Will using the VA’s Choice Program wreck your credit?

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It very well might according to the VA itself.  

The VA wants my husband to drive about 200 miles round-trip for an x-ray and pulmonary appointment.  I called to see if the VA Choice Program (LINK) or non-VA care program could be used instead based on the geographical hardship factor. The VT scheduler said to call back in two days. Then I checked out the VA website and saw the alarming notice to the right.  Talk about disincentives!

 

I will follow-up to see if he’s eligible however after seeing this notice and doing a little reading, I think we’d rather use his Medicare Advantage card, cough up the $50 specialist co-pay and not jeopardize our good credit rating.  Besides, according to the VA Choice Provider Search tool, there are no local pulmonary specialists in the program.

According to a recent article in the Military Times (HADIT.com link here) providers are not being paid for months and some veterans are getting calls from collection agencies.  If Medicare fees and payment practices are acceptable to most private practices, the VA and their contractors should be able to follow suit.

We’ve found that Medicare, a single-payer government (yes, democratic socialist) insurance plan, works pretty darn well. Depending on your choices, it can get expensive. We employ different strategies each year.   I have original Medicare, plus a medigap policy, and a standalone Part D plan; My husband has a very cheap Medicare Advantage plan until he turns 65. Then we’ll shell out for another medigap plan for him.  Dual-eligible, his care will be split between the VA and private care.

The Choice Program is temporary according to the law but it should be perfected, expanded and permanent.  Probably Medicare should handle the non-VA care payment aspect of the program since they have the expertise.  It would save taxpayers a ton of money too.

Posted in All about Veterans, Guest authors, Medical News, Medicare for VETS, VA Medical Mysteries Explained, vA news, Veterans Choice card | Tagged , , , , , , , , , , , , , , , , , | 6 Comments

HADIT.COM “POST IT” RADIO NOTES

haditlogo2007One hour and four minutes to launch. Here are a few notes to consider on DRO reviews:

Bryant v. Shinseki  is here

38 CFR 3.103(c)(2) is here:

(2) The purpose of a hearing is to permit the claimant to introduce into the record, in person, any available evidence which he or she considers material and any arguments or contentions with respect to the facts and applicable law which he or she may consider pertinent. All testimony will be under oath or affirmation. The claimant is entitled to produce witnesses, but the claimant and witnesses are expected to be present. The Veterans Benefits Administration will not normally schedule a hearing for the sole purpose of receiving argument from a representative.

 

It is the responsibility of the VA employee or employees conducting the hearings to explain fully the issues and suggest the submission of evidence which the claimant may have overlooked and which would be of advantage to the claimant’s position.

 

To assure clarity and completeness of the hearing record, questions which are directed to the claimant and to witnesses are to be framed to explore fully the basis for claimed entitlement rather than with an intent to refute evidence or to discredit testimony.

In cases in which the nature, origin, or degree of disability is in issue, the claimant may request visual examination by a physician designated by VA and the physician’s observations will be read into the record.

(Authority: 38 U.S.C. 501)

This should be read into the record at the beginning of any hearing-be it a Predetermination hearing, a DRO hearing or a Video or Travel Board Hearing face to face. Put VA on notice that this is not an adversarial event.

It isn’t VA against Johnny Vet and his mouthpiece. It’s all three collaborating in such a way as to make sure Johnny Vet is given that to which he is entitled. If a DRO fails to mention that it sure would help a shit ton if Johnny’s chowderhead DAV rep had presented him (Mr. DRO)with a nexus letter (attached to, say, the DBQ) saying Johnny’s flat feet were more likely than less likely attributable to service because he used to jump out of perfectly aerodynamic C-130s with a parachute on his back when he was in the 173rd Airborne- then the DRO has failed to comply with 38 CFR 3.103(c)(2) and it is more evidence of a shoddy claims adjudication.

This is important to have on appeal above to the BVA or the CAVC.

NEVER GO TO A DRO HEARING WITHOUT NME 

I guess I need to point that out.

  • Take witnesses.
  • Make Johnny Vet a person- not a SSN. Show the debilities to the DRO. Have your witness(es) testify to the “before and after” version of Johnny Vet.
  • Your contentions must focus on either case (law) or controversy ( how the facts are being weighed).
  • Focus on why you are right and VA is wrong without making the DRO feel like a dumb shit. Always give your opponent an “out”. Let the blame fall on the poop-for-brains GS 10 VSR who wrote the denial and isn’t acquainted with the laws/regulations your Johnboy is claiming.
  • And yes-bring a new nexus or some dynamite evidence that clinches the deal. You screwed up and didn’t show up with one of the three items required to win. This is your opportunity to avoid four long years of appeals to the BVA to accomplish what you can do right here.
  • Always go on the record.
  • If your DRO discovers something missing that would help you win, then ask for the record to be left open for a 60-day window to allow submission of new evidence to “fix” it.
  • If it is merely to grab his noggin and jamb his eyeballs into a STR from 1966 that is already in the Evidence of Record (EOR or c-file), then there is no need to keep the record open and you ask for the DRO review to proceed apace.

Mr. Goss, who taught the class, also gave us a sample letter to submit. I excerpt part here to give you an idea of where you want to head.

To make the hearing productive, per Bryant the DRO hearing officer is requested to review the file prior to the hearing in order to provide:

1. what elements of the disability the VA agrees the veteran has satisfied;

2. what evidence the decision review officer requires to grant the claim; and

3. what other issues or methods of proving the claim the veteran may have overlooked.

The purpose of the meeting is to expedite the veteran’s claim in a positive professional manner and to meet with the DRO/RO working their claims. The discussion should cover the VCAA requirements the VA owes the veteran, have the DRO/RO tell the veteran what the VA has accepted, what evidence is needed to grant the claim(s), and allow the veteran to Understand exactly what evidence is required to prove the claim, and to have a positive working relationship. The veteran deserves this professionalism.

If you wish to learn more about Mr. Goss’ briefing, you may contact him for the course materials.

Law Office of Robert B. Goss, P.C.

Bob@gosslaw.com

713-572-4838 (4Vet)

There’s a lot more there I could discourse on but it belongs to Mr. Goss. That’s why we pay big bucks to go to NOVA school.

_______________________________________

VA Agent Alan Gumpenburger put up 99 test questions for what was going to be on the VA agent’s exam. I wrote of a few of them. Here’s a few more as reported back by those who took the test.

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Here’s a sample of NOVA’s  Friday, March 11, 2016 schedule of available things to partake of. Thursday and Saturday were equally rich in topics to choose from. Sometimes the choices were difficult.

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Feel free to hit #1 on the phone and ask a question. John said he’d run it for 90 minutes tonight.

___________________________________________________

Also in the news, LZ Cork’s Butch Long got a few xrays taken in a newer machine. They turned up a lot more that the 1950’s  machine we first used to look for metal. VA hasn’t even begun to pay him for the 2.9mm chunk in his forehead-let alone any of the rest of this. He filed for it April 1970. VA has yet to even x ray his left hand or his head. They don’t even know there’s any steel on board in the noggin, face, left hand or the rib cage. We Gonna Burn Their Asses  (WGBTA)as they say down in Georgia.

Butch Long X Rays shrapnel 3-16 Redacted

 

Posted in DRO and BVA Hearings, KP Veterans, Lawyering Up, Medical News, Nexus Information, Tips and Tricks, vA news, VBMS Tricks, Veterans Law | Tagged , , , , , , , , , , , , , , , , , , | 2 Comments

MILESTONES–PAUL BURCH

leigh-and-paulSome of you older followers know the long series of battles we fought to get Leigh “Silver Queen” Burch her long-overdue Permanent and Total rating. No one fought harder, drove further and read the law deeper into the night than her husband of 30 years. Paul probably emailed me over a thousand times on just her claims. They bought the Silver Queen corn Cupcake and I planted for the last three years. They encouraged me to fight for my greenhouse. In the course of the claim, Leigh had to have a liver transplant. 

They finally prevailed February 2015 after years of appeals to the BVA and even an Extraordinary Writ to the CAVC in pursuit of her c-file. I learned  that Paul had been diagnosed in September with cancer and had prayed the chemo had been successful. Apparently it wasn’t. Paul passed on March 8th, 2016 and was buried with full military honors at Sarasota Veterans Cemetery March 10.

One of the greatest advocates for HCVets  now joins a treasured list on my site. With the advent of Sovaldi/Harvoni, the list is not growing quite as fast as it was. We’ll sure miss Paul as he and Leigh had made plans to come out west when they won. I had looked forward to shaking the hand of a True Marine- one who refused to leave his wife of thirty years behind.

Paul Burch 1.jpg

Paul Burch 2.jpg

Sarasota, Florida Veterans Cemetery 

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Posted in Inspirational Veterans, Milestones | Tagged , , , , , , , , , , , , , , | 1 Comment

I’M APOLITICAL, BUT JUST SAYIN’…

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USAF SSGT. Alicia Watkins (ret.)

I do not condone any candidate. I refuse to be political because they are all cut from the same bolt of cloth. But… you do have to admit this is the stuff that wins votes. It’s like kissing babies  and  gladhanding or any other meaningless political gesture, but… this is the second time Mr. T has decided to do something  Pro-Veteran in as many months. 

I’m not a betting man and I do not need to slay a chicken to study its entrails. Conduct of this nature will bring him much in the way of Veterans’ support. It appears he has learned Vetspeak. Whether this particular incident was contrived or genuine, it was a masterful ploy to play on our collective conscience. I’d say it works. You don’t notice any other candidates from either party jumping in there and hiring us cold off the street.

Incredible timing? Coincidence? I doubt it. Occam’s Razor dictates the whole thing was orchestrated. But… Veterans are natural problem-solvers and solution oriented folks. We get about 15% of our due so any uptick in successes is noticed. Do it on a National stage and you stand out like white on rice.

And that’s all I’m going to say about that.

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Posted in All about Veterans, Food for thought, KP Veterans | Tagged , , , , , , , , , , , , , , , , , , , | 2 Comments

HADIT.COM RADIO– WHAT HAPPENS IN VEGAS NEVER STAYS THERE

2016-03-15 17.19.35John and Jerrel have invited me to come spill the secrets of the NOVA Witches and Warlocks Supreme Council in Lost Wages, Nevada last week. I gladly do so in hopes none of this valuable information is buried but rather   dispersed far and wide. What we learn to help others should never be hoarded and kept in a locked room. This is the primary reason for NOVA’s spring and fall conferences. Unfortunately, I am not able to bail on harvest season to go gallivanting hither and yon for legal acumen. My tryst is always spring after the tomato starts are safely birthed. 

Eagle-eyed horticulturalists will spot the cilantro in the foreground and try to call me out. Well, excuuuuuuuuuuuuuuuuse me.I have a powerful hankering for that in my salsa and my last batch bolted. I think the tomato count was about 488 yesterday morning  and they’re still popping up like popcorn.

The show Wednesday will focus initially on DRO reviews. I learned a passel of goodies in that class. The one on VA agent training for the test was even more intense. I’d love to share that one with any of you who aspire to that high calling. The information is proprietary but by no means unique and unheard of law. As most who know me will agree, it’s just a springboard to more audacious behaviour. I can never sit still when I consider the enormity of the crime being perpetrated on Veterans. The more regulations I read the more I discover how dumb I am.  Did you know we have the power to subpoena a VA doctor and/or his curriculum vitae and present it as evidence? Did you know you could ask for a “Predetermination hearing” to allow a briefing to the VSR/RVSR who will be adjudicating your claim —before they decide it? Think of it as a “pre-denial review.” You can make certain s/he doesn’t come down with a bad case of dumbitis right before doing your claim or go temporarily blind and miss the exculpatory evidence. Pretty cool beans, huh?

If that doesn’t perk your interest, maybe the abysmal report from Mr. James Ridgeway Chief Counsel for Policy and Procedure (and a BVA VLJ) will. He sees seven lean years of slow BVA progress until the appeals subside. Newsflash. We just finished 16 years of continuous warfare and a Marine bought the farm last week in Iraq. What part of Appeals Nightmare on Elm Street don’t these chuckleheads get? Their own current statistics are projecting a certified appeal today will see the light in 3.5 years sans remands. Let’s do the math. 60, 000 claims in each year. 40,000 out currently. They’ll catch up in… (use VA core math). Ridgeway estimates a million appeals on “hold” in 2020. Then the shit really begins to hit the fan.

Mr. Ridgeway is an avid advocate of the new Fully Developed Appeal. That might seem like tongue in cheek humor but it isn’t far off the mark. The lengths the BVA is willing to go to fix USB Allison Hickey’s VBMS hurry up and wait program is legend. All manner short of outright suspension of any rights to due process is subject to rescission in order to make this go away. Their desperation is palpable. You thought the VA budget was in trouble? Try adding about another one hundred or more VLJs to the payroll at $150 K + and  see Congress’ eyes roll back in their collective head. What do you do with all them leagle beagles when this phenomenon finally subsides? Right. Sub it out to 3M or Xerox.

As for my favorite Vegas hobby, I was not disappointed. Cupcake made me refrain until school was out.

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The show will begin at 1900 Hrs on the East Coast and a far more civilized time of 1600 Hrs on the left. We welcome callers and will be happy to hand out tips on the care and feeding of one-armed bandits. The call in number remains

347-237-4819

Hit #1 if you wish to speak to the peanut gallery. haditlogo2007

Posted in BvA Decisions, CAVC Knowledge, KP Veterans, Medical News, Nexus Information, Tips and Tricks, VA Attorneys, vA news, VBMS Tricks, Veterans Law | Tagged , , , , , , , , , , , , , , , , , , , , , | 5 Comments

VA–VA AGENT’S TEST FOR ACCREDITATION

Wowser. My fingers are getting laryngitis. One of the primary reasons for Cupcake’s and my expedition to the NOVA conference  was Alan Gumpenburger’s presentation on the VA Agent’s examination for accreditation as a non-attorney practitioner. While it might not seem as daunting as, say, scaling the Eiffel tower, reading over the questions seems like a scenario I witnessed as a child. 

In 1962, during dove season. my father was adamant that I begin learning the art of deflection shooting. Towards that end, he would show up at St. Mary’s (Catholic) and remove me from Fifth grade shortly before lunchtime to practice the 20 gauge art of birding. Somewhere in the last 50 years that term headed south and has taken on a completely different meaning. The Audubon Society has perverted it to convey “observing” birds.

On one foray, we had to stop by the Goldsboro, N.C. Police Department and get the gate keys to a promising cornfield recently harvested. The Chief ( who owned the property) invited us in and an old black man was standing in front of him. He had come for permission to vote that fall and, like all blacks in rural North Carolina at the time, had to pass a ‘literacy test’ to qualify. The Sheriff withdrew an old faded copy of a Japanese newspaper from his top desk drawer and held it up.

” How ’bout you tell me what this says, Lenny.” he asked.

“It say I h’aint gonna be voting this year agin, suh.” Lenny remarked.

“That’s right, Lenny. Now you run on home and get back to work. I reckon I’ll see you next year, hear? Give my best to the missus.” was the Sheriff’s parting remark.

Now you can imagine how I felt when I saw Alan Gumpenburger’s epistle of questions. I felt like Perry Mason being told he was going to have to memorize patent law with a side of international tax law in order to practice in LA County. Seriously. Alan tells me that prospective agents who have taken this send back some of the zingers they encountered (below). I was prepared for some highly technical how-to’s on SMC or perhaps suspense dates for various motions. Chew on a few of these actual questions.

6. Is it true that Active Duty for Training includes duty performed as a temporary member of the Coast Guard Reserve?
a. True
b. False

9. A claimant’s net worth is a factor in determining eligibility for Improved Pension and for continuing eligibility to Section 306 Pension, but is not a factor in determining whether to continue entitlement to Old Law Pension.
a. True
b. False

43. What is the deadline to request a waiver of a debt owed to the VA?
a. 180 days
b. 90 days
c. 30 days
d. 100 days

57. According to 38 CFR 1.911, when a veteran challenges the amount owed from an individual participating in a VA benefit or Home Loan program, and the VA determines that an overpayment amount was proper and renders a decision indicating the amount owed and specific reasons for the debt, does the veteran have 1 year to appeal this decision?
a. Yes, paragraph (c)(3) provides…”In accordance with parts 19 and 20 of this title, the debtor may appeal the decision underlying the debt.”
b. No, the appeal must be submitted within 180 days as provided under section 1.963 and 1.964.

79. The Vietnam veteran has been service connected for diabetes type I since 1999. Initially, the VA regional office granted service connection as a presumptive condition under 3.309(e) as due to herbicide exposure (Agent Orange). The VA regional office determined that service connection was not in order, since presumptive only extends to Type II diabetes and has determined that service connection should be severed. Can the VA sever service connection? Explain the basis for your answer.
a. Yes…________________________________

_____________________________________
b. No…________________________________

_____________________________________

The last one here is a piece of cake but it illustrates that there may or can be written answers as opposed to strictly multiple choice answers.

Mr. Gumpenberger teaches classes on this subject and can be reached at:

Allen Gumpenberger, Independently Accredited VA Claims Agent

Gumpslegal Veterans Service, LLC

888 854 8677 Ext 110

agumpenberger@gumpslegal.com

http://www.gumpslegal.com

dea1e5cff1f84af61eb633473b001172I’m gonna go out on the little branches here and just guess that Alan’s not related to Forrest but I bet he gets a lot of ribbing. The Las Vegas presenter informed us that the Office of General Counsel’s (OGC) test now consists  of just 19 questions and you have to answer 75% correctly within 90 minutes-or 14.25 questions. Rounding up means 15 answered correctly.

However, here’s an update. I sat for the test July 18th, 2016 and it was 27 questions. 21 would be the required 75% to pass in this instance.

Of note, I would have expected the conference to draw a large number who would be seeking accreditation.  I doubt there were more than 15 of us in the room. Keep in mind even VSOs have to have a couple of these guys salted around the country to nominally be in charge of a Veteran’s claims. A gomer representative in East Bumfork, NY can still work under the auspices and accreditation of the poohbah in Syracuse or Albany. Unlike them, every VA agent like me has to pass it. Legally, I can have no one working under me on VA claims whatsoever. I do plan on hiring Cupcake as a typist though.

After reading half of 38 CFR, I now understand why only 15% of of us win our claims. First, no one in the ratings biz down at Fort Fumble or even up at the Puzzle Palace at 810 Yellow Brick Rd NW knows as much as an attorney or an agent. No one at a VSO, with the possible exception of a few who have passed the test, are even remotely educated enough on the subject to do more than fill out a 526EZ. Thus you cannot depend on the little people (or pray) for much more than their ability to spell correctly. Since VSOs owe their allegiance to those who pay their rent and provide them their electricity/heat/ phones/desks, you cannot rely on them to represent your best interests. Being beholden to someone else and professing to be free quality legal help is a non sequitur. Well, actually I never heard a service officer blurt out or imply he was “quality”-or qualified for that matter.

Considering I have heard nothing but pure hatred and vitriol towards attorneys from the VSOs for the last decade, I find it almost risible that DAV Grand Poohbah Roy Spicer confided in me that Chisholm, Chisholm and Kilpatrick now are the go-to law firm for all DAV appeals to the Court. Roy even actively solicits them (Veterans repped by DAV at the BVA) for CCK.  He tells me the Vietnam Veterans of America (VVA) now use Bergmann and Moore exclusively as well. Seems I remember a buddy who went to them recently only to discover they require a tithe of 33 1/3% instead of 20%. That’s legal if the matter is of some complexity but will require some tall talking through the top of your hat when you submit your fee agreement to the OGC. You almost have to be God’s gift to jurisprudence to justify 33 1/3.

And speaking of God’s gift to Veterans jurisprudence, I had the good fortune to meet and talk to none other than Kenneth Carpenter, that mellifluous,  golden-tongued legal orator about taking my EAJA fee dispute up to the Dead Circus if I get the bum’s rush from my request for a panel at the CAVC.  I promised I would never badmouth any Veterans Charity ever again if he’d let me take a picture of us. Et voilà! He believed me!

Alex and Ken Carpenter

One day soon I hope to be street legal and continue this marvelous tradition of helping Veterans navigate their way through the maze, onto and off the hamster wheel and up to the BVA if necessary. Having made the trip three times now all the way to the CAVC, I almost have the train schedule to DC memorized. I’m still working on memorizing 38 CFR.

P.S. Street Legal August 4th, 2016. Accepted to the CAVC to practice, November 22nd, 2017.

Posted in KP Veterans, VA Agents, VA Attorneys, Veterans Law | Tagged , , , , , , , , , , , , , , , , , , | 7 Comments

VHA–RELAX. WE HAVE YOUR SIX

635646931319099161-veterans-administration-logoWell, boy howdy. All this consternation over trying to obtain Harvoni and be cured of this HCV blight was much ado about nothing. Well, that is until we find out VA might not be considering Harvoni exclusively. VA is trying like the devil to pawn off everything but Harvoni in order to keep the costs down. Viekira Pak seems to  be their choice now. Well, that and Olysio with a side of Incivek. Jez, I thought they 86’d all the NS3A inhibitors and were moving on to NS7As from the fives by now. With our luck, VA will be going naturopathic and opting for Milk Thistle and licorice root with a side of anise seed mandibular therapy.

Seriously, folks. An Agency (unarguably the largest) of government that keeps asking for more and more bucks for this just now (last month) finally said “Okay. You caught us. We promise not to ration it out and give it to all who are infected.”

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Really? A more aggressive roll out? Just for shits and grins, I have maintained that I am still infected all these years. I think that is a legally sufficient statement. I certainly cannot go down to the blood bank and offer my wares. VA labors under that misconception for good reason. I wanted to see how long it would take for them to “reach out” to me. I’m still waiting. I was informed in November 2013 that June 2014 was the magic month of salvation. They were prepared to offer the triple drug therapy (Interferon/Ribavirin/ Boceprivir) knowing I have a raging autoimmune disorder.  Last December, on a routine LLRP into the VAMC, I allowed as I was still infected. No one batted an eyelash when I pointed out I was Stage 4 and still waiting. The suggestion was another liver biopsy to “make sure” I was still infected and perhaps a butt tractor (colonoscopy) to take a gander at my large intestine. I pointed to my liver threatening to grow out of my upper right quadrant and they reassured me that was completely normal.

The letter above, to me, is simply more CYA and feed the media a bone to assuage criticism. Considering that they’ve managed to suppress waiting times across the fruited plain and make it appear a localized anomaly in Phoenix, I’d say the letter will save a ton of money. Vets with HCV are going to die without it so why spend the money on them? Delay and deny has always worked in the past. Why change horses in mid-stream when you can hand out a press release saying you did.

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I apologize for the spelling of chronic. I found this and it evoked the essence of VA rating principles.

Posted in HCV Health, Sofosbuvir, VA Health Care, VA Medical Mysteries Explained, vA news, Vietnam Disease Issues | Tagged , , , , , , , , , , , , , , , , , , , , , , | 1 Comment

ILP–OLD FACTS BUT NEW REVELATIONS

635646931319099161-veterans-administration-logoHere’s a piece of history on the VR&E’s IL program that shines a bright light into a murky pail of water. Only the GAO could crow about this particular piece of work and conclude they hit one out of the park. Frankly, it leaves more questions unanswered or vaguely interpreted than its power to enlighten. No one even notes the oddity that Wyoming still seems to be devoid of severely disabled Veterans. The report does explain why Manila has never seen a successful IL program launched and any of its Veterans “rehabilitated”. 

My favorite passage was a detailed description of how they mind-meld with participants and interpolate the significance of age, era of the majority of participants (Vietnam), the remarkably fact that they can have over 3,000 enrolled in a given year when there are ostensibly only 2,700 slots and other inane facts. Here’s an important formula to measure “hazard” all of us should memorize. Why they buried it on page 49 escapes me. I wonder if it takes into account a paper cut while loading your ILP-issued printer.

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I wonder if Hannibal had bean counters doing this when he opted to go over the Alps? Most importantly, I worry that the report is long on immaterial facts and short on what most of us would consider useful data. In the pages detailing services rendered, I see a large quantity of grab bars installed near…yup… toilets. Seems we can’t perform our ablutions without assistance rising. Considering most of the recipients were identified as having PTSD, this speaks volumes about…what? Rarely have I seen a Rand McNally roadmap leading to no destination with little or no useful intermediate landmarks as references.

Here’s another snapshot of wasted GAO dollars. VR&E freely admits they have no clue who got what and how much it costs. They’re just sure they denied when they could and granted if they couldn’t.

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I would like to thank Member Extraordinaire (as well as Emeritus) Randy . He was recently very helpful in communicating to CBS that there were recently some really wild Not-For-Profit parties afoot at the Broadmoor Hotel down in his neck of the woods Colorado). Perhaps the only one nearly as prolific at  finding these is Member Maple Syrup Frank. He, too, is adept at finding VA’s poules de luxe hidden amid the chaff of VA hyperbole.

After reading the report, I came away with one bright idea. Since I’m going to become a VA Agent, I need an up-to-date Lexis Nexis VA Benefits manual by NVLSP with the latest CD disc and supporting 38 USC/38 CFR. Member Loyal (BroncoVet) sent me an old one in 2010 and LawBob Squarepants provided me with the “gold” 2013 version. However, time marches on and the CAVC/Dead Circus continue to produce new law. As the GAO report points out, we severely disabled Veterans can have more than one IL program running at the same time. To which I say “Incoming!”

Tomorrow morning I am going to contact my erstwhile Veterans Service Counselor Kris Holloway straightaway. I will inform him of my impending VA agent status and my burning ILP need for a current VBM. Perhaps, since the IL Programs run for several years, to ensure rehabilitation, mayhap I should ask for next year’s copy in advance  to ensure a successful outcome and proper rehabilitation. Well, after all, that’s the metric they use to measure success in this business. I sure don’t want to get an F or flunk out of the program for lack of course materials. After all, I’ve been moderately successful so far in attaining my IL objectives. I think VR&E should issue a bright red “R” for rehabilitated we could wear on our lapels.

Speaking of which, the answer to all of you is no. No, as in VR&E is still in a quandary as to whether they should ship my greenhouse via UPS or FEDEX. Seriously, it’s been over six months since I was awarded this and no word back from Jack K.  What the hey? I told him to just give me his VA credit card number and that 3 digit code/exp. date and I’d take care of it myself.  Maybe his card has less than a $150 K limit…I think I feel an Extraordinary Writ coming on. You all don’t reckon they’re funning me, do you?

More anon.

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Posted in Independent Living Program, KP Veterans, vA news | Tagged , , , , , , , , , , , , , , , , , , , , , | 1 Comment

BVA–MEANWHILE, BACK ON THE HAMSTER WHEEL…

VAI finally got down to the ownership of who coined “the hamster wheel” to disparage the VA adjudications treadmill. It was(drumroll) Carol Wild Scott. It stuck. I am also reaching that plateau with the word jetgun. I coined that in 2008 when I was wee young blogger still wet behind the ears. 

Here’s a great Hepatitis decision. Johnny Reb out of  Greenbough, Alabama is finally hitting his umpteenth remand but this time he’s going to be depositing a goodly amount of samoles soon. In spite of the American Legion’s best service reps, he’s onto the need for that magic IMO. What the hey? it’s the 2000’s now. Everybody is getting on the internet and figuring Caluza/ Hickson/Shedden out.

What caught my eyes was VLJ Marjorie A.  Auer’s ascerbic, dripping invective that was barely controlled, http://www.va.gov/vetapp16/Files1/1602130.txt

Regarding the fibromyalgia claim, the Board remanded that claim in September 2011 in order for a VA examination to be provided; such was provided in May 2012. During that examination, the examiner noted that the Veteran did not meet the criteria for a diagnosis of fibromyalgia, but rather was diagnosed with chronic myalgia. He then opined that the Veteran’s condition was less likely as not due to service, because he “does not meet criteria for fibromyalgia[, rather] he has chronic myalgia and joint pains which are probably related to hepatitis C and DJD.”

The Board notes that there are several instances of diagnosis of fibromyalgia in the Veteran’s VA and private treatment records of record; the May 2012 examiner does not discuss the veracity of those diagnoses, nor does he address whether the Veteran’s chronic myalgia is related to his service, only stating that such is “probably due to” hepatitis C and DJD without explaining that speculative conclusion. The examination and medical opinion is woefully inadequate.

Likewise, the Veteran underwent a VA examination for his claimed IBS at that same time. The examiner noted that the Veteran did not have a diagnosis of IBS, although he noted a diagnosis of diverticulitis in 1992, noted a history of diagnosis of GERD since at least 1997, and that an upper endoscopy noted a diagnosis of erosive esophagitis in 2003. The examiner then opined that the Veteran’s gastrointestinal disorder was less likely due to military service, because “he has no non-specific symptoms but none consistent with IBS.” Aside from the double negative and the incredibly difficult-to-understand rationale, the Board notes that opinion does not address any of the noted potentially present gastrointestinal disorders that are not IBS, and whether such are related to military service. That examination and medical opinion is also woefully inadequate.

Finally, the Veteran underwent a VA examination of his claimed chronic fatigue syndrome claim that same date as well. After examination, wherein it was unclear whether the Veteran was diagnosed with any disorder at all, the examiner opined that the Veteran’s condition was less likely due to military service, because “he does not meet the criteria for chronic fatigue syndrome[, rather] suspect [that] his fatigue is related to PTSD, insomnia and hepatitis C.” Again, the examiner gives no rationale for why the Veteran does not meet the criteria for diagnosis, and again relates the symptom of fatigue to either nonservice-connected hepatitis C or insomniathe Board is unclear whether the Veteran was being diagnosed with insomnia or whether that is also a symptom of some larger condition-or his service-connected PTSD, which could significantly impact the evaluation and rating of the Veteran’s PTSD. Clearly, that examination and medical opinion are also woefully inadequate.

Shoo doggies. My mom was an English and French teacher and I cut my teeth on double negatives and dangling participles. I can declinate lie lay laid in my sleep, Français? Je ne comprends pas rien. It’s almost music to my ears to hear that double negative noticed and mentioned.

We need more Marjorie A. Auers in our BVA life and less American Legion. I’ll bet she can bake a killer cake, too. Women with that outlook and personality are Type A and don’t brook stupidity. It’s about time, too. This is on appeal of a June 2005 DRO Review disaster. That means he filed in 2004 or earlier. Thank Goodness for the VBMS.

Hey, Marjorie. Spring NOVA 2017 is in San Antonio next year. I hope to shake your hand.

Win or Die VA

 

 

 

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BVA–PHIL CUSHMAN? NEVER HEARD OF HIM.

FROM THE HEAVENSGATE RO

IN SAINT PETER’S BURG

 

downloadPhil Cushman’s name will probably remain high in the pantheon of heroes at the VA along with Mario Caluza, Norman NMI Gilbert and Joe Fenderson. Hosannas in the highest and good incense always linger around those folks who give us due process for eternity. So who in the  Sam F. Hill would you expect to be tampering with private medical records at the VA in this day and age? The VA Examiner? The Veteran?  That certainly might be the uppermost thought that comes to mind in the warped world of raters.

Unfortunately, the laws  changed and ostensibly only VA shrinks can cast dem bones since 2010. Before that, as here,  VSRs had to manually staple the proper interpretation onto the front of the Veteran’s nexus instructing the VA examiner to inflate the GAF score up about 20 before pushing print on the denial.  Or… God forbid, an Accredited VFW service representative blowing a hole in the bottom of his own Vet’s claim boat? I can almost hear Tim Allen going Arrhuuuu?

Additionally, both the July 2009 and October 2009 reports from Dr. O. have an additional note stapled to them which reads as follows:

BVA,

As per discussions w/RO 317 Rating Specialists, Decision Review Officers, and their reviews, they indicate that this private examiner has a known history of assigning much lower GAF scores as opposed to VA Mental Health C&P examiners, and as such do not assign greater probative value to the examiner’s assessments.

R. Epps VFW ACCRED[ited]. REP[presentative].

The Veteran has asserted that he was unaware of these notes placed in between his medical reports until after he appealed the February 2013 Board decision. He has argued that he has not had an opportunity to rebut this negative notation evidence. See Cushman v. Shinseki, 576 F.3d 1290, 1300 (Fed. Cir. 2009) (finding a violation of a constitutional right to a fair hearing where the Board considered an altered medical record). On remand, the Veteran must be given an opportunity to rebut this negative notation evidence.

Now, unless I’d been smoking some really aged 2004 Mantanuska Thunderf**k with good hashish slivers on top, I’d have thought the whole idea of this Veterans Service Representative gig was to be your buddy , your, pal, your friend -from the 526 until the end. What I’m hearing is

Dear Veterans Law Judge Bradley W. Hennings,

Please disregard my client’s nexus due to the feverishly overworked mind of a very liberal, Thorazined-out phrenologist cum shrink who has a noted propensity to err on the side of the Veteran. Since VA would never stoop so low as to denigrate a Veteran, we at the VFW, as officers of the Court, feel obligated to come forward and sandbag our client. Granted, he’s entitled to a 1154(b) but we think he’s blowing bubbles.

R. Epps VFW ACCRED. REP.

I congratulate VLJ Hennings for his  intestinal fortitude in calling a spade a spade. I fear for his longevity in this endeavour if he persists in openly advocating for Vets. One does not give away free meal passes for long without dire consequences. They’ll start insinuating that you aren’t a TEAM player and personifying the proper image of a VLJ.

We have few friends in this compensation business and far more who seem indifferent. Do not be fooled or taken in by those who purport to be your Huckleberry. Likewise, don’t be so quick to pull the trigger on your VLJ when you eventually deal with him/her. Just because I’m 2/7 (with one VLJ failing entirely to comply with a JMPR) doesn’t mean you won’t run into somone as kind and paternalistic as Judge Hennings. What the hey? I’ve met the gentleman and he’s far more pro-Vet and forward thinking than he even appears here (in the decision, not the picture).

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Alex Graham (asknod), the Honorable Alan G. Lance, Sr. (Court of Appeals for Veterans Claims) and Veterans Law Judge Bradley W. Hennings at Friday night NOVA meet and greet (Spring Break 2016)

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