Does anyone have experience with "clinical appeals"?

[slangpdx]

On 5/8/2020 at 1:37 PM, broncovet said:

"Well, Im not sure how many hoops I would jump through to get VA to pay for a test that costs 100.00..the obvious answer here is to go to a private doc and get the test done, if you think its all that necessary. "

The cost for the test plus private do visit would be $300.  I had an order in at a medical college which was then cancelled due to the pandemic and they will not put it back in.  So have to start over.  Requested order for covid antibody test, which doc could not place to
Quest after a week of faxing and calling, so left hard copy at clinic which I then picked up and hand carried to Quest for blood draw.  This in an era of phone internet and fax for a doctors order.  Of course VA would not order it.

This test I am requesting I had done previously and VA refused to incorporate it into my records, so I am pursuing this to get them to order the test so it  will then have to be acknowledged as internally generated.  See my response to GBArmy at this topic.

 

 

[Oceanbound]

On 5/7/2020 at 3:23 PM, kanewnut said:

Try a search for "VA clinical appeal form". I found an interesting document from 2016.

I searched and only show up claims. Can you not have posted that link?

[broncovet]

If you search the BVA chairmans report, you will see that "compensation claims" is not the ONLY reason Vets appeal to the BVA.  

On the 2019 BVA chairmans report, it shows the board processed 371 medical claim appeals in addition to 32,000 compensation appeal  claims.  (page 32)

There were also 2 insurance issues, and many more.  See for yourself.

https://www.bva.va.gov/Chairman_Annual_Rpts.asp

I suggest people read the BVA chairmans report, but most people dont.  It has a wealth of information.  For example, if you appeal to the BVA, only 20.7 percent of those are denied.  The rest are awarded, remanded or "other".  Im not sure what "other" means, but it may include if the Veteran dies and no one filed a substituiton of claimant.