VA ratings machine
We decided to take the Ric Shinseki ‘Find a needy Vet’ challenge and see if we could find even one sick needy Vet falling through the cracks this Christmas. Turns out we didn’t have to look very far. Our very own Hepsick, Mark, got hornswoggled into a DRO review down in Oakland’s Puzzle Palace back in February of this year. For any of you who don’t know how they are manipulating the backlog, gather around and let me illuminate you.
Entering the VA jungle, you may not notice that you often lose the first time out. That is a 5 month fast-track claim or something fully developed. I am not referring to Presumptive AO diseases. They are in another office and do not count. They’re an automatic gimme but still take a year. No, I’m talking about a bad back, busted up knees or some good old-fashioned bent brain disease with a side of IED-shaken not stirred.
The glorious process only moves forward like a merry go round because there are just so many seats on the ride. The journey actually begins back in the line waiting to get on. After a period of time ( a year or two) you get off and have traversed the diameter of the merry go round circle and no further. You then get in line for the next merry go round and wait for your shot at the appeal or DRO review. This lather, rinse, repeat begins anew at each stop along the way to the Court of Veterans Appeals. Hurry up and wait. Sounds horribly familiar.
The Board of Veterans Appeals, in 2004, invented yet another VA Regional office in which to conduct Kangaroo justice and print up SSOCs to speed up the denial process. They call it the AMC and its located over on Eye Street near Vermin Ave.
To visualize this as a parody, think back on Lucille Ball in I love Lucy. Remember the hilarious scene in the bon bon factory where the chocolates overwhelmed the gals? Now picture them as VA raters yelling down the hall ” Yep. Got it. We’re on target to pump a bunch of ratings out here. Stand back.” Unfortunately the filing cabinets are stuffed, the storage areas are swamped, the building is being structurally tortured and the claims pile up.
When it begins to look like they may get hoist on their own petard come Monday Morning, they merely create a new file or column and label it “Fast Track Claims” When it begins to overflow, they’ll bifurcate it again or another one similar.
Mr. Hepsick has been riding these merry go rounds now for seven years and has won. The next merry go round he boarded gave him a 20% rating in spite of his painfully obvious condition. There’s a reason for this. If he goes away, they have less Mark work to do. If he files a NOD for a higher rating, that is an appeal and Mark has to go get in the appeal line. While standing there, the VA asked him if he was a real glutton for punishment. He answered in the affirmative and signed up for a magic 585 day DRO review. They promptly sent him out for the C&P that they should have done before rating him and had him move over to the Group W bench. And no, it wasn’t named after a guy from Texas. W stands for Wait. As in A Long Wait.
Back in the days, the old, senior raters would see one of these come in and pull it out of the stack. Off Mark would go to the VAMC for a checkie-checkie and bingo- home again, home again. Instead, with a limited number of seats, he will get on several more merry go rounds and eventually get off at 100% Permanent and Total. He knows this. VA knows this. It’s a game. Unfortunately for us, the game is getting longer. We are assured that the corner has been turned and a new dawn is just a year or less away. Yet Mark gets bushwhacked with a knowingly lowballed rating forcing him into an appeal posture to protect himself. Welcome to merry go round number 2 -your very first post-BVA win appeal for a real rating.
In case none of you recognize this, it is the VAMC version of a DBQ for Hepatitis. They are only now doing it post-appeal. This should have been done before the rating in February.
How is it then that this is allowed to happen? February 2013 to approximately August-December 2014 for a DRO decision on whether the Markster gets a full ride? This must be some kind of heavy reading. Why you’d have to wait until Hell freezes over to get someone to give this the once over and a rubber stamp is crazy. That is the depths unto which we have now subsided. Just think if we didn’t have VBMS or Veterans Service Organizations. You wonder how long it would takes then, huh? Naw. I’m not gonna go there.
asknod
Bethanie Spangenberg
kcraveiro
robinhoodesqvetsatty
Wesley McCauley
Veterans Claims Help 
2006 filed hcv stage iii w/fibrosis /depression secondary, after seven years I received 20% hcv stage iii w/fibrosis va stated- mild fatigue?, no mention of secondary depression. filed nod, with new nexus stating chronic condition, with others debilitating symptoms, while my file is still at ro.
lesson learned – obtain new nexus stating your symptoms, never stop obtaining evidence to support your claim, ro is ground zero, it must happen there, new nexus, evidence for a fair rating is a must. refilled 2006 secondary – depression? and yes I anticipate a problem with the filed date due to the fact that I first had to be service-connected for hcv iii w/fibrosis in order to prevail with secondary – depression, now that hcv has been granted, my filed date should be 2006, 2005 diagnosed bipolar-massive depressive.
lesson learned- pending secondary bipolar-major depressive disorders, obtained nexus stating hcv-bipolar/depression more likely than not related. this nexus for my depression my not be needed, however my dealing with va tell me otherwise, leave no stone unturned.
quick review – 2013 -hcv stage iii with fibrosis 20% (low balled) nod filed, with new evidence nexus stating chronic, & debilitating. pending secondary – depression – provided nexus for bipolar & depression & hcv-connection. At this time both issues are still at the regional office. I have been down this road over seven year ago, and attempting to stop any further unfair rating and more delays regarding my claim, by provided new evidence in the form of nexus, stating my health & condition, symptoms, and most importantly the relationship between my hcv iii stage w/fibrosis & depression. seven years + and counting
Seems I haven’t seen anyone come out of this Hamster wheel Hall of Mirrors in less than 7 except for WGM. He followed my book and got four letters that were bulletproof. I always advise that if possible to get the doctor to sew up the secondaries at the time of filing of the preliminary hep. that way, after your win, you can simply file for all of them and point to the C-file and say “Look at these items( supplied) that are part of the record. They clearly connect the two”. It’s pretty hard to argue with what’s been accepted as evidence beforehand. Go for the throat and get the near constant and debilitating done early.
It is getting harder to just get one nexus, 4 is impossible unless you have a pile of money.When the VAs hired hand started belittleing Dr Cecil, I sent them his multi-page vitae.When I looked up her record, the best I could find was that she was an average student and theVA was the only hospital she was associated with.And she is not even a major player there.Dr Sasaki who does all the transplants at both VA and OHSU stated during biopsy that it was clear who was at fault.But once I filed a claim,she would not get involved.I am quite convinced that your RO is a big factor whether you win or not.Some seem to be clearly Pro Vet, while ones like Portland are fight you all the way no matter how good your nexus is.Dr Cecil is one of the Best in his field and only writes a Nexus if he believes in your claim. Since he charges no fee for his service, it is an unquestionable honor to have one.There are others out there who charge $9000. Too rich for my blood! Mikey
Mine went 1100 days before DRO Hearing. Been over 4 months since Hearing and no denial yet. Thanks to HealtheVet, I have already seen latest C&P exam( 4 outta 4 Drs. have stated facts wrong) and newest VA Dr opinion.Same Dr who did first Hep C denial.She did so well last time,she got to dispute all my expert Drs.in all medical fields.(she is an internal Dr).She insulted all my Drs while baseing her denial on the hearsay of a nurse who had more risk factors than I did. I didn’t think they were allowed to use the same Dr to deny me a second time?Thought ties went to the Veteran! Guess not, just have old doc get a new shot at it.40 years of elevated wbcs,is not what drs have been calling it. It is no unknown source. Bad PFT test was Specialized Drs error and not growths choking vet. Hemmroids after 40 years are now called Skin Flaps?According to this Dr I’m as healthy as a Horse? I and the whole medical community have been mistaken for the last 40 yrs.Whew,glad all this was a figment of our mutual imaginations.mikey( waiting for SOC)
You have the right to dispute the C&P doctor’s credentials. Simply ask for a sheet listing her bona fides from the VHA. It’s always comforting to learn some lowly FNG ENT doctor’s nexus is more probative than your treating physician of 10 years for your gastroenterological complaints… and his three buddies similarly trained. Why, this sounds like collusion. Round up the usual suspects. Call the OIG White Mice.
585 days? Wow I’m over 800 days waiting for a DRO review, if I would have known that the DRO review would take so long I would have went right to the BVA. I have SUCKER printed on my forehead!!!!!!!
Hang in there….
And The Beat Go On, The Beat Goes On, The Beat goes On………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..The beat Goes on.