A CP exam was just completed without my knowledge

[JaeT.21]

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.

 

 

[Buck52]

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.

[JaeT.21]

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...

[Richard1954]

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.

[Richard1954]

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...

[JaeT.21]

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.

[JaeT.21]

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.