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Higher level review


Joey Ross

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I had a higher level review, and new C&P yesterday, and went to ebenefits this morning, and disabilities and payment history, and letters unavailable this morning. Is that a good or bad thing or is the site just down

Edited by Joey Ross (see edit history)
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  • HadIt.com Elder

They usually do maintenance over the weekends. The results of your C&P yesterday wouldn't be in the system yet anyway. 

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1 minute ago, brokensoldier244th said:

They usually do maintenance over the weekends. The results of your C&P yesterday wouldn't be in the system yet anyway. 

Ok that you. How long will it be, since this is a higher level review C&P

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  • HadIt.com Elder

Depending on what it was for, could be a few days, or a few months. The findings of the doctor have to be dictated and uploaded into VHA, then pulled into VBMS by whomever works on your claim, then read and evaluated to make sure they answered all the questions and provided the relevant opinions for completeness (part of what I do), then sent to a rater.

Our work is assigned by a national work queue that sends the claim to the least busy office based on overall number of claims at that station. I may work part of a claim, then add notes about what I did, then shift to someone else's claim. If I worked through each one to completion I would never get anything done, so my goal every day is to advance as many claims as I can with notation of medical records, checking status of pending exams, sending letters for evidence, and evaluating whats there. If I can get it unstuck, at least, I consider it a success. 

Edited by brokensoldier244th (see edit history)
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On 8/8/2020 at 8:42 AM, brokensoldier244th said:

Depending on what it was for, could be a few days, or a few months. The findings of the doctor have to be dictated and uploaded into VHA, then pulled into VBMS by whomever works on your claim, then read and evaluated to make sure they answered all the questions and provided the relevant opinions for completeness (part of what I do), then sent to a rater.

Our work is assigned by a national work queue that sends the claim to the least busy office based on overall number of claims at that station. I may work part of a claim, then add notes about what I did, then shift to someone else's claim. If I worked through each one to completion I would never get anything done, so my goal every day is to advance as many claims as I can with notation of medical records, checking status of pending exams, sending letters for evidence, and evaluating whats there. If I can get it unstuck, at least, I consider it a success. 

I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even  reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and  nothing about stressor,

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3 hours ago, Joey Ross said:

I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even  reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and  nothing about stressor,

 

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On 8/9/2020 at 1:40 PM, Joey Ross said:

I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even  reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and  nothing about stressor,

I filed a increase for depression and had a completely jacked up exam by some asshead about 2 months ago. He left out tons of stuff I said (i had notes and filed complaint with VES because he lied on the exam) and even went a step further to say I shouldn't be service connected. I got reduced 50 to 30, filed a supplemental with a DBQ from a private provider, just had another CP exam, went well. Should have me at 70 if things go right (not that I have faith in the VBA). 

Edited by wood78221 (see edit history)
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Wood Undoubtedly you had a bad dude doing your exam. One comment you made is a little strange though. You said the examiner  "even went a step further to say I shouldn't be service connected." Of course you realize that is one of the primary functions of the examiner; to determine whether or not it is s-c. If yes, then to what extent ex. at least as likely as not...

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23 hours ago, GBArmy said:

Wood Undoubtedly you had a bad dude doing your exam. One comment you made is a little strange though. You said the examiner  "even went a step further to say I shouldn't be service connected." Of course you realize that is one of the primary functions of the examiner; to determine whether or not it is s-c. If yes, then to what extent ex. at least as likely as not...

My examiner blamed my childhood for my mental conditions, but I had to have a waiver just to get in, from the doc that I had treatment with, stating I didn't have any mental conditions. I found my granny shot when I was 11, but after seeing her, went on to go to the 88' Junior Olympics , and skip a grade in high school' just so I could join early. Nothing about Iraq at all. Guy was a really A$$h@le too. 

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Joey, some of us are more lucky than others at  finding these negative examiners. They're still out there, but I think they are slowly being weeded out. At least, I hope so. 

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22 minutes ago, GBArmy said:

Joey, some of us are more lucky than others at  finding these negative examiners. They're still out there, but I think they are slowly being weeded out. At least, I hope so. 

I hope so, We Vet's deserve better.

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  • HadIt.com Elder

Sounds like you guys might want to appeal for sure. Maybe DAV can help, if not get an attorney that works for Veterans. I had Chisholm, Chisholm, and KilPatrick, but they were very selective of the cases they pick. I referred a buddy with several purple hearts, and they had been low balling him. He is over 100% now with SMC.

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On 8/8/2020 at 7:32 AM, Joey Ross said:

Ok that you. How long will it be, since this is a higher level review C&P

You can sign up for eBenefits or VA.gov to follow your status.  It is usually about a month or two behind but when you have an open claim it will give you a time frame.  Nothing more than 18 months is acceptable since Godsey v Wilkie, Vet. App. 17-4361.  You can look it up online via a search engine.

My last C&P in response to a BVA took from 02/24/2020 to 03/30/2020 from examination to RO Decision because I had filed a Rule 21 Petition (Godsey format) because of the delay.  The examiner was a Nurse Practitioner who on referenced items in my file that were negative to my claim.  Because of the BVA remand, she was forced to grant something so she did minimal, granting 10% from claim date (07/09/2009) to examination date (02/24/2020) and the 20%.  Part of my decision was probably retaliation for going to the Court.

If you read Godsey v Wilkie (433 pages) you will find a very high percentage of appeals to the BVA are successful.  What is going on now is the VA is trying to shorten the back pay period so attorneys will not take your case because the amount of back pay will not be enough to cover their time.

Expect to have to appeal and come back to this board for assistance.  There are several who have done their own appeals who can help you frame one in the year allowed to do so.

If you can afford it, subscribe to Adobe DC Pro so that you can redact your personal ID (VA c number, SSA number, DOB, required for submitting to the Court) from your medical file documents you might want to share.  Another option in redacting is printing the document, then blacking out what you need to, and then scanning it back to a new document.

If you are lucky, you can find a good VSO (Veterans' Service Organization) (Officer) to help you but most on this site will tell you those are few and far between.  Ask around at your VA facility to other veterans for which organization has the best at your VARO.  Get several opinions before deciding.  DAV used to be the best while still manned by WWII vets but not any longer.  Still worth asking about the successes had with your local VSO of any stripe.

Edited by Lemuel
left out important part (see edit history)
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21 hours ago, Joey Ross said:

My examiner blamed my childhood for my mental conditions, but I had to have a waiver just to get in, from the doc that I had treatment with, stating I didn't have any mental conditions. I found my granny shot when I was 11, but after seeing her, went on to go to the 88' Junior Olympics , and skip a grade in high school' just so I could join early. Nothing about Iraq at all. Guy was a really A$$h@le too. 

Sorry, missed page two in my remarks above. 

VES has contracts for C&P exams.  The examination controls must be rigid for an examiner to get any new referrals.  The reason I say that is there are qualified examiners within 30 miles of me for all of my examinations and do them for SSI and SSDI, yet they sent me over 150 miles for orthopedic examination.  My TBI exam was scheduled over 4 hours (over 300 miles away) across Denver to a Golden Colorado clinic when the University of Colorado Medical School was over an hour closer and directly accessible by a Shuttle.  Scottsbluff 30 miles away and Cheyenne, 81 miles away on the way via Denver to Golden Colorado. The examination was a one day exam, not in TBI exam protocol.  I didn't have a driver and refused to go without transportation.  They would not provide the $190.00 round trip from Torrington, WY plus 2 overnights because of the shuttle schedule.  Now VES is using CORVID as an excuse to delay.  (Thanks for your post.  My response caused me to think of a motion on my Bray v Wilkie, Vet. App. 20-1415 petition.  I need to submit a motion for relief in the form of an order to VES to schedule the examination in Scottsbluff where there are multiple qualified examiners available.)

I have an attorney who is in San Diego.  It is alright for me because I have 13 plus years as a Navy Hospital Corpsman and entry level as a category I mental.  (sounds like you were also).  Since being treated for my temporal lobe epilepsy correctly finally in 2015, 25 years after it was confirmed and 30 years after a correct treatment was recommended, my mental functioning has improved to the point I am more employable at 79 than I was at 35. 

If you have a TBI history or multiple trauma history in which a TBI is often overlooked, my 2017 BVA Judge stated I am qualified to give evidence on things I have direct knowledge of and cited a CAFC decision.  I studied at the NIH Library for about 1 to 2 year total of work hours in the years between 1995 and 2003 trying to understand my on dysfunctions.  Between 1995 and 1998 the amount of TBI studies available went up over 5 times.  And I have kept up online since then.

I am a Vietnam Vet.  My experience in PTSD groups was that most of the veterans with PTSD had an organic history.  Mostly in service.  You do not say if you had a head knocker or close exposure to  blast.  Either a major blast or repeated outgoing artillery.  Does not matter if it was pre service.  The service PTSD events happened after you were accepted as sound.  On entry they gave you an MMPI, Minnesota Multiple Personality Inventory examination.  The test that asked things that would have shown any problem at the time with your experience with your grandmother.  Your representative will have to know that and state it, acknowledging the VA can produce the results for a definitive answer to the question.  Even when I went in in 1961 the results were prepared on an IBM machine.  You probably took one at the VA since.  Hope you did not give unfavorable answers to you regarding your reflection on your grandmother on that one.  Look for the report on it.

Yes, you are going to need to appeal.  If you are in a high density population area you have more options.  One way to short cut the system and get a good look at your medical record done is to claim an extra-schedular rating.  The grandmother event is cause to do that as it complicates your decision.  The Executive Director, Compensation Services will have to take a look at it after it is developed.  Currently, Beth Murphy, who does not like to be overturned by the BVA or CAVC so no lies will be sent up to her.  My file was developed by a DRO in the Central Office in DC.  I was granted TDIU back to my last day of full time employment, September 16, 1985.  (a big check from 40% to 100%)  The DRO covered my file without leaving anything out and favorably weighed the evidence.  Ms. Murphy sent back a favorable opinion and I was granted the decision within 5 months of my Rule 21 Petition on 02/17/2020.

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On 8/16/2020 at 2:45 PM, GBArmy said:

Joey, some of us are more lucky than others at  finding these negative examiners. They're still out there, but I think they are slowly being weeded out. At least, I hope so. 

GB you junks me..... I went for a C & P on October 7th. Had to drive 110 miles one way because I made the send me to a real doctor.  They made me wait 2 hrs. for an 11:00 AM appointment. The the bitch low balls the ratting does not look at anything in my folder did not look at the evidence I presented at the appointment. So they gave me 10% on my knees that have disabled me from 2008 VIA workers Comp and SSDI. Yup GB its all your fault. (NOT)

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Sorry brother; if I were you I wouldn't be buying any lottery tickets anytime soon! You got to re-group and figure out your next step. I don't know if you have it already, but I would get a new dbq from an ortho specialist that documents the severity of your symptoms. Look up the diagnostic code they used and see if you in all honesty meet the next level, say 20 or 30%. If yes, resubmit a supplemental claim. In addition, do you have other issues SECONDARY to the knees. like back or foot problems, stomach problems from pain meds, maybe MH issues because of lack of mobility and/or constant pain? I'd consider those types of actions as well. Get the data into your medical records with or before the submittal of the claim, and, be sure to add a new, strong Statement in support of your claim that talks about how it affects your daily life. Once you get a denial, you really need to be sure you address what the reason for denial of the higher rating is. If your specialist can refute what the examiner said, even better. Get cracken'; you can win this rating increase.

 

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I have been following cases at the Court of Appeals for Veterans Claims (CAVC) and the Court of Appeals for Federal Claims (CAFC) for a couple of years.

What I got out of that is that the BVA is the "fact finder" which neither the CAVC or the CAFC can overturn a decision based upon "the facts" decided by the BVA.

You must ask for an independent medical opinion (IMO) at the BVA level and a referral to the Director Compensation Services at that level to get a Constitutional abridgement of the law based upon the "Regulations" (CFR) that require certain things to be done. 

I have an appeal in to the BVA and am waiting for a hearing.  At the hearing I must raise all of the questions of fact to develop my claim such as the nexus of my seizures in my TBI hospitalization record, performance reports that are indicative of "procrastination" (when I was staring at the wall, a symptom of temporal lobe epilepsy), the failure to ever do a  38 CFR 4.42 compliant examination, the failure of the DRO to order the specific examinations ordered by the BVA Judge in my previous BVA Decision, etc..

If the BVA judge says it did not happen, the only way to appeal the decision is to get the CAVC or next level CAFC to find the decision "arbitrary and capricious" or the examinations reports to be "arbitrary and capricious" or that a Constitutional civil right has been abridged.

For the Constitutional civil rights review the Amendments to the Constitution, particularly the Fifth Amendment and Section 4 of the Fourteenth Amendment. 

I am going for earlier effective dates for my TBI, service connection for temporal lobe epilepsy, secondary service connection to the temporal lobe epilepsy spinal disc disease from an MVA caused by an "altered state of consciousness" reported by the VA physician to the DMV causing a suspension of my DL and some more items including a "next of friend" claim for all veterans suffering from organic brain syndromes that I made and ask for a referral to the Director, Compensation Services in 1994 which was denied to exist by the Director of Denver VARO in 1998.

When I get my hearing and my BVA docket no., I will post it so that anyone with a TBI before 2008 can join and claim an earlier effective date back to the date of release from the service for their TBI or other organic brain syndrome such as cerebral malaria.

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Joey, the eBenefits site is not kept up to date.  You need to request a CD of your file now to get the evidence to see if you need to appeal your "higher level review" to the BVA.  Higher level reviews typically rubberstamp the Rating Officer Decision though some do not like to be overturned by the BVA.

On 8/8/2020 at 7:29 AM, Joey Ross said:

I had a higher level review, and new C&P yesterday, and went to ebenefits this morning, and disabilities and payment history, and letters unavailable this morning. Is that a good or bad thing or is the site just down

 

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  • HadIt.com Elder

Ebenefits has been in sunset mode for the last year or more, and is being decommissioned. Most everything on it has been moved to VA.gov and the only reason Ebenefits is still up is because there are a few things left to convert, and for informational purposes for veterans that already started claims there. 

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2 minutes ago, brokensoldier244th said:

Ebenefits has been in sunset mode for the last year or more, and is being decommissioned. Most everything on it has been moved to VA.gov and the only reason Ebenefits is still up is because there are a few things left to convert, and for informational purposes for veterans that already started claims there. 

I sign on to VA.gov and it takes me to eBenefits for status of my appeal.  So nothing available period until they finish the conversion for some of us.  Is there a specific way to sign on if you had a "prime" eBenefits account prior to the conversion?  Do we need to get a new log on ID?  What the hell is going on?

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