Inaccurate C&P exam

[Devildoc2448]

I had an inaccurate C&P exam for depression on 18 February 2020. The examiner basically minimized my diagnosis, symptoms and ability to work. Her report was the very opposite of what my psychiatrist and therapist have diagnosed. I’ve been seeing them for 3 years, so I feel they know my illness better. The C&P exam was made available in my healthe vet record on 6 April and the board made their decision on 7 April. I had no chance to disagree with the raters findings. 
The day I did read the exam report and noticed the differences and a incorrect ICD coding, I called my therapist and she got the rater to make an addendum with the correct ICD code. I don’t know if the VA reviewer got to see the correction because they made their decision the next day. 
How can I dispute the C&P exam?  Is it  possible to request another C&P exam?

[Hucast21]

12 hours ago, Devildoc2448 said:

I had an inaccurate C&P exam for depression on 18 February 2020. The examiner basically minimized my diagnosis, symptoms and ability to work. Her report was the very opposite of what my psychiatrist and therapist have diagnosed. I’ve been seeing them for 3 years, so I feel they know my illness better. The C&P exam was made available in my healthe vet record on 6 April and the board made their decision on 7 April. I had no chance to disagree with the raters findings. 
The day I did read the exam report and noticed the differences and a incorrect ICD coding, I called my therapist and she got the rater to make an addendum with the correct ICD code. I don’t know if the VA reviewer got to see the correction because they made their decision the next day. 
How can I dispute the C&P exam?  Is it  possible to request another C&P exam?

From one DevilDoc to another, you either file a NOD or a supplemental claim. 

If you file a NOD and still get denied, lawyer up and appeal to the BVA. It is downright pathetic how a low percentage of VA claims are actually rated correctly on the very first try.

You would need to channel your inner Zen because the claims process takes a lot of patience once you appeal to the BVA.

[broncovet]

Its my "opinion" that you will need to "get to the BVA" to get any significant retro..GS 5's, GS7''s or even GS 9's "probably" are not authorized to sign paperwork which results in a retro check of 100,000 dollars or more.  That will likely take a BVA judge to do that.  SCL will likely just delay you getting to the BVA judge, the SCL is another VARO employee who probably also does not hand out 100,000 dollar checks like they are candy at a parade, either. 

    In order to get to the BVA, dont file an SCL, but instead file a NOD, and select "appeal to the Board of Veterans Appeals".   If you have new evidence so indicate in your timely filed appeal to the BVA.  

    If/when you get in front of a BVA judge, you at least have a reasonable chance of getting your claim/retro awarded.  Most often "another" VA decision (DRO, SCL, HLR etc) will usually result in another denial "especially" if it involves large retro.  Appealing to the VARO is often like trying to talk the Janitor into hiring you..he probably has no authority to do so, but he will talk to you and may not even like to admit he has no authority...

    How many Veterans do you know who "actually got" 100k plus retro's at the VA regional office level "without" a BVA appeal (or remand) directing the VARO to do so first?  Sure, they can implement a decision if a BVA judge has decided on it.  

    I dont know "1" Veteran who has ever gotten a six figure retro "without" one or more BVA appeals.  In my case, I had to appeal to the BVA not just once, but several times.  I think 7 BVA appeals in total.  

     If anyone has gotten a six figure retro at the VARO level without one or more appeals to the BVA or above, please post your success story.  

 

Edited April 11, 2020 by broncovet

[Hucast21]

45 minutes ago, broncovet said:

Its my "opinion" that you will need to "get to the BVA" to get any significant retro..GS 5's, GS7''s or even GS 9's "probably" are not authorized to sign paperwork which results in a retro check of 100,000 dollars or more.  That will likely take a BVA judge to do that.  SCL will likely just delay you getting to the BVA judge, the SCL is another VARO employee who probably also does not hand out 100,000 dollar checks like they are candy at a parade, either. 

    In order to get to the BVA, dont file an SCL, but instead file a NOD, and select "appeal to the Board of Veterans Appeals".   If you have new evidence so indicate in your timely filed appeal to the BVA.  

    If/when you get in front of a BVA judge, you at least have a reasonable chance of getting your claim/retro awarded.  Most often "another" VA decision (DRO, SCL, HLR etc) will usually result in another denial "especially" if it involves large retro.  Appealing to the VARO is often like trying to talk the Janitor into hiring you..he probably has no authority to do so, but he will talk to you and may not even like to admit he has no authority...

    How many Veterans do you know who "actually got" 100k plus retro's at the VA regional office level "without" a BVA appeal (or remand) directing the VARO to do so first?  Sure, they can implement a decision if a BVA judge has decided on it.  

    I dont know "1" Veteran who has ever gotten a six figure retro "without" one or more BVA appeals.  In my case, I had to appeal to the BVA not just once, but several times.  I think 7 BVA appeals in total.  

     If anyone has gotten a six figure retro at the VARO level without one or more appeals to the BVA or above, please post your success story.  

 

I agree broncovet - I never heard or read anywhere that a veteran got a six figure retro check at the VARO level.

To new users reading this on why broncovet advocates appealing to the BVA -The reason why most veterans are likely to win at the BVA is because the judge actually applies VA laws and regulations such as equipoise - when there is an equal amount of evidence for and against service-connection, the benefit of the doubt goes to the veteran.

Now why a rater at a VARO does not apply the same logic is baffling. An unfavorable C&P exam done by an NP should not be given more weight compared to a favorable IME/IMO from a board-certified specialist, but it does happen.

And it happens way to often at the VARO level (DRO, SCL, HLR, etc).

[brokensoldier244th]

RVSRS Don't start until at least gs9 and rarely At that. In any case it wouldn't matter what the GS rating of the rvsr is. Anything over a certain amount has to go director level or higher anyway whether it's BVA or not. Supplemental vs BVA appeal has nothing to do with it. They gave  you an option to add evidence to a closed case without having to do a full Appeal that takes years. There is no nefarious motive. You can use it or not, and it doesn't affect your effective date Not every policy change is an implicit something to deny you benefits. 

Edited April 11, 2020 by brokensoldier244th

[brokensoldier244th]

1 hour ago, broncovet said:

Its my "opinion" that you will need to "get to the BVA" to get any significant retro..GS 5's, GS7''s or even GS 9's "probably" are not authorized to sign paperwork which results in a retro check of 100,000 dollars or more.  That will likely take a BVA judge to do that.  SCL will likely just delay you getting to the BVA judge, the SCL is another VARO employee who probably also does not hand out 100,000 dollar checks like they are candy at a parade, either. 

    In order to get to the BVA, dont file an SCL, but instead file a NOD, and select "appeal to the Board of Veterans Appeals".   If you have new evidence so indicate in your timely filed appeal to the BVA.  

    If/when you get in front of a BVA judge, you at least have a reasonable chance of getting your claim/retro awarded.  Most often "another" VA decision (DRO, SCL, HLR etc) will usually result in another denial "especially" if it involves large retro.  Appealing to the VARO is often like trying to talk the Janitor into hiring you..he probably has no authority to do so, but he will talk to you and may not even like to admit he has no authority...

    How many Veterans do you know who "actually got" 100k plus retro's at the VA regional office level "without" a BVA appeal (or remand) directing the VARO to do so first?  Sure, they can implement a decision if a BVA judge has decided on it.  

    I dont know "1" Veteran who has ever gotten a six figure retro "without" one or more BVA appeals.  In my case, I had to appeal to the BVA not just once, but several times.  I think 7 BVA appeals in total.  

     If anyone has gotten a six figure retro at the VARO level without one or more appeals to the BVA or above, please post your success story.  

 

And you know EVERY veteran that has or hasn't gotten a large retro to make that assertion? You are basing that on an assumption, not evidence. There is a difference. You can have your opinion but that's all it is.
 

There are large retros every day that are awarded and you dont hear about them- you only hear the negative. Sure VA makes mistakes all the  time -they aren't any more perfect than you are. Claims files, even digital are thousands of  pages that still can't be searched with ctrl-f like on TV. That requires someone to still go through them.

Don't attribute To malice what is more likely due to laziness (they get fired every day), ignorance of some processes and ways to find some documents (younger development vsrs- most of them are not nearly as old as the vets they are looking at things for), and sometimes conflicting regulations and diagnoses and contentions, and occasionally, like the fire in St Louis, acts of God. 

Edited April 11, 2020 by brokensoldier244th

[brokensoldier244th]

26 minutes ago, Hucast21 said:

I agree broncovet - I never heard or read anywhere that a veteran got a six figure retro check at the VARO level.

To new users reading this on why broncovet advocates appealing to the BVA -The reason why most veterans are likely to win at the BVA is because the judge actually applies VA laws and regulations such as equipoise - when there is an equal amount of evidence for and against service-connection, the benefit of the doubt goes to the veteran.

Now why a rater at a VARO does not apply the same logic is baffling. An unfavorable C&P exam done by an NP should not be given more weight compared to a favorable IME/IMO from a board-certified specialist, but it does happen.

And it happens way to often at the VARO level (DRO, SCL, HLR, etc).

And you probably wouldn't because it wouldn't be granted at that level without much higher level signatures anyway. If you know you are Potentially due for retro that far back then file a full appeal. No one is forcing anyone to do a supplement.