Best Claim Reference Material?

[john999]

What is the best claim reference material these days?  I have not filed a claim in a few years.  I have an old vet benefits manual.  What has changed in the last five years?  

[broncovet]

VBM is still the best.  There have been many many changes.  The biggest is RAMP, now called AMA.  

Edited July 28, 2019 by broncovet

[john999]

Thanks Bronco

 

               I worry that as I approach my 20 year mark at current disability they VA will pull a fast one and call me in for a C&P exam.  Most of the doctors I relied on for IMO's have retired.  I still have one doctor who will help me.  These doctors who will write IMO's for vets are a valuable resource and a shrinking resource I think.  I don't trust anyone working at the VA or through the VA.

[GeekySquid]

6 hours ago, john999 said:

I worry that as I approach my 20 year mark at current disability they VA will pull a fast one and call me in for a C&P exam.

why do you think they would do that.... barriers are raised at different levels at different milestones. 1 is being 55 or older. then 5, 10, 15 years more appear. Then there is the whole P&T issue that pretty much wipes you out of consideration for every review (that you yourself don't initiate) except a random audit of your payments but not your conditions and ratings..

Breathe Breathe Breathe

[Oceanbound]

I'm three years and three months away for my 20th year mark and not worried. That is why I said in the IMO section we need to find a range of many more new physicians that are young to do these IMEs and IMOs because no one stays young forever.

[broncovet]

John, I recommed you not worry, but instead take some action.  Order a new copy of your cfile.    Check to see if there is evidence of "actual improvement under ordinary conditions of life".    Given the regulation which follows, its tough for VA to reduce you.  

"Ordinary conditions of life" means while working, because "ordinary" people work, while disabled people dont.  

Read the part about "prolonged rest" and single exam.  

You can not be reduced over a single C and P exam, UNLESS that exam is consistent with your medical history.    

Go over this regulation..with a fine tooth comb.  I have, but its been a while.

Quote

 3.344 Stabilization of disability evaluations.

(a)Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b)Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c)Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

[26 FR 1586, Feb. 24, 1961; 58 FR 53660, Oct. 18, 1993]

 

Edited July 28, 2019 by broncovet