Shady C&P Cover-up After Appeal. What now?

[BabyShark]

This is my 1st post although I've been lurking for a few months and have learned a ton. So thanks to you all! 

I was originally diagnosed with PTSD last year @ 30%. At that time I was really new to the claims process and had no idea what a DBQ was. Once I started researching and reading various blogs and forums I went back to the review the original C&P DBQ and didn't think I was rated high enough based on the C&P notes, private records and buddy letters. So I did a supplemental appeal about 5 months after receiving the rating decision. I included a statement stating I didn't think the rating accurately reflected my disability and stated the various reasons and evidence. I was given a review C&P and stressed to the examiner that I was appealing the initial rating and that my current symptoms. She claimed she understood.

Timeline:

12/24/19 - C&P exam at VES for ADHD secondary to PTSD. All of the questions were related to ADHD.  (SN: Didn't care for the psych at all. Especially after she made a slick comment about me "knowing the system."  (In fact, I didn't. I'm just well-researched and fed up with being sick)

12/26/19 - C&P exam at LHI for PTSD in response to supplemental appeal. Very nice PsychD who actually took the time to listen. Rating increased to 70% 2 weeks later but my effective date was the date of the appeal, not the original claim.The decision letter made it seem as if I requested a rating increase due to worsening symptoms instead of appealing the initial rating.

1/11/20-filed supplemental appeal for EED based on continuously pursued claim. I pointed out in appeal that all of the symptoms listed in their 70% decision were also listed on my original decision letter for 30% rating and included a buddy letter from my mom that they hadn't listed (considered) during the last appeal that shows all of the symptoms were there during the original claim.

Here's where the shadiness starts...

1/22/20 - C&P exam for a PTSD review. WTF? I just had one less than a month ago and all I'm appealing is the effective date. I was immediately suspicious. And guess who they sent me to--the evil psych who did my ADHD exam. When I asked her why i needed another C&P she said I was getting a PTSD review but seemed confused about why since my last one was just 9 months ago. I corrected her and told her no my last one was less than a month ago. She claimed she didn't see it in her system. I told her I saw her for the ADHD exam on 12/24 and did a PTSD exam with another vendor 2 days later. She then claimed the VA sent her the wrong DBQ and we needed to redo it. So once again, I had to go through my PTSD saga. I could feel something was off.

1/31/20 - denied EED. In fact, the VA claims they made a CUE by awarding me the effective date of the supplemental claim . Instead, they made my effective date even later-- the same date as my 12/26 C&P exam claiming that's when entitlement arose. I noticed that they had added a new symptom to the decision letter to try to justify this.

 

Fast fwd to today when I go to the RO to get all of my C&P exam results. She could not find any evidence of a PTSD exam (or any other exam) on 1/22. I went back and looked at the exam from 12/26 and the new symptom they listed on the decision letter isn't listed. BUT...I looked at the ADHD exam from 12/24 and the evil psych had completely replaced my ADHD DBQ with a PTSD review. And it was dated 12/23/19. It had the new symptoms that the VA used as a basis for saying my entitlement arose on 12/26. Also, it looks like she forgot to update the first page of the DBQ. It still says "for the established compensation of ADHD secondary to PTSD". So not only did they purposely screw me over on back pay but they did a really bad job of covering their tracks. 

Question is, how do I even address this? It's obvious (to me) that they engaged in wrongdoing but I'm sure they will never admit that. If I file a HLR I wouldn't even know what to say without calling them out. I'm so pissed! 

Edited February 21, 2020 by BabyShark
typos

[GBArmy]

Hi BabyShark Welcome officially to Hadit. This is my opinion and I know others may disagree, but here it is. EED's can be tricky, especially as you are a witness to the slight of hand the VA can do. IMO, again, in my opinion, your effective date is 12/24/19. Today is 2/21/20. You are not going to win much if you should win your appeal. If you go for HLR, you are going to lose because the D;O has enough conflicting info to do so, even if it is wrong. They have done you wrong; sometimes the bad guy wins. Is winning, basically on principal, really worth the aggravation and heart burn for one month's back pay? You're going to have to appeal at least to BVA which will be months away after the HLR if you go, IMO. Would you not be better off punting on this rather than letting it eat away on you for maybe another year? Normally, I would recommend the veteran to go after anything they have coming to them, but for one month back pay I would think for your well being,considering your disability,  let it go. Whatever you decide to do, I wish you well.

[Guest]

First things first. It really doesn't matter how many mental health diagnosis a veteran has, VA will only pay for one.  I have seen VA combining more than one mental health condition but VA will chose the highest one with symptoms and rate that one.  PTSD would be the highest one.  70% is about the highest rating you want to go with a mental health disorder because VA will try to label a veteran 100% PTSD incompetent to handle his/her own finances with the 100% rating, you cannot work except in a shelter environment (family owned business)  and you can't own guns. 

Now with your EED, I hope you have a copy or can get a copy of the C & P exam on 01/22/2020.  If not just file an appeal to the BVA.  I say BVA because if you think the VARO screwed you over what do you think a HRL will do when the HRL works in the same building same office.  The HRL maybe on a different floor,  in a different room but it seems it might be a rubber stamp.  It is your claim and you can file in any way you want but be prepared for your appeal to go to BVA or maybe even to CAVC.  You can read my post how VA made me file a claim to CAVC just to get my second remand to grant my claim and a third remand from BVA just to get a correct EED. Others may chime in Hope the best Good Luck.

[broncovet]

I agree with Pete.  Get a copy of the mysterous missing exam, and submit it, if favorable, with your appeal to the BVA.  Make sure its a BVA  appeal which allows new evidence, since it sounds like a favorable exam went awol.  

I never cease to be amazed at the stuff VA pulls to deny.  Its amazing how many times favorable evidence in our files vanishes.  Well, I "unvanished mine" and eventually won 100 percent back to the date I first applied, but it took many appeals and a long road to do that.  

I wonder why VA never loses "unfavorable" evidence??  Keep your own records and dont expect VA to do you any favors, gathering up evidence to win your claim.  

    I do suggest you appeal, and try not go on and on insulting VA or accusing them especially of stuff that isnt directly related to your claim.  I appeal mine as follows:

    "While the VARO decision stated the symptoms only met the criteria for 30 percent, in an exam dated 11-14-19, Doc x stated that you had suicidal ideations, which is ONLY present in the 70 and 100 percent criteria"..(Example only).  You see, I refute their reasons and bases..with evidence...from a medical exam and the cfr's.  

Edited February 25, 2020 by broncovet
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[vetquest]

Broncovet has some good advice.  If you make a claim that the VA misplaced your exam you better have backup or the VA will bury you.  The VA also gets very unhappy when you tell them they goofed, especially if you are not nice about it.  About a missing exam and an exam a month later I will believe anything at the VA.  Once they did testing on my disability that was favorable and then lost all records of the testing.  Another time they did a medical exam to refute an exam performed that the University of San Francisco, developed to deny.

I agree that you need to take this to the BVA if you can get a copy of the missing exam.