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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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I dont doubt it- the recent GAO report ( posted link in the S 221 topic)

indicated VA is hiring 'disqualified doctors'....... yeah -no surprise there.

If this doctor did the C &P for a contractor ( VES, QTC, or LHI) you can complain to them -I posted their contact info here, avaialable under a search. ( but so much time has gone by)

And /or you can file an IRIS complaint at the Main VA web site, and /or you can call the White House hot line for vets at 1-855-948-2311- 

as I said so much time has passed but the VA could still deny unless the exam is corrected or re done by your request.

Then  again I did all of the above ( called white house about 2 weeks ago) on a Feb 2015 posthumous C & P exam.

They reversed right way under CUE but that is not the point.My evidence came from VA's Top Cardologist.

Last I heard the WH said I would hear something soon. I have been trying to get this exam since August 2018.

I should have acted on it sooner but then again they awarded on CUE and I have another CUE pending on that award.

I am involved in something else that this would be great evidence for, because I do not think anyone with a medical background prepared the ridiculous C & P exam.  I could use the SOC rendition of it , to send  to the S HAC, but the actual exam was signed (I assume) and I want to know who did it.

A bad C & P exam will follow the claimant all the way to the BVA, and CAVC if they are denied solely on a bogus exam.

The best time to correct crap like that is Yesterday!

 

 

Edited by Berta
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I think your question is answered in this thread-

The contractor contact info is there, or you can call the VA and ask for a better exam, or complaint to IRIS, at  the main VA web site, or complaint to the White House  vet's hot line,1-855-948-2311

or as Broncovet said you can get an IME from a real doctor.

Specifically from a podiatrist.

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HIs it better to file a soc, ask for another c and p.  We filed soc.  This was for a purposed reduction that will effect overall rating.  And also to set up to deny a appeal which is in remand.  Clearly examiner did not review uploaded material.  Lied on stating hubby could work.  Also stating he could use push mower for mowing our yard and heavy yard work.  Took previous exam to rate.  But previous exam had Mets at 3-5 and he put them at 5-7.  I have letters from two dr stating hubby can not work,  due to having dizziness and falling spells.  It is really stressing my husband out, and I suspect the stress in turn is causing his blood sugar up into 300 to 476.    We don’t want this to drag on for ever.  My husband is 72 and has to mow with riding mower.   No way he can do  it with push mower.  And I’m not sure he will even be able to do that much longer.

Edited by treysnonna
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"I have letters from two dr stating hubby can not work,  due to having dizziness and falling spells.  "

Was either doctor a Cardiologist, and if so, did they follow the IMO/IME criteria here at hadit?

A proposed reduction has to be aggressively fought with Medical evidence.

I changed some of the advice I gave here in a prior reply-

If you get a faulty C & P exam, 

1. complain to the Contractor who hired the doctor to do the exam.

Their contact info is here somewhere under a search.

2. Look the doctor up on google to see if they have any expertise at all in the field of the C & P disability

3. Go to the VA Main site , use the Contact Us Button and then Use the Ask a question button and file an IRIS complaint. ( the complaint area is a pop down box.)

4.Call the WH Hot Line 1-855-948-2311 and file a complaint by phone.

5.Sometimes the Best recourse is to get an IMO/IME.

Did the VA ignore the "letters from two doctors"  in their proposed reduction letter?

If so you can file CUE ( if the letters complied with the IMO/IME criteria here at hadit and the doctors gave a full medical rational to their statements, refering to all of his medical records, and if those 2 doctors were cardiologists )

Did you file the SOC within the proper time frame deadline? 

I have done all of the above many times, as a claimant.

My recent WH Hot Line complaint was that the VA has still not sent to me the copy of an actual C & P they did in 2015. I won that claim but still I want to know who did it and what contractor paid them to do it.

I believe it was NOT done by anyone with any medical expertise.

Lousy C & P exams has come to the attention of the GAO and to a few veterans lawyers.

Veterans have been putting up with this crap for decades. These exams are geared solely to denying claims or in your case, to warrant a reduction.

In my case the veteran is dead. My husband has not been able to speak for himself for 24 years, dead due to VA health care.

My 2015 claim that received the bogus C & P exam ,had evidence from the Top Cardio doctor in VA Central.

The denial listed the fact that they had it but never considered it. I CUed them the next day and 3 weeks later they reversed the denial.

Personally I feel that you need a strong IMO/IME from a real cardio doctor-

unless that is what you have, from 2 doctors, that VA might have completely ignored or found not compelling enough to drop the reduction.

As a widow claimant Many times since my husband died, I have NEVER recieved a proper initial  posthumous C & P exam.

I only needed IMos for one of those claims, and fought back all denials aggressively at the RO level....except the BVA award, wwhich I obtain 3 IMos for- and even paid for a 4th I didnt even need.

In 1988 the VA proposed to reduce my husband's 30% SC for PTSD to 10%.

In that case ,I wrote the NOD, using their statements, the regulations they used, and the actual documented facts of the case.

They dropped the proposed reduction as soon as they read the NOD.

It took 8 months for them to read it-I knew they had no legal position at all that would warrant the reduction.

VA Ultimately awarded (posthumously) 100% P & T SC for my husband's PTSD-with an EED 2 years after they restored his 30%.

Proposed reduction from 30% to 10% PTSD -Christmas eve 1988, NOD filed early 1989 , proposal dropped  Nov 1989. 

EED posthumous award for 100% P & T for SC PTSD.Nov 1991.

Figure that.

It just points out how we must never accept a bogus C & P exam. 

And if it costs $$$$ for an IMO/IME- it will be a smart investment,

based on the actual medical facts of the case,

costing far less than the  accumulated loss of a reduction can be.

 

 

 

 

 

 

 

Edited by Berta
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