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IMO not listed


wood78221

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I just recently received a decision (award) on part of my claim. I noticed on the letter that they sent me telling me what evidence they reviewed, it did not have my IMO listed on the list. Does this mean they did not consider it? I did receive a favorable CP exam, and I also sent in a nexus statement from my treating doctor as well. I also went to see Dr. Ellis also. The Ellis/treating doc records were not listed. This has me concerned that my next claims that will be decided might be at risk. Thoughts? Would this have been a CUE if denied?

 

Thanks

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Well they may not needed your IMO  to make a decision if it was a favorable one?

from what you mention above it sounds like they never needed it.

I Had a IMO done  just in case...but they never mention it in my BBE ..but since I won  I don't care...sure it was needless $$$ spent  but I do have it in case I need it later.

if they don't use it as evidence   then you can use it as evidence later if you need it.  just hang on to it.

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I also would not be concerned about the IMO if the award is favorable.  I would be something to bring to the BVA's attention if was not there and you lost your case or were not awarded properly.  I would not call it a CUE unless you really needed to.  I would just request a BVA hearing in that all evidence was not weighed properly.  As I have seen the BVA considers evidence in a different manner than the RO topically does.  One one BVA decision they noted that my buddy letters were not properly weighted even though they were in the evidence section.

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Yes I’m not concerned but just curious. However, I’ll be upset if it’s not listed in this next decision after my last 3 claims are finalized.

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I would be Concerned!

But that is because I have had this happen to me Many times.

If you have proof that they received it, and it impinges on the claims they are still deciding-

You can either file an IRIS complaint or a CUE or do both.

If the VA has probative evidence, that regards any claim we file, and they completely ignore it  and does not list it on the evidence list, it is a violation of 38 CFR 4.6 ( aka a Clear and Unmistakable error.)

 

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"Every element in any way affecting the probative value to be assigned to the evidence in each individual claim must be thoroughly and conscientiously studied by each member of the rating board in the light of the established policies of the Department of Veterans Affairs to the end that decisions will be equitable and just as contemplated by the requirements of the law."   38 CFR 4.6

Why wait until they might deny those other claims and not use it for them?

This is tactic VA uses to deny. You paid money for the IMO. They should consider it.

But maybe it has nothing to do with the deferred issues.

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My Ellis IMO will be involved in the next 3 disabilities to be decided soon (I have a CP exam this week). How do I file an IRIS complaint and what is it?  Thanks!

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Go to the main VA website -www.va.gov and click on Contact Us, Then click on Ask a question, follow the stuff IRIS wants to know- then tell them what you told us.

The complaint box is a Pop down-

I filed one of my multiple CUEs that way and got a response from the VARO before I could get the actual CUE in the mail.

However that was  when VA was faster- ask IRIS for a email reply so that you have hard copy of their answer. 

It is possible that they will use it for the other claims, but I have no reason to believe they will-due to decades of experience dealing with the VA.

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I just looked at the award letter again, it never specifically mentioned Ellis Clinic. So Possibly I should file the complaint now before they "Va" screws up my next part of the claim. 

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I was not sure about the deferred issues or if this IMO is needed For this Particular claim? 

 as he has other C&P to do assuming for other claims filed separate.?

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2 minutes ago, Buck52 said:

I was not sure about the deferred issues or if this IMO is needed For this Particular claim? 

 as he has other C&P to do assuming for other claims filed separate.?

The IMO was for everything I claimed. They have only decided on 3 out of 6 disabilities so far. I have the CP for the last 3 conditions this week.

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oh okay  then as Ms berta suggested call IRIS tell then what you mention here.

sorry I miss read your post.

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I mentioned here the other day my 1151 HBP claim, denied, March 4, 2015, then awarded Aptil 2, 2015 ,when I cued them immediately, they day the denial came.

I cannot express how important 38 CFR 4.6 is.

There are CUE templates here for CUEs.

Saturday I received the actual C & P examiner's C & P.

Oddly enough she works for the VA and is not a contracter.

The Evidence list on the denial contains my sole piece of evidence for this claim.

It is a 2 page response from a VA Central Cardiologist ( with Fabulous credentials) to the Office of General COunsel, acknowledging their malpractice, some being on my husband's HBP.

The actual C & P exam reveal she did not use ACE , telehealth, etc but had the veteran's C file.

She did state it was an inperson interview.

Then they asked for an addendum on March 3, 2015, and she stated "please note this was an ace/exam/chart review not an inperson exam.

I dont what the hell she used- My husband by date of the 'exam" had been dead for 19 years.

I have a C file , he doesn't.

In spite of having the exam from the top VACO Cardio doctor , her statements are ludicrous.

She is an internist but is the sole person who handles the AO Registry at Buffalo NY.

That really bothers me.

Based on what she stated, if she had treated my husband, she would have been part of the malpractice on his HBP. She lied in the C & P. I have emailed her for a response.

I am filing a formal complaint.

Veterans ( and their survivors) MUST challenge some of these C & P exams.

None of my husband's claims were denied in his lifetime, they all were at first after I became the claimant. Every single one of them became a battle- that they LOST!

I posted some weeks ago the latest GAO report on improper C & P exams.And I contacted GAO directly and asked them if they ever consider,in these reports what veterans actually go through, often needing a costly IMO to get a full complete medical review  and to get a professional opinion that reverses the denial-because the C & P contractor did not have the expertise to do the exam or , worse yet, was not literate enough to read the entire record.

I told the GAO person that  that maybe they should ask for veteran input on these crappy C & Ps -but I dont think they will.

Something has to be done about this crap.

To me it is actually malpractice when a C & P doctor deliberately denies the claim, without reviewing the entire record.Because many C & P results ( and I have quite a few) reveal they dont know what they are talking about, medically.

I filed CUE on the award letter. That was screwed up too.

I am calling the WH Hot Line tomorrow. Maybe if EVERY vet or survivor calls the WH Hot Line when they get a C & P exam that is deficient, based on the medical record, and specifically based on a probative IMO/IME -maybe something will be done.

If I was a lawyer I would start a class action to recover every penny vets and survivors had to pay to get a real doctor to opine on their claim, if the IMO/IME caused the VA to reverse and award the claim.

 

 

 

 

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Forgot to add President Trump's White House Hot Line for veterans:

1-855-948-2311

My last WH call was serendipidous! 

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https://www.nvlsp.org/news-and-events/press-releases/nvlsp-dismayed-over-gao-report-on-va-disability-exams-and-the-need-for-impr

VA will continue to deliberately deny probative claims with lousy C & P exams until vets do something about it.

Do not let the VA get away with false statements or lies about what your medical records reveal.

I already posted the numbers for the 3 main contractors, If they get enough complaints too, they might fear they will lose their payments from the VA and their contractual agreement.

I was surprised to see that th C & P I got was done by an actual VA employee.

I wonder if she is downplaying what vets state as to the AO registry questions.Maybe she even tells them it is a VA claim. It sure isnt.

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Here is the CUE- tweek as needed-----

This link holds one of many CUE claims I have posted here for vets-

https://community.hadit.com/topic/71863-need-help-fast-on-this-cue-because-they-want-me-to-change-it-to-nod/page/2/

I will change the above CUE  a little because this is not quite the usual CUE situation I see here:

 

To VARO                                                                                       Date:

                                                                                                       C file #

          Attention to -put here the alphanumeric code on the upper right hand side                                                                            of   the  decision- the alpha is initials for the last person who handled your claim )                                                                                                           

This is a claim of CUE (Clear and Unmistakable Error) under auspices  of 38 USC 5109 et al.

In your ( date here ),    decision , you violated regulations within 38 CFR 4.6. Exhibit A.

“Every element in any way affecting the probative value to be assigned to the evidence in each individual claim must be thoroughly and conscientiously studied by each member of the rating board in the light of the established policies of the Department of Veterans Affairs to the end that decisions will be equitable and just as contemplated by the requirements of the law. “ 38 CFR 4.6.

Although the decision awards for  ( put that here), there are 3 other claims pending, and they all regard an Independedent Medical Opinion from Dr. Ellis that is Not listed as evidence, yet you received his opinion on 

(date) if you have a USPS tracking slip or state when you sent it to them.)             Exhibit B

Without proper consideration of this opinion, it could manifest a detrimental  outcome to me ,when the other claims are decided..

Exhibit A   Copy decision dated ( date)   _ pages                            Sincerely,

Exhibit B   Copy IMO from Dr. Ellis dated (date)  __pages.            

-----------------------------------------------------------------------------------------------------------------------------------------------------------

Maybe this can be sent via ebenefits? I have not used that system for years- others will advise.

It may have impacted on the rating for the awarded claim(claims), if they were not the rating you expected.

If you feel that is possible, tell them that too.

 

 

 

 

 

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Actually I think you can Fax the CUE to Janesville Intake Center-

VA should have attached an enclosure with the award that would give you the Fax number - I am not sure the #  have is the right one ...but others here have it and will post it.

 

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I just filed a White House complaint on a C & P exam I got.

I won that claim but realized that it was one more case whereby the VA C & P exams were deficient ,for every issue I ever had with the VA. 

My point is, if we accept any C & P exam results that reveal a lack of proper information based on the medical record and our evidence, we need to fight back right away ,before the BVA gets the case- years down the road....

I have read BVA decision ever since BVA came on line and MANY if not MOST of those appeals that were granted at BVA, or remanded , should not even be at the BVA at all.

This is why we have a tremendous backlog.

Valid probative claims are denied at ROs, because they dont know what they are doing or they simply dont care.

As I said before the Director of my VARO ( she has been there for close to 20 years) does not even know basic VA case law- or she does, but thought she could make up some Title 38  BS and that I would accept it.

If your spouse is not PC literate, and you die- the spouse will be victimized by the ROs and probably their claim for DIC or accrued will be denied erroneously. 

It is easy to say appeal to the BVA and more difficult to see if a CUE has occurred.

Some of those lazy assed vet reps and VSOs usually never mention CUE , they probably wont recognize a CUE in a decision and if they do they probably wont take the time to really assess the potential of filing one.

It is far easier for  vet rep to say appeal to the BVA because CUE involves thinking and reading.

Edited by Berta (see edit history)
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4 hours ago, Berta said:

Actually I think you can Fax the CUE to Janesville Intake Center-

VA should have attached an enclosure with the award that would give you the Fax number - I am not sure the #  have is the right one ...but others here have it and will post it.

 

I just tried to fax it but it was busy. Shocker. I will try again

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I finally got it faxed over. I had technical problems with the IRIS site filing a complaint. I am not sure how to find out if it actually went through when I tried to send the complaint in. 

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