HLR or Board

[SPO]

This might get a little long winded but please stick with me.  I just had my supplemental claim for arthritis closed.  I was awarded 2 out of about 15 affected joints, and suprise, suprise it seems that the reason the others were denied was because of the C&P examiner not doing a thorough exam and incorrect reporting on the paperwork.  The reason for denial on all of them was no diagnosis.  Now the problem with this was that she was provided with a letter and medical records from my rhuematologist (an M.D.) stating specifically which joints are diagnosed and affected, and the letter is  from May 2020, so it is current information (she is a nurse practitioner, and best I can tell specializing in family medicine).  She decided she didn't believe me when I told her joints hurt during the exam so basically said nothing was wrong, thus no diagnosis.  In particular I know she lied about the range of motion of my shoulders.  I have a difficult time getting to 90 degrees on either arm, but her range of motion says 120 degrees.  she did actually measure this, but I know where my arms were and it was less than 90.  She did measure my back (which was approved) but nothing else.  She didn't even actually examine my hands or feet.  She "examined my elbows and knee from across the room.  Also, she stated I have no flare ups, but I know for a fact the QTC questionairre I submitted to her stated that I do, as well as my statement I filed with the claim to the VA.

I called DAV as soon as I left the exam and asked them what to do and they said, just wait for the exams to come in and see what they say.  When the exams came in I couldn't get anyone at DAV to actually look through them all, so they said just wait for the decision.  I finally got someone to look through a few of them (after the decision was made) and from what the DAV is telling me, many of the joints don't look like the reach the compensable level based on her C&P. 

Now I am at a crossroads.  I can either Higher level review and see if maybe they will give me 0% service connection because my doc's diagnosis should outweigh her 10 minute "exam"(maybe a couple 10% ratings if I'm lucky), or get in line at the the BVA.  I'm not sure what to do next and I've heard advice to go both ways from the DAV.  They say I can't fight the bad C&P through HLR.  Any thoughts or advice?

[SPO]

The letter and medical record from my doctor were on the list of evidence used.  
as far as the exam, I contacted DAV as soon as I left and they advised to just let the VA make a decision, there wasn’t anything I could do about it. I didn’t contact anyone and I assume it’s far to late now

[Berta]

Have you posted the  redacted decision here anywhere?

 

Quite a few vets here have complained to the outfits who provide these C & P examiners, and some have called the White House hot line ,1-855-948 2311 about lousy C & P exams.

Sometimes they get a different C & P examiner ,if they complain, and sometimes they realize they have to pay a real  doctor for a strong IMO/IME.

 

 

 

 

 

Edited August 7, 2020 by Berta

[SPO]

would calling the white house hotline be a lost cause at this point?  The VA already issued a decision.

I will post a copy of the decision as soon as I can

Edited August 7, 2020 by SPO

[Miken2c74]

Hey, don't let anyone say you can't challenge exam on your own, I did and won. Complain to the contractor and then make a IRIS complaint to cover yourself. Then sit down and write a letter (Word) Your name at the top and your file number and the Greeting Veterans Affairs Representative and so on and so on. When you finish the letter proof read it so it flows and then when iots finished sign and date it and submit to VA through your VSO.

[Berta]

You bet, and Congrats on your success Miken!!!!!

After my husband died I had to challenge every single posthumous C & P exam he got.

And I challenged a C & P exam  that one of my claims was remanded for., by the BVA.*

The last C & P exam they did was a few years ago and the examiner said it was an "inperson" exam.

I raised hell on that , as my husband had been dead by then for more than 20 years.

Whatever claim that was, I won on a CUE, three weeks after their ridiculous denial.

I think it was my HBP 1151 claim.

* Dont forget, if you have a BVA case, you can send the BVA additional evidence when you get a docket #.

I sent my rebuttal to the lousy C & P exam to the BVA.

BVA remanded for an additional VA opinion, from a cardio doctor I had 3 IMOs for the claim and they had two against.

I got a PA opinion. That is a far cry from a real cardio opinion.

BVA agreed that it was too speculative and awarded my claim.

Just to add here- when a veteran is dead, they cannot speak for themselves.

Their survivors can speak for them, with evidence.

You would be surprised how the VA handles some survivor claims they get.

And how some VSOs and vet reps handle them. 

 

 

 

 

 

 

 

 

 

 

Edited August 8, 2020 by Berta

[Miken2c74]

Thanks @Berta