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Can anyone explain the difference between a C&P examiners Medical Statement vs a Medical Opinion?
I'm reading up on Gulf War Medical Exams. I had a Gulf War Medical C&P exam in August which lasted 4 hours; this exam consisted of many DBQs, including one for CFS. Although, I'd already had a C&P exam a few months prior for CFS. It took 6 weeks for the examiner to get the report to the VBA. A few days ago, the VBA just requested another C&P exam for the CFS for "rework" and a medical opinion for CFS. I don't know if I have to attend an exam or if this is something that the C&P examiner is going to do with what's already in the file. I haven't gotten a call yet from VES and when I called them, they didn't really seem to know if I actually had to go in for another C&P exam or not- just said someone would be contacting me to schedule an appointment (?).
From what I'm reading in the DMA Gulf War General Medical Examination training Sorting Symptoms Exercise (sharedfedtraining.org), certain conditions require Medical Statements and other require Medical Opinions.
The training says for CFS, the examiner is required to provide a medical statement but not a nexus medical opinion. For migraine headaches the examiner is required to provide a Medical Nexus Opinion.
I'm wondering why the VBA is requesting a medical opinion if they only need a medical statement for the CFS exam report. From my understating the medical opinion is the one where the examiner has to state the "as least as likely as not" VA language, but I don't know what the VBA wants the examiner to say in a medical statement.
Does anyone know?
Once again, hoping this is posted correctly. Not sure, but can't quite seem to get the hang of this particular version of a forum, so my apologies if I'm doing this wrong.
Real quick background, I'm rated for PTSD/major depression/alcohol/TBI at 70%, kidneys 60%, bladder 10%, headaches 0%, and seems like something else I'm forgetting at the moment. Those were all completed about 13 months ago. Pending is a back issue, hypersomnia, hypertension, and heart disease. Total after VA math is 91% (maybe 92?). I was involved in a training in which another soldier died.
Due to the hypersomnia claim, the VA has asked that I be reviewed for the PTSD and TBI. In preparing for those reviews, I've found various mistakes in both reports, some which seem immaterial, and some that may matter. For example:
The report states I was cleared of charges at trial. That is inaccurate. I was cleared of charges during the investigation phase due to a malfunctioning piece of equipment. I was never charged (that I know of... 1st sarge got defense attorney involved pretty quick, so I kind of lost track of a lot of the process). I was in the brig for a while, and then on supervised house arrest until the investigation was over, which I told the examiner. Seems immaterial to the overall findings, but still not accurate. The report states that I was "dazed for 3-4 minutes". That is inaccurate. I was dazed for 3-4 days, not minutes. Depends on the clinical definition of dazed I suppose. I have zero recollection of the minutes following the incident (probably 3-4), and only wispy memories of the 3-4 days following the accident. Frankly, as I've thought about it over the past year, I'm not completely sure what is actual memory, and what is "recollection" based on what my squad members who were supervising me told me about the incident. I'd like to get those cleared up, but don't want to get tagged with a "veteran has changed his story" line somewhere. I guess the answer is they are inaccuracies, and I need to take them head on, but was interested in the thoughts of those who have more experience with this sort of thing.
Should these inaccuracies be addressed in the these review exams, or is there a different and/or more appropriate process to challenge the inaccuracies?
Dont know if Im in the right spot, have spent hours trying to figure out how to use this site
I read "6 reasons to keep pursuing va claims and appeals - AFTER you reach 100%". Im rated 100% P&T tdui from 'Nam days. but clicking on it brings "10 tips to help you keep the c and p exam in perspective". Is it hidden somewhere else, or not here at all?
and man, its tough reading and understanding lots of stuff on here.... abbreviations. "secondary" conditions, one thing caused by another....code numbers, medical/technical names. there must be a bunch of lists somewhere? Im a 'regular' type guy, but lots of stuff I have read makes me feel pretty dumb trying to understand things. and now I cant recall the title of this 'forum' for this question, and I looked back, cant find the name of it anywhere, this site is so confusing.
I recently had a C&P exam on the 9th of July, the examiner told me that it would take 30 days for her to do her research and come to a decision about my claim. So the 9th of September was the 30 day mark and the case is still open as of today. I checked my blue button records and she actually made a decision on my claim the same day she said it's less likely than not. So my question is has any one seen results take this long and why would she lie to me and say it's going to take 30 days for her to find results and she made a decision the same day.
I served from 1988 to 2009, roughly 18 of those 21 years were as an Army CID Special Agent. In 2001, I was shot in the leg, which destroy the femur. This occurred on a US military installation, however I was taken to a civilian hospital for the surgery and was later transferred to a MEDDAC. The bullet traveled through the femur, so a rod was inserted with two lower and two upper screws. I lost not only length in the leg (2cm) but my hamstring atrophied. Since then, I've encountered continued pain in my knee and hip. All was documented in my military medical records. Often times, the pain would have me seek medical attention about 2 times per year, which again is documented.
I underwent surgery last year to remove one of the screws (all are now broken) that was pressing against a tendon causing extreme pain. The surgeon explained the others will need be replaced and I will also need a hip replacement in the coming years. The pain continues.
My VA exam was in 2009 and at that time the length difference in my legs was disclosed to me for the first time and as xrays were obtained, the screws were discovered to be broken. The VA Rating Decision gave me 0%.
Unknown to me was the appeal process. Last year, I found someone who is helping me with the appeal. I live in a remote part of southern Germany, so connection to other retirees and vets is nil.
This week, through my appeal representative, the VA has contacted me. They want all the background information on the shooting. They require the who, what, when, where, why, and how of this incident. I am also to supply them with records I have that they don't. First, they have a copy of my entire medical record. How am I to know what they don't have? Second, the Rating Decision states that this injury was service connected and in the line of duty, so why is the background information required? Had I been shot while in Afghanistan would they be asking the same questions?
Perhaps I simply do not know exactly how the VA adjudicates the claims. As this is not a presumptive matter, evidence of the injury must be presented. They have that in the form of my military medical records. Do the circumstances behind the shooting hold weight on determining the extent of either the injury or the level and percentage of my disability? Does the background on an injury play some part of the adjudication process and awarded disability to which I am unaware?
Thank you in advance for any insight into this.
rebabevets posted a question in VA Disability Compensation Benefits Claims Research Forum,I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently
Ddsr posted a question in VA Disability Compensation Benefits Claims Research Forum,The 5, 10, 20 year rules...
Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.
Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.
Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.
If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"
At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.
NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.
Example for 2020 using the same disability rating
1998 - Initially Service Connected @ 10%
RESULT: Service Connection Protected in 2008
RESULT: 10% Protected from reduction in 2018 (20 years)
2020 - Service Connection Increased @ 30%
RESULT: 30% is Protected from reduction in 2040 (20 years)
broncovet posted an answer to a question,While the BVA has some discretion here, often they "chop up claims". For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.
I hate that its that way. The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.
Ztmiller8 posted a question in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC,Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!
My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.
Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
Joey Ross posted an answer to a question,I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and nothing about stressor,
Picked ByJoey Ross,