Jump to content

Ask Your VA Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules 

  • tbirds-va-claims-struggle (1).png

  • Donate Now and Keep Us Helping You

     

  • 0

C&P Exam coming and I'm starting to stress

Rate this question


Ranmic

Question

No particular question about the exam as I've been through a few to date but even though I'm listed as static on my disabilities I'm still stressing that asking for an increase on one of my disability's will trigger my entire file to be reviewed.  I'm just not in the mood right now to fight with them if they think a decrease is warranted.  Granted my conditions haven't improved and I don't "think" it would happen but this can be a PITA and I'm second guessing asking for an increase on my knees now.  Oh well, exam is next week so I guess it's too late.  Wish me luck.

Link to comment
Share on other sites

Recommended Posts

  • 0
  • Moderator

Unless something is glaringly obvious as an error, or you've had major improvement, or you have multiple conditions tied to this one that you are asking for an increase for, we schedule the exam for the contention that you are seeking to increase. It's an easy claim, it doesn't require research for service connection which involves digging through all your stuff. A claim for an increase focuses mostly on your more recent treatment, whether private or VAMC. You are already SC for whatever you are claiming, there is no need for us to reinvent the wheel, and reducing someone is at least twice the work of continuing or increasing a rating. With as many claims as we have to go through we don't have time to do a lot of spelunking around for something that has already been determined to be both SC and static. 

The Earth is degenerating these days. Bribery and corruption abound.Children no longer mind their parents, every man wants to write a book,and it is evident that the end of the world is fast approaching. --17 different possible sources, all lacking verifiable attribution.

B.S. Doane College, Mgt Info Systems/Systems Analysis 2008

M.S.Ed. Purdue University, Instructional Development and Technology, Feb. 2021

M.S. Purdue University Information Technology/InfoSec, Dec 2022

100% P/T

MDD

Spine

Radiculopathy

Sleep Apnea

Some other stuff

-------------------------------------------
B.S. Info Systems Mgt/Systems Analysis-Doane College 2008
M.S. Instructional Technology and Design- Purdue University 2021

 

(I AM NOT A RATER- I work the claims BEFORE they are rated, annotating medical evidence in your records, VA and Legal documents,  and DA/DD forms- basically a paralegal/vso/etc except that I also evaluate your records based on Caluza and try to justify and schedule the exams that you go to based on whether or not your records have enough in them to warrant those)

Link to comment
Share on other sites

  • 0
3 hours ago, brokensoldier244th said:

Unless something is glaringly obvious as an error, or you've had major improvement, or you have multiple conditions tied to this one that you are asking for an increase for, we schedule the exam for the contention that you are seeking to increase. It's an easy claim, it doesn't require research for service connection which involves digging through all your stuff. A claim for an increase focuses mostly on your more recent treatment, whether private or VAMC. You are already SC for whatever you are claiming, there is no need for us to reinvent the wheel, and reducing someone is at least twice the work of continuing or increasing a rating. With as many claims as we have to go through we don't have time to do a lot of spelunking around for something that has already been determined to be both SC and static. 

Thanks Broken!  That makes me feel better.  Yeah, no improvement at all....guess I'm just overthinking it.

Link to comment
Share on other sites

  • 0

VA is supposed to review claims that are not P&T every 3-5 years. If you put in a claim and other disabilities would be timely for review, they may check how the existing conditions are doing. This is required by Congress. Exceptions exist, for example, if you are over 55 they should not be reviewing you at all unless there is a specific reason written in the notes of your CFile. Most of the time, P&T awards are not reviewed unless you apply for increase. Another issue would be fraud, so if the RO suspects fraud he may muck things up a bit. In 2018, the VA got dinged for unnecessary C&Ps, noting that in the following 5 years, the IG identified that over 100 million tax dollars would be wasted on unnecessary exams. Just keep your eyes open and understand the system and usually your claim will go just fine. 

Link to comment
Share on other sites

  • 0
  • Moderator

Funny but true story. My last claim I filed was for an EED (Earlier Effective Date), the VA accepted my claim and sent me to a LHI C & P exam. A few years ago, I started asking my C & P examiners why I was there and what was the exam for. So, this final time I asked the examiner why I was there and why did the VA make this appointment. She explained that the VA wanted her opinion if my disability had increased and that I filed a claim for increase in my rating. I simply explained to her that I did not file for an increase in rating because I was already maxed out in my rating, and I have been rated for my condition for well over a decade. I then explained to her that I filed a claim for an EED. that when I was looking through my VAMC records that I found treatment records that I was being treated and I was diagnosed for my disability close to a decade prior to the VA granting my claim and that I did file an earlier claim where the VA denied my claim and I wanted the VA to reopen/review my records and pay me for an earlier effective date.

She looked through my records and told me she could not find any records. I then handed her a copy of my VAMC records and told her that VA has a policy that after the VA makes a decision. If the veteran or the VA find records that establishes an earlier effective date that VA would reopen the claim and re-adjudicate it. She was shocked and irritated that the VA was misleading her to get a misleading opinion. I explained to her that the VA did this all the time, and it really is not right. She accepted all my evidence and told me not to worry about it that she agreed with me and that she would write up her opinion and I should not worry about the VA and their games.

After my exam I filed a request to get a copy of my LHI C & P exam but of course the VA made me wait for it. When I finally got a copy of it, I found out that the examiner did exactly what she said. She went through my records again and found the records that I gave her in the system and the treatment that I was talking about and wrote an excellent opinion and dated the multiple times that I was treated and the symptoms that I was having and still having to this date. Well, you know the VA still ignored her opinion and continued my current ratings and did not even address my claim for an EED. I knew this claim would have to go to the BVA, but the VARO did reopen my claim, requested a medical opinion and the evidence does support that I should get an EED based on 38 CFR 3.156(b), 38 U. S. C. 5110.  I had to file an appeal to the BVA and now I am waiting on my final appeals.

My intentions are to help, my advice maybe wrong, be your own advocate and know what is in your C-File and the 38 CFR that governs your disabilities and conditions.

Do your own homework. No one knows the veteran’s symptoms like the veteran. Never Give Up.

I do not give my consent for anyone to view my personal VA records.

 

Link to comment
Share on other sites

  • 0

If your condition is worse, file for and increase.  If you have new medical records showing your condition is worse, file for an increase.

My last round of claims, I claimed a condition secondary that my physical theropist detailed in my medical record.  The VA denied that condition in my "first" rating letter, but had deferred two things related to that same condition.  Then a couple months later, the VA service connected two new conditions, that I had not claimed, because of what I had claimed for increase, because of what the C&P exam report found.

So, basically, I had a 20 and was looking (the next step) for a 30.  Ended up getting a 40 and two 10's.  And they denied my one "new" 10.

So, you never really know until you file.

Good luck,

Hamslice

I started at 30, 7 rating increases, no reductions ever.  Just sayin..

 

“There is no hook my friend. There's only what we do.”  Doc Holiday 

Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

I went for an exam to try and get my DMII raised from 20% to 40%.  I also had a claim for PN that was rated at 10% for each limb.  The VA ended up increasing my claim for PN by 80% but failed to increase the rating for DMII.  The increase in PN did raise me from 90% TDIU to schedular 100%.  All I wanted was for my DMII to be reevaluated in light of a recent hospitalization when my sugar got way out of control. You just never know what will come out of one of these exams and subsequent rating.  VA looked at my DMII rating and found one detail that did not match a 40% rating. I mean I have to have two injections of insulin a day plus pills and restricted diet.  I do not have restricted activity, so no 40%.   I can tell you how hard it is to go from 90% to 100%.  Even with the extra 80% I did not make it to actual 100%.  I got 98% rounded off to 100%. 

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • LEArmy93P earned a badge
      Dedicated
    • LtDave earned a badge
      Week One Done
    • HillTopVet earned a badge
      First Post
    • kidva went up a rank
      Contributor
    • AFguy1999 went up a rank
      Rookie
  • Our picks

    • These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.

      Service Connection

      Frost v. Shulkin (2017)
      This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected. 

      Saunders v. Wilkie (2018)
      The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.

      Effective Dates

      Martinez v. McDonough (2023)
      This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.

      Rating Issues

      Continue Reading on HadIt.com
      • 1 review
    • I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful.  We decided I should submit a few new claims which we did.  He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims.  He said that the VA now has entire military medical record on file and would find the record(s) in their own file.  It seemed odd to me as my service dates back to  1981 and spans 34 years through my retirement in 2015.  It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me.  He didn't want my copies.  Anyone have any information on this.  Much thanks in advance.  
      • 4 replies
    • Caluza Triangle defines what is necessary for service connection
      Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

      This has to be MEDICALLY Documented in your records:

      Current Diagnosis.   (No diagnosis, no Service Connection.)

      In-Service Event or Aggravation.
      Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
      • 0 reviews
    • Do the sct codes help or hurt my disability rating 
    • VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

      They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.  

      This is not true, 

      Proof:  

          About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because  when they cant work, they can not keep their home.  I was one of those Veterans who they denied for a bogus reason:  "Its been too long since military service".  This is bogus because its not one of the criteria for service connection, but simply made up by VA.  And, I was a homeless Vet, albeit a short time,  mostly due to the kindness of strangers and friends. 

          Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly.  The VA is broken. 

          A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals.  I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision.  All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did. 

          I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt".   Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day?  Va likes to blame the Veterans, not their system.   
×
×
  • Create New...

Important Information

Guidelines and Terms of Use