C&P exam wasn’t listed?

Bluntly · July 8, 2023

Greetings to all and hope all is well. Recently I’ve been granted service connection for tbi from the BVA this year and had to attend 3 exams after. All 3 was in regards to my tbi which the exams were for ptsd, tbi, & migraines. After all my evaluations the VA decided to combine my tbi with ptsd which didn’t change my overall % and only gave me 10% for tbi. When I read my letter it only mentioned 2 exams and not the one for migraines, why are the residuals of tbi which are migraines missing from the letter?

It’s not even mentioned or anything and only talks about tbi & ptsd. To be proactive I decided to of course appeal and put in for a higher level review. It’s a list of things I disagree with but the one that’s confusing me is the missing exam. I believe I should have a new rating for headaches just like they did with the ptsd/tbi.

As it stands I’m 0% for headaches and been like that since I got out in 2009. It’s like they sent me to an exam for no reason and I don’t get it. Had this happened to anyone? I had to do the supplemental route for increase on my headaches a couple months ago. Just felt like that was unnecessary when I should have a new rating for it when they decided to combine my ptsd/tbi. Still waiting on a decision for the increase & the higher level review, thanks for listening as any insights or replies are appreciated.

broncovet · July 25, 2023

The problem with HLR: How in the heck do we know, in real time, what evidence the VA has/does not have?

Our file is a moving target..stuff is added or deleted all the time. It reminds me of the person who wrote to a friend, and asked "the exact time". Its a moving target. Same with our cfile. Yea, you can read the decision and its references to evidence considered, but that is often vague.

An example is the evidence section of the decision may say something like: "Medical records for the Veteran from May 1, 2002, through July 21, 2023." We Veterans have no idea if this medical record is complete or missing key evidence (often).

This makes a decision to appeal "with no new evidence" problematic, because we often have no idea "what" medical records (evidence) they are referring to, and whether or not a key exam was included or not. And, a HLR excludes "new evidence".

There is some rumor that, if you do a HLR and you do submit new evidence, its automatically converted to another type of appeal which allows new evidence, a supplemental claim, for example. But, how do we know if the VA employee at the time is going to be generous and allow new evidence and convert it to SCL, or just deny it? We dont. This is the reason I avoid HLR unless I know for sure the evidence the VA had at the time of decision was complete, and, since I never know that, I avoid HLR.

In other words, I dont want to "burn down" the new evidence bridge, until after I have crossed that bridge, and I cant cross that bridge until I get the (new) appeal decision!

Rather than burn down the "new evidence bridge" I can cross that, and later, if new

evidence isnt needed, I can burn it down. But it makes no sense to burn the "new evidence bridge" when I dont know whats on the other side.

In short, if you submit a SCL but have no new evidence, there is no penalty that I can see.

If the VA contacts you and wants to know what new evidence it is, you can have a list ready:

Did you have the favorable exam on Mar 23, 2008? Or how about the x rays on

June 3, 2009? What about the nexus provided by Dr. Smith on May, 14, 2020?

Did you have all those? They completed the Caluza elements, and documented my symptoms

This takes a thorough review of the file, and we often need to make a appeal decision (HLR, SCL, BVA) BEFORE reviewing the file, often because we dont have our current medical file. .

Edited July 25, 2023 by broncovet