I have hadit

[Whodat]

Denial Letters are in a rise again. 

2019, I had filed a Supplemental for Migraines, Bilateral knee condition, and ED. All was filed as primary, and as a secondary for my already SC conditions. DENIED. 

Filed the HLR.  Then I get a letter for  DTA. Not sure what the error was for but was sent back to Supplemental.  Had more C&P exams in Feb 2022. 

05/02/22 today, got another denial letter.  Evidence shows my injury in service. Shows my current Diagnosis. C&P examiners can't find a link.  Of course, LHI examiners can't find a link. But the letter states, VA examiners can't find a link. 

Makes me wonder. Some people says that you need an IMO some days you don't. What is the real truth? 

 

[63Charlie]

I'll share one of my VA stories, if I may.

 

The VA sent me to a C&P exam for my bad ankles seven years ago.

The examiner found medical evidence in my service treatment records and opined i was entitled to service connection.

You'd think that would be a win, right?

Not so fast.

 

The rater wasn't down for that, so I was sent for another C&P exam for my ankles only a few weeks later.

Can you believe that the second examiner opined there was no entitlement to service connection?

Want to guess which examiner the VA rater found more "persuasive"?

 

I believe that there is a practice at the VA known as "doctor shopping".

If the VA doesn't like what one examiner said, the VA will send you to a different examiner with a known track record of unfavorable opinions who will pencil whip you.

 

Hey.... what is good for the goose, is good for the gander, so I went doctor shopping myself.

I obtained some solid medical opinions from doctors I found, and from doctors my attorney found, and the rest is history.

 

I still have a few more compensation issues to iron out with the BVA due to a remand by the CAVC.

The VLJ is currently reviewing the issues and I expect a decision soon.

Edited May 3, 2022 by 63Charlie (see edit history)

[Whodat]

63c, I am a 63x. I hear you. I have had it. VA is looking for denial statements instead of the truth. 

Some Vets wants to make it as a career. Do not complain because the threats of a discharge, flipping burgers for the rest of their lives. 

Career soldiers drive on. self treatment.  No evidence. Duh. Chapter, discharge. Here for my country.  20 years. Records silence.  Beat me up tear me down, denied.  What? I was 18 in an all volunteering force. Heathy on initial exam. My first job. But caused by age. Not military. I am 52; 

[Whodat]

Oh. Ds  O   187ord Bn  4th BDE  Cell Block c.  Charlie co. 

[john999]

For federal worker's compensation they will send you for a second opinion and create disagreement until they find some doctor who will say you have grown an extra leg while off work.  The VA does doctor shop as well.  How can a C&P doctor opine on your SC status or not.  They are just supposed to describe your condition.  If your service records show an injury then it should be as like as not that your are service connected. That is benefit of doubt.  I know they don't do that half the time and make you wait for years.  They pay no penalty for this abuse.

[63Charlie]

4 hours ago, Whodat said:

 

Some Vets wants to make it as a career. Do not complain because the threats of a discharge, flipping burgers for the rest of their lives. 

 

I was ostracized by my chain of command for receiving medical treatment.

It got bad, and I don't want to say no more.

[Whodat]

My age and smoking was used against me for ED. Did not consider meds that I am taking. I didn't start smoking until 2 years after I joined the service. 

 

They also said from PTSD with alcohol abuse. Go figure. 

[Whodat]

[Richard1954]

It is very unfornatuate that the VA turned the system into an adversarial one. Many of my initial claims were denied for no good reason. I was medically retired due to Asthma. The va in 1986 denied service connection for Asthma on the initial claim. It took me two years and two appeals to show them they had CUE.  My COPD was in my army medical records, in fact when I retired the Doctors  stated I had COPD secondary to Asthma, and wrote this in the medical records. The VA had to have seen this diagnosas but it was never adjudicated in 1986. Instead  because of my ignorance in 1986 thinking COPD  and asthma were the same thing, so I did not claiim it either. By 2005, I claimed it and provided copies from my active duty medical records that it was secondary to Asthma, they approvd it and gave me a 30% award, by this time I was 60% for Asthma, which by the way are basically rated the same way based on Pulmonary fuction test. I appealed and the appeal was denied, and that was when they combined the asthma and copd into one rating. TBI was also in my active medical records, it was listed as concussion and indicated I was out for 3.5 days, in 1986 the term TBI did not exist, fast foward to 2016, I was awarded 40% for TBI, the rating was based on my reactions to the examiner doing the C/P exam. I requested an EED for both TBI and COPD claiming the VA should have seen these issues in 1986. Of course the appeal was denied, saying it was my responsibility to claim the issues. It was also denied at the BVA. I am now fighting a denial of arthritis of my left knee. The rules say arthritis found on xray warrant a 10% rating. The c/p examiner I had for the left knee and also was the c/p examiner fop the right knee, stated my left knee was worse than my right knee. I received an increase for my right knee arthritis,  for the left knee the rater combined the arthritis with my rating for a torn meniscus of 10% rating , that was awarded years before, denying not only a separate rating, but any rating at all. This is CUE which is on appeal as we speak. My claim for sinusitis was denied for years no matter what I did, I finally took my active duty medical records to Army doctors inm 2004, requesting they review the records and write an opinion. both opinion stated I had serious sinusitisin service. I was award 10%, but it was a real fight to get it. I claimed hearing loss and tinnitis in 1986 again denied and denied 3 more times until 2005 when the VA doctor who gave me my first hearing aids, said I should have been service connected 20 years ago based on the history of my hearing test. The va gave me a whopping 0% for hearing, and 10% for tinnitis. I never claimed knee scars, for what? a 0% rating. Didn't seem worth the time or paperwork. The VA knew I had a second surgery in 1995, at a va faculity, and when I requested an increase ( which was denied) they mentioned the scars, but gave me nothing, Ok so when I requested an increase again in 2018, the c/p examiner measured the scars and I was awared 0%. In 2021 again the scars were measured when I requested an award for my knee rating. Both 2016 and 2021 increases were denied, but they sure made sure I got that 0% rating. The knee claims were not worth the trouble to appeal based on the higherst rating available, it would require IMO's and a lot of hope.My claim for specially adapted housing in 2002 was initially denied, I appealed and told them to read the requirements for an award, I won on appeal. Some of my claims came years after military service, because I had learned a lot since then about claims. But the VA isn't teaching raters how to do the job correctly, and I still get denials or awards for that matter that make no sense or are only rated at 0% or combined with other issues that were approved years before but do not increase the ratings. For examples read what I said above about my left knee arthritis, and for ED, they combied the ED to my diabetes II rating from two years prior without a seperate rating of any percentage, and failed to award SMC K. That claim is now on appeal for CUE. I could go on and on, but most of you see what I am saying. Its too bad the VA does not spend time and money on training raters correctly it would save a lot of time and money if the VA would issue the correct rating the first time. It is because of the VA that many veterans feel the need for lawyers, and paying for  independant medical opinions even when the disability is in active duty records the VA will deny the claim.  In fact when I asked for service connection for Sleep apnea, I paid for an IMO, which was a waste of money becaue the C/P examiner said that it was widely known that anyone with COPD and or asthma have sleep apnea, I was awarded 50% the first try, as secondary to my Asthma/COPD.

[Richard1954]

Unfornatuly this happends to many veterans. First if this or any  issue was in your active duty medical records, and you still have problems and are receiving treatment, it should be considered service connected. Sometimes the VA will make stupid statements and say you did not receive treatment for two or three years after discharge. The facts are that there are no requirements to seek medical care for medical issues, just as there are no requirements to take any medication that was prescribed for any condition. I have noticed within the last 3 years that the raters are really being creative when denying claim, and sometimes even when awarding a claim.

 You should not need an Independant Medical Opinion (IMO), however it is becoming more and more necessary.

Recommendations:

Speak to your primary care doctor and ask his opinion about how your service connected issue has gotten worse, and what can he do to make it better, The Idea is to get something in the record that your doctors think the condition started in service.  You can also ask him straight out to write a medical opinion in you medical records indicating how these conditions are secondary to an already service connected. If he is a VA primary care  doctor,  many do not want to write letters for fear of reprisal from VA bosses, but rest assure they can and most will write something for you if you ask. See attached VA guidance concerning writing IMO's for veterans.

Another recommendation is to go on line, and find all the articles you can concerning your medical issues, and how they can be secondary to your already service connected condition, don't provide the va with every article, but 3 or 4 per medical issue can help.

The bottom line the VA was never setup to be adversial but they are now and have been for a long time, and many claims that should be approved on the first claim are denied over and over again, before  they finally get approved. I too have faced this issue many times, and all we can do is to continue fighting.

Form for Doctors Statements.pdf VHA directive 2000-029 Medical Opinions by VA Doctors.pdf

[Whodat]

Great info. Thank you. 

[Dot09]

I won my claim for migraines due to mental health stress in 2 months. You need to have the compensation examiner fill out section 6 of the aggravation on the disability questionaire. Stress is a big culprit in triggering migraines. Try to get a DBQ filled out as well.

Edited May 27, 2022 by Dot09 (see edit history)

[Whodat]

Thank you Dot. 

Actually I have did what you said. Still got a denial. I even have case studies for migraines. My lawyer had submitted my dbq and imo. Denied. 

The frustrating part is the time it takes for the appeal. 

[Dot09]

Remember sometime you can get a decision notification faster online. Sign on to my healthevet go to benefits tab and sign on. When you review your claim and there is a determination go to profile and look at your rating awards each should have a yes or no with a percentage 

[Whodat]

Thanks. As to mine, not serviced connected. Not too much movement on my case. I just completed an appeal on April 26, just waiting for the outcome. I think once this appeal is done, I think VLG, my law firm will work on the migraines and other conditions.

[Dot09]

I wish you the best of luck. Sometimes we just want something to stick. Hang in there

[Whodat]

Yes you are right. I wish that I was more knowledgeable years ago when I had first filed. 

Thanks to great people like yourself have educated me.

The disabilities that I have now should have been serviced connected when I had gotten out. I had never appealed. My attorney stated that I have a very strong case now. 

[InfantryAndIntel]

LOL.  I'm not laughing at you.  I am laughing at how corrupt the VA is and no one, not POTUS, not SCOTUS, not any member of Congress will hold them accountable.  I'm laughing more because someone pointed out that they are "doctor shopping."  This is nothing new in the corruption of American government.  The FBI is notorious for this with judges.  Get shot down by one judge, FIND ANOTHER!  It is quite simply visible and open corruption.  Government employees in any agency who have an agenda will shop around for "expertise" and bias "opinions" they want to shift their agenda.  In truth, the VA is severely underfunded.  I have run the numbers and I estimate that the VA actually needs about 3 times its current budget to actually provide good healthcare, just compensation, and competition to clear out society's lazy dirtbags currently working at the VA.  Because the budget is behind and the amount of Veterans that need care and compensation, they have a secret program to deny care and compensation as much as possible without causing public outrage.  Of course, your neighbor that claims to be pro Veteran and has a yellow ribbon, really does not care about you getting top healthcare.  The "patriotism" and the yellow ribbon are for image and self stroking.  I'm sorry, this is reality.  I just finished reporting to a Senator who claims to be pro Veteran, but he turned my case over to his staff, who lazily and blindly accepted a quick and corrupt answer from a VA patient advocate.  Patient advocates ARE VA employees, they ARE NOT on your side.  It is quite a show.  "Pro Veteran" Veterans, Citizens, and people in government with power (Congress), at the end of the day, do not care about Veterans.  It is a great show.  Trust me, if people really cared, the VA would have a larger budget and would be fixed by now.  The VA now exists solely to provide lazy dirtbags in society a job.  It also is a training and staging ground for newly trained and poor performing graduates to make healthcare mistakes on you before they get accepted into a real practice where results count.  Rejoice Veterans!  You have been used, abused, and now you are just an experiment and reason to give low performers a guaranteed job.  I'll quote Metallica, "sad but true."

[john999]

I

    Even after "The Good War" the VA screwed vets with service -connected injuries.  Many vets had been rated 40% plus, and just a few years after the peace they were reduced.  Many did not even protest that much since the amount of compensation was so small.  Doctor shopping is SOP for the VA, but with them farming it out to LHI and others it can backfire on them since those exam "doctors" don't seem to care about how much compensation they award.  The nation takes us out of mothballs once or twice a year and says  "Thanks for your service".  How about decent compensation rates?

[USNDW]

I would agree, just from my experience. Now I have had a couple of good VA examiners through QTC or LHI but also some bad ones.

At the BVA the ALJ demanded they consider lay evidence in an arthritis claim, and they did not.

They did pull the more persuasive argument, but I countered with overwhelming evidence and Benefit of the Doubt where we are supposed to have "tie goes to the runner"

If you appeal you have to look for any process that was not done correctly, where in your service records evidence exists, possibly get an examiner to find a neus.

In other words, look for every I and T and fight it