Should you ask your VA doctor for a statement to help your case? I once asked a doctor about 4 years ago, but she refused to assist me. Not sure if I should ask my new doctor(s) for thier personal views on whether most likely than not my disability began in service.
I think this would qualify as one of them "case by case" basis.
When I was doing "the dance" with my claim and the VA from 95 to 00 I was VERY fortunate to have a REAL VA Doc(Actual Staff Doc that was chief of orthopedic services for 3 VAMCs)that actually volunteered "would you like me to write a letter for you??", and he also was the Doctor that pretty much told me that my injuries and issues cumulatively probably made me a totally and permanently service connected veteran.
He had been seeing me at least once every 90 days, sometimes as much as once a month, for YEARS, and had monitored and watched me as my issues slowly degenerated and got worse. ALOT of my SC is for "conditions secondary to" an original SC condition.
He wrote a VERY long detailed letter outlining my history & progression with all the relevant test results and his expert medical opinion.
Did his letter actually help in my claim?? I'm sure it did but my case got so muddled and mired with remands and mistakes by the VA Benefits personnel at my local VARO(Boton Ma) who couldn't read and comprehend their agencies own rules and regulations my case eventually got taken over and decided by the Board Of Veterans Appeals in Wash DC.
By this Doctor was VERY kind, VERY caring, and VERY compassionate. And he was also a veteran having run a MASH unit in Vietnam as a young Captain in the USN-JRC
I haven't had any luck with the VA doctors and getting anything in writting. When I was going through the process for social security disability none of them would write anything for me. I was told by one that it was against the rules and he didn't want to expose himself for any future legal problems. They were quick to tell me to stay off my feet and lighten my work load....but wouldn't give me anything to take to my employer or to show the social security folks. Good luck!
Personally I tell every doctor and nurse if I am filing for a condition before they diagnose. I lay it all out before they exam me or test me. And before I am done with the office visit and they type in their notes in the computer, I ask them if they agree that it is from my service injury. And make it clear that if they have an opinion that will help me. to put it in my medical records. but the doctors have given me their honest opinion and if I don't agree I make the case to them right there and then. I am not confrontational about it, and am very nice about it..
Now I don't know what good this has done. I have gotten a few that have raised their eyebrows and said hmmm..
And I have not looked at my medical records in a while so not sure what they wrote.
I have gotten the impression that VA doctors are suppossed to be neutral.
I think at the least it makes them think before they put anything in the diagnosis that might hurt your case.
*** HIGHLY IMPORTANT ***
Moderators, pls read the following and tell me why it is NOT being followed by VA Medical Professionals:
VHA Directive 2000-029, Provision of Medical Opinions by VA Health Care Practitioners, September 2000
WHY is it that they will NOT abide by their own directives? I asked my VA Shrink for a statement as to the degree of my mental disability and he said, "I am in the treatment side of the house; I am not in claims."
Please read and explain this directive to me. Thank you. It reads as follows:
Veteran patients may request descriptive statements regarding their medical conditions and/or opinions concerning the “possible cause(s)” of an existing medical condition for VA disability claims purposes. VHA health care providers shall provide a statement or opinion describing a patient’s medical condition. If the health care provider is the veteran’s treating physician, and is unable, or deems it inappropriate, to provide an opinion of statement, such physician shall refer the veteran’s request to another health care provider for the opinion or statement.
NOTE: For purpose of this policy, a note in the consolidated health record containing a statement such as, “in my medical opinion the currently existing medical condition is ‘related to,’ ‘possibly related, to.’ or ‘at least as likely as not related to’ and injury, disease, or
OK... 2000-029 was recended by: VHA DIRECTIVE 2007-024 Pls comment on its requirements.
I advise my clients to make lists of what bothers them and discuss it with providers, as a result we have minimal problems. Note I said minimal, did not say no problems. Doctors are just people, some good, some bad some indifferent.
OK... 2000-029 was recended by: VHA DIRECTIVE 2007-024 Pls comment on its requirements.
I think this is the portion of 2007-024 you are questioning. So often I hear someone state that their VA provider "said it was definitely service connected" and such:
"d. Medical Statements to Support VA Benefits Claims. When honoring requests for medical statements by veterans for VA claims adjudication, care must be taken to avoid conflict of interest or ambiguity.
(1) Determination of causality and degrees of service connection for VA benefits is exclusively a function of 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. As a result, they may not feel comfortable in stating causality of a current condition. However, this does not preclude VHA providers from recording any observations on the current medical status of the veteran found in the medical record, including their current functional status. All pertinent medical records must be available for review by VBA. NOTE: VHA continues to provide compensation and pension (C&P) examinations and reports as requested by VBA, as part of any new disability claims or review process.
I got letters from 2 of my VA Doctors, and I must say these letters helped my case immensely. Both were/are great guys !!
Doctors can document your disability and help compare it to the rules. They can not make determinations that they are service connected.
For me, the MOST important part would be if my VA Shrink would write a statement as to my employability. He won't do that.... contrary to the VA Directive. The diagnosis, prognosis, and service connection (NEXUS) has already been firmly established in my case. What I need is a statement from a professional on the impact that my ailment has on my life.
So, 2 days ago, I wrote the VA Social Worker at my VA Clinic and asked that she conduct a Social and Industrial Survey for me. Too early yet, but haven't heard anything.
Jan 22nd, I see my new private Shrink, a Forensic Psychiatrist that does Disability Evaluations/Management. I am going to ask him for such a statement... after he does the testing/evaluation.
The VA ortho Doc that wrote my letter for me pretty much did it in the style format "schwanke" refered to in his post.
It was essentially a "connect the dots" letter where he outlined what my already verified exsisting service connected condition was and then "built up" from there.
In the last para he DID opine that what he had just documented; with all the tests, results, and VA medical record documentation, was directly related to and of a condition "secondary to" my initial service connected injury, but he DIDN'T come right out and say all the other issues I had were specifically "service connected".
Like I said, he just "connected the dots"- condition A caused condition B, condition B caused condition C, and so on and so forth.
What was kinda "funny", but DEFINETLY not in a "Ha-Ha" way(at least to me), was that the VARO(Boston Ma) that originally got the letter from my Ortho Doc(and this ortho Doc; who, at that time was head of the VA ortho service for the 3 VAMC's that are identified as the BOSTONVA healthcare system)pretty much "fluffed off" his letter.
In their "statement of the case" in regards to my claim it was included at the beginning where they list "supporting documentation", but NOWHERE in the rather lenghtly "statement of the case" document that THEY authored and produced was his name or the letter he wrote mentioned. They just kinda totally "poo-pooed" and ignored him and his written opinion.
BUT; after the BVA took total control of my case due to the TOTAL ineptitude and ABSOLUTE lack of any consistency or adherance to exsisting VA rules and regs from my VARO, and during the BVA's writing of my award letter, they relied heavily on the wording and opinion of my VA Ortho Doc. The same guy the local VARO pretty much ignored.
Dealing with the BVA was a VERY enlightening experience for me. Things may have changed as this was 8 plus years ago, but they were VERY polite, VERY courteous, and did things to the EXACT letter of the exsisting VA rules & regs.
I was "chatting" with one of the employees there, NO idea what his job title was,and he told me that in reviewing my case he felt I had a good case of "clear and unmistakeable error" in regards to my initial awarding of 10% back in 1981 after I got out of the military.
Said they only gave me the initial 10% for the scar on my right knee from the surgery(which I was aware of), while VA & miltary records and documentation from that time clearly showed internal damage to my right knee still exsisting and that I intially shoulda recieved another 10 or 20% for. I never thought of it from that standpoint when the injury 1st happened when I was on active duty. But they (they being the US Naval Hospital in Great Lakes Il)did operate on my right knee after I "blew it out" on duty, and they did remove stuff from it. So I guess I SHOULDA got some extra coin for it.
But heck, I was SO sick & tired of dealing with the VA by then I just wanted it to be done and over with-JRC
Good strong EVIDENCE is what wins claims. You must find a way. C&P Docs won't do it. VA treatment Docs won't.... so......
For instance: I was denied services by my local VA Voc Rehab, in writing, because of my SCed condition. Thats evidence. Now, more good strong evidence. Then, more.
The various arms of the VA barely talk to each other. Voc Rehab requires that you have a rated disability and a plan to use the training for regaining employment. You must apply within a time frame of the award of your disability. You can not use the denial of one service as the basis of a claim.
I agree, 100%.... the Voc Rehab denial for services is not a "basis" for the claim, but is substancial and creditable evidence concerning the impact of the SCed disability has on your industrial life. Thats important.... in determining your rating, be it low or higher.
Doesn't look like the VA Social Worker at my VA Clinic is gonna honor my request. That really upsets me because they are suppose to by their own procedures manual. Boy !!!!! I haven't heard a thing from my written request.
Oh well, I don't need a statement from the VA Social Worker. Tuesday of this week, I met with my private Forensic Psychiatrist. He's also a disable veteran and will work with me to develop a strong statement that I am, truly, unemployable... a statement that includes rational and reasoning. For my IU claim, that is what is needed.... a strong statement (opinion) from a MD Specialist. The VA cannot argue with that.
I don't know if getting a statement from a VA doctor helps or not. I do know that in 5 years I've had 5 different doctors and everytime I have to go see them I have to go over all my problems with them, hell it looks like they should just look at the notes from the previous doctor and be prepared to treat me instead of me having to give my life story to each of them. I haven't had one long enough to build up any trust with them much less ask for a letter. Sgt D
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