Jump to content


  • veteranscrisisline-badge-chat-1.gif

  • Fund HadIt.com

    168%
    $2,528.00 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

  • 0

PLEASE ADVISE AS TO HOW RESTRICTED CLAIMS FILES ARE


Question

My C&P report was so F'd up that the doc has disciplinary exposure with the State medical Board and even a civil action. I am offering her a chance to avoid any complaints. I want to honestly tell her how hard it is for anyone not working on my claim to access the claim file. Please advise.

I would like to be able to tell her that there is a snowball's chance in hell that anyone (particularly her supervisors) on the West Coast will find out she has owned up to and corrected her errors. Is this true? Citations to controlling regs would be great.

Thank you.

Link to post
Share on other sites
  • Answers 59
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

Popular Posts

This is just my humble opinion, but I think you are missing the point. You have the right to challenge a negative medical opinion any way you deem fit, but the simplest way is to get a positive medica

All I can suggest is , if the remand does not award the claim or at least the Brain injury and TDIU, another strong  IMO/IME would be in order. I had two very strong IMOs and a brief freebee opin

"Medical personnel have statutory immunity from “individual” malpractice liability while acting within scope of employment. A VA physician cannot be sued in civil court for the malpractice (tort) clai

Recommended Posts

  • 0
  • Moderator
Posted (edited)

https://www.va.gov/FOIA/docs/Updated_Documents/Sample_FOIA_Request.pdf

i Would send a request for my C-File at my R.O. AND ONE TO THE INTAKE CENTER

Requestors should mail or fax their FOIA requests to the Intake Center in Janesville, Wisconsin, Department of Veterans Affairs - Claims Intake Center, P.O. Box 4444 Janesville, WI 53547-4444, Fax: 844-531-7818 or DID: 608-373-6690

If you seek other benefits records maintained by VA, to include Vocational Rehabilitation & Employment, Insurance, Loan Guaranty or Education Service, you must submit these records to the FOIA Officer at the VA Regional Office serving the individual's jurisdiction, or to the FOIA Officer of the VBA, VA Central Office.

Here is a PDF Link to the FOIA Form

https://www.vba.va.gov/pubs/forms/VBA-20-10206-ARE.pdf

DO NOT FOR GET TO DATE IT AND SIGN IT.

 

 

Edited by Buck52
Link to post
Share on other sites

  • 0
  • Moderator

I agree with Buck.  A c and p exam is "a doctor's opinion" on your condition. He is not treating you, and he wont be sued for malpractice because he has a different opinion on your condition than his peers.  All doctors have difference of opinions. 

If you dispute information contained in your c and p exam, my advice is to do the following:

1.  Ask for the records in question to be amended (changed), by following this regulation to the letter:

https://www.law.cornell.edu/cfr/text/38/1.579

2.  If the competency of the examiner is in dispute, then dispute his/her competency as explained here:

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

3.  If the above fails, then you can refute an unfavorable exam with a favorable exam, by hiring an IMO/IME to refute the exam.  

Link to post
Share on other sites
  • 0
  • HadIt.com Elder

You have three separate topics her and it is confusing me-

I assume this is your remand:

https://www.va.gov/vetapp18/files11/18148874.txt

Have you had those C & P s yet, that the remand calls for?

Have any of them- and particularly the one for the main issue-the brain injury due to proven toxin exposure,already been done?

Or is it that you expect another crappy exam for that issue?

You do have a good claim,but like many of us you have gotten lousy C & P exams,which many of us have overcome with medical evidence, that most often warrants a strong IMO/IME hat will knock down the C & P results with a full medical rationale.

I hope other will take the time to read the Remand.

You said:

"My C&P report was so F'd up that the doc has disciplinary exposure with the State medical Board and even a civil action."

If you mean the older C & P exam, documented proof of that would help challenge any new C & P exam that also might be  " f'd "up.

You had two strong IMO/IMEs in the BVA decision----TDIU also depends on the remand .

Would Dr. "P.L." be willing to do an additional opinion that covers the remand questions that the VA examiner will have to answer?

(a) For each currently diagnosed neurological, state whether the disability clearly and unmistakably existed prior to the Veteran’s active service. In responding to this question, the examiner is advised that “clear and unmistakable” means that the conclusion is undebatable, unconditional, and unqualified, and cannot be misinterpreted or misunderstood.

(b) For any currently diagnosed neurological disability that DID clearly and unmistakably exist prior to service, the examiner should provide an opinion as to whether that disability was clearly and unmistakably NOT aggravated by service. The examiner should comment on the Veteran’s pre-service history of a head injury and multiple grand mal seizures as well as his post-service concussions. Additionally, the examiner should specifically address the Veteran’s conceded exposure to toxic jet fuel, chemicals, paint fumes, and assorted solvents during service; service personnel records regarding the Veteran’s character of discharge; and the Veteran’s history of alcohol use.

(c) For any currently diagnosed neurological disability that did NOT clearly and unmistakably exist prior to service, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that such condition is etiologically related to the Veteran’s active service. The examiner should specifically address the Veteran’s post-service concussions, prolonged exposure to toxic jet fuel, chemicals, and assorted solvents during service, and service personnel records regarding the Veteran’s character of discharge. The examiner should consider the relevant STRs discussed above, the conflicting opinions of record, and any medical articles submitted by the Veteran. The examiner should consider that the Veteran’s lay assertions alone are not a sufficient basis to determine that he clearly and unmistakably had a neurological disability that pre-existed entrance to active service. Further, the lack of medical treatment or diagnosis of a neurological disability during service alone is not a sufficient basis to determine that a neurological disability was clearly and unmistakably not aggravated during active service. The rationale for all opinions expressed must be provided."

 

 

 

 

 

Link to post
Share on other sites
  • 0
  • Moderator

I was a little bit confused too Ms Berta

Maybe he means how restricted our files are to look at  via VBMS?

I know it takes the higher ups at the VA VSO's VSR's and a VA Approved Attorney's and Certified Accredited VA Claims Agent's to have access or security clearance to be able to get into the VBMS.  IF so then I'd say its pretty well restricted.

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 retiredat44
      who else had c&p doctor say a surgery was procedure not surgery. The c&p doctor argued and said that a Procedure is Not Surgery.
      Surgery for Pancreatic Cysts | Memorial Sloan Kettering ...
      https://www.mskcc.org/.../surgery-pancreatic-cysts Named after a surgeon who worked at MSK in the 1940s, the Whipple Procedure (also known as pancreatoduodenectomy) is used to remove cysts in the head of the pancreas. In this approach, surgeons remove not only the head of the pancreas but also part of the small intestine, the lower half of the bile duct, the surrounding lymph nodes, the gallbladder, and sometimes part of the stomach.
      a link, many links say:
       
      ==================
       
      This c&p was about my pancreas surgery that ended up being a 6 month month hospital stay ending with necrotizing pancreatitis and liver disease. They went with endoscope and cut the wrong thing. It took over a decade and the BVA and 1151 claim to fight these crooks. He insisted there was no surgery for his report. I call it another page of dirty tricks used by VA C&P ! IMHO
      I know this has been hashed over and while already adjudicated, well not quite done yet (still might have to file appeal, but my VA rep still tells me I have to wait until they get done denying me. I have until December 2020 to file a disagreement of their lowball 1151 percentage), but I have to live with it and constantly suffering thinking about all the B.S. the VA put me through for 20 years of the denied claims !
       
      Yes
      ACCORDING TO 3 SOURCES         Pancreatic Cyst Gastronomy Pancreatic cyst gastronomy is a drainage procedure that an advanced endoscopist or surgeon may use if a pancreatic pseudocyst—a fluid-filled sac—develops in the abdomen and causes symptoms such as pain, the sensation of a full stomach, or vomiting. Surgery & Endoscopic Procedures for Pancreatitis …
      nyulangone.org The Whipple Procedure (also known as a pancreatoduodenectomy) is used to remove cysts in the head of the pancreas. Surgeons remove the head of the pancreas; the duodenum, part of the small intestine; the lower half of the bile duct; the surrounding lymph nodes; the gallbladder, and, in some cases, the pylorus, part of the stomach. Surgical Oncology Program - Pancreatic Cysts
      surgicaloncology.surgery.ucsf.edu Surgery is often a good option for treating a pancreatic cyst. Young, healthy patients may prefer this option to draining, as it is often the most effective approach. It is also usually the preferred method if a biopsy indicates the cyst may become cancerous. What Is the Treatment for a Pancreatic Cyst?  
      wisegeek.com   https://www.mskcc.org/cancer-care/types/pancreatic-cysts/treatment/surgery-pancreatic-cysts    
    • By kent101
      My provider's name appears on the front of the letter where it can be seen by anyone. Isn't this a breach of veteran's privacy?
    • By bolt_vet23
      Morning,
      Just wanted to let everyone know that after 9 months of submitting a FOIA request for a complete copy of my C&P file, my claim was closed yesterday since it was apparently processed.  There was no movement on it up until this week when I decided to have my congressman submit a congressional inquiry on my behalf.  I also emailed every organizational account at http://www.oprm.va.gov/contacts.aspx and notified the Department of Justice FOIA office at https://www.justice.gov/oip/contact-office.  Not sure which one ended up pushing the VA to actually do their job, but my claim was closed a few days later.  I really regret waiting this long to take action...should have notified all of them on the 31st day after the original submission.  
      Bolt
    • By Ginterkill
      In hopes that this is the correct site, and this is the correct forum, upon permission from the site moderator I will post the tactics, methods, and stratagems that I have employed after being incorrectly labelled, and with malicious intent, a Category One Violent and Disruptive Patient. Commonly known as a Patient Record Flag (PRF). I have made extensive use of the Privacy Act of 1974, and the Freedom Of Information Act (FOIA), and stand ready to present the official documents verifying what you will not believe without documentation. You just will not believe it.

      The PRF in my case was originally issued by the Manager of the Community Based Outpatient Clinic (CBOC). According FOIA documents obtained by me, along with the official letter from the Chief Of Staff, in an act of shear either stupidity, or arrogance said precisely why they had so labelled me.

      What did I do, according to the official letter sent me by Chief of Staff, and the minutes of the DBC that got me labelled as a Violent Patient?

      FACT: I went as a private citizen to the Circuit Court building about a five-ten in walk from my apartment. Filled out a simple to fill out form regarding some disturbing telephone calls made to me by the clinic manager, who threatened to terminate my care (100% schedular vet), if I did not stop FAXing complaints about chronic medications shortages. The Judge, under a State Statute issued a Restraining Order To Prevent Further Abuse, naming myself as the protected person, and the CBOC manager as the Molester.

      This was possible in my State, because of a seldom used version of the Restraining Order mechanism that allows a disabled person to beg the court for relief if they become threatened by anyone within state boundaries with the discontinuation of medical care. Please note that this particular statute was available to me ONLY because I qualified as a "Person with a disability".

      The RO was obtained legally, and with merit of fact. NEVER LIE! This gives the enemy the means to defeat you.


      Details will follow upon approval by admin, so place and names and exact legal statutes will be withheld until I am granted permission.

      FACT: The VHA in official letter to me, and confirmed by FOIA documents, placed a Category One Violent and Disruptive PRF overtly onto me with the stated reason that I had obtained a Restraining Order to Prevent Further Abuse which named me as the protected person and the CBOC manager as the "molester". (Act Name - statute will follow later). Please note that a Restraining Order is issued by a Circuit Court Judge. So, they issued a PRF because a Circuit Court Judge ordered them to cease "further molestation by the protected person"


      Please note this is nowhere near a simplistic case as just those two initial facts. It grew into a colossal Civil Rights abuse, Criminal Abuse, and a whole lot of other types of illegal abuses.

      FACT: They picked the wrong Marine to pull this on.



      That is enough for now. It is going on 3 years now and the "keystone cop" antics that ensued trying to cover up that first enormous judgment error of their part might be deemed hilarious if not for the fact that people have died because of this stuff.

      I have completed 19 interviews with the press over an extreme example of government gone horribly astray, story nearly about to break. I have multiple documents sent to myself and my congressman trying to explain away the treatment directed towards me. The Oregon State Police (yep, for facts and proof not listed yet, they confirmed to me that VHA employees involved in an incredibly convoluted case was of "...a magnitude and scale we have never seen before." They have referred it to the State Attorney General for prosecution, and pleaded with me two years ago to be patient and not go to the press with the material facts until they make public the indictments, for fear the perps will become alerted.

      This is big time stuff. What they did, and in three years over this my local VA facility is now on Chief Of Staff #4, and virtually every one of the players in this tawdry affair have been booted for life from government service.

      WHAT I WILL NOT DO IS POST SPECIFIC NAMES OF VHA PERSONNEL! This is not the time in our country to stand up out of a sense of vendetta. We cannot do the honorable thing if we disregard the individual rights of these people and be willing to stand tall for them too! Besides, the list is growing beyond my measure to report on. This is a big thing.

      I am a Marine. A Marine is not the Judge, or Jury, and we damn sure are not serving our country to bring harm upon our fellow citizens. I am 100% rated. I have nothing to gain monetarily nor will I accept any blood money in return for withdrawing my efforts. Beyond that moral code, as a practical matter focusing on just singular incidents and narrowing the scope to that will go nowhere. My stratagems successfully, though painful to me, work. I am of the opinion that when you see my evidence, you will agree and see the light at the end of the tunnel.

      I raise my glass to you in hopes that the light you see is not the headlamp of the train!

      I will stand up for what is right until my last breath. I am a United States Marine. I can do no less.


      I will leave this post now with the oft quoted phrase from that text The Art of War, by Tsun Tsu, "He will prevail who knows when to fight, and when not to."

      Semper Fi
    • By hedgey
      I wrote a thread a while ago about Nosey Parkers and how non-vets (and many vets, too) react to Disabled Veterans and the benefits, etc., some of us receive.

      I don't remember what made me write about it before, but this time it's because of something that happened this week.

      My took me & my car over to Sears so I could get a tune-up, tires changed to summer tires (up north here!), etc. After the work was done and I was about to swipe my card, I asked the salesguy if there was a military discount (trying hard to get in the habit - a lot of places here offer them).

      He said, oh, if only I'd asked at the beginning, because Sears has a whole separate fee chart for military customers, and I would have had to have the work done under this classification, nope, nothing he could do. Next time, let them know right away. He said usually they ask the customer if they're military because they look military. (I guess my chubby gray-haired self does not.)

      So okay, my bad, I'll ask at the beginning next time. He said the whole store had the discount, so I'll keep it in mind. But he'd seen my MWR card, and asked "so you're a disabled veteran? What do you get for that, do you get paid for that?" I said it was like a military retirement and my kid was steering me out the door because she could tell I was getting stressed.

      When DH was heading over to the VSO on Friday, I knew he'd be going back to work. I asked him NOT to discuss it with anyone except to let his boss know where he was going. Then yesterday, while we were spending the day in bed (talking, not rumpussing, we don't rumpus any more (blush!)) we talked about who we could/should tell.

      I voted that he only tell his boss (so he can start thinking about retiring or whatever, but boss needs to know about his status & state of health) and the one other guy he knows is 100% ..... this same guy was the fellow that told DH he should be going to the VA for healthcare back in 2007. Nobody else needs to know.

      Why be so stingey with good news? Because the others don't have a clue. Non-vets have no idea what we have traded for the compensation that we finally receive, after fighting tooth and nail, or being afraid to file for years, or not even knowing we had the option. No one else knows about the pain and suffering.

      People will say (the woman at the farm store who was gossiping with another customer about a veteran who'd just left the store was saying she has so much pain in her shoulders she could cry, but she doesn't have any one to file a claim with.... must be nice...)

      That's it.. that's the phrase. "Must be nice." Yeah well, it would have been a lot nicer to have come home in one piece, finished college and become a psychologist like I'd planned. It would've been nice if my DH had been able to move up and become a General like his cousin (no, really, Mikey just made General!)

      Instead, we've suffered physical and emotional pain for 20, 30+ years. We will NEVER heal. Now old age is creeping into the picture and the future holds more pain than ever.

      Anyway, NOBODY needs to know that you're a disabled vet except the person at the checkout when you're getting your discount. If they ask, tell them it's a kind of medical retirement deal. If you just have your VA health card (most places will give you the discount with just that) and they ask, tell them the same thing. If they ask how much money, tell them it's "Not as much as I would've been making if I hadn't got hurt!".

      My DH will never be able to pick up his grandchildren (whenever they come along). I'll never be able to take them for walks or chase them around the yard. We aren't old, but our bodies have aged us and our minds and medications have us acting like dementia is our middle names.

      Okay, this isn't a whine & sneeze party. It's about saving yourself some heartache and keeping your status to yourself. People gossip and your neighbors will think you're rich and living off 'free' money from the government - their tax money!! You might expect that your neighbors, etc, would think better of you, respect your sacrifice, but more likely they will feel envy.

      I'm sorry if I have a dark view of people. I wish I could believe better things. I just know first hand that envy is powerful and alive and thriving in the hearts of those around us.

      I also should tell you this. When I first got my 80% a year ago, my VA primary care person at the time wanted me to go to a special physical therapist for my feet, for more therapy than the VA would allow (hydro massage stuff). She wrote out the prescription on her personal pad and handed it to me. She said "the VA won't pay for this, but with your new rating, you can afford it." Uh..... okay. She doesn't work there anymore, so I don't know what happened. I didn't complain to anyone, but I think she might've been getting payola or whatever. It was weird.

      I was upset, because yes, I got an increase, but she also knew that my private insurance wouldn't cover it either. She wanted me to go 3 times a week! Can you imagine what that would cost? Besides, that dang increase had come along just in time to stretch the months so they would meet, not in time for me to have money to burn!

      Point of my rant is that nobody else knows your situation. People say "oh, they get money from the VA, they can afford XXX." Ever look at the expressions on the faces behind you in line when you're asking for your military discount?

      I'm done now. Sorry for being fretful and paranoid.

      Thanks for being a place to get things off my chest.
  • Ads

  • Our picks

    • I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently 
      • 10 replies
    • 5,10, 20 Rule
      The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
        • Like
      • 53 replies
    • 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.  
        • Like
    • 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
      • 18 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,
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines