PLEASE ADVISE AS TO HOW RESTRICTED CLAIMS FILES ARE

[Otrgypsy]

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.

[Buck52]

To Answer this question

''PLEASE ADVISE AS TO HOW RESTRICTED CLAIMS FILES ARE''

They maybe different opinions as to who can see our claims file  if your meaning our C-FILE?

Normally the claims file is highly protected at our respected  V.A. Regional Office.

IF YOUR MEANING PROCESSD OUT CLAIMS APPLICATIONS it is who ever the VA Claims Intake Center sends the claims too  different RO across the country that are less busy with logged down claims  the lesser busy R.O. will normally get the claims   and it's who ever gets the claims VSR (raters) or this senior rater   a DRO may get the claim depending on which lane the veteran choose to process his/her claim

There are different levels in the claim process  and its now in a AMA system which was implemented Feb 19 2019

As stated above the C&P Examiner is sent our files (records) about a week before our scheduled C&P Exam  they look at our files on their computer read them study them, so they will be up to date during your C&P Exam   and they ask question as you most likely know this.

so by now its to late to make any changes in our records  this change needs to be amended by the Dr before the C&P Exam.

other wise if the C&P Examiner gives a bad report  or your denied because of his report ...then you will need to Appeal that decision and you have 1 year    during this time you will need to seek another Dr TO REUTT what this C&P EXAMINER MENTION  IN HIS C&P and this new Dr needs to give his medical opinion to the contrary of the C&P Dr THAT IT IS LEASET LIKLY AS NOT  OR IS LIKLEY AS NOT  *****IN YOUR FAVOR a specialist is best to use for this ..this is what we call over come a Bad C&P that caused our claim to be denied.

THIS IS ALL I KNOW TO SAY most higher ups WITHIN THE VA EMPLOYESS WILL NEED TO BE CERTIFIED AND VA Approved for them to access your files. and they need a security clearance to do so.

I hope what Ms Berta mention above and broncovet mention  will help you understand the system a little better.

As for as receiving Payment here on Hadit  Not one of us get a dime  THIS IS ALL VOLUNTEER WORK and the satisfaction helping Veterans  WIN their claims is our reward.

So not everyone can look at our files  they are protected under rules and regulations to many to mention    so our files are only looked at by the VA Personal who work our claims  be it VA INTAKE CENTER EMPLOYEES WHICH ARE VA Employees VSR's DRO's  BVA Judges &  haired Attorneys  & VA Accredited Claims Agents and so on  for compensation purposes all that are Accredit by the VA.

You being an Attorney I would think you should know most of this that we been letting you know, VA Law is different from General Public Law  They make their own regulations and is passed through congress and other committees .  as Ms Berta Has helped with.

but That said I do not know that much about it.

[FormerMember]

Lotsa talk but no real answer to the member's original question. 

If you have a VSO or VA attorney/agent representing you, they, and only they, can view your efile online in VBMS. There is no such thing as a paper claims file anymore. At the VARMC in St. Louis are all the remaining, inactive ones. If the Veteran reopens an old claim, they scan it and convert it to an electronic record. 

If you work for VA and have a claim in, you must have your file maintained in St. Paul (VBA 335). St. Paul is a RACC office.  RACC stands for restricted access claims center.  That is what VA calls a "restricted" file. I filed a VAF 21-22a on myself and can see my own efile in VBMS but my VA contacts insist it's against the law for me to do so. I'm considered a VA employee by law because I have access to VBMS. 

Now, with that said, if one of my clients is getting shafted, I can call my VA Change Management Agent CMA) and ask her to look in the client's efolder and see if a mistake was made. Not a rating decision but a mistake such as another Vet's documents inadvertently put in his/her file or incorrect info relating to a claim. Sickels v Shinseki grants the presumption of regularity to all VA personnel-including subcontractors like LHI/QTC or VES. If I don't represent you, I cannot see your file online. Anyone on a team doing your claim can view it. Once a decision is promulgated, the file is closed for viewing unless an ancillary decision will be adjudicated from the decision. Once all that is complete, the file is not accessible unless you have the need to know-such at your representative.

VA personnel are far too busy to go off the reservation and start looking at files they aren't working on. VBMS also leaves a trail showing who's been in your file to ensure privacy. There is a lot of data in there that could be used against a person-including HIPPA data. The M 21 computer is the one who automatically "remembers" you are almost at the 5-year mark (or 20) and decides to reschedule you out of the blue for a c&p to confirm your "disability" has not improved. 

Right now, VAROs and DROCs have the capability to do 8,000 claims per day per USB Tom Murphy. Currently, the OAR/NWQ is dispatching 6,000 +/day as that is all they have ready for a decision  to be made. VA is getting caught up by just churning out decisions en masse without proper development. This process began in earnest in March last year with the advent of teleworking from home. Yesterday morning, I see in CASEFLOW I won a Blue Water Squid's MDD due to CUE at the BVA (VLJ J. Parker) all the way back to 9/17/2002. I tried very hard ahead of time to convince them they were wrong but they refused to listen. They even refused to CEST the CUE for me until I blew an ass gasket re due process. Boom. 6 days later they granted-but with an effective date of 12/05/2020-the day I filed it. 

Last year, the VA did away with our being able to review a rating decision for up to 48 hours to correct it or point out an error. Yesterday, they announced they are bringing this process back. What does that tell you? VA justice is getting worse every day. And that's all I'm going to say about that...

Edited March 26, 2021 by asknod

[broncovet]

You posted:

Quote

 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.

Back up here.  Ok, you said you "got a good result" (from the lawyer), but were (apparently) upset with the effective date being the date of the exam.  

You are right that most lawyers "dont want to touch you" if you are in a dispute with your last attorney.  

Most Vets advocates "do not" recommend "changing your representative" in midstream, tho sometimes that cant be helped.  

I would have advised you to go ahead and compensate (the old attorney), and, if unsatisfied with the Board decision, you can appeal it, (especially the effective date). 

Its not to late to still do just that!  You should simply contact the old attorney, and ask him (how much) you owe him for the work he did.  Its my opinion, you get more flies with honey than vinegar, so I dont advise attacking him, just ask him to explain how much you owe, so that it may be straightened out as you want to move on.  

Your attorney may well be willing to release the lien "if you and he can reach agreement" to what he is owed, and you pay him.  

      I know attorneys are unpopular, and most people think they sit around and collect low hanging fruit, and make big bucks.  Its not that way for attorneys who represent Vets.  Why?  Well first of all they, like us, have wait an enormously long time for their money.  And, they have to invest in your claim their own labor, as well as any legal assistants, not to mention general office expenses such as lights and phone bills.  

      If you negotiate with him a release, you should be able to insist that is in writing, and, then you are free to hire a representative of your choice.  Just send the new potential attorney a copy of your old attorney's release.  

      I had to do that.  While Im no legal expert, I do know that attorneys have "clients", and if I hire attorney "A" and speak to "attorney b" about this issue, well that attorney is not allowed to talk to you as you HAVE a representative of record, and you cant have 2 attorney "unless" they make an agreement and that mostly does not happen with Vets claims.  

       When/If "you force the attorney to withdraw" (that is fire him) he is still due payment for the work he did, "just like" if you hire someone to clean your garage, and then fire them a week later.  You still owe them for the work they did.  

       You need to recognize there is a fair amount of work he did.  Its " a lot of work" JUST to read your file and figure out what is going on.  My file is 1400 pages, and it took me probably 100 hours, or more, to read it.  Yes, the attorney wont take 100 hours..if he knows what he is looking for (I didnt) he may well be able to review it in 2 or 3 hours well enough.  

       When you hire an attorney, he does not necessarily send you  a copy of "every document he files".  Mine did not.  Again, my advice is to get over your anger at him, pay him for his work, and move on.  Your anger at him is bring on problems for YOU, and this is not unusual.  How do I know?  Because I did that..and learned the hard way.  I could tell the whole story, but "forgiveness" is healing, and hate is toxic.  You got a good result so pay him for the hours he worked on your claim and move on.  

       If this was a "NOVA" attorney, then he was experienced in Vets claims against VA.  If not, frankly, it was your mistake for not hiring a NOVA (experienced in Vets claims).   I dont suggest "blaming the attorney" because you did not do a great job "vetting" him, and did not make sure he was competent and qualified.  

      I recently bought a Lexus (car).  I found out later it does not have android auto or Apple car play.  I was livid.  Why would a "premium brand" with heated and cooled seats, blind spot monitor, navigation, NOT have andriod auto?  

      Well, bottom line it was my mistake, I should have found out before I bought it.  Now, Im gonna have to pay for my mistake.  The salesman did not tell me it had android..I did not ask, as I "assumed" it would have it with all those other premium features.  I still dont know why the premium brand of Toyota, would do that.  But, If I had researched it online thoroughly enough..there it is..no android auto.  

     Keeping a chip on your shoulder against the attorney is gonna hurt you long term.  Fix it and forgive.  That is my opinion, and sorry if it offends you. 

 

[Otrgypsy]

AFTER I HAVE BEEN A REAL TRIAL LAWYER, NOT A PAPER SHUFFLER, FOR 35 YEARS BEFORE DISABILITY, I AM SURPRISED THAT PEOPLE ARE TRYING TO TELL ME ABOUT WHAT LAWYERS DO, AS IF NON LAWYERS KNOW.  IT IS BECAUSE OF MY KNOWLEDGE THAT THIS SCUM BAG WILL NEVER BE FORGIVEN. WITH WHAT I KNOW NOW, IT WAS A GIVEN THAT THE WORST RESULT THAT WOULD HAVE HAPPENED, IF HE HAD ONLY BOTHERED TO CHECK SOME FACTS OR TALK TO ME, IS THAT IT WOULD HAVE ONLY BEEN SENT BACK JUST FOR RATING, VERY POSSIBLY JUST ISSUED AN AWARD, BECAUSE EVERYONE AGREES I AM UNEMPLOYABLE. THIS CLOWN COULD F**K UP A WET DREAM

What I was saying is the result was pretty good, especially in light of THE FACT THE ATTORNEY DIDN'T DO SHIT AND HE MADE NO EFFORT TO FIND OR PRESENT THE ACTUAL FACTS. The attorney was blowing smoke up my ass and had me snowed for a while thinking he had mostly won and saved the case. He was trying to take credit for what the BVA did without anyone pointing them to any errors, like a C&P that could have been proven 100% invalid by simple reference to the facts in my service jacket. Being a real attorney, not a paper shuffler like THIS VA lawyer, I just couldn't understand how the major errors got by. I ended up demanding to see everything they did, every scrap of paper they filed and with the exception of 1 marginally qualified expert (that's a 10 minute phone call to retain) they didn't do a damned thing other than file the expert report, from an expert that clearly didn't read the STR's that document in service treatment for diagnosed solvent poisoning which C&P claimed didn't happen. One thing that is universal in the US, is the file ALWAYS BELONGS TO THE CLIENT. THEY WERE OBLIGATED TO PROVIDE IT TO ME AND THEY TOLD ME THEY HAD. They never learned the facts of the case, they never copied me with the absolutely rotten C&P, never advised me of the results AND NEVER BOTHERED TO CHECK THE TRUTH OF A LOT OF TOTALLY FALSE OR TOTALLY IRRELEVANT BS IN C&P OR ORIGINAL DENIAL.

Then they refused to try to correct even the most simple things, like the effective date. Refused to address any of the errors and the whole time they were telling me what a great job they had done.

I HAD BEEN PROMISED THEY WOULD HAVE ALL NECESSARY EXPERTS AND FULLY BRIEF IT TO THE BVA YOU KNOW, LIKE A LEGITIMATE LAWYER WOULD DO, IF HE GAVE A SHIT ABOUT WINNING. THEN THE WORTHLESS SON ON OF A BITCH STARTED GIVING ME "THE TALK" TO GET ME PREPARED FOR A LESS THAN DESIRED RESULT, AND TELLING ME THERE WERE CONFOUNDING FACTORS.

The only confounding factor was a lazy scum bag attorney running a mill without giving a damn about anything other than making a little something on as many files as possible. A lot of scum bags do business this way. Unfortunately, it is a common business model in any kind of injury or disability claim. People get rich without being talented, or doing real attorney work. They get rich by always screwing their clients and convincing them they were well served. Not many laymen can tell the difference.. Avoiding a shit hook like that was at the top of my list, I failed. That this guy would try to pull this shit on a real brass knuckle litigator tells me how absolutely invincible and protected from discipline he feels. All because he knows the VA won't do their Duty. In a state where the Bar actually disciplines lawyers for misconduct he would have been worried about his license. Turned out he was absolutely lying about having a New York license that he falsely claimed to have on his website. New York won't discipline him because he isn't actually licensed there. And I learned that the New Jersey Bar doesn't police their lawyers, it is just a good ole boys club that serves to protect the lawyers and doesn't care about the public. The New Jersey Bar will not even look at a complaint about one of their lawyers if he was working on a contingent fee basis until the case is entirely resolved, no matter how bad they screw the client. It is a fact that if he were a California Lawyer, he would already be suspended or fighting hard to prevent it. On the docs I put together there is no doubt he WOULD AT THE VERY LEAST BE SUSPENDED, QUITE POSSIBLY DISBARRED!!!

The type of law I did was similar to a VA claims in that it was about injuries. The only difference was when things got stuck or screwed up, or the other side were being assholes and not doing what they were supposed to, I could always go to a judge, sometimes immediately, more often I would have to wait for 30 days. And if there was no defense I could make a special motion and win the case.

I asked him to come to an agreement to put a dollar figure on his lien and he refused because this scum bag wants to extort as much money as possible, for not doing a damned thing.

I still have fantasies about running into the guy. If I do, he won't walk away. My son doesn't live far from the city with his office. I may visit. I will ensure that this scum bag never sees a penny.

Edited March 27, 2021 by Otrgypsy
clean up

[Buck52]

 With all due Respect ''They are no reason for you to write this,  this comment it is very rude to our members and disrespectful sir they are merely trying to advise you and give you some information from their experience.

''AFTER I HAVE BEEN A REAL TRIAL LAWYER, NOT A PAPER SHUFFLER, FOR 35 YEARS BEFORE DISABILITY, I AM SURPRISED THAT PEOPLE ARE TRYING TO TELL ME ABOUT WHAT LAWYERS DO, AS IF NON LAWYERS KNOW''

and threats  ''I still have fantasies about running into the guy. If I do, he won't walk away. ''

This is not what hadit is about sir.

They (VA) did not perform any medical procedures on you did they? They merely read your records, listen to your lay testimony and opine on the info. so how can you sue them?  WERE IS THE HARM? or medical malpractice?

IF YOUR A LAWYER YOU YOURSELF SHOULD REALIZE THAT.

Also 

I don't mean to be rude here or out of line sir  but have you ever thought about seeking medical care from the VA MH Clinics ? they have a good system helping veteran cope  with mental illness/ANGER MANAGEMENT  , you can get evaluated and treated  and these treatment session help I am in treatment myself and have been for the last 6 years or so.

Now if you are in treatment and seeking the help you possibly need then my apologies to you sir.

but please don't come in here wanting to sue VA Dr's that have not did you any body harm,  besides  they are federally protected from law suits.

with that said 

Now if they perform medical mal practice on you and harm your body  and you can prove they did the medical mal practice intentionally  then you may have a good case   but just because a VA  C&P examiner gives his opinion for the VA is no reason to sue.

WOULD YOU WANT TO SUE IF THE SITUATION WAS REVERSED? HELL NO YOU WOULDN'T.

Again if your a lawyer  like you say you are  you should know this too especially with 35 years of service being a legal eagle.

I agree that some C&P Examiner will not do there job right and not read things they should read and it ends up a denial for our claims.

  We have mention to you how to over come these types of examiners  not all C&P Examiners are bad  they do have some that will actually read and do there jobs  and do what the VA ASK THEM TO DO and that's read your medical files and opine on what he/she reads   if the outcome is negative and your denied  we have mention to you what you should do.

 You have got some great  information from people here that know what they are talking about  they been there and done that many many times.

[Berta]

If you signed a fee agreement with this lawyer, you can file a complaint with the specific state bar association.

If this was an accredited lawyer ( accredited to handle VA claims) I suggest you file a complaint with the Office of General Counsel.

https://www.va.gov/OGC/docs/Accred/HowtoFileaComplaint.pdf

He might not even be an accredited lawyer with the VA.

All of their accredited lawyers are listed somewhere at the VA web site.

Many years ago a lawyer gave me some crap and I asked for my money back, (not a VA issue) by phone and he refused and hung up, and I called back saying-" or I will contact the NJ State Bar Association." A few hours later a courier brought me the fee I had paid him. NJ Bar Association, not NY Bar.

Also many years ago a vet I was asked to help by a local vet org had been to the BVA three times and to the CAVC twice-

There is a five point criteria for payment of a legal fee.

I helped him win his case.

I wrote to the VARO and BVA as to how I had helped him , with a full review of his SMRs, a lay medical opinion he gave to his private endocrinologist and I proved his lawyers ( a firm)had not done anything-to help him.They had never ever read his BVA decision or recommended an IMO/IME.

This veteran was a bully and contacted me constantly to get something done about his claim.

After he won his claim he said the VA had withheld thousands for his legal fees and I better do something about that.

He sent me the decision and I sent him a copy of the letter I had written and sent to the VARO and the BVA ( Maybe to the CAVC as wel)l---I forget and he never contacted me again so I am sure those lousy lawyers he had -never got paid.

Your claim is on remand, How did he legally determine some sort of fee? YOu were denied . Did he ask for up front money?

"Disability Benefits Appeals

Attorneys are permitted by law to charge between 20% and 33½% for handling an appeal, but cannot charge more than 33%. These fees will be paid to the attorney only if the veteran wins the appeal and the veteran is awarded benefits. Typically these fees will be paid directly out of the veteran's lump sum payment from the VA."

https://www.nolo.com/legal-encyclopedia/hiring-va-certified-disability-lawyer.html

Has this regulation changed?????

 anyone -----????????

My former lawyer ,years ago,  in country Vietnam War, asked me for advice on his VA claim. He claimed he had IHD and PTSD from Vietnam.

He had a great deal of problems understanding the advice I gave him-VA law is not Civil law-

He interrupted me at every point when I tried to help him word his claim properly and access the evidence he needed-he finally got an award but died from AO shortly after getting the award.

I FTCAed the VA without any lawyer at all and succeeded in proving wrongful death.

I also sued a former vet rep I had and his lawyer, and after I deposed the NSO, told me privately to become a lawyer. My evidence was impeccable.

So did the former lawyer above. who died due to AO.

You are putting anger in place of action. 

You have a severe brain trauma and I know it is difficult to see things without that anger but it wont help you.