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

[Ranmic]

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.

[brokensoldier244th]

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. 

[Ranmic]

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.

[pwrslm]

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. 

[pacmanx1]

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.

[Carl the Engineer]

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..

 

[john999]

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%.