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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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ArmyVet270

5 Year Review (All ailments or only some?)

Question

Hello,

I have a question about the first 5 year review of C&P Exams. I have 7 conditions that are rated Lumbar Spine 40%, Insomnia/Anxiety Disorder 10%, Migraines 0%, Ankle 10%, Bilateral Pea Plants 30%, Tinnitus 10% & Gastro 60% for a combine rating of 90%.

My gastro was a reconsideration with surgical scope and biopsies and private dbq was accepted. All other ailments were from initial ETS physical and 1st C&P Exam. 

I currently use the VA for primary medical care and have all my medications prescribed through them. 

 

My question is the 5 year review for each and every ailment or is the VA going to let me know what is under reconsideration?

Only 1 condition Back states at the bottom of the write up "Since there is a likelihood of improvement, the assigned evaluation is not considered permanent and is subject to a future review".

The majority of my conditions are basically treated with a regiment of medication I get from the VA and the standard 6-9 month checkups barring any acute instances. 

The VA Health care is great but the administrative side of consistently proving or re-justifying ones ailments is mentally stressful. I guess I just don't know what the threshold of acceptable is like is there a certain amount of appointments I need or checkups with specialists other than just continuing my regiment of medications and VA checkups like I have been. 

Thanks for any potential insights and have a great day!

ArmyVet

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Thanks for everyones insights! I was able to review the primary care providers notes and while nothing was inaccurate its wasn't quite as substantive as it should have been. I drafted up some notes to update my Problem Lists, Notes, Medications, & Assessment & Plan that covers all conditions I am being treated for. 

On a final note I am rated 0% for Migraines although its service connected and been being treated for about 5 years with 4-5 episodes a week. Didn't  realize I met parameters of CFR as everyone has pointed out for this.

Should I get my VA Primary Care Doctor( Been my doc for 5 years) to fill out a Migraine DBQ for me or would I be better off to bring my records to a private doc and try to get a Neurologist to fill one out for me after I provide records and my log? 

Thanks for any additional insight and have a great night!

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YOU pay your doc.  VA pays VA docs.  The dog will be loyal to the one who feeds him. 

So, feed the dog, dont depend on others to feed YOUR dog.  

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VA was dinged by the IG for unnecessary C&P exams over the last year.

I would make sure that your VA PCP thoroughly documents your migraines. Review the DBQ associated with migraines and get the PCP to enter as much into the record as you can that the DBQ asks for. Once it is done, get a copy of your blue-button report from the EVet sight 3 or 4 days after your appointment when it updates. In the BB report, highlight the documentation, and bookmark it in PDF format. Write a short note to "whom it may concern" about the documentation you are providing, and drag it in PDF format into the beginning of the BB report before you upload it. Upload it as VA/Govt medical records.

This is acceptable clinical evidence.  The rating official can send this information to a medical professional for an opinion if its necessary. They might still send you to the C&P, but because of the evidence submitted in the BB report, you are way ahead of the game.

 

Note that over  55, both USC and CFR, as well as the VBA''s M21 training manual forbid them from conducting C&P re-examinations without specifically noted causes. I was scheduled for 3 C&P exams in 2.5 years, and the last one I raised cane and they cancelled the entire exam, and completely deleted it from the record.

Edited by pwrslm
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11 hours ago, pwrslm said:

Note that over  55, both USC and CFR, as well as the VBA''s M21 training manual forbid them from conducting C&P re-examinations without specifically noted causes. I was scheduled for 3 C&P exams in 2.5 years, and the last one I raised cane and they cancelled the entire exam, and completely deleted it from the record.

Good info sir.

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