avoiding reduction

[SPO]

I am mildly worried about the VA wanting to reduce my IBS rating at some point in the future, which is currently at 30% .  I went to see my VA PCP and he noted that I had "dramatic improvement" when he asked me how it was.  This is not what I told him.  I said it was a little better at the moment, but it is absolutely not dramatic.  I want use these records, which contain information on another condition, when I submit for another claim, but I don't want the VA to think this issue is getting better,  I just happen to be on a short stretch where it wasn't at its worst.  Should I avoid submitting these records now, or just send a message and/or get another appointment when it flares back up?  Other than some poor wording choices, this doc is very helpful.  He basically wrote a nexus statement in my records for my sciatic issues.

[GBArmy]

SPO I would do 2 things. If you use a VSO, or lawyer, I'd ask them to look up in VBMS what is the status rating on your disability rating sheet. It will either be "static" or, it will indicate another C&P exam will be required in the future. If it is static, there is less to worry about but still will be on their radar. If you submit a new claim, the existing disabilities you have are fair game for them to re-evaluate, and if you use some of those records as part of your claim, you may have a problem. The second thing I would definitely do is correct the record on dramatically improvement. Go onto ebenefits and use secure messaging. Ask the doc why he used those words; tell him your status and current conditions and tell him how that is going to potentially hurt your rating. Ask him to correct it. You want to address that record now, not later. I don't know how often you have flair ups but then when you have one and your symptoms are bad, ask for a doc appointment. When you get there, bring up the previous and remind him about he selection of his wording. If that doesn't fly, I'd consider getting a re-eval with an outside source if the send you a decision letter saying you are scheduled for a rating reduction.If your rating is 5 years or more or you happen to be 55 years old etc. you have some protections. The VA is not supposed to reduce your rating based on one follow-up C&P exam. That doesn't mean that they won't; they still could and then you have to appeal. You are right to be concerned; take action.

[SPO]

The last copy of my c-file stated all my conditions are static.  Would the secure email be the best way to ask him about this since it will be kept in my records that I disagreed?  Should I him his wording is concerning because it could result in a reduction?

[GBArmy]

I would put it in either; but if you use email, be sure to get it scanned into your  record. You want it to be part of your paperwork trail. In otherwords, you want it in your record that you took exception quickly, and of course, what he responded. Well, as for wording, your doc may be conveniently ignorant about the claims process. They don't want to be part of the claims process and they don't want to know. Period. But you said he seemed reasonable. So word it like "I'm sure you may not be aware, but the wording used and recorded in the record has a very significant impact on whether or not my disability remains the same, or could be downgraded in the future. So to say my condition was "dramatically improved" but realizing it is just at a point in time and can, and will flare up again, puts my disability in jeopardy at a future evaluation. That wording can be taken out of context and result in serious financial impact to me." Something like that. The objective is for him to identify his incorrect wording, and correct it in the record. If you can do it outside  the written word, fine. But you still want to be on record as taking exception to his original wording, and, you want a correction. 

[broncovet]

Key issue is if have been rated over 5 years or its permanent.  Knowledge beats fear.   So read this OR worry:

https://www.law.cornell.edu/cfr/text/38/3.344

and

https://www.law.cornell.edu/cfr/text/38/3.105

    When you understand, the VA:

1.  Has to give you 60 days notice

2.  Has to give you  an opportunity for a hearing

3.  They have to show you have "actual improvement" under ordinary conditions of life; that this is sustained improvement, and cant reduce you based on an exam that was less thorough than the c and p exam which got you rated.  

   And, has multiple hoops to jump through before they can reduce you, it should set your mind at ease.

Edited December 17, 2020 by broncovet

[Buck52]

I've learned over the years to never tell a VA Dr or even a Private Doc  not to say ( ''its better'') I always say  when they ask me how I am doing or how is your condition?  I always say well its about the same Dr  I take my meds as prescribe on the bottle, but all in all my condition is about the same.

Never tell a VA Dr  your condition seems to be doing better...they take that as a huge improvement  and that's a feather in their cap so-to-speak.

(not saying they are trying to get your rating reduced )  but its just an ethical thing with these Dr's

but with this said  never dwell on what if's ....

you may never get a notice to come to a C&P for your  s.c. condition.  if you do  just deal with it then.  just wait until the what if's comes around.

[broncovet]

I agree with Buck.  Dont tell them you are "better", tell them you have good days and bad days.  Dont lie, but also dont open your mouth and let the flies in and lay eggs in your mouth.   

Edited December 17, 2020 by broncovet