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.

[vetquest]

SPO, you can file a CUE if you wish but I would also file an NOD as @rsm-esq advises.  Your NOD will process and you might get a favorable outcome as you are working on your CUE.

[Berta]

SPO did you post the decision here somewhere yet?

I believe you are the same SPO who won a CUE before?

We have a member who has, TOO many times, tried to argue over my CUE advice.

My advice is based on many CUEs I have won, plus years of reading BVA CUE decision, and having the VBM ( NVLSP)since 1991.

In order to avoid being drawn into a ridiculous argument with him again, (his legal advice on CUE is always incorrect, and others know it)  I think maybe someone else should help you.

The CUE will be in the decision and /or the Rating sheet.

Many here do know what is and isn't a valid CUE.

 

[SPO]

I posted my decision back in May on this thread,  It looks like the attachment is still there if you would like to take a look.  I'm currently still waiting for my c-file to see what was said on my C&P's so I can file the NOD.

[SPO]

My best guess for a CUE basis is that they claimed I had no clinical diagnosis, even though I provided a DBQ that should my private doctor diagnosing the condition I claimed. Could it also be that it appears they didn't fully consider it as a secondary condition? Anybody have any ideas?

Edited August 30, 2019 by SPO

[rsm-esq]

On 8/30/2019 at 7:31 AM, SPO said:

My best guess for a CUE basis is that they claimed I had no clinical diagnosis, even though I provided a DBQ that should my private doctor diagnosing the condition I claimed. Could it also be that it appears they didn't fully consider it as a secondary condition? Anybody have any ideas?

CUE generally has very little chance of success.  It is an extremely technical, procedural tool that is rarely successful--usually because it isn't applied correctly.  Every claim denial includes instructions from the VA about what to do if you disagree with the decision.  Review those options and select the appropriate response based on whether you have additional EVIDENCE to support your claim.  

[SPO]

I understand the CUE process.  I have already won one before.  I thought because they didn’t properly evaluate all the evidence granted to them it would constitute a CUE.  This is how i won the last one.  I’m just trying to make sure this is what others were referring to.  I plan to file a NOD once I get my c-file and know exactly what was in my c&p exams.