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PLEASE ADVISE AS TO HOW RESTRICTED CLAIMS FILES ARE

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Otrgypsy

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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.

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  • HadIt.com Elder

I also Suggest you go to Myhealthvet and read your progress notes of the report your Dr wrote up and make copies  and next time you see this Dr confront her/him with these notes  that are not true.

   Every VA Dr  P.A. /N.P. LVN/ R/N /Dentist  ect,,,ect,,,,,, CERTIFIED MEDICAL PERSONAL  must write out a medical report on each veteran they see, you can copy these notes and confront the Dr. about the report.....but you better do it in a nice and civil way...the Dr also has a right to due process of law.

They are not allowed to change anything they write in their medical notes   however they can write out an addendum to make a correction. 

However you need to recheck YOUR RIGHTS UNDER THE HIPPAA Law.

Edited by Buck52
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I dont think there are many actual VSRs here at hadit-

Most of us are  unpaid volunteers, and I have been  helping vets since 1983.

In all of those long years, -in my opinion- the single thing that denies most valid claims , can be a lousy C & P exam.

Most C & P exams these days  are farmed out to QTC, VES, and LHI and can be challenged with the firm who hired the doctor. Vets here have done that when they acted swiftly to contact those entities- their contact info is available under a search.

They can overcome a lousy C & P with an IMO/IME from a real doctor- someone with expertise in the field of their disability. An IMO /IME doctor will give the first thorough reading a veteran's medical records and other relevant files , they will ever get.

Veterans have never done anything significant  to change this part of the arbitrary nature of the VA claims process. Yet many veterans do get a fair C & P exam.

You are on Remand- you might get a fair C & P exam on your main issue.

If it is done by QTC, VES, or LHI you can challenge it with the firm who hey work for- right away.

Our former President established a White House  Hot Line- to help veterans with complaints against the VA.

A complaint I made to the  WH Hot line ( long story) caused a Bill to be developed in Congress regarding VA malpractice  issues :

"S.221 - Department of Veterans Affairs Provider Accountability Act116th Congress (2019-2020)"

https://www.congress.gov/bill/116th-congress/senate-bill/221/all-info

 

Since non of the sponsors-co sponsrs were veterans, and had never dealt with the VA medical system, I had to send them additional correction to the bill.

It passed the Senate and is in the House -with the H VAC.

Covid held it up.

"Official Titles as Introduced

"A bill to amend title 38, United States Code, to require the Under Secretary of Health to report major adverse personnel actions involving certain health care employees to the National Practitioner Data Bank and to applicable State licensing boards, and for other purposes."

If the VA finally does that ( the NPDB mandate has been in existence for years, yet the VA ignores it)

it can certainly change the high level of malpractice at the VA.

I have another Bill at the H VAC as well- have not checked it lately-

Veterans can propose  Bills to Congress/Senate themselves. Any American can.

The Bill should mandate that C & P examiners assess every disability correctly by addressing all medical evidence the veteran has.

Also the Bill should call for an expert in the field of the disability to perform the C & P exam and the results should be readily available to the veteran , with an immediate option to obtain another C & P ,if the examiner's epertise is inadequate.

C & P examiners should have their identity and License #public on the exam so that the veteran ( or their survivor) can run them through the NPDB and all state licensing Boards , to see if they have been disciplined in the past and/or have been named in a FTCA matter)

The White House Veterans Hot line # is 855-948-2311

I dont know if it is still working due to new president.

My husband never got any denials on his two claims pending at his death.

When I became th claimant on those claims and other claims regarding his malpractice and also SC disabilities EVERY C & P exam I got was completely wrong-

The last one I got was done by a VA doctor who did not handle patients,for diagnosis and treatment and she said the C & P exam had been done "in person"-with the veteran but my husband had been dead for over 2 decades by then and I called the WH Hot Line to complain.

But I also had filed a CUE immediately, a day  after getting the denial and the VARO reversed their decision to an award in 3 weeks..

1151  HBP contributing to death

 

 

 

 

 

Edited by Berta
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I agree, a bad c and p exam is murder to your claim.  But, IF YOU ARE AWARE of the bad c and p exam, AND if you are willing and able to fix it (and have the resources to do so), then you can overcome.  

Too many Vets go to appeals (especially represented by a VSO) with a bad c and p exam "and dont even know it".  

The best you could hope for, is a remand, but the remand wont always explain you need an IMO to win it either.  

Bottom line:  Check you Caluza's.  YOu can do it, you just have to read your cfile.  

Years ago, I thought "well, Im pretty sure this is related to service" and did not check to see if it was "documented" that it was related to service.    There is a difference.  

However, on my first claim, I had an in service event, current diagnosis, AND a good nexus and still got denied.  

When I appealed to the Board (2002), I noticed:  "Gee the audiologist opined that it was at least as likely as not related to service".  So, I told the BVA highlighting what the audiologist said.  So, I reasoned, if the audiologist said it is related to service, why did the VARO say "No"?  

Later I figured out "why"..because the VARO was lazy, top sheeted my claim and did not read it and look for the nexus.  They also "convieniently forgot" to notice that I had written an email (they had in their possession) explaining I was out of work and could not find a job.  (THAT is a reasonably raised claim for tdiu, and I argued that later..when I fought for an EED)

The hamster wheel VA put me on for decades resulted in me losing my home.  I could not hang on and make the payments with virtually no income.  

When I figured it all out, I was determined to "get those back benefits" and get my home back.  I did just that, but it took 17 years to correct those VARO mistakes, since VARO fought me tooth and nail "even with a perfect nexus".  

It did not help, that, after I won at the BVA in 2002, the VARO "implemented" my decision saying I was SC and deserved 0 percent.  GRRRR.  

They (VARO Cleveland) kept blowing it, and I kept getting angrier and angrier..until I filed a writ of mandamus in 2008.  Low and behold, even tho the Pro Se writ was denied, I magically got my full benefits 2 months later.  VARO had "promised the judge" to "perform certain actions" to address my "concerns", and asked for a dismissal.    The judge gave them the dismissal (denial of the writ).  But, the writ did its job, winning my beneftis, but allowed VARO to sweep their ineptitude under the rug, and continue doing the same "business as usual".  

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  • HadIt.com Elder

I would think you can request another C&P Exam with different Examiner...if your reason is within good reason the C&P Chief may order you another new C&P Exam

If you have been denied remember you have 1 year to make your Appeal

As for as you wanting to get revenge on this Dr , it could be more beneficial to drop that and go with another IMO/IME  as stated in the above post by Ms Berta and Broncovet.......Other wise you could be caught up in a legal Battle For Years to come.

I remember like broncovet  I had a VA C&P Examiner botch up my C&P EXAM, I over came that with a private Specialist with a IMO/IME....for years I wanted to kick this VA C&P Examiners ASSPEROLO  its  good thing he finally retired  and I was not the only one that felt that way.

Sure it was unfortunate I/we had to do that  but that's just how this crazy VA System works  and I lot of Veterans do not realize this. 

Edited by Buck52
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He is on Remand- and will get a new C & P exam.

If that exam is bogus he can fight back right away.

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Buck, you just brought up another major problem with the VA. I had a lawyer. He talked an exceptionally good game, he knew enough about toxics to make me believe he would be a proactive aggressive lawyer, and I am not one to trust lawyers. He snowed me good. I only checked with him annually while waiting for the BVA. The result came down and as noted by Berta, it's really pretty good. But their worst incredibly harmful errors like the bullshit claim that my exposures didn't start before an exam (caused by my exposures). I eventually learned this scum bag was a scam artist just babysitting claim numbers, waiting to collect the low hanging fruit that comes from the VA correcting a lot of  its own errors which it will do, if you have a lifetime to wait. He never even filed a letter brief with the BVA, the only errors they found they found on their own. Things went south from there. In the beggining of 2019 he was saying the right thing to do was nothing just wait for the "upcoming" exams and then sandbag with legit reports. Sandbagging is for scum lawyers that don't have strong claims. I filed a complaint against him that in California would have caused his immediate investigation, the cancellation of his lien and by now he would have lost his license or still be fighting to keep it. That was 17 months ago. The VA can't do shit right. I forced him to withdraw because in most jurisdictions a lawyer on a contingent fee that withdraws basically waives his fee. Then I learned that no competent lawyer will talk to me, because of the lien. a Lien that I know is based on no more than 2.5 hours of lawyer work.

So, now because of the VA's refusal to discipline the lawyers they accredit and certify as qualified they are blocking my constitutional and statutory right to a lawyer. NO lawyer will talk to a Vet with a lien, because the VA inserts itself where it doesn't belong - into the eventual division of fees. and I have been told that that adds years to the lawyer getting a fee, so they won't get involved. This is the VA blocking right to counsel. They should be hung!!! VSO's are as useless as tits on a boar. In civil work, this never happens the lawyers are just left to either behave like adults or sue each other. More bullshit, the VA "protecting" veteran's, by f**king them.

Because I am representing myself, no REAL experts will talk to me. Neurologists are the hardest experts to find. I need a good neurologist specializing in the brain - CNS.

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