waited instead of tempting the VA's "Let's F^&* with a Veteran" habit.

 

Good luck

[Ocean]

Thank you for the reply, the C&Ps were done in house but are still not showing up. They might be riding the wave until the due date or actually going through the 300 pages of private sector records that I gave them.

[GeekySquid]

4 minutes ago, Ocean said:

actually going through the 300 pages of private sector records that I gave them.

@ocean

that's a lot of pages, i hate to sound gleeful but good for you!. I know they were expensive, time consuming and probably felt like delay after delay, but if they help you get your earned compensation then they were worth the expense.

procedurally I don't know that they wait to post your C&P until they wade through it and any evidence you submitted to the doctor, but as I understand if you did give the doctor papers (and they are allowed to use that) you still have to do the upload yourself or mail them in. This may apply only to outside C&P examiners, maybe one of the Edlers know different.