Jump to content

Ask Your VA   Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
 Search | View All Forums | Donate | Blogs | New Users | Rules 

  • homepage-banner-2024.png

  • donate-be-a-hero.png

  • 0

A CP exam was just completed without my knowledge

Rate this question


JaeT.21

Question

I just discovered that a C&P exam was held without me even knowing about it on August 16th. I just happened to see it in my Blue Button VA medical record download today.

I have submitted a few claims last year. One in May and another in October. The VA combined my claims and back dated them to May 2018. The estimated completion date has jumped around 4 times. In July it jumped to an estimated completion date of 9 May 2019. 

At the beginning of August it jumped to 22 May 2019.  It's still in the "Evidence gathering, review, and decision" phase.

Does anybody know why they did a C&P without notifying me?  Does anybody know what this means regarding my increase requests for the following?

- VA exam for sleep apnea (Increase) -I'm trying to service connect my sleep apnea- I submitted Statements in Support of claim dating back to 2007.

- VA exam for headaches (Increase)- I've been hospitalized twice in the past year diagnosed with hemiplegic migraines. They mimic strokes and can mess you up just like strokes. And exertional headaches.  The worst headaches ever.

I originally submitted a claim for TIA and stroke and got a 'not service connected'. Got the migraine diagnosis after they denied the claim, after the 2nd "stroke" episode. 


- 4138 and MTR for esophageal (Increase)- Not sure what this is for., but I di have a disc replacement in my neck....and my GERD is the weapon of demons.

 

 

Link to comment
Share on other sites

Recommended Posts

  • 0
  • HadIt.com Elder

I am not 100%  sure but only guessing here  that your medical records showed all evidence of what your claiming and they can decide rather or not to send you to a C&P Exam , in your case they decided that your medical evidence meets the criteria for your condition and an exam is not needed. (at this time)  so they render a decision without an exam,  if you disagree you can always appeal  because  if you get a low ball rating you can still appeal.  if your ok with the decision  then leave it be.

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

Link to comment
Share on other sites

  • 0
10 hours ago, Richard1954 said:

The VA did what is called an ACE C/P exam. They started doing these back a few years. The idea of ACE was that the medical record might have all the answers to the questions asked by the DBQ. This happened to me a couple of times a few years ago. I raised holy He** and I was given actual exams. What the VA fails to realize is that some veterans do not get all of their care at the VA. In my case, I use Fort Hood and on a limited basic a private practitioner...  If you do not question the exams they will stand, you will have to discredit them in order to get new exams... In my case I told the VA that they missed important medical records out side the VA.  In my cases I was notified by phone once, and I was not notified of the other one. In both cases the examiners that completed the ACE indicated "less than not ", when I got actually exams I was awarded both claims, one for my Sleep apnea, and one for TBI. ( 50% and 40%  ratings )

See my attachments for more information about ACE

ACE Directive.pdf 55.37 kB · 2 downloads ACE News Release.docx 113.8 kB · 1 download

Thanks for this information. I'm actually going to head over to the Jacksonville clinic and request to see my C&P exams notes. I did it last year when the VA gave me an impromptu C&P for by bilateral foot pain aka plantar fasciitis and the dropped my percentage from 30% to 10%.

I believe it was clearly done rather coincidentally done as I was about to go from 90%(92% no rounding down) to 100% (96% before rounding up).

Now I'm sitting at 94% combined with 3  claims all with definitive proof of service connected damage.

We'll see...

Link to comment
Share on other sites

  • 0
3 hours ago, Buck52 said:

I am not 100%  sure but only guessing here  that your medical records showed all evidence of what your claiming and they can decide rather or not to send you to a C&P Exam , in your case they decided that your medical evidence meets the criteria for your condition and an exam is not needed. (at this time)  so they render a decision without an exam,  if you disagree you can always appeal  because  if you get a low ball rating you can still appeal.  if your ok with the decision  then leave it be.

Actually,  the decision to do an ACE is made before even looking at the Medical Records. The decision is also made by the doctor who is assigned to do the C/P exam.  ACE exam are only conducted at a VA Facility, and  while the idea seems sound its misplaced,   for the reasons I indicated above. Any exam that is done in person is better than the ACE, because the veteran can present evidence to an examiner and can talk with the examiner which can be very important. Those examiners doing ACE exams are really Lazy.  In one of my cases, I had filed a claim for sleep apnea, all my sleep apnea  medical records came from two different places, Fort Hood, and Lackland AFB , I had never even spoken to a VA employee about sleep apnea, the examiner (a female doctor from Burma ) took 5 minutes to look at my VA medical record and decided it was less likely than not. This doctor wasn't even at my local VA medical Center she was at the Houston VA on the southeast side of Texas, I am in central Texas. Anyway the only real reason they try to get away with this is because they are lazy, and to save money.

                                                                                I am not a lawyer so take my opinions with a grain of salt...

If I had listened to the nay sayers, I would never have acheived any ratings after I was awarded TDIU in 1999. Now I have not one but two 100% ratings, a TDIU  and 4 SMC awards !  I say JUST GO For It

Two things are infinite: the universe and human stupidity; and I'm not sure about the universe.” -Albert Einstein.

 

 

 

 

 

Link to comment
Share on other sites

  • 0
8 minutes ago, JaeT.21 said:

Thanks for this information. I'm actually going to head over to the Jacksonville clinic and request to see my C&P exams notes. I did it last year when the VA gave me an impromptu C&P for by bilateral foot pain aka plantar fasciitis and the dropped my percentage from 30% to 10%.

I believe it was clearly done rather coincidentally done as I was about to go from 90%(92% no rounding down) to 100% (96% before rounding up).

Now I'm sitting at 94% combined with 3  claims all with definitive proof of service connected damage.

We'll see...

I wish you the best of luck, if you decide to fight the c/p exam you will have to do it in  writing...

                                                                                I am not a lawyer so take my opinions with a grain of salt...

If I had listened to the nay sayers, I would never have acheived any ratings after I was awarded TDIU in 1999. Now I have not one but two 100% ratings, a TDIU  and 4 SMC awards !  I say JUST GO For It

Two things are infinite: the universe and human stupidity; and I'm not sure about the universe.” -Albert Einstein.

 

 

 

 

 

Link to comment
Share on other sites

  • 0
5 hours ago, Buck52 said:

I am not 100%  sure but only guessing here  that your medical records showed all evidence of what your claiming and they can decide rather or not to send you to a C&P Exam , in your case they decided that your medical evidence meets the criteria for your condition and an exam is not needed. (at this time)  so they render a decision without an exam,  if you disagree you can always appeal  because  if you get a low ball rating you can still appeal.  if your ok with the decision  then leave it be.

I hope so, as far as I'm concerned, I've supplied enough information the VA should feel like they were there when it all happened. Sheesh. We'll see.I'm right at the cusp of 100% so VA claims seem a little different now.

Link to comment
Share on other sites

  • 0
On 8/21/2019 at 12:15 PM, JaeT.21 said:

I hope so, as far as I'm concerned, I've supplied enough information the VA should feel like they were there when it all happened. Sheesh. We'll see.I'm right at the cusp of 100% so VA claims seem a little different now.

Okay update. They actually dropped my GERD percentage from 60% to 10% and no increase for my actual claims increase request. Now I sit at 87% rating vice my 94%. Nope I haven't received the decision letter , just saw it on ebenefits and VA.gov. sooo appeal it is.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • RICHKAY earned a badge
      One Month Later
    • pacmanx1 earned a badge
      Great Content
    • czqiang1079 earned a badge
      First Post
    • Vicdamon12 earned a badge
      Week One Done
    • Panther8151 earned a badge
      One Year In
  • Our picks

    • Caluza Triangle defines what is necessary for service connection
      Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

      This has to be MEDICALLY Documented in your records:

      Current Diagnosis.   (No diagnosis, no Service Connection.)

      In-Service Event or Aggravation.
      Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

      They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.  

      This is not true, 

      Proof:  

          About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because  when they cant work, they can not keep their home.  I was one of those Veterans who they denied for a bogus reason:  "Its been too long since military service".  This is bogus because its not one of the criteria for service connection, but simply made up by VA.  And, I was a homeless Vet, albeit a short time,  mostly due to the kindness of strangers and friends. 

          Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly.  The VA is broken. 

          A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals.  I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision.  All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did. 

          I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt".   Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day?  Va likes to blame the Veterans, not their system.   
    • Welcome to hadit!  

          There are certain rules about community care reimbursement, and I have no idea if you met them or not.  Try reading this:

      https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/

         However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.  

         When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait!  Is this money from disability compensation, or did you earn it working at a regular job?"  Not once.  Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.  

          However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.  

      That rumor is false but I do hear people tell Veterans that a lot.  There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.  

      Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.  

          Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:

      https://www.law.cornell.edu/cfr/text/38/3.344

       
    • Good question.   

          Maybe I can clear it up.  

          The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more.  (my paraphrase).  

      More here:

      Source:

      https://www.va.gov/disability/dependency-indemnity-compensation/

      NOTE:   TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY.  This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond.    If you were P and T for 10 full years, then the cause of death may not matter so much. 
×
×
  • Create New...

Important Information

Guidelines and Terms of Use