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Did you get a flawed C & P exam-what you can do

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Berta

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You can immediately ask for a different doctor to do the exam.

When I say 'flawed', I mean the examiner did not have the expertise to opine on your claim, 

or the doctor did not have any of your medical  records, to include SMRs in many cases,

or the doctor failed to consider any other probative evidence that you moght have brought with you to the C & P yet the doctor didn't want to see it---

or the examiner LIED. There are probably many more reasons why an exam can be flawed.

This AM I received a call from OAWP-VA-DC, as to the ongoing investigation they are doing based on my other complaint .

I have more evidence to send to them-we went over some of the evidence they already have- it is solid to support my complaint-It is a different issue than this post is about-

But then I mentioned to the Triage manager the C & P situations I see so many of you here are dealing with.

I told him of 2 of my C & P exams (posthumously done on my husband) and am waiting until Jan 15, 2019 for a copy of one of them-to adequately prepare a OAWB complaint. on that matter, which affects so many veterans....and I am sure I am not the only survivor of a vet who has had this problem consistently with the RO I deal with.

He was shocked at what one SOC C & P examiner had stated..... I told him this was only one of many C & Ps they did- all wrong, to deny my claims. (all awarded since-yet not the point))

Would anyone here be willing to follow up my next complaint on the C& P problems many here have?

If it took a costly IMO/IME to get a full reading of your evidence, and then attain an award, tell them that.

If  your are in financial diffculties and cannot possibly afford an IMO/IME, tell them that.

If they lied about your condition , tell the OAWB that- and give evidence to show that they lied.

Be prepared to attach the C & P exam to the email you send to them, and attach any other evidence you feel they might need.

I told the OAWB Triage  manager I  have seen many C & Ps over the years that are highly erroneous and deny many valid claims . Claims that will add to the backlog and if they are valid they should never even be in the appeals process at all.

If you prepare a complaint, specific only to the C & P problem, you can refer OAWB  to my complaint ( Berta Simmons, NY ) that will be at OAWB on the 16th of this month.I am waiting until the 15th to see if VA will send me a C & P exam I requested.Whether I get it or not the complaint will still be filed on the 16th.

I do not really have a dog in this fight because so far I won any claim VA gave a lousy C & P on.I only needed the IMOs I have for one claim.

Something needs to be done about this situation.That wont happen with one complaint from a dead veteran's widow. The only evidence I have is my own personal

letters and C & P exams from the VA, And the info from NVLSP and GAO-which covers all veterans but  is general, and not specific to what many of you really go through with C & P exams,   that are geared to what the VAROs want-

                                                                     and that is - to deny the claim.

 

 

 

 

 

 

 

 

 

 

 

 

Edited by Berta
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Yes, you are right- also a copy of the actual exam should be provided to the claimant as soon as it is complete.

Real VA doctors used to do these C & Ps.

They were no better in those days sometimes, then they are now by the non VA contractors- but still in the olden days the ROs used to identify the C & P doctor by name in ther SOCs. A C & P doctor I called up when I got an SOC many years ago was stunned to learn what my RO deiberately  withheld from him.

He sent me the actual exam he did which was much different from the way the RO manipulated and parsed it in the C & P exam. They withheld this same Probative evidence from the OGC and the Top VA Cardio doc-I called her up in DC asking her how she could opine on my charges with the 6 page autopsy available- and she screamed "What autopsy!". I faxed it to her and they OGC -began negotiations immediately.Wrongful death.

I sent a copy of  my FTCA settlement to the RO- it supported my 1151 DIC claim.They ignored it and denied the claim AGAIN.Third time or more - Then I called up the DC lawyer who negotiated with me at OGC and told him VA owed me more money.I said my settlement was void, since the RO would not accept evidence  of it. He was horrified.

Within a few weeks they awarded my DIC. OGC had called them up and probably ordered them to award the 1151.. also there was an offset but when I won direct SC death the Regional Counsel filed CUE on them and then OGC had to order them to refund it. There was no other case like that- VA ever had but still the regs are what they are, and they paid it.

 

 

 

 

 

 

 

 

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  • HadIt.com Elder

Generally speaking,  every vet should get a IMO/IME and not trust your future to a C&P exam done by some contract doctor whose bread is buttered by the VA.  I am not saying that all these contract doctors make it a practice to low ball or attempt to deny disabilities, but consider who pays them.  I had the same experience with OWCP which is federal worker's compensation.  The OWCP was like the VA in that their doctors usually took the agency side.  
These agencies are just not going to send their clients to doctors who will increase their compensation expense.  A few lucky people get by but majority get whacked by these quacks IMO.  If there is subjective elements to your claim the contract doctors will come down on the side of the VA.  It happened to me many times before I got some good IME/IMO doctor to help me refute VA's absurd exams.

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  • HadIt.com Elder

I agree John999

Even when the evidence is right in front of them they still find a way to screw the Vet.

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I just got an email notification that wirat comented on this thread- but I cant find it here--?

But my response to it is this-

The Office of Accountability needs Evidence to look into any complaint they get.

I have made multiple submissions of evidence to them on all of the issues my original WH Hot Line complaint turned into.

My main issue had nothing to do with me-too late for that ----it regards all veterans in VA health care and their survivors.

OAWB asked me 2 questions about a month ago- on my personal issue -and although the OGC coud have called me back with an answer  right away ,they didnt, and it took me 2 weeks to find the answer.

Their (OAWB)next question involved a C & P exam I got in 1996.

I immediately made a pdf of it and also of a 2015 SOC C & P, and that supported that specific issue and sent it to them.

I was, since 1995 , and still am, targeted by my VARO. I have years of proof of that. I can fight back and always do- the point of that specific issue is how my VARO treats widows- or maybe it is just me.

I think this is because of the wrongful death issue (FTCA) but I dont care why-

If you love your spouse , make sure they understand your VA issues and any claims you might have pending, but might die before any proper resolve of those claims comes...

and if your spouse cannot use a PC their claims might well be doomed.

And even if the spouse is up to speed on the PC and survivor's regulations, they might get the same crap I did, and not know how to fight back

 

Due to the evidence I have sent to OAWB ( and have more if needed, the matters I raised are being "investigated" and I  have a case number.

Send them documented evidence of any complaint you make. But try to resolve those legitimate issues ( as I did-with the H VAC , OGC , VARO ,etc etc) long ago, but with no resolution from them...for over 20  years in one big issue- which  has nothing for me to gain personally- it is for all of you.

And it has taken up a lot of my time- and might take up more time-soon.If I am not here.

 

 

 

 

Edited by Berta
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I suggest reading what Wirat did ,in this thread, to complain about a lousy C & P exam.

I posted LHI and QTC contact info above-I had not had time to find VES contact info-

anyone here have that info?

By contracting the C & P  contractor directly might well be the best way to get these complaints resolved, with a better C & P exam.Or by calling the White House Hot Line 1-855-948-2311.

Or do both. These lousy exams have occurred for DECADES-the only way I foresee this issue being resolved is if veterans complain .

One vet here did complain to OAWB and his complaint was refered to someone else in the system-apparently his complaint had serious  merit.

There is no doubt , when OAWB got some of my posthumous C & P results, that my complaint had merit.

But my issues grew into far more serious ones, with evidence on other matters..

An OAWB complaint must fit into the purvue of their mission:

"OUR MISSION

The Office of Accountability and Whistleblower Protection serves to improve the performance and accountability of VA senior executives and employees through thorough, timely and unbiased investigation of all allegations and concerns. Where these actions are found factually true, the Office will provide recommended actions related to the removal, demotion or suspension based on poor performance and/or misconduct. Additionally, OAWP provides the protection of valued VA whistleblowers against retaliation for their disclosures."

https://www.va.gov/accountability/

My complaint regards not only the OGC, in one matter ,but also a Senior executive of my VARO (and her staff)in another matter.

I have made multiple submissions of evidence for both main complaints.I have more pdfs but believe when they saw the 2 C & P postumous exams (1996) and (2015), I sent last week -it was evident that I had been targeted.

I have 3 CUES pending and oddly enough I found a nexus to the OGC that I didnt know of- for 24 years.

If VA gives me a battle on those CUEs, I will file another OAWB complaint.

When you are willing to really dig into research, you will find Serendepitious stuff.

As a new member here said "Google is our friend".

 

 

 

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On 1/30/2019 at 7:07 AM, Berta said:

"I suggest reading what Wirat did ,in this thread, to complain about a lousy C & P exam.

I posted LHI and QTC contact info above-I had not had time to find VES contact info-

anyone here have that info?"

VES Phone 1-877-637-8387;  https://www.vesservices.com/?page_id=37

Veterans Evaluation Services 
PO Box 924089 
Houston, Texas 77292

On 1/30/2019 at 7:07 AM, Berta said:

 

 

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