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VA did C&P and now sent to VES for second C&P?


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Good rainy morning everyone!

I have a claim in for an ankle problem secondary to my SC left knee.  My ankle currently suffers from Ankle Impingement due to repeated sprains and in my MEPS exam it was noted that I had previously broken my ankle.  My knee condition causes me to favor my right ankle.  My MD and VA noted some limited ROM as well as instability.  The doctor at the VA noted her opinion that it is LESS likely than not (<50%) that it is secondary to my left knee SC disability.  I am kinda ok with that. Weeks later my claim moves to Pending Decision Approval for a few days then back to Review of Evidence then back to Gathering of Evidence. Weird but whatever.  Then I see they want to schedule a C&P exam (Still have two open claims) and I figure it was related to that.  It turns out, the VA is sending me to VES for a second C&P exam.  I think they are requesting their medical opinion.  This is where I am baffled.  I thought since the VA Doc said LESS likely than not it would go quickly to a denial.  I am confused about the second C&P for my ankle.  The VA paperwork for the C&P exam is well documented and accurate.  Thoughts on this? Good? Bad? Just getting support for the denial?  thanks!!

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Here is the salient takeaway. You NEED to get the DBQ, the Code Sheet, the Dr;s Notes AND most importantly the Letters/emails between the Examining company/Dr and VA. for both the first and that Secon

Thanks Buck, it is just too convoluted and can hurt the brain trying to unravel it all. I am not giving up this time until I beat the VA into submission HAHAHAHA

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15 minutes ago, Buck52 said:

sorry to hear all about that

Thanks Buck, it is just too convoluted and can hurt the brain trying to unravel it all. I am not giving up this time until I beat the VA into submission HAHAHAHA

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Thank you everyone for your response and I am sorry to hear what the VA is doing to you GeekySquad.

I did confirm the appointment is for the ankle. I believe (could be wrong) that the VA said it is for a medical opinion. I don't know if that means another C&P exam or just go over the questions again. Don't know.  I will update everyone how if goes after my appointment his Friday.  I did review the DBQ from the original doctor and it was very thorough and complete (As far as I can tell).  She also did  remeasurement / C&P of my left new due to my appeal where the first doctor said extension was from 60 to 10 and 10 to 60 but wrote down 60 to 0 and 0 to 60.  I will give them the benefit of the doubt as she was also doing a C&P of my right knee.  We shall see. I just think it is REALLY odd that they would send me for a second C&P after what I assume is a denial.  See the medical opinion below:

 

MEDICAL OPINION SUMMARY -----------------------

RESTATEMENT OF REQUESTED OPINION:

a. Opinion from general remarks: Is the veteran's right ankle condition at least as likely as not proximately due to or the result of residuals, meniscectomy, left knee?

b. Indicate type of exam for which opinion has been requested:

DBQ Ankle TYPE OF MEDICAL OPINION PROVIDED:

[ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ]

b. The condition claimed is less likely than not (less than 50% probability) proximately due to or the result of the Veteran's service connected condition. c. Rationale: The veteran has been diagnosed with ankle impingement syndrome and instability. Review of the medical literature and the recent orthopedic opinion reveals this to be most likely the result of repeated past ankle sprains. The veteran reports that he sprained the ankle on multiple occasions during service but was never evaluated for any of those injuries. Review of STR's does not reveal any evaluation or treatment for an ankle condition during active service. The right ankle condition is not caused by the service-connected left knee condition but is rather a progression of previous sprains. It is less likely than not that the veteran's right ankle condition is proximately due to or the result of residuals, meniscectomy, left knee.

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46 minutes ago, WBrennan said:

I am sorry to hear what the VA is doing to you GeekySquad.

Thanks WBrennan, but for the record it is GeekySquid...Geeky for short 🙂

was trying not to hijack your thread. I have said those things in my own threads but since everyone here follows dozens of others, having people not remember the deets is normal. Go figure, right? LOL.

I am not a Dr and my own conditions don't deal with Range of Motion stuff so I cannot comment on this post but in general I would look in my STR's to see if there was any mention of a sprained ankle any where. i would also question the statement that you told her you basically had lots of sprained ankles in service and self-treated. If true shame on you. If not  then challenge that statement from her.

No matter what you do, even if you still think she did an honest job, include a challenge to her credentials and abilities in any NOD you file. The reason is that it preserves that right to challenge her later in higher courts. If you don't do it at the first possible instance you lose that right later on in the higher courts.

It is a legal thing and every vet should include it in every NOD or appeal.

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Sorry GeekySquid, must have been the booze.

I was in 1991-1995 and Infantry in an LRS unit.  Sprain your ankle? Tie your boots tighter, suck it up and drive on. Yeah. It fooked me but that is my fault for being young and dumb and now paying the price. :S  As you can see in her notes, she is setting up a denial but then why the second C&P?  Weird, I know.   I will update everyone here once I have the appt.  Is it best to do the FOIA for the C&P exam before or after their decision?  Thank you.

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4 minutes ago, WBrennan said:

Is it best to do the FOIA for the C&P exam before or after their decision? 

okay here we go with this discussion again... lol you wouldn't know but getting C&P exam results can be a strain.   This is the form the Change Management Agent at my VARO sent me as she tried for the dozenth time to "change the subject" of our email exchanges. Be aware that when you file this you have a 50/50 chance of getting a response that says they are denying your FOIA request and try to tell you that you have to use a basic records request form.  They will provide one. 

Their reasoning is that by law FOIA's must be addressed in 20 days. The records request can be shoved under a pile and ignored forever.

My Suggestion to you is to request another C-file NOW. plead poverty so you don't have to pay. The C-File can take 6 Months.

If you have a VSO AND they have VBMS Access AND they are physically located in the VARO office they can get a copy printed. My VSO in the VARO Seattle Office keeps saying they don't have Access Cards. Lying sacks. 

I would also submit the FOIA and the Release of Records Requests. Make the requests by both FAX and MAIL CMRRR them to Janesville under separate covers.      

Getting these documents is one of the procedural barriers the VA intentionally puts up in front of Vets.

I would include in my request the DBQ, the Letters to and from the C&P, the Code Sheet, and all Dr's notes about the exam. They have them. They just hate releasing them and the notes will never appear in your C-File unless you demand them and keep demanding them all through your appeals. The VA is required to Assist you in getting the salient records and those notes are salient records.

All that being said your VARO might be one of those that is easy to work with to get these files, mine isn't.

Your VSO in the VARO office may be willing and have access. Mine obviously does not care. In fact I am heading down there again tomorrow morning. I am out of my wheelchair so I can get around better. I have also taken the morning off, so if I leave around 6 a.m. I can be there before 8 a.m. when they are supposed to be in the office.

Good luck and let us know how easy or hard it is w/ your VARO/VSO

VA7259 FOIA.pdf

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