Source: https://community.hadit.com/leaderboard/?custom_date_start=1552564800&amp;custom_date_end=1552564800
Timestamp: 2019-04-20 09:01:07+00:00

Document:
Lawyer Needed for TDUI or DIY?
As a veteran who fought for SC for almost 30 years, and now accredited, I would ask you to review any and all DBQs and show me where there is a box that says "Is the condition at least as likely as not SC?" This option is available on the ones used by VES/QTC/LHI occasionally. However, regardless of what the VBA says, the general rule is as it states in your attachment ( VHA Directive 1134) above: 1. Service connection and disability ratings for VA benefits are purely legal determinations belonging exclusively to the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure. Additionally, the issues of service connection and disability ratings are governed by statutory and regulatory provisions beyond the scope of VHA examination and/or primary care. Consequently, they are often not well suited to assess causality of a current condition in a manner helpful to inform the VBA adjudication process. VHA providers who wish to provide medical opinions that state causality must include clear and specific rationale citing evidence to support the conclusion reached, and should employ standard language appropriate for medical opinions (such as “at least as likely as not”, etc.) As for the second document (VHA Directive 2000-029), it is obsolete. It was issued prior to 2010. I don't wish to argue with you. I'm sure you feel I'm wrong. I litigate each and every day for Vets. I live and breathe VA law and study new techniques. I pay $3,000 a year to maintain that accreditation by taking the required CLEs. If I don't know the answer, I use Westlaw to confirm it. Westlaw costs $59 a minute to access. If I thought using VA doctors was a viable option, you would have heard about it years ago, sir. The CAVC and the Fed. Circuit would have tons of cites saying a VA doctor's word is gold. Now, if you are familiar with VA case law and precedence, you will know that a medical opinion is based on knowledge (the claims file and private medical records-or VA medical records). VHA doctors can fill out generic DBQs listed at the link above. If they do opine, it rarely has any bearing on a win. If they have not researched your case via the claims file, it isn't a probative nexus, sir. Try talking your VA doctor into reading a 2,000-page c-file and providing a IMO with supportive, peer-reviewed studies. I see hundreds of "nexus letters" by doctors. VA ignores them if they do not specifically note they have reviewed the claims file. You are welcome to believe what you will but speaking from experience, depending entirely on a VA doctor for a nexus is not advised. Here's a few from my file I find very much on point taken from Fed. Circuit and CAVC decisions: >The credibility and weight to be attached to medical opinions is within the providence of the Board as adjudicators. Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Greater weight may be placed on one physician's opinion over another depending on factors such as reasoning employed by the physicians and the extent to which they reviewed prior clinical records and other evidence. Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994). >However, Dr. Bash did not address contemporaneous evidence, including VA and private treatment records from throughout the period under consideration, that note the Veteran was, in fact, ambulatory, albeit at times with the assistance of a walker or cane. His opinions are conclusory, inconsistent with contemporaneous clinically recorded data (which he does not acknowledge), and cannot be afforded any substantial probative value. >See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008) (stating that a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (stating that a medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions). To begin, a VA medical examination report is entitled to no weight if it contains only data and conclusions. Nieves-Rodriguez v. Peake, 22 Vet. App. 304 (2008) Remember, we are here to help Veterans win. Each must tailor his defense to win using proven techniques. As an example, if you try to submit a psychiatric evaluation from a private doctor at the beginning of your claim, it will be rejected even if it's probative. VA's shrink must always opine first. It's the law. VA c&p doctors/nurses offer their assessment of a disease or injury for the VBA adjudicators to study. It is not binding on VA. I've had hundreds who said "Yep. It's due to AO. A month later I get the denial saying it isn't. I take no pleasure in arguing with any of you here. My desire is to teach you what you need to succeed. As they say, you can lead a horse to water but you cannot make him drink. You are free to ignore my advice and it will not hurt my feelings. I've helped thousands over several decades attain SC-usually IU or 100% +. It's a recipe-just like baking cookies. If you choose to substitute baking soda instead of the baking powder called for, you don't get what you desire. Many tell me I'm wrong here at Hadit. Considering I have never lost a claim or appeal yet (knock on wood), I take it with a grain of salt. I wish the best for all of you. VA screwed me in '89 & '94. Every win is a b*tchslap for that treatment I received. They should never have said I was not in Vietnam.
@acesup I was previously in the same boat. My DRO appeal was granted on July 31, 2018. I learned the hard way that White House phone calls and Congressional Inquiries don’t work. Last month (February), I called the VA 1-800 # like I did everyday, three times a day. And the representative said she would give me the number to the VA liaison for my regional office which is Baltimore. Long story short, her office was directly across from the person who oversees the entire appeals Dept. The liaison took action on my behalf and was quite upset about the whole ordeal. My claim was closed the very next day and money in my account three days later.
BroncoVet touches on an interesting precept with attys/agents. Most of us will never touch a new claim but will advise you to use a VSO to file it. The reason is simple. We are forbidden by law to charge you to file a claim. We only can enter in to the fray once a denial is issued. It also is a good experience to discover what "hands on" really means in claims development. I do not fault VSOs for their lack of ability. They are not trained to do this. They are glorified mailmen. They fill out your 526 and deliver it. I have learned to file an 8940 at the outset of a claim regardless of whether a client is working. I've won on a Vet being "marginally employed" in a sheltered work environment. He was a CPA working for himself and all but unemployed but for some of his oldest clients. The VR&E angle is good but time consuming if attempted after filing. With the new AMA, you want that in your file at the outset if possible. I advise you begin that asap and prepare it as a tool ahead of time. I never procure an IMO until I lose. Why waste the money? I'm an undying optimist that VA might be agreeable and give my client his due. Of course, I was convinced we were going to win in SEA in 70-72. As with all techniques, VA is learning to deny IMOs by sending out to get second opinions. This is called developing to deny and is forbidden by Mariano v Principi and §3.304. Thus, I always ask for a SOC asap and submit it to a VLJ. I just got back from a TB hearing in Oakland before VLJ Matt Blackwelder last Thursday. My client has Hep C and he admitted to snorting toot in 88. He has no medrecs. They burned up in 73 or so VA says. I had to explain to the judge that Stage 4 cirrhosis takes 50 years-not 30. 1988 doesn't fit the medical scenario. You could never accomplish a win like this without an extraordinary IMO presented in person to the judge. He read it while we sat there and nodded in agreement. I never forecast wins but I feel good on this one. Absent qualified counsel, he could never have won it on his own or with a VSO. A videoconference would never have conveyed my client's advanced debility from the cirrhosis. One thing I cannot impress on you folks here. There is no template for a claim. Each of you is unique as are your circumstances. There is some commonality in how it is done but each one must be produced based on the evidence you possess-and most especially- what you do not possess. I like to use this as the ultimate example of what you can create with absolutely nothing to work with but negative evidence-or worse- no evidence whatsoever. The gentleman was advised in 2015 by his VSO not to waste his time filing as he could never win it. We shall see.
Hi Everyone I've learned so much from this site over the past 5 years. I was granted service connection for PTSD (02/28/2019) and I am in the same boat. My effective date is the date of my last C&P (01/31/2019) even though I had a diagnosis from a private doc from and never let my claim close. I just filed an appeal using the higher level review lane (03/28/2019) so I will try and post my timeline and eventual outcome.
VA quit allowing their doctors to opine on Veterans' conditions and whether they are service connected back in 2010. You'll have to look to an outside source in the private sector to get the opinion [option]. You can use an PA-C, PA, or ARNP but an MD is the best. VA often uses registered nurses at the ROs to make the decisions. They are called "VA examiners". Good luck.
I wouldn’t pay a lawyer for something you and a good service Officer can do for free. You’ve got a lot of options, but going it alone is a bad one. If you’ve got issues after a surgery by the VA look into the possibility of filing an 1151 Claim. It may be wise for legal counsel on that approach. Discuss it with a service officer first and any recommendation she/he may have. TDIU you can not be working if you file. Filing for SS is an option too. Their standards are different for rating conditions and based on your length of work history. A medical option by a VA doctor is the best option. She/he must state in the option that your condition is due to or more likely than not due to your d/x disability. Maybe even permanent and total in nature. Again, this needs to be an MD.
I personally believe that a letter from your spouse or significant other is one of the most important pieces of evidence you can have inside your claim. I believe that many examiners and raters do not consider them important and tend to dismiss them and give them no credibility. However, on appeal it is something that seems to be a deciding factor in overturning a poor rating decisions by the BVA. There are two important pieces to this letter that I believe is critical. 1. Your spouse should only list symptoms they see. They should never state in the letter a diagnosis. If your letter has a diagnosis in it and your spouse is not qualified to render a diagnosis the rater will immediately ignore it. 2. Your spouse should state how your disabilities impact your day to day living. What things you could do in the past but cannot do now because of your disabilities. No one is more qualified to stated how your daily life is impacted than your spouse. I think anything else in the letter would be overkill but that is just one man's opinion.
That evidence should carry the day.
A claims file request made by the veteran is legally designated as a Privacy Act request, not a FOIA request.
It’s been a long road 4 years and 7 months long but finally WON! Never thought at my age I would ever see P&T. Now on to SS. Thank you to everyone who has posted. This site has helped me along the way in so many ways!
Which one of the following best describes your situation? This is a general idea of how they will rate it. They don't go off of one statement a doctor will place on there, it is more of a puzzle and finding out which once you fit into. After looking it over page 9 is where I would look to see how they will rate it. If I am reading this correctly the 70% seems to fit. But I am not a rater, so It will based on what they see.
Winston Churchill once said “Never give up, never give up, never, never, never.” This holds true for those that have the invisible wounds of war. Sixteen years after my retirement I received a letter that outlined possible VA presumptions. The letter explained many challenges I experienced and encouraged me to apply for VA disability and the beginnings of denial. I received a 60% rating in 2017 with a service connection date of Aug 2014. However, my main challenge (PTSD) was denied. The denial was because I didn’t have a therapist confirming my condition; they agreed with the stressor. Since I am retired and use Tricare Prime, I went there for therapy and appealed. I was again denied because the therapist was not a certified therapist. How would I know? i was headed to an appeal with the BVA and my VSO (Virginia Department of Veteran Services), specifically Caleb Johnson, helped me get two independent evaluations from a university and a therapist. I entered the RAMP program and received a 50% PTSD rating in 2018 but with a service connection date of Dec 2017. I appealed the date and for an increase in Nov 2018 and yesterday (19 March 2019) received a 100% P&T with SMC (S-1) with a service connection date of Aug 2014. Below is my HLR Ramp timeline: 1.. 1/17/19 CR 26 Apr 19 - 10 Aug 19 2. 1/28/19 PFD 25 Feb 19 - 1 Apr 19 3. 2/6/19 PDA 6 Feb 19 - 10 Mar 19 4. 2/7/19 9 PFN Feb 19 - 11 Feb 19 5. 2/11/19 PDA 26 Feb 19 - 15 Mar 19 6. 2/19/19 PDA 6 Mar 19 - 23 Mar 19 7. 3/4/19 PFD 1 Apr 19 - 6 May 19 8. 3/5/19 PDA 20 Mar 19 - 6 Apr 19 9. 3/5/19 PFN 7 Mar 19 - 9 Mar 19 10. 3/6/19 PDA 21 Mar - 7 Apr 19 11. 3/8/19 PFD 5 Apr - 10 May 19 12. 3/11/19 PDA 26 Mar - 12 Apr 19 13. 3/13/19 UR 10 May - 23 Jul 19 14. 3/15/19 PDA 30 Mar - 16 Apr 19 15. 3/18/19 PFN 20 Mar - 22 Mar 19 16. 3/19/19 Complete As you can read above, there was a lot of bouncing back and forth. Yes, I watched eBenefits more than I should. This site was a source of support throughout my painful wait. This is what I learned: 1. Don’t quit! 2. EBenefits does not accurately demonstarate the RAMP stages. You may see the progress in EBenefits but the stages don’t apply correctly. 3. It is futile to tell a veteran to stop watching EBenefits. What else are they going to do? 4. If you feel like you must call EBenefits (Peggy), they cannot tell you everything they see but some will tell you more than others. I called several times till I at least got some type of information I thought was the most they could give. 5. While I had success with my VSO, it was with Caleb and not with the other people that worked there. So, sometimes you have to ensure your VSO cares. As a matter of fact, after receiving the 50% PTSD an idiot at that office told me to be happy with it. I submitted the HLR RAMP on my own. I didn’t bother to complain to Caleb but he found out and that person’s supervisor called me to apologize. The moral is that you are ultimately accountable for the outcome so don’t give up!
And, depending on which RAMP path you chose, you are not allowed to submit any new evidence to the BVA that might mitigate in your favor once you start down that road. The problem with RAMP is simple. You trade in due process rights-in this case, the duty to assist you in developing your claim(s)- for a speedier decision and an expedited decision at the BVA. Since the new system BVA RAMP part doesn't kick in until February 2019 (we hope), you could never get it expedited in the truest sense. If you are not permitted to submit a new nexus/IMO at the BVA, what, pray tell, would be the purpose of appealing? The sole purpose of the BVA is to give you another bite of the claims apple. This is the stage where more claims denials are overturned-many due to introduction of new evidence. RAMP is a feel good panacea to give Vets the illusion of a faster decision. Unfortunately, it strips you of protections accorded you under the old legacy situation. All this will end up doing is overburdening the CAVC with a huge backlog. USB Allison Hickey promised us a streamlined system in 2013 with the advent of VBMS and electronic claims processing. That led to Fully Developed Claims (FDC) where you do all the work in collecting the evidence. With RAMP, in essence they effectively forbid your doing even that. So... FDC gets you a 125-day decision with a 75% error rate. Add in RAMP and you get a denied appeal with no added evidence permitted within a month after you get the appeal(s) certified. If it were just a pure law argument like CUE where you are not permitted to supplement the record with anything new, it (RAMP) would be advantageous. This poker game is already stacked against us. RAMP is just one more tool to be used against us. One thing I see in VA law is when I get in front of a VLJ literally face-to- face rather than video conferencing, I win. Granted, I submit a new IMO, too. You want that interpersonal relationship. You need to get the Judge to view you as a Veteran and not a number. It's one thing to see an ASPCA commercial showing a shivering dog. It's another thing entirely (and far more poignant) when you come across a shivering dog in the flesh. A VLJ's compassion level goes up immensely face-to-face and even more so if your appeal is justified.
Thank you , Tbird for sharing this site. You probably have done it many times before but I just saw it. Great resource!
Only the VA can diagnosis PTSD. Until they do you do not have a leg to stand on. In your treatment you need to tell the doctor exactly what happened, even if you do not want to. If the doctor is not putting in your records what you are saying you need to speak to the doctor in a mild mannered way and ask them why. Never raise your voice or become frustrated, it is a losing proposition. I know this because I have been there, frustrated and angry. I had a doctor walk out of a session and say I threatened him. It was not a happy experience. It all goes into your records forever.
Just to make sure I understand correctly, you are currently receiving disability compensation for PTSD at the 70% level. Is that correct? If so, I am wondering if the letter asking you for more details on your stressors might be a mistake. Verifying stressors is something that happens before a veteran is service connected for PTSD. Once you are service connected why would they go back to the service connection question? It's like them saying, "You are service connected for PTSD, so we want to confirm that you have PTSD." As Spock would say, "that does not compute."
Thank you Shrek. It may not have been said, but I got the gist of what he meant. Thank you for clarifying though!
The Calusa triangle is to have a condition noted in your service records, evidence of a chronic condition, and a doctor's statement that the condition is as likely as not incurred due to service. You appear to have the first one but lack the second two. I am most concerned with the fact that you have been medicating with alcohol. Do you have combat in your service records? You may be suffering from a mental condition also. As brokensoldier noted you need to get in and get treatment.
Has nothing to do with that. I am 314516 in line according to va.gov. My appeal is from 2014. I would be happy they are working on it. I am now 10 months after remand was issued and they have just scheduled me for another c&p. You should be happy it is moving!
Look here: https://www.benefits.va.gov/WARMS/bookc.asp Find knee (probably under muscular skeletal) and compare your symptoms and diagnosis from your doc notes to whats listed. Each percentage rating has criteria you have to meet, primarily range of motion, though pain can be rated as well. Make sure you have a relatively regular attendance to doctor appointments so you have a good record of how the condition affects you, then file.
Wow, this is a great thread. Nothing like the voices of experience to get a good sense of what's available in terms of an IMO/IME/Nexus Opinion. I don't know any of the physicians personally, but similar to what y'all have written, I have been impressed with Drs. Bash and Anise with regard to their breadth and depth of knowledge and ability to communicate effectively in writing. I have also enjoyed listening to Dr. Bash on the HadIt radio hour. I don't know as much about Dr. Ellis but I have read numerous positive reports here and on other forums. I have never read anything negative. Setting one's fees as an expert witness (which is how the federal courts refer to doctors like Ellis, Bash, & Anise) is interesting. I suspect a lot of it has to do with the stage of one's career, overall financial situation, and staff resources. If you're still in the midst of your career and you've got kids in college or grad/med school, then you should run your practice like a good small business and make some money. If you're approaching retirement and are financially secure then you might charge less as a community service. I am guessing, but Dr. Bash is probably following sound business principles for consultants of all kinds: If you have done good work, built up a solid reputation, and are swamped with referrals, you should raise your rates until you have a manageable number of referrals. Basic supply and demand in a free market economy (capitalism). Some people complain about such professionals, saying they are "too expensive". My usual response to such judgments is something like: "Well, if you want an economic system based on the principle, from each according to his ability, to each according to his needs, such a system has been proposed."
Yea he's good at what he does. He went through my smr and found I had stomach issues that started in-service and they've gotten worse over the years but I have a claim pending. So, I'm gonna hold off on that.
Hi all, My Husband is the disabled veteran with TBI, PTSD and other problems. He doesn't read or understand a lot of this. we have been married for about three years and I am trying to help him. My native language is not English and I have some friends help me with editing what I write before I post them. I was a social worker in Europe for several years, but this VA stuff is over my head. My husband told me that Berta, Dr Bash, and others on hadit had helped his wife before and she was in the process of getting his PTSD and TBI separated, Getting his migraines service connected and CUEs but she died of cancer before she could finish. we wanted to have Dr. Bash do an IMO, but my husband's fiduciary would not pay for it. we are living out of the country now waiting for my son and I to acquire our US visas. I have gotten a lot of help here from all of you and really truly appreciate it, but I am completely lost without the help you have given me. My husband always gets stressed when I have to post his personal information on the site, but he tries to stay calm. I am going to post his old C&P exam and other VA claim info over the next few days. Thank you for helping my disabled veteran husband "all hadit members"
It sounds like you need a forensic IMO. They would need to review your service records and VA records and state that they did than and then provide a nexus between your service and current chronic condition. This is a high hurdle to make but it sounds like your only option. I looked for local doctors that did IMO's and found a neurologist that performed two IMO's for me. It is expensive unless @Buck52 or @broncovet can offer something else it looks like that is your only route.
What you are looking at is an appeal for EED. If your case was before BVA there is not much chance of winning. If your case was at the RO I would appeal to the BVA. I will go out on a limb and say what the VA is stating is that your disability could not be verified until the date of your last C&P. They did this to me on a claim for PTSD and I won on appeal to the BVA. They can and do use this to avoid paying backpay when a claim has taken a considerable amount of time for them to get their act together. It should not be right that they use the date of your last C&P and they can get away with this if you let them.
You're not less of a man for having PTSD. You're more of a man for admitting your problems and facing them. No one else has walked in your shoes. No reason to feel guilt anymore Buck. Forget everyone else's opinions. You have no need for their approval.
That is part of the problem. The VA is vindictive against anyone who complains about the process! There needs to be a better whistleblower policy for veterans who are being abused in their attempts to obtain their benefits.
Good to see your claim is picking up speed bud. Have a safe weekend and one day soon you will be posting some good news on here.
Right on Proudvet, I agree., and thanks! It was hard at first and I was really nervous, but she was pretty empathetic and it was easier to open up to her once it got started. I was a little worried too about the work thing and how it may affect my PTSD claim...I've got to stay busy, it has always helped to keep my mind off of things. It's easier when I stay busy to avoid thinking about other things. Plus...the courts wouldn't really listen to any claims of PTSD if I wasnt paying child support. I even told the lady that at my exam...She asked about work, and I told her I had to work no matter how hard it was because if I didnt, I wouldnt have been able to make it to the exam because I would be in jail, LOL. It's just a wait and see now!

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