Plantar Fasciitis claim denied how do I fix it?

[Patton]

They made a decision on my appeal (RAMP) and I am confused?  I am happy with the outcome except for the Plantar Fasciitis which was denied. I talked to the Benefits Delivery at Discharge program (BDD) here in Germany and he said that it states:

•  History of Plantar Fasciitis in service.
•  Ongoing treatment after service.
•  Claim denied due to missed C&P exam.

Veterans Evaluation Services (VES) conducted the C&P Exam north of Frankfurt on January 22d, 2019. I also had an Insomnia C&P Exam on the same day, and they tied that to my SC  Depression (which is what I expected them to do). I wrote the person who setup the appointments but she have not gotten a reply back to me yet. 

What steps should I take next, so that it doesn't take another 3 years before I get this resolved? In my experience, they do the DBQ after the appointment, is there a regulation to ensure that I get a copy of the DBQ before I leave the appointment? I have asked for it before and was told no.

Thanks for any help.

Edited February 17, 2019 by Patton
wording

[broncovet]

VA is "rough" on missing c and p exams, and rarely entertain our excuses, even when they are valid.  Fortunately, you can appeal and "plead your case" in your nod..

You can "try" a reconsideration due to new evidence requesting an exam reschedule.  

Dont expect it to be resolved quickly..."fast" for VA is 3 years.  I have been trying to resolve my claims since 2002.  

When you do an appeal or reconsideration, remember:

1. A reconsideration is not an appeal, so your 1 year period will expire and you should file a nod if reconsideration is not resolved by 11 months after the VARO decision.  

2.  Do a thorough job.  Order your cfile.  Know what is in it.  Do you have the Caluza elements?  Its not the VA's fault if you are persuing a claim missing one or more caluza elements, it will be denied.  Caluza:  current diagnosis, in service event, nexus.  Dont blame VA for delays if you did a poor job with your claim documentation as i explained.  

Edited February 17, 2019 by broncovet

[Patton]

The sad part is that I did not miss my appointment. I don't know who dropped the ball, VES or the VA, but I am the one who is being punished for their screw up! I will get a copy of my C-File and get to the bottom of it. I will look into doing a reconsideration.

The last time I questioned the VA on making a false statement, I was escorted to mental health. Then they refused to correct their mistake? My VA Medical records has so many mistakes in it because they copy and paste bad information and nobody will do anything about it. 

I will get it fixed by not using the VA until I get everything documented correctly! Then hopefully I will get the correct disability rating.

 

[broncovet]

I have been on hadit for about 10 years, and I can assure you that you are not the first who was "not notified" of a c and p exam, then VA denies when the vet fails to show.  

I would humbly suggest that "calling someone a liar" at VA is nearly always counterproductive.  There is a regulation to correct mistakes on ones medical records.  Its found here:

https://www.law.cornell.edu/cfr/text/38/1.579

Almost anyone would be offended by sugesting "they made a false statement".  My suggestion is, instead, tell them "there are errors on my record" and ask to have them corrected.  

You see, this way you are not calling them a liar..you are "depersonalizing" the mistake.  Its like you are saying, "Gee, there is a mistake in my records, can you help me fix it?"  This is almost always better than accusing someone of a false statement, even if they made the same.  

In other words, give the doc the "benefit of the doubt".  What sometimes happens is the doc has "generic fill ins" when he speaks to you.  As an example, I have never had either a drinking or drug problem and I dont smoke.  However, this appears in my records to the contrary on several occassions, even with docs I know and trust.  

Why?  Well they are under the gun to see many patients a .day..so they take a few shortcuts on the paperwork and have "fill ins" that put generic stuff, and it sometimes gets overlooked.  The doc often does not mean to, its they are under the gun and must see 100 patients a day, so that means they get 4 minutes, no more, per patient.  

Now, your doc may have been a bad guy, but its also likely he made a mistake.  Give him the beneift of the doubt, and you will likely get more flys with honey than vinegar.  Just a humble suggestion.  

[doc25]

7 hours ago, Patton said:

The sad part is that I did not miss my appointment. I don't know who dropped the ball, VES or the VA, but I am the one who is being punished for their screw up! I will get a copy of my C-File and get to the bottom of it. I will look into doing a reconsideration.

The last time I questioned the VA on making a false statement, I was escorted to mental health. Then they refused to correct their mistake? My VA Medical records has so many mistakes in it because they copy and paste bad information and nobody will do anything about it. 

I will get it fixed by not using the VA until I get everything documented correctly! Then hopefully I will get the correct disability rating.

 

Upon discharge, were you provided a copy of your Service Medical Record from medical?

The Plantar Fasciitis diagnosis should be in there and if you had more complaints pertaining to it.

[Patton]

Thanks Broncovet,

I should have example myself a little better. I did not use false statement. I requested my records to be corrected twice now and nothing has been changed. I last time was a year ago and I followed up about 45 days later. I was told that the Doctor needs more time. When I had my next appointment (6 months later) with him I asked him to please make the changes. He called the Nurse in and they escorted me to Mental Health.

The PA for my GERD C&P Exam pointed this out to me. My Prime Care Doctor has me on Loperamide for Diarrhea, but then he goes on to say: 

GI: Negative for nausea, negative for vomiting, negative for abdominal pain, negative for melena, negative for hematochezia, negative for hematemesis, negative for constipation, negative for diarrhea.

Looking at my records, it has been the same ever since I started using the VA. I had a history of Irritable bowel syndrome (IBS) in service and I am SC for GERD. I still have the same issues today but he has not add it to my VA Problem list. I requested a new Prime Care Doctor, but by the time I seen her, it was 2 weeks before I was moving. So she wanted to ensure I got all my medication refilled and did not address the issue. 

The first time was with sleep medicine. He stated:

This is a 56 year-old overweight gentleman with severe obstructive sleep apnea who presents for follow-up evaluation. He reports trying to use his CPAP machine nightly but has difficulty tolerating it long. The CPAP machine inadvertently comes off overnight. He generally sleeps until about 12 midnight then wakes up and can't go back to sleep. He reports intermittent morning headaches.

This one really bothers me, because it has nothing to do with me tolerating my mask. I stated that I only get 4 to 5 hours of sleep on a good night and if something is bothering me I don't sleep at all. I don't sleep for a number of reasons to include stress (or mad about something), pain and acid reflux. I also fight in my sleep or cannot get comfortable at night. He said that I needed to lose weigh because my BMI was at 28.8, so I needed to exercise. I stated that I am exhausted and have no energy to exercise because of lack of sleep. He did not offer any solutions. I reported that I have morning headaches 2 to 3 times a week. It as if he is saying that my Sleep Apnea is caused by my weigh. I am not buying it. Hopefully I can find a Doctor here that will address the real issue.

Thanks Doc25,  

I have all my documentation except for the DBQ from the VA Contractor (VES). I did include everything with my packet.

[doc25]

9 hours ago, Patton said:

Thanks Broncovet,

I should have example myself a little better. I did not use false statement. I requested my records to be corrected twice now and nothing has been changed. I last time was a year ago and I followed up about 45 days later. I was told that the Doctor needs more time. When I had my next appointment (6 months later) with him I asked him to please make the changes. He called the Nurse in and they escorted me to Mental Health.

The PA for my GERD C&P Exam pointed this out to me. My Prime Care Doctor has me on Loperamide for Diarrhea, but then he goes on to say: 

GI: Negative for nausea, negative for vomiting, negative for abdominal pain, negative for melena, negative for hematochezia, negative for hematemesis, negative for constipation, negative for diarrhea.

Looking at my records, it has been the same ever since I started using the VA. I had a history of Irritable bowel syndrome (IBS) in service and I am SC for GERD. I still have the same issues today but he has not add it to my VA Problem list. I requested a new Prime Care Doctor, but by the time I seen her, it was 2 weeks before I was moving. So she wanted to ensure I got all my medication refilled and did not address the issue. 

The first time was with sleep medicine. He stated:

This is a 56 year-old overweight gentleman with severe obstructive sleep apnea who presents for follow-up evaluation. He reports trying to use his CPAP machine nightly but has difficulty tolerating it long. The CPAP machine inadvertently comes off overnight. He generally sleeps until about 12 midnight then wakes up and can't go back to sleep. He reports intermittent morning headaches.

This one really bothers me, because it has nothing to do with me tolerating my mask. I stated that I only get 4 to 5 hours of sleep on a good night and if something is bothering me I don't sleep at all. I don't sleep for a number of reasons to include stress (or mad about something), pain and acid reflux. I also fight in my sleep or cannot get comfortable at night. He said that I needed to lose weigh because my BMI was at 28.8, so I needed to exercise. I stated that I am exhausted and have no energy to exercise because of lack of sleep. He did not offer any solutions. I reported that I have morning headaches 2 to 3 times a week. It as if he is saying that my Sleep Apnea is caused by my weigh. I am not buying it. Hopefully I can find a Doctor here that will address the real issue.

Thanks Doc25,  

I have all my documentation except for the DBQ from the VA Contractor (VES). I did include everything with my packet.

On the issue of Sleep Apnea:

Being overweight is one factor that has been debunked. Yes. It can cause sleep apnea but so can GERD, Mental Health conditions, and others.

There are plenty of veterans out there that are not overweight that still have Sleep Apnea.

What are your SC conditions? and I will let you know if you can secondary service connect Sleep Apnea.