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

[Berta]

Great!   I got a result from my WH complaint of last year, that I did not expect- and it caused me to have a wealth of more work to do. That's OK

But it was not a claims issue. And it prompted a Bill in the senate. It has to be changed by the sponsors however, because they have never been in the VA system as veterans or claimants as far as I know.

I hope to hear from them soon- I stated how it should be changed and why.

It will affect any veteran in the VA Health Care system...when they change it.

I hope I did not seem too aggressive with my advice to you- and I am so glad you are taking action on this.

Your CUE was great!   This can get resolved.

It would also be great if, by now the VARO did get that DBQ but I wonder what VARO it should have gone to?????

The VA can and will call CUE on itself sometimes when the evidence reveals they erred in a decision and they catch it. But I would never depend on VA to do that even though M21-1MR  now says they should, during a Higher Level Review.

 

 

 

 

 

[SgtE5]

Just an update that I haven't heard anything yet on the WH complaint. When I made the complaint, I was told that if I don't hear anyting by the end of the month, to call back and check on it. So still waiting.

[Berta]

That is a good idea-to keep track of it by calling them-

I filed a complaint in about mid July 2018 and had so much going on, but by end of September I was very concerned but on Oct 1, 2018 I got email from OAWB, where the complaint was directed to-

then a lot happened with that complaint after OAWB got it.

It still involves more work for me but that's OK- 

I believe it depends on the issues.... and finding the best place to deal with those issues.

My complaint did not involve the claims process.It involved Accountability regarding malpractice issues.

 

[GBArmy]

I would absolutely call as soon as they said it was time for a follow-up. If they said by the end of the month (March?), just call, be polite, and say you are just following up when they suggested you to do. Squeaky wheel, you know.

[SgtE5]

Called the hotline, nothing yet. I didn't think the Government would move that fast anyway..lol

[Berta]

Has the RO acknowledged receipt of the CUE claim you filed?