Higher Level Review

[paulstrgn]

I am filing a HLR for the decision on my hand, I discovered after I received my C-File from the VA that in my opinion the VA did not rate me properly for my hand and fingers.During the medical appointment the individual had marked my right hand range of motion as abnormal, and the gap for my index finger was 5 cm. My current rating on my hand is 10%, I believe it should be at least 20% now (30% might be a stretch if at all possible).

My question is I also need to file a HLR for my knees which were denied, do I file these two together or separately (the decision on the hand is from 7/2018 and the knees 2/2019)?  I believe (which means nothing) that the hand can be evaluated without another medical evaluation where the knees will need a new one (they were not properly evaluated). 

In my mind it is best to file them separately and at different times (the hand right away since the one year is almost up) and the knees once a decision is made on the hand. Should I wait (since the effective date would be the same no matter when I file) or do them both now?

[vetquest]

Good, I wish you luck.

[Phury & Rhage]

On 5/10/2019 at 6:44 PM, paulstrgn said:

 

I feel like I should call QTC 800 number and report this doctor for all the false information he put in my DBQ (my only concern it might hurt me on future C&Ps). I will raise this issue in the HLR though. 

1st - write up a 4138 right now and get it into the record or call or submit a statement through eBenefits.  Don't wait for the review.

2nd - do you get care at a VA medical center?  You can take a copy of a DBQ in and have them fill out that DBQ ASAP.  It will carry more weight if it's done by VA docs and the closer in time to the contract exam the better.  It will be obvious what happened if the VA exam/DBQ shows very different results from the contract exam.

3rd - you can take a DBQ to a private doc as well.  Those forms (most of them are downloadable) are available to the public with a few exceptions.  

By the way, if you do get another DBQ to turn in, you want to submit it with a VA Form 20-0995 - Supplemental Claim.  HLRs are "closed" records so no new evidence after the decision you disagreed with.  You can file a Supplemental any time as long as you have "new and relevant" evidence.

 

 

[paulstrgn]

I have a QTC appointment on May 29. When they called me I asked about my complaint and was told don't worry it is in our records not to schedule any appointments with him or the office he works out in. I am pleased that it is in their system so I don't need to always ask if it is that particular doctor. With that said I know many of these doctors also work for LHI and VES so I will always make sure if scheduled for an appointment it is not with that doctor.

 

[vetquest]

Good job.  I had a two very adversarial C&P's but they were both with VA doctors.  I complained but I did not get a new C&P. 

[paulstrgn]

36 minutes ago, vetquest said:

I had a two very adversarial C&P's but they were both with VA doctors. 

The advantage of seeing contractors, you can ask for different ones and they seem to always accommodate.

[paulstrgn]

I had my C&P with VES today, the doctor was flown in from Tennessee to Virginia to do this and other exams this weekend. She seemed nice and listed to everything I said and also looked at all the documents I brought (MRI, X-Ray, Driving restriction letter from pain management, list of medications, and the medical letters from last year putting me on sick leave for more than 9 weeks). I told her that this exam was because the doctor I saw last December said my back was getting betting and my nerve issues had gone away. She looked at me like I was crazy, and said nothing has gotten better. She wanted me to do leg lifts to check my femoral nerves but had me stopped as soon as I started, she said I can see you are already in pain. She also made the comment that she has to dummy down the words she uses because the raters don't understand them. She was very perturbed about that.

Now I just hope she writes it up correctly and I see an increase in my back and legs. My fingers are crossed needless to say.