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VERY strange C & P exam


Mantana

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20200214_063707.thumb.jpg.719b89e6abc71f2a4fab2cbb2ef338c3.jpgYesterday I drove 87 miles over an unplowed pass in a blizzard at 530 in the morning to make a c & p exam. The appointment time was 8am, but I was determined to be early so I showed at 740. But the drive isnt the weird part... I was scheduled to get evaluated for neck pain and GERD. The nurse was nice and drew my blood quickly, the doctor arrived and it was the same doctor I had 8 months ago in another town and he actually gave me my first service connection at that time. He starts with neck pain, does very fast measurements and basically then tells me I have no strong claim. I was claiming it secondary to TMD and had provided with a nexus  (which he read) 2 appeals that the board granted for this same issue. There was also 2 scholarly articles in the nexus letter. He shrugged it off and said he was going to deny it.... now it gets weird...

 

He stated he "lastnight i made up my mind" and was going to deny both my conditions. But then he said this morning he changed his mind and decides to make a statement with my GERD at least as likely as not. He even read me the statement and told me he would use one of the articles provided in my claim. But then he tells me he was going to deny because he thinks I don't have GERD But another disease(just similar symptoms), AND he thinks my articles are bogus and flawed. I am claiming GERD secondary via NSAID over use. He basically explained to me the VA likes to play a game and that he realized I was a veteran who wanted to play back.... Also he said GERD needs to be confirmed and he told me not do have a scope until I'm service connected in case it's negative. 

Oh yeah, and he diagnosed me with GERD

Isn't that weird as heck?????

Edited by Mantana
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4 hours ago, Oceanbound said:

How do you know if you have GERD if you never had a camera down your throat? He should have denied you just for that reason alone and not give you 

Again he should have never gave you "atleast as likely as not" but a denied--since you don't have proof from a scope down your throat to your stomach.

No he was right about your three doctors being wrong. They never properly examined you with again a scope down your throat.

That is like saying I bought a box of chocolate cookies, and I ate them, even though they're still in the wrapped box moldy.

Straight from mayo clinic.... "Your doctor might be able to diagnose GERD based on a physical examination and history of your signs and symptoms."

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4 hours ago, Buck52 said:

This Veteran is not allowing Fraud? he simply was stating what this Idiot C&P Examiner mention.

 

Thanks for that. Honestly It was very hard for me to reach out in this community. I thought the support would be better. 3 of my own personal doctors who know my history diagnosed me. I didnt diagnose me. Also, the c and p examiner isn't my treating physician. He doesn't know my history like my doctor does. I have GERD, just because some crazy c and p doc said I don't doesn't mean I don't have it.

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Mantana Don't get discouraged. As you can see this is an active forum, and with many people, opinions can sometimes go off target a bit. You are absolutely correct; the VA doc is the one that is wrong. You have your evidence and you can win on your claim, if you do one thing. Don't give up! If you have been diagnosed for GERD, you can win out. In fact, that holds for everyone. If you believe you have an injury or disease because of your service, don't quit if you get denied the first time. Work on it so you develop a strong case. So, if you get advise or an opinion that is wrong, no problem. Ignore it and follow the advise that makes sense. You can win!

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1 hour ago, GBArmy said:

if you get advise or an opinion that is wrong, no problem. Ignore it and follow the advise that makes sense. You can win!

Thanks for the pep talk. I'm hoping I win and don't need to do an appeal or anything. A higher level review may be in the works if I don't. I learned that the only thing between someone getting their condition service connected and not is giving up. If I didn't know any better I would have tapped out by now. After this exam I considered that, I was frustrated thinking what he said.  

Edited by Mantana
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 Normally this Hadit board is where you will find all the information you will need to win your claim  I PROMISE YOU THAT.

Please don't let others discourage you!

 Sometime some members get a little ahead of them self on this board and don't comprehend what they type and may say discouraging words,  like GB Army mention  just Ignore those type comments.

stay positive!!!

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@Mantana, do not be discouraged about this website.  I have been here a little while and have seen excellent advice from some of the old hands and the younger ones too.  As you have noticed sometimes a person will of off on a tangent.  We are all human and make mistakes.  Overall this is the best website for winning your claim.  Keep up the fight and never surrender.

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@Mantana Like stated above don't get discouraged from some comments on this site. There is alot of amazing guidance on this site from the memebers who have gone through what you are going through and those with a lot of experience. You have three doctors who state you have GERD then I would argue thay all can't be wrong.

Like I have said before take the advice that you believe is best suited for your situation and ignore those that may not understand or know what they are talking about. I know for me I don't comment on PTSD for I know nothing about it, I may give words of in couragement but that is really it. 

Always remember you have the most to lose by not getting the best advice and never giving up on the fight until you get what you deserve.

Good luck and stay positive!!!

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Mantana,  Sounds like the same examiner I had four years ago for my back and lungs.  The examiner told me he was going to deny me, "because that's what I do.  Everyone likes me here".  Then he said "I would appeal if I were you, because you have a strong case".  Appeal I did!  I got a DRO hearing in which they agreed totally with me, give me what I was appealing and also several other issues with my back and lower legs.  I also filed a complaint on that doctor as well.

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35 minutes ago, Jimmer said:

 I also filed a complaint on that doctor as well.

How do you do this? I want to be prepared because if anything fishy is on the exam notes I want to submit some sort of complaint. I just sat there in shock and listened to what he had to say. 

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Mantana

I believe you have to have a denial or a proposal to reduce your benefits First.

   Then they are suppose to send you instructions on how to appeal  or try to get this settle at your R.O. with a DRO REVIEW OR DRO HEARING WITH YOU IN-PERSON.

  THEY SHOULD SEND YOU A LETTER DETAILING WHAT YOU NEED TO DO , YOU HAVE 60 DAYS TO REQUEST THE DRO REVIEW  OR DRO HEARING.  FROM THE DATE OF THE INSTRUCTION LETTER.

YOU REQUEST THE DRO REVIEW  OR THE DRO HEARING.,, I RECOMMEND THE DRO HEARING AND TAKE ANY EVIDENCE YOU HAVE TO HELP YOU WITH THIS CLAIM  IT NEEDS TO BE NEW AND RELEVANT EVIDENCE.

lIke a new IMO  from a qualified Dr  Ect,,,ect,,,

USUALLY THE DRO   IS APPOINTED YOUR CASE WILL SEND YOU A LETTER.TO EXPLAIN HIS INSTRUCTION DATE /TIME LOCATION OF HEARING...

NOW IF THEY DO IT DIFFERENT  WITH THIS NEW AMA STUFF  SINCE IT'S BIRTH  ON FEB 19TH 2018.... I DON'T KNOW.?.YOU CAN CALL THE 1-800 # AND ASK.

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10 hours ago, Buck52 said:

Mantana

I believe you have to have a denial or a proposal to reduce your benefits First.

   

Thanks for the info.  Lots of good advice, now just a waiting game

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  • Content Curator/HadIt.com Elder

@Mantana Always keep in mind that the standard for service connection is subject to relative equipoise, or benefit of the doubt. If you have one doc saying yes and another saying no, as long as the evidence is in balance, the VA is supposed to find in favor of the veteran.

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Vync is correct

Also what vync means here   is

if the evidence is in a tie   the evidence in question goes to the veterans favor.

I use to think its a matter of what Dr  or which Dr they believe?

So this is a good reason for a Veteran to use a * ''specialist'' in the field of medicine the veteran is claiming For IMO/IME's

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@Buck52 They are supposed to consider the credibility and give weight to the opinions. These M21-1 articles provide some additional information on examination requests and reports. I was unable to locate the exact spot where they will determine which report to hold as more credible.

M21-1, Part III, Subpart iv, Chapter 3, Section D - Examination Reports

Article ID: 554400000015812

https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000015812/M21-1-Part-III-Subpart-iv-Chapter-3-Section-D-Examination-Reports

 

 

M21-1, Part III, Subpart iv, Chapter 3, Section A - Examination Requests Overview

Article ID: 554400000015809

https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000015809/M21-1,-Part-III,-Subpart-iv,-Chapter-3,-Section-A---Examination-Requests-Overview

And it ties in to 

 

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Roger that Vync!!

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Alright all, today I obtained the DBQ.

 

here is it in a nut shell

"Conclusion: Although examiner is uncomfortable with this conclusion , using the VA's loose and non verified diagnostic criteria for GERD claimant has a dx of GERD and it 
is at least as likely as not that claimants symptom and use of acid suppressing medication are related to chronic NSAID use related to his service connected TMJ 
disorder."

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Again, this examiner is playing "God" with you. There are some really strange people out there. If I read it correctly, He, the examiner, is saying that you "at least as likely as not" have GERD. Whether or not he is trying to to appease the rater into saying "not my fault" or not, doesn't matter. He is agreeing with the doc that you have the disability. You should get the 10% award IMO. If you don't, appeal.

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