Can I add Additional Denial Rebuttable While In NOD?

[SgtE5]

Filed for ankle and knee problems that both are documented in my SMR. I was denied with a reason stating that both were acute problems. I filed a NOD. I requested my c-file, received it on Monday. Had a c&p from a contracted VA doctor so was not in my medical file as it was a contractor. The c&p doctor that did the ankle and knee exam opined the claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness. Her rationale: Veteran had no issues related to the claimed CONDITION prior to military service. Onset of the condition was during service, documented in the Service Medical Records. There is evidence of current, chronic and continuous treatment and care. A nexus has been established.

I don't understand why I was denied if the c&p doctor opined claimed conditions was related to service and I have met all 3 elements.

Even though her opinion is in the record, can I add a statment arguing the c&p doctor provided nexus? Or just wait for the SOC as I know it will be denied again and argure to the BVA?

SECTION III – MEDICAL OPINION FOR DIRECT SERVICE CONNECTION
Choose the statement that most closely approximates the etiology of this claimed condition.
X 3a. The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury,
event, or illness.
3b. The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event,
or illness.
3c. Provide rationale:
Veteran had no issues related to the claimed CONDITION prior to military service. Onset of the condition was during service, documented in the
Service Medical Records. There is evidence of current, chronic and continuous treatment and care. A nexus has been established.

Edited March 13, 2019 by SgtE5

[SgtE5]

Thank you sir. I was actually wrong on the decision date. Got my claims confused. This was decided June 28, 2018. I just recieved my c-file this week. Oddly enough, reading further into the c-file, the LHI opinion was signed off on June 8, 2018 and decision was June 28, 2018. Wonder if that was enough time to have LHI entered in the record.

[FormerMember]

There's the problem. I doubt it would have been uploaded to VBMS before the 6/28 rating decision. Call 800 827-1000 and explain what happened. You may not even have to file a CUE for it. The 800 folks just got VBMS in it's most primitive form but they may be able to see it. Use the M 21 cite above. M21-1, pt. III, subpt. iv, ch. 7, sec. B(3)(a),(b).  VA pukes don't speak 38 CFR. The LHI/QTC/VES  run about 30 days out on most of the subcontractor submittals on the c&ps unless it's flashed RFN. If June 28th is the day they confirmed it, I'd guess they "promulgated" it about three to five days before that. Welcome to the new VA National Work Queue (NWQ), Sgt. Evidence? We don't need no stinkin' evidence. 

[SgtE5]

Letter is dated 6/28 with date of decision is 6/26

Edited March 16, 2019 by SgtE5

[Oceanbound]

I have saved this  "M21-1, pt. III, subpt. iv, ch. 7, sec. B(3)(a),(b)."  so that I can use it with someone I'm helping

[FormerMember]

Try Fergoogle developed by a RVSR/DRO. Type in an identifier like 3.156(c) in the search bar and hit the magnifying glass. Then chose  the Manual choice under it to get a good M 21 cite. It's what the raters use.

Fergoogle.

[Berta]

If you have filed a CUE or not, I suggest also to contact LHI directly. ASAP

LHI Logistics Health, Inc.

328 Front Street- South

La Crosse, Wi 54601

https://logisticshealth.com/our-company.aspx

or at 

LHI Headquarters

328 Front Street South
La Crosse, WI 54601

information@logisticshealth.com

Phone: 866.284.8788
Fax: 608.783.7532

 

The VA pays this outfit to do these exams. I wonder how many of their exams were not in VA's possession, when the VA might have denied the claim, for other veterans,  but the exam was favorable- because they (VA) denied without the exam, that they ordered and probably paid for already.

Not every veteran would know what to do in a case like that-

I suggest you call them ( LHI) because you have a valid complaint and the CUE might just be sitting somewhere-at your VARO because we cannot depend on anyone at VA to really understand their own regulations involving CUE.

Years ago 2 CUEs I finally won, I was told, were with a RO "specialist"- it must have been the guy who fills their water cooler. My RO had no specialist at all. They were awarded only because they went to a Nehmer RO, where the VA  claims people there could read.