RAMP

[KC3]

I just wanted to share my experiences with RAMP. My rep phoned me and told me I was denied on two of my issues but will receive C&P exams on the other two issues including Migraines. 

I was not involved with the higher level review conversation which I thought I would be.   I believe I should have went supplemental lane instead of taking the advice of my rep to do HLR

I was also informed that all lay evidence was ignored including buddy letters. I was told that me and my wife need to write additional letters for all denied issues that will go to the RAMP legacy BVA lane now. The problem is that we have already written everything my rep said we needed to write about. It's there in black and white. 

All opinions I had in my claim from Doctors  included in them:     thorough review of SMR's,   board certified,   rational and at least as likely as not/more likely than not opinion. 

Now I am told I have to have these doctors (2 of them retired) include that they have reviewed a certified copy of my c-file or any new medical opinions that I receive in order to be accepted. 

I hope when it comes decision time that the IMO from my neurologist has some bearing and that the initial C&P gets ignored since the doctor was wrong. 

Does anyone have a general guideline on how physicians should construct an IMO letter for the Bva? My rep was supposed to let me know but ignores my emails. I am being referred to a veteran friendly pulmonologist and wanted to have it ready. 

Thanks

[Vync]

Oof...

 

1 hour ago, KC3 said:

Now I am told I have to have these doctors (2 of them retired) include that they have reviewed a certified copy of my c-file or any new medical opinions that I receive in order to be accepted. 

Was this the advice of your rep or did the VA request this? Unless the Caluzza requirements changed, this does not sound correct to me.

My advice would be to personally review the SSOC to learn how the VA justified the denial.

 

If your original C&P was not performed by a neurologist, your IMO may should be given more consideration/weight.

 

Here are some links regarding nexus letters:
http://www.nd.gov/veterans/files/resource/Nexus Letters.pdf

https://www.hillandponton.com/how-to-make-sure-a-nexus-letter-effectively-supports-your-va-claim

[KC3]

Thank you for the links Vync; this is the format I had the doctors review. I thought there might  be another way for the C file review. 

I will await until I receive the actual decision and review. My rep says he already seen it; however he is 4 hours away and the only contact I have is via phone. 

Thanks 

[Vync]

Yep, without the decision letter, it is kind of difficult to know exactly why they denied. When you get it, if it is not clear, you can post the text of the decision for others to review. Just be sure to redact/omit any personally identifiable information to protect your privacy.

When I filed my last round of claims, the non-VA orthopedic surgeon who wrote my nexus used a similar format (he used to work at the VA).

I recall a case in the distant past of denials being issued because the non-VA doctor did not review the actual claims file. I'm not certain if that is a rock solid requirement. I believe the doc must review relevant records and use appropriate jargon when writing a strong medical opinion.

 

Edited December 20, 2018 by Vync