New Claim I didn't file

[mclevela726]

Hello,
The VA is sending me to a C&P exam. Partially for a new claim that I did not file. When I went into eBenefits (I know it isn't completely accurate) it states that a new claim has been filed; as denoted by "(New)". The only problem is that I didn't open a new claim. Could the VA or a VA Doctor have opened this new claim?

Thanks.

[brokensoldier244th]

Or, you know, it could just be a C&P exam- like they can and will do periodically for a condition that is rated. Not everything is a precursor to a reduction. Sometimes, you know, they do an exam because you haven't had one in awhile. 

[BigRedDog]

I'm also in the process of deciphering eBenefits.

The request for the exam being closed simply means that the VA has successfully handed it off to the contractor.  My own C&P was approximately a month ago, and it still says the same thing; VES got the results to VA a couple of weeks ago.  Definitely show up for your exam.  You may even want to call QTC and ask how many issues you're exactly being examined for, and what they are, so that you can be better prepared.  Ebenefits will simply show "one" exam request, even if it's for multiple issues.

I'd bet $2 that your doc or specialist referred your issue.  I think there is a lot of variability here; some of them really take the "duty to assist" part of their jobs very seriously.  On the other hand, I've been telling my doc at the VA about my worsening conditions for 2 or 3 years, and it hasn't gotten me anywhere.

[brokensoldier244th]

They can request a C&P for existing conditions to see if they are static, better, or still progressing, too. 

[doc25]

1 hour ago, mclevela726 said:

Hello,
The VA is sending me to a C&P exam. Partially for a new claim that I did not file. When I went into eBenefits (I know it isn't completely accurate) it states that a new claim has been filed; as denoted by "(New)". The only problem is that I didn't open a new claim. Could the VA or a VA Doctor have opened this new claim?

Thanks.

Hmmm...sounds sketchy to me.

But, I'm usually paranoid. Do you have scheduler rated PTSD or other mental health condition? It might be one of those C&P exam to reduce a rating. Don't quote me on that. But IF it is to reduce ratings, they should've sent you a letter before the C&P. exam. If you go to the C&P exam and your ratings get reduced. Appeal because if they don't notify you first that's the Regional Office screw up.

Be advised, I'm not trying to cause any unnecessary stress, my intention is just making you aware of what the VA "might" or "may" want to do. Here's some info for you to be prepared, in the event, this does occur. I really hope they don't try to screw with your disability.

 

WHAT TO DO IF YOU GET NOTICE OF A POTENTIAL RATING REDUCTION

VA is required to send a letter proposing the reduction of your benefits, if the decrease will affect the amount of monthly compensation you receive. The letter is not a final VA decision and so cannot be appealed, but VA gives you the opportunity to respond to the proposal by submitting evidence and/or attending a hearing.

From the date of the letter, you have 60 days to submit evidence if you believe the reduction is not warranted. Within the first 30 days of the 60-day period, you have the option to request a hearing to be conducted by VA personnel unrelated to the proposed reduction. VA must consider evidence you submit during this period (including the transcript of the hearing, if you choose to attend one) and all previous evidence and medical records associated with your file.

What are some types of evidence you might submit? You do not need to submit treatment records from your VA Medical Center as VA already has access to those documents. But it can be helpful to submit a medical opinion from an outside, independent doctor if your Compensation and Pension exam was not favorable. Additionally, you may want to submit statements from family, friends, or employers who have observed your ability to function in daily life and/or at work. If you choose not to submit evidence within the 60-day period, VA will issue a final decision reducing your rating.

If, after 60 days or the review of your submitted evidence, VA sends a final decision that reduces your rating, you can file an appeal with a Notice of Disagreement form.

[BigRedDog]

What's the new claim in regards to?  Did you recently attend another C&P exam?

I had a C&P exam about three weeks ago, and the VES doctor must have indicated something, because I'm also showing a "new" claim, for something I'm already rated for.  I'm guessing that the rater will get this all figured out.

But if your C&P exam came out of nowhere, I'm guessing that they are reexamining your condition.

[doc25]

15 minutes ago, brokensoldier244th said:

Or, you know, it could just be a C&P exam- like they can and will do periodically for a condition that is rated. Not everything is a precursor to a reduction. Sometimes, you know, they do an exam because you haven't had one in awhile. 

I concur.