Jump to content
HadIt.com Anniversary 24 years on Jan 20, 2021 ×


  • veteranscrisisline-badge-chat-1.gif

  • Fund HadIt.com

    11%
    $175.00 of $1,500.00 Donate Now
  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

HadIt.com Anniversary 24 years on Jan 20, 2021
  • 0

Insufficient C&P exam, supplemental claim, TDIU, and other strategy


Question

Hi, new member here, longterm lurker.

I'm seeking advice on moving forward with my claim regarding loss of peripheral vision (code 6080), TDIU as a result. Specifically, I'm wondering if I should file the supplemental reopen to include EED, SC, and the TDIU?  Here's the timeline:

Initial VA claim in 2015 for numerous things including field of vision loss, back pain, lower leg numbness, etc. This resulted in only 30% service connected lower back arthritis, but denial on the vision issue.  By 2018, the back worsened and a few other issues arose, so I submitted another claim resulting in the back increasing to 40% SC, hemorrhoids 20% SC, lower limb radiculopathy 20% for 70% total. 

I did not appeal the vision due to lack of education on the VA claims process. However, I've done my research and found that my initial vision C&P exam was insufficient.  Per 38 CFR § 4.77 - Visual fields., the exam must be conducted using Goldman kinetic perimetry or Humphrey/Octopus automated. Neither of those occurred during my test. My vision test was outsourced via LSI (?) to a local optometry store. After meeting the doctor, he was informed that the "machine" was broken, so my test was performed manually using a tangent screen skipping Goldman. This is the basis for the insufficient exam.

After receiving my initial 30% in 2015 I entered into the VA for my medical care, as a part of that I indicated I had vision issues and thus began annual visits at the VA to get an exam and meet the ophthalmologist. My initial Humphrey scans did show significant loss of peripheral vision and I was transferred to the head of the department for follow on analysis. She did a full eye exam, could not find anything physical in the eye that might be causing the loss and recommended annual visits to track the progress. Fine.

3 years passed and each year the Humphrey test showed continued loss of peripheral vision.  In 2019 I started seeing the neuro-ophthalmologist who decided it was time to do more investigating and ordered a MRI and then later a CT Angiogram. The results of those tests was that once again no physical cause could be seen for the vision loss. I'm a Gulf War vet with 42 combat missions in the aircraft in 1991 and then a 2nd tour in the Gulf during Southern Watch during 1992. Additionally, our airwing was based and I lived at NAF Atsugi which has been highlighted for issues regarding a dioxin incinerator just south of base. I was going to name these issues to garner a SC but recognize that may be weak sauce. 

My left eye concentric contraction is around 15% and the right eye is around 20%. Based on the better eye this translates to 50% rating. 

The TDIU is something I've only recently thought about. I have issues with driving and going into busy stores is extremely stressful as I cannot see people coming from the sides so I avoid them. Previously, I owned my own business but prior to Covid I had already shut one location and sold another as I was reducing my workload due to my back and vision. In March I closed my last location and do not anticipate reopening because I don't think I can handle it. Physical labor is out of the question and the back/hemorrhoid precludes extending sitting and the vision is making driving near impossible and headaches are an issue.

Thanks for any advice on how best to further the vision claim and perhaps include some of those issues I've talked about. Any problems with reopening a claim based on an insufficient initial exam?

Link to post
Share on other sites
  • Answers 2
  • Created
  • Last Reply

Top Posters For This Question

Popular Days

Top Posters For This Question

Popular Posts

Yes, you can challenge the competency of the examiner. https://cck-law.com/blog/how-to-challenge-va-cp-exam/ However, if you are seeking "back" benefits on an unappealed claim, its more comp

2 answers to this question

Recommended Posts

  • 0
  • Moderator

Yes, you can challenge the competency of the examiner.

https://cck-law.com/blog/how-to-challenge-va-cp-exam/

However, if you are seeking "back" benefits on an unappealed claim, its more complicated than that. 

First you should have your file reviewed.  

If you did not receive "notice" of your appeal rights, you may still be within the appeal period because it does not begin to you recieve notice of your rights to appeal. 

Also, if you submitted "new evidence" in the appeal period, you have reopened the claim and you may not even know that, if VA didnt re adjuticate it.  

https://cck-law.com/video/how-to-reopen-a-va-claim-2/

Lastly, there may be CUE, but we would not know that until we reviewed your decision as well as your cfile.  

  • Like 1
Link to post
Share on other sites

  • 0
1 hour ago, broncovet said:

Yes, you can challenge the competency of the examiner.

https://cck-law.com/blog/how-to-challenge-va-cp-exam/

Thanks for the link I had not read that particular article. However, among my reading on the subject I found that there is a distinction between "insufficient" C&P exam and other challenges. It's somewhere in M21-1. My appeal window closed and I received notification of such at the proper time. As I mentioned I was fairly ignorant to the VA claim process so I just let it go by. However, it seems that in the instance where the examiner failed to follow the procedures as specified in 38 CFR § 4.77 the exam is considered "insufficient". In the specifications for CUE filings they specifically exclude insufficient exams as there was no error it's just considered not finished. 

2 hours ago, broncovet said:

Also, if you submitted "new evidence" in the appeal period, you have reopened the claim and you may not even know that, if VA didnt re adjuticate it. 

The "new evidence" is my now 5 years of treatment at the VA hospital in town along with recognition by the head ophthalmologist and neuro-ophthalmologist. I've also had numerous Humprey tests and one Octopus test on the eyes all showing loss of peripheral vision.

I believe from all my reading that the proper process is to reopen my claim showing the insufficient C&P vision exam and the new evidence from my VA treatment. Then, depending on how that is adjudicated, follow up with HLR or CUE. At that point I would push for EED as well. 

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Answer this question...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Ads

  • Ads

  • Similar Content

    • By shrekthetank1
      Now that i have reached P&T how does it work for the veteran with vision and dental?  Do we go to the VA for this or how does this work?  
    • By XIbodybag
      Filed a supplemental claim 12 days ago.  Sent a current diagnosis from VHA of combat related PTSD (they diagnosed me with other stressor related disorder at 30%) and evidence of symptoms and interactions with police that should put me at 50 or 70% in like 50 pages of evidence via .  Called 1800 number today to check on status and they said that it had already been decided for 10/20/2020 (tomorrow???) and no new C&P was given.  Does this seem a bit fast to you?  Does that mean its unfavorable or have you seen favorable decisions made that quickly?  
    • By scooter318
      Hi Everyone
      I want to file a supplemental claim but I was told that I have to fill out form 20-0995 and fax it to the office that sent me my denial letter. But I also wanted to know when I fax in the form do I also fax in the IMO the lay statement and the case law that I have as new evidence in support of my claim. 
    • By MMTOTZ
      Good morning all. 
       
      Hoping someone could shed some light on a couple things. I’m on second go around with Supplemental claim on the same issues, but this time, actually got to see a doctor through QTC that listened, and looked at everything with me.
      Tried for a higher level review, but missed the second phone call to schedule appointment, was in VA appt. 
       
      I called Peggy last week and they explained the DRO is requesting a records review from the doctor? 
       
      Last night I received a package from QTC explaining that a different nurse practitioner will be reviewing my records ?   I’m a little confused and wondering if this will bode well for my claim as this person did not see or speak with me. 


       
       
    • By wood78221
      May-
      1. Filed for increase on mental health condition (Depression 2nd to Tinnitus)
      2. VES exam, didnt go well, got reduced. Examiner said I had another condition, it wasn't service related, etc, etc. 
      July-
      3. Filed a supplemental with a DBQ from a private psychologist (looked like 50-70 percent)
      August-
      4. New exam from QTC, went well, probably around 70 percent 
      5.  VSO told me a few weeks ago they sent it back to examiner for medical opinion. I know the QTC examiner had mentioned that they did not ask for one in which he thought was odd during my exam in August. 
      September- 
      6. VSO told me today that they sent it back to the VES examiner from May, and the examiner basically regurgitated the same thing he already said. He already provided a medical opinion previously in May. Examiner said I had OCD (never been diagnosed by anyone in 5 years). 

      I am confused to why they sent it back to the VES examiner and not my most recent examiner? Could this be a mistake? Thanks. Not sure how this will pan out. 
  • Ads

  • Our picks

    • Post in New BVA Grants
      While the BVA has some discretion here, often they "chop up claims".  For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.  

      I hate that its that way.  The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.  
    • Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!

      My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.

      Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
        • Like
      • 13 replies
    • 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,
    • This is the latest Compensation & Pension (C&P) Clinicians Guide dated 20180719. The only other one I've seen is dated 2002, including the one on this website and the VA website. I got this from my claims agent, who got it from the VA.

      VA Compensation & Pension (C&P) Clinicians Guide 2 Final Corrected 20180719.pdf
      • 12 replies
    • I don’t say thank you enough to all of you...
      You, yes you, are the reason HadIt.com has remained a resource-rich resource. Thousands come each month to read, ask questions, or to feel a sense of community.

      Last month June 2020, we over 50k visitors they viewed over 160k pages. Veterans and their advocates, spouses, children, and friends of veterans come looking for answers. Because we have posts dating back 15 years and articles on the home page, they usually can find an answer or at least get pointed in the right direction.

      You all made that possible. Thank you.
        • Like
      • 8 replies
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines