Hello, I retired 2.5 years ago after 21 years. Rated 80% for various things, sleep apnea with CPAP, disk disease, hip joint disease, etc. I was just called by a doctors office saying the VA had set up an appointment for me for re-evaluation to see if I have improved. I see the VA once a year as I am supposed to and the rest of the time I see my local doctor. Anyone know what this is about? Is it normal?
The C & P section and the VA Medical are separate. They have the right to reevaluate you on a regular basis up to some legal limits in time. This is no unusual if they think you might improve.
Thanks for the reply. Can they take away from 80% rating? Is there something I should or should not do or say?
If they find that you improved, they can change the rating. You need to be honest with them. It helps to be prepared. Having medical information documenting the status of your disabilities helps. I think today, you need to have a least twice a year visits with each specialty you are rated for, so Sleep/Chest, Ortho, etc. That way there is a record. After a few years they will not look if you have a better history.
Yes, it is quite normal.
You have been scheduled for a C&P exam by the VA's "Virtual Calender."
What this entails is basically you have retired. It has been over 2 years since the VA's ratings. The "virtual calender" the VA's computer maintains tracks you, your appointments and time, and schedules "periodic" examinations. The VA would like to know where you stand in contrast to your disabilities. How many disability ratings do you have. Have any improved over time. Is there any likelihood of any improvement if ANY disabilities. Have any improved where a reduction OR an increase in disability compensation may be warranted.
These are the basics of why you are scheduled for a C&P examination.
Side note: No one of course can say with any authority exactly "why" you have been scheduled for the C&P other than the reasons I gave you above, but I can also see why the "virtual calender" kicked in for you right on schedule too, as follows:
a) You are by 38CFR subject to a C&P exam at any time without any justification from the VA within the 1st ten years of disability compensation, unless the rating specifically states "Total & Permanent"
b) You """may""" emphasis on the 'may'...have coincidentally helped the VA staff who monitors that virtual calendar from time to time by keeping a very low profile.
c) Sometimes it helps to help the VA know what's going on with you. Since your retirement, you saw the VA 2 times, yet draw an 80% disability compensation. Essentially, you have little or no history in the VISTA system, likely do not have a PCP assigned to you, no entries in your medical file, no prescriptions..basically, you are a blank form.
d) If the VA accesses your medical file, which they do, they can't ascertain if your conditions are improving, stable, or degenerating, so they schedule you for a C&P.
e) It is perhaps a wise thing to consider making your presence known, especially if you have various ratings that total to 80% which in the scheme of things can be considered a relatively high comp rating.
f) You may want to consider being part of the system. At least to the point where you have a clinic or a PCP assigned, and an active medical file. That way, you're more likely to "scoot" under the radar screen, ironically, by being in their radar, and thus "may" avoid future, perhaps even closer scheduled C&P's
The above will not be of any help to you in the present form. The C&P has been scheduled and YOU DO NOT want to be a no-show..That would be very unwise and may cause an immediate adjudication to reduce your disability ratings, or even drop them to ZERO. I would think that you'll fare well with the exam, be honest, forthright and careful in your answers.
Wishing you the best.
P/S btw...WELCOME HOME..and WELCOME to this Forum, we're glad you're here and hope you stick around as well. DAVE_M Is the resident expert and he's surrounded by some good people. We also have DAVE BARKER, who happens to be the FIRST VSO in human History, Since he began his journey as a VSO upon representing MOSES before the Great One when Moses was told He would not be allowed to go to the promised land..The rest is history.
AND I see that DAVE_M is feeling "Chippier" today as he beat me with 2 answers...Although, I should mention that he is an IT Expert and VERY P/C savvy...I'm the turtle !
Thank you Dave !
Thanks alot for the replies, I really appreciate them. I dont see the VA on a regular basis because it is a 45 minute drive to the nearest clinic yet 5 minutes to my local provider. I have been to the local doctor a few times about my conditions, plus an ER visit, since retiring. I just had an MRI and appointment with a specialist about my back. I have been recieving treatment for my problems but just not thru the VA. I havent seen a doctor for my sleep apnea since getting my first study and being diagnosed with it and prescribed a CPAP. The CPAP helps and I was told I am not a candidate for surgery so I assumed that was all there was to that issue.
If the VA provides your CPAP, you should see a sleep Specialist in the Chest clinic twice a year with your device. The CPAP tracks usage, and that way your record reflects usage.
The VA will compensate you for travel, and I would bite the bullet and have relationships with the clinics that handle your disabilities twice a year.
As Freddy said, up until 20 years, they can review your disabilities, but they usually do not after 10 years. I received VA treatment for my low ratings the first few years and then fell off the grid. Since I was rated 70%, I see VA doctors many often and have compiled a lot of info in the system. You are best to see VA doctors at least twice a year. That way they can use that record for seeing your conditions have not improved.
In any case, we DO wish you the very best.
Btw. Blackhorse Squadron...are we talking about the ACR in Germany? I was with the 1/14 armored Calvary Regiment...forget what "Troop" in Fulda, Germany. "The Border" even placed my foot in the "ZONE" just so I could say I did it..before I was about to get shot at by the Russians in the Towers, come to find out "The Dogs they had were MEANER" jeeze
< was a good runner way back then.
Freddy, I was in Fulda from '86 to '88. 11th ACR all the way! I was stationed with HHT. Those 2 years are my most fond.
I want to thank you for your posts and questions. I am in the same boat as you for benefits. I retired with 60% disability and wondered about the review as well. I thought I would just fly under the radar so to speak but after seeing your review I am going to go and schedule and appointment.
And if I were you, I would do so with great dispatch as well.
Also be prepared top answer "why" (if asked) you haven't sought any treatment before now. Lastly, notes are made and become part of your permanent record, so be careful how questions are answered if and when you do start seeing a PCP
I have deleted the new topic the OP started. Please continue the discussion here.
Dave, I appreciate your efforts at moderating but I asked something different in the other thread. I dont feel like retyping it all again, I am a one finger typer. Thanks anyways.
<<Here is your post. It really is the same topic.>>
I have my first review coming up and received some paperwork in the mail. They sent me info about time and date for the review and sent me a questionaire to fill out. My rating is for different things but the only things listed in the questionaire is my sleep apnea and spine/disk problem. It seems those are the only two things they want to look at/ talk about. They also stated in the paperwork that I dont need to bring any medical records. So what do they want to do, just talk? I havent been back to a doctor for the sleep apnea cause the CPAP does wonders. I have been back to the doctor a few times plus an emergency room trip for my disk/spine issues. Recently had an MRI and visit with neurosurgon who told me I was not a candidate for surgery cause it wouldnt resolve my issue. Seems like I am going to be on pills forever. Why would they not want me to bring any of this documentation?
By the way, you all are a great resource and the way everyone on here helps each other is fantastic. Hopefully some day I will know enough to be of help to the younger crowd coming up behind us.
They're re-evaluating you to see if your condition has improved, i.e. the VA examiner will address the issues that the RO has identified which is sleep apnea and your spine/disc problem.
Depending on your current eval, they may confirm and continue your rating, propose a reduction, or grant an increase.
***Note that if you have had these issues for more than 5 years VA may not reduce based on one VA examination, however, if improvement is shown they will diary a new exam for some point in the future.***
(1) Back conditions are based on range of motion forward, backward, and side-to-side, i.e. the more restricted your range of motion, the more severely disabling your condition. The subjective complaints must coincide with the objective findings (MRI, Xray showing causation).
They will also consider incapacitating episodes necessitating bed rest as prescribed by a doctor.
(2) Migraine-type headaches are rated based on characteristic prostrating attacks on a given basis, i.e. 3-4 times a month, a week, ect.
You will want to provide the VA (or your VSO if you have one) with any medical documentation which supports current treatment for the conditions. The VA examiner can only review what is in the claims folder when he/she receives it.
Hope this helps and Happy New Year.
Rakkwarrior, thank you for the response. I am reading over the packet they sent me and they are telling me not to bring medical records. Well then this is going to be a waste of our time cause I dont see the VA, I use a local doctor and he has all my info. I go to the VA for my once a year check-in and the VA doc justs asks if I am happy with my care from the local doc.
I am not disputing the post by Tim. He is a VSO and knows what he's saying and doing. However, 38USC does not specifically state and prohibit the DVA from a rating reduction part and parcel of an evaluation. The 5 year rule referenced can be found in the M-21 series manuals for internal guidance, and then, there you go again, each VARO seems to have their own little set of rules as if its their own little universe, some better than others, more compassionate, and some seemingly trying to lowball you to death..Be careful, be wise, be document everything SAVVY.
OK, I just found this forum and was reading intensely. Now I'm concerned, so I have to ask my own quesiton. I just go rated at 80% and thought that was the end of it. I didn't know about the reevaluations. I have sleep apnea, and it was diagnosed prior to retiring 6 months ago. I've tried the CPAP for 3 months, but could never adjust to using it. It's like a claustrophobia, I feel I can't breath with the mask on. Do I need to contact the VA now that I'm out and see about a different type of mask or equipment? If I'm not using the machine and get re-evaluated, will I take a loss on the percentage for sleep apnea?
Short answer" YES.
Also, it's in your best interest to establish a relationship with the VAMC that serves your area, have a PCP assigned and insure they have copies of all treatments prior to....
Side note: I see that you dug up a very old post of mine....so to Dave_M or Bruce..is it possible to correct the # of post as well as my signature skull back? If not, no biggie, but it would be nice, thanks.
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