Denied service connection

[SPO]

I posted this same info in another thread, longer, thread in C&P exams, but I'll put this here to see if anyone has any ideas.

I apologize in advance for the length of this, but here is an excerpt from my decision letter, I'll try to upload the whole thing later. Most of my contentions have an explanation just like this, or very similiar.

"Service connection for psoriatic arthritis of the left shoulder is not established. Service connection may only be granted for a chronic disability which began in military service or was caused by some event or experience in service.

The evidence does not show an event, disease or injury in service. (38 CFR 3.303, 38 CFR 3 .30~). Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The VA medical opinion found no persistent disability. 

The medical opinion we received from the VA contract examination was more persuasive than your private physician's opinion because it was based on an in-person examination and a thorough review of your relevant military and /or personal history and contained a more convincing rationale. (38 CFR 4.6) The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. (38 CFR 3.303, 38 CFR 3.304) The evidence does not show that your disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. (38 CFR 3.307, 38 CFR 3.309)

 The VA contract medical opinion dated December 15, 2018, was not based on a review of your claims file or an in-person examination. 

Service connection for psoriatic arthritis of the left shoulder is denied because the medical evidence of record fails to show that this disability has been clinically diagnosed. (38 cfr 3.303)"

I can make sense of this.  I submitted a DBQ from my doctor with a diagnosis, but the say its not clinically diagnosed.  Also CFR 3.07 and 3.308 are presumptive conditions, I did not claim this as a presumptive condition, its a secondary to psoriasis.  I don't have the copies of the opinion and exam yet.  Also they say the medical opinion was not based on my claim file or an exam, how is that valid for anything? 

Also the VA got a medical opinion in December 2018, and an in-person C&P exam in April 2019.

[Berta]

Just to add:

You are already a successful Cuerino!

If I see a CUE in the downloads, I will prepare it for you ,you can tweek it, and it will fly-

 

 

[SPO]

Berta,

here is the full decision letter (redacted).   Also something that just caught my attention is the decision for my right hip.

"Favorable Findings identified in this decision:
The evidence shows that a qualifying event, injury, or disease had its onset during your service.
You reported symptoms of a right hip condition in service.
You have been diagnosed with a disability. The prior VA examination diagnosed you with a right hip strain."

They denied service connection on this all the way back to 2009, but I'll let you read the whole thing.  

For whats its worth I just added the DBQ I submitted, and my doc changed it to not answer the question about limitation of motion because he didn't actually test himself.

 

decision.pdf

1444241425_DermDQB2_Redacted (2).pdf

Edited May 21, 2019 by SPO

[Berta]

I have to leave in a few minutes- 

Am I understanding this correctly:

"The VA contract medical opinion dated December 15, 2018, was not based on a review of your claims file or an in-person examination." They stated that many times.

"The medical opinion we received from the VA contract examination was more persuasive than your private physician's opinion because it was based on an in-person examination and a thorough review of your relevant military and /or personal history and contained a more convincing rationale. (38 CFR 4.6)"

Are they talking about two separate contracted C & P exams?

The DBQ is not good at all. It says no files were reviewed. Right off the bat they gave it no weight because of that- But it also says that for the VA Contract Exam, as well. ???????

You need an IMO that conforms to the IMO /IME criteria here at hadit from a real dermatologist.

I could not find the Evidence list.

They throw in the presumptive stuff to CTAs, in case it was a presumptive. 

 

 

 

 

[SPO]

There was 2 separate exams.  They requested a medical opinion which was done by VES in december, and an in person C&P in april.  I thought the dbq would hold at least a little weight, at least for the diagnosis part, because he has been my treating physician for both psoriasis and psoriatic arthritis.  I'll add the evidence list as an attachment.  I can probably get my dermatologist to write an opinion, he has been very veteran friendly, just a matter of telling him the details and format that it needs to have.

I don't have a copy of the exams yet, I have to get to the RO and request everything.  added the evidence list as.

Also i've never requested any documents from the VA.  Is everything done through a FOIA request by fax/mail for the c-file information, or should I be able to get the pertinent exam results at the RO same day?

evidence.pdf

Edited May 21, 2019 by SPO

[Berta]

"The medical opinion we received from the VA contract examination was more persuasive than your private physician's opinion because it was based on an in-person examination and a thorough review of your relevant military and /or personal history and contained a more convincing rationale. (38 CFR 4.6)"

Are they talking about two separate contracted C & P exams?

Do you have a copy of the other exam, where the contractor did have all of your records and they say it was an inperson Exam?

I got a posthumous C & P exam copy last week.The specific claim was awarded in 3 weeks after their denial because they listed my sole piece of evidence, but the examiner never considered it.

The exam stated it was an inperson exam, but my husband had been dead for 19 years by date of the exam.

She said she used his C file.He does not have a C file anymore, it is under my name as the accrued surviving claimant.

The examiner had to put an addendum to that error but she was completely unqualified to do the exam. My evidence came from the top Cardiologist at VA Central Office. I have Cue pending on the award letter as the EED is all wrong.

Hopefully others will chime in------I have to leave for hours-----

 

 

[SPO]

DAV ordered my c-file for me yesterday, so now I have to wait for that.  Should I wait to look at that before I file the NOD? Any thoughts on all the documentation I posted?