Found random C&P exam

[Foxhound6]

Not sure who might know this, possibly @brokensoldier244th, but would there be any reason for a C&P exam being performed (in my record), without me filing a claim during the time I had the exam? It appears favorable with exception to the examiner making a remark toward the end.

I recall sitting down with someone from mental health during that time at the VA because I indicated my issues with mental health during my (presumptive from exiting active duty) left knee claim that was SC'd.

I just find it odd that, even with diagnosis and favorable findings, it was never listed as a disability or NSC disability. I never even knew it existed until recently

I can redact and post exam if needed. Thanks!

[pacmanx1]

8 hours ago, Foxhound6 said:

I did not have a rep then. Only recently. I dont recall getting notified of something but its been some time and I could have just as easily forgot that. Im just waiting on my cfile

Yes ,I totally understand, I am finding stuff on my CD C-File that I have had for a decade that I never knew which is changing a lot of things.

[Foxhound6]

9 hours ago, brokensoldier244th said:

Good point. I sometimes forget about those

It is a good point!
 

Once i get my C file, things will make sense for me. 
 

But from my reading, prior to 2015, the VA did sometimes initiate a claim based on record or an indicator in another exam (at that time considered an informal claim). Sometimes they did not follow up with it properly which has been coming back to bite them in terms of EED. 

Since 2015 they've required the Veteran or rep to initiate the claim formally (submitting the fully developed claim) or informally (filing an ITF). Prior to 2015, this wasn't the case. So it should be interesting to say the least.

[brokensoldier244th]

18 minutes ago, Foxhound6 said:

It is a good point!
 

Once i get my C file, things will make sense for me. 
 

But from my reading, prior to 2015, the VA did sometimes initiate a claim based on record or an indicator in another exam (at that time considered an informal claim). Sometimes they did not follow up with it properly which has been coming back to bite them in terms of EED. 

Since 2015 they've required the Veteran or rep to initiate the claim formally (submitting the fully developed claim) or informally (filing an ITF). Prior to 2015, this wasn't the case. So it should be interesting to say the least.

The rule still stands- if a rater comes across something in a C and P or the evidence that points to the possibility of another condition, they can infer and add it to a claim. Then it usually gets kicked back to us (VSRs) to schedule an exam for it, or go on a data mining exposition to try to find more incidents of it in the records on hand. The requirement for a specific form only is for Supplemental claims asking for a re-review, or a full on appeal, i.e. you can't file a new claim based on a previously denied condition on a -526ez. It will get kicked back to you, pending, and  processed as a review or appeal once we get the 0995 or 0996- if you ever send it in. That part we can't initiate for you, even the raters can't push an appeal in your name for you- you have to ask for one. 

[Foxhound6]

1 hour ago, brokensoldier244th said:

The rule still stands- if a rater comes across something in a C and P or the evidence that points to the possibility of another condition, they can infer and add it to a claim. Then it usually gets kicked back to us (VSRs) to schedule an exam for it, or go on a data mining exposition to try to find more incidents of it in the records on hand. The requirement for a specific form only is for Supplemental claims asking for a re-review, or a full on appeal, i.e. you can't file a new claim based on a previously denied condition on a -526ez. It will get kicked back to you, pending, and  processed as a review or appeal once we get the 0995 or 0996- if you ever send it in. That part we can't initiate for you, even the raters can't push an appeal in your name for you- you have to ask for one. 

Understood. Ill have to go back and look at the point made in the article i read regarding how they did things prior to 2015. Its more to do with the follow thru itself rather than the initiation or appeal. It had something to do with the way formal and informal claims were being done at that time. Thank you for the clarification, I don’t want to inadvertently give bad info!

[brokensoldier244th]

43 minutes ago, Foxhound6 said:

Understood. Ill have to go back and look at the point made in the article i read regarding how they did things prior to 2015. Its more to do with the follow thru itself rather than the initiation or appeal. It had something to do with the way formal and informal claims were being done at that time. Thank you for the clarification, I don’t want to inadvertently give bad info!

Yeah the informal claims part changed. They used to take itf on the back of a napkin and stuff. Now it has its own form. Much easier to find in the data base to check for during processing because it’s clearly labeled rather that being named “miscellaneous correspondence “ by the upload system.

[Foxhound6]

20 minutes ago, brokensoldier244th said:

Yeah the informal claims part changed. They used to take itf on the back of a napkin and stuff. Now it has its own form. Much easier to find in the data base to check for during processing because it’s clearly labeled rather that being named “miscellaneous correspondence “ by the upload system.

This makes sense. I guess once I get my CFile, I just need to see if they fully adjudicate it (final decision) or if it just got forgotten.
 

Then i can see what my next step might be

Edited October 1, 2020 by Foxhound6