Why Is the VA Requesting That I get a new C&P exam after I appealed their effective date of my disability decision?

[Rambo123]

Here is my Va dilemma. First of all, I have been fighting the VA since 1994!  I have since been granted small disability increases until I finally was granted an increase from 90% to 100%.  During this long arduous and challenging struggle,  I have filed disagreements and a Form 9 to Veteran Board of Appeals (VBA).  Next,  VBA  has remanded my claim back to my local VARO because there was so many disparities the VARO raters either deliberately missed, or missed because of being overwhelmed by so much work they are facing. Personally it appears to be both. Here is my question: After finally being granted the 100%, the VARO raters decided the make my disability effective date  the date of my most recent C&P exam, which was just a few month earlier.  While I was elated about the award, they were a few years off for the effective date!  They changed my diagnosis from that recent exam, and said that was the first time I got this diagnosis, and based their effective date on the apparent new diagnosis.  However, what they failed to recognized, was I already had that new diagnosis for several years prior. Therefore, I again disagreed and filed the proper form stating my disagreement with the effective date.  I made it specific that I ONLY want to appeal the effective date,  So after several months of not doing anything with my claim, they are trying to request that I get a new C&P exam for an "Increase disability"  They have all of the evidence, such as progress notes, medical treatment and even other C&P doctors  stating that I had that new diagnosis.  I don't feel that I need a new C&P exam!  What do you think about all this?  I am so sorry for all this writing.

 

[GBArmy]

Rambo 123 Sorry that you have been getting the run a round but as you realize, it is confusing trying to deal with the VA. The short answer is that they feel that there is clarification to be had by having a review at a new C&P. It is further development. Maybe, it has something to do with the conflict between the diagnosis/effective dates? You didn't say when you are scheduled, but I assume it is fairly soon. You should know that it is important to be sure you attend; otherwise you could be denied. You could try to contact the director at the RO who schedules the C&P's and state your reasoning for it not being necessary, but short of that go to the exam and see how it falls out. If it is bad, you can always appeal. 

[pacmanx1]

Actually this new C & P exam may not be a bad thing. It could have a result in you getting an earlier effective date for your 100% rating. It could also get you a P & T rating which could generate a retro payment and or extra benefits like CH 35, DEA Dependent Education, waiver of life insurance and other benefits that come along with being rated P & T. So It is not necessary a bad thing to have a new C & P exam.  We all have to go through it. As you stated that your progress notes are up to date, just keep going and it should go well.  Now if for any reason VA tries to reduce any of your ratings make sure you appeal. If VA grants you the wrong effective date, you can still appeal to.   

[broncovet]

I agree with the answers above.  Think of it this way.  You go to a c and p exam, say March 1, 2019.  The doc says you are totally disabled but does not give a date.  (often).  So, the va uses the exam date.  

    Understand what this means.  On Feb. 28, 2019, you are fine..no disabilities.  You go to an exam, and poof, you are 100 percent disaled.  Gee what did that doc do to you to make you disabled?  

    Instead, your doc should have said, "records show" you have been disabled since mm-dd-yy.  For example, that effective date may have been when you sought,

     You will need a new exam, but I recommend its worth it for this exam to be done by a doc on YOUR payroll, not the VA's .  

     I fought my (100 percent) effective date, and won, eventually, but only with lawyers fighting for me, and, yep, IMO's.  

     Its my opinion if you dont want to spend the money on imo's you wont get it.  HINT:  Some lawyers will up front IMO cost if they think you will win with an IMO.  My lawyer did.   

 

[broncovet]

Make no mistake.  

The va will fight you harder on the effective date than they did granting your disablities.  This is due to MONEY> 

    Most raters dont have the authority to cut you a 100,000 check.  So they just deny them.  You are gonna have to go before a judge, and he has the authority to cut you a six figure check.  But, that judge was a lawyer, and he wants you to hire a lawyer too.  

    In short, if you want your full retro (eed), get a lawyer.  I have been on this board over 10 plus years, and, never once did anyone ever win six figure retro represented by self or vso.  You need big guns, so get a lawyer.  Or, go home and settle with what you have.  

[broncovet]

Correction:  Berta could win this, but she was in the legal field and she knows more than many lawyers about va law.  

[blahsaysme2u]

42 minutes ago, broncovet said:

Make no mistake.  

The va will fight you harder on the effective date than they did granting your disablities.  This is due to MONEY> 

    Most raters dont have the authority to cut you a 100,000 check.  So they just deny them.  You are gonna have to go before a judge, and he has the authority to cut you a six figure check.  But, that judge was a lawyer, and he wants you to hire a lawyer too.  

    In short, if you want your full retro (eed), get a lawyer.  I have been on this board over 10 plus years, and, never once did anyone ever win six figure retro represented by self or vso.  You need big guns, so get a lawyer.  Or, go home and settle with what you have.  

i am about to win retro pay for OSA back to 2008 with bva and i used VSO. but i used my states VSO that provided me a free lawyer! this is sound advice, @broncovet. most VSO's out there i have tried were junk. i am currently using Virginia Department of Veteran Services! they are incredible. have been johny on the spot with everything. if you live in Virginia and you are using another VSO you are waisting your time and your tax dollars on poor help with the VFW and DAV, imho.....

Edited September 11, 2020 by blahsaysme2u