Proven Tips #3: Ace a VA Disability Exam

February 12, 2011 | Benjamin Krause

Here’s a continuance of my own little story for service connection for the following: Sleep Apnea secondary to Sinusitis and Allergic Rhinitis. I was denied for these conditions right after my separation from service, in 2001.

A little background. I had a sleep study in service conducted by the Fargo VA. The VA had the records of a sleep study and was notified as such. Yet, during my evaluation, the VA did not request its own files and subsequently denied my condition. I had brief episodes of apnea but did not require a machine. They also denied service connection for the other conditions despite at least 12 instances within my service records requiring treatment. The effects of sinusitis were later confirmed in 2009 via an MRI as were the polyps from allergic rhinitis. The next year I was given a CPAP machine. 

Rubber, meet Road. In 2010, I put the whole claim together with a little documentation help from law school and “The Little Book on Legal Writing.” To see what I mean, here are the first couple pages of my claim. I called the Fargo VA for the actual sleep study from 1998. While on the phone, the FOIA guy at the VA faxed the records to me after a little convincing (that was the morning of my recent VA examination – don’t wait to the last second like I did). The records verified my apnea. I was also able to find Congressional Reports about the conditions of the dormitories we lived in while at tech school – there were issues of asbestos and leaking sewage along with outdated HVAC systems blowing particles around. I immediately came down with sinusitis and pneumonia after arrival. I included this documentation in the event that I come down with certain cancers down the road. 

Armed with the report, my medical records and a typed summary, I went to the exam. The first appointment was with an Ear Nose and Throat doctor. He said the VA already conceded service connection but he needed to find out how many episodes I have every year. I handed him my documentation. While he did not read over the documentation in full, he most likely referred to it after the meeting while filling out his exam notes. This is key, especially if the examiner did not take good notes while in the meeting or forgot some key point that you mention. The summary you hand him may be the difference between a 10 or 30 percent.

My second evaluation was for sleep apnea. I showed the doctor my current diagnosis along with the former diagnosis while I was in service. She took the time to read over my summary, which explained how the VA missed my earlier diagnosis. Since I had the old sleep study exam with me, she was able to clearly tell that I had sleep apnea while in service. Because of the way my documentation was set out, she told me on the spot that she was going to tell the VA I had sleep apnea in 1998. This could result in a decision for retroactive pay if I can prove VA committed a Clear and Unmistakable Error during their 2001 denial. 

For you. After you file your claim,VA will send a letter verifying receipt of your claim and notifying you of the information they need. This will include release forms they will need you to fill out in order to request files from civilian doctors you have seen. Be sure to read everything very carefully. Sometimes the dates can be wrong or VA might be asking for the wrong information. In addition, you may have better luck getting documents from doctors than will the VA. When you forward medical release letters to civilian medical providers for their records, be sure to follow up with a phone call to ensure they understand what you are requesting, especially for psychologists. Leave nothing to chance and never expect the VA will figure out how to contact these people for you.

At the examination for conditions like PTSD, VA has examination criteria online. Google whatever condition to read about the experience of other veterans after their exams. This can help a lot. First, it will help you frame your condition in terms that the VA examiner will use in their analysis of your condition. Second, it will help you think through relevant dates and issues prior to the evaluation. This increases your credibility factor with the examiner.

Lastly, write a one or two page summary about your condition. Click here to view my own example. Use bullet points with brief explanations of each and every treatment for that particular condition. Be careful to not overwhelm your examiner. Ask if the examiner has viewed your C-File before the exam. If not, you may have a claim for a review if the examiner gives you and adverse finding. If the C-File is not present for the exam, be sure to note the fact. A lack of C-File can bias your exam and be cause for a new one if you do not get the results you think you deserve.

In closing, be patient. The whole process can take up to one year or longer. So, do not expect the cash to start flowing in quick enough to pay next month’s rent. Next week is the last Proven Tips, where I will discuss VA grants and denials.

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Voc Rehab Survival GuideBenjamin Krause is an award winning investigative journalist, attorney, and disabled veteran of the US Air Force, where he served in its Special Operations Command. He wrote his guide, the Voc Rehab Survival Guide for Veterans, after winning his long fight for benefits against VA to help other veterans do the same. Benjamin is a graduate of Northwestern University and the University of Minnesota Law School using VA Vocational Rehabilitation.

About Benjamin Krause

Benjamin Krause is a Veterans Benefits Attorney and journalist who investigates problems veterans face with the Dept. of Veterans Affairs. He regularly reports on veterans' benefits news and analysis on the website DisabledVeterans.org.

Comments

  1. Excellent information!! Thank you for helping my fellow vets!

  2. TVC Counselor says:

    If your CSO can not help you or if you do not want his/her assistance, then try your local VFW or American Legion as they all have a service officer appointed. I am not excluding other organizations as there are too many to list on this page. The service officer's point of contact is usually the organization's representative at the nearest VA Regional Officer, where the claim is to be processed. Sign me also a VN vet.

  3. TVC Counselor says:

    Most "classified" missions into Camboia/Loas have already been declassified. When his NSC receives his C-File fm DVARO, look at his DD Form 214/personnel rcds for overseas svc, PMOS/DMOS, assignments, security clearance (which he should have had when and if he was attached to/for CIA mssions); The VA denial decision(s) to his claims will state actual "reasons for the denial decision" and "what is needed to overcome the denial decision". If he did serve during that time-frame, is homeless, and is having problems in getting his PTSD (+) other items approved, then maybe he should put in for NSC Pension. A key word he should put in his stressor letter "I was afraid for my life" , a phrase that might give him a better chance. Everybody in RVN should have been receiving combat pay and that alone does not really support the claim. A classified document stands a good chance to be declassified for the purpose in processing a claim. Vet can also obtain a "buddy statement" from someone who served with him in RVN/Cambodia, etc…. Sign me also a VN vet.

  4. Hope these help you:

    1. http://www.veteransdisabilitylawyersite.com/ptsd_….
    Under the old rules, veterans who did not have proof of a combat experience such a certain metals had to have evidence that showed corroboration of a veterans claimed stressor. This was often times difficult if not impossible for many veterans who suffer from PTSD. According to the VA press release dated July 12, 2010: "Under the new rule, VA would not require corroboration of a stressor related to fear of hostile military or terrorist activity if a VA doctor confirms that the stressful experience recalled by a Veteran adequately supports a diagnosis of PTSD and the Veteran's symptoms are related to the claimed stressor.

    2. http://www.va.gov/PTSD_QA.pdf
    para 8: Is the new regulation applicable only if the Veteran's statements relate to combat or POW service?
    No. The rule states that the stressor must be related to a “fear of hostile military or terrorist activity,” and the claimed stressor must be “consistent with the places, types, and circumstances of the veteran’s service.”

    Doug
    DC Veterans Medical Center

  5. Don Cloer Sr, says:

    I have requested, and received my C File from the VA. (in my case, Tampa, Fl) To my knowledge, your C File is an accounting (copy) of anything/everything, medical, Doctors, everything you ever had relating to your visits, medical procedures,. in short a comprehensive,complete,exacting record of YOUR medical history. While that file may be thin for some service members, It may be 12" thick, or thicker for others. To my knowledge it is a comprehensive report WELL WORTH the efforts to obtain one, regardless of your current/latent, known or unknown NEEDS.

  6. Don Cloer Sr says:

    How about an old adage, and advice, that is older than dirt, rings very true, (most of the time) and is 100% as good and dependible as the giver. IF YOU WANT SOMETHING DONE RIGHT, DO IT YOURSELF…

  7. Fred, I recently went for my C & P Evaluation after (40 Yrs.), I served in country 1968-70, the shrink gave me a (49 rating), I am waiting for the review board to see what percentage there going to give me, I also have Agent Orange, tested (Positive), I also have acute & subacute neuropathy, they denied me on that one, I have to appeal that decision, I wish you all the best, kindly keep me informed on what your % rating is for the agent orange, best of health & Good Luck. Tim

  8. when i applied for ptsd, va sent me a package of forms to fill out. i had no idea where to start. i called va & made an appointment to get someone to help me. the guy at va told me approx. date & place of occurance. good luck

  9. brainman says:

    the best way to get your rating increase is too work with a state disbility organization, i.e. Texas dept of va, Fla.dept of VA the state pays these guys to get your file processed fast and right the first time , you do notneed a lawyer or other organiztion. trust me I have tryed them all and those folks know rhe laws inside and out. my opinion………………….

  10. My previous comment on my request for an increase in my AO % WAS ILL-CONCEIVED AND IMPROPER! It took 5 months for a decision but I received 2 personal letters from VA stating that they were sorry for the delay but that they were working hard to arrive at a conclusion in view of my AML terminal condition. Not only did they approve my request but they also notified me by phone the same day, a week before official written notification. Nice going, VA, thank you!

  11. Thank you again, VA. You have taken a burden from my wife to attempt to reconcile my claim after my death. You know what? it`s making me feel better physically. Some will fall through the cracks, but given the facts and the mandate, you will prevail. God Bless America and the dedicated employees at VA.

  12. The Veteran Adminstration makes it hard for anyone to win my case it seems the veterans doesnt care about veteran. I went to the Regional Veterans in Denver Colorado i see how hard the veterans employees work coffee break every 10 minutes in seems.That why the va is so far behind I have no Faith In the Veteran System.

  13. kyle roseboro says:

    my ptsd claim has left the rating board and is now at the supervisor level. what does this mean?

  14. kyle roseboro says:

    my ptsd claim has left the rating board and is now with the adjucator. is this good or bad?

  15. gloria green says:

    my husband contacted MRSA at the V.A. hospital in Kansas we have tried to to tell the VA this for years only to went before a board they did not beleive him although it is in his medical records he got this after a herina operation which had infected stitches which were removed three different times.but they say this is normal. I cannot beleive this but we have tried for years to tell them this but always comes back not there fault.Guess the older Vets are ot good enough for compension or anything else I know all the youg men coming back now but remember we are lder vets and need help also. Now he has cancer
    GG /wife of Korean Vet

    • Gloria
      Have you ever considered on filing a Tort claim. In addition, you should come to a veteran friendly website called hadit.com.

  16. DarylGrimes22 says:

    If you consult a online physician consultation, it'll be easier for you to take an exam. You won't have to go to the hospital because all you need to do is turn on your computer and take the exam online. Results will come out faster as well, and you'll know your problem in an instant.

  17. I was given a sleep study by the va and a month later they want me too come in for a cpap and class will I now receive a rating for sleep apnea

  18. Brain cancer surviour. Stationed at Ft Mc Clellan have been trying to get disability for 2 1/2 yrs. We may lose our house. Does anyone know how to et this claim moving

    • Hi Robyn, I assumed you have applied for disability compensation already? Are you aware of the incident regarding the PCB chemcial exposure at Ft McClellan?

      • Hi I was told I don't need an exam I have been told this 2x just the records. They have the records are they correct are the VA reps correct?

        • You need to contact the 1-800-827-1000 number and put in for financial hardship in order to have the claim expedited.

  19. I was asthmatic as a child. My last attack was at the age of 11 and I joined the military at the age of 28. When I took my my entrance physical I told the doctor about this condition, but he said that since it had been so long since an attack I was eligible to join. However, when I started doing PT, going through the gas chamber and being stationed in different climates, lo and behold my asthma came back with a vengence. I was given a P3 profile and could not be stationed anywhere if a medical facility was not within a certain radius. When I applied for compensation, I was denied because they say "it was a pre-existing illness." I looked it up and it states that "if this condition was aggravated" I qualify for compensation. I have been denied twice but I refuse to let them do this to me. I gave them 13 years of my life and now they want to give me nothing but my medication. Has anyone else had this problem?

    • Denny Sent. says:

      Terry have you talked to a Lawyer about this? There are some excellent lawyers that do nothing but VA.appeals.. Just Google VA compensation attorney's and you should find many willing to take your case and many of them take no fee until you win your case. They will not even take it if it isn't winable

  20. With the current government financial sequestration, VA Claim seems to be getting harder to process. VA claim evaluator are really trained to persuade or discourage claimer to continue with the disability claim process. One has to find the loopholes/evidences really hard to convince evaluator that he or she deserves such claim.

    • As a VA disability examiner, I find it very offensive that you indicate that we're training to persuade or discourage any veteran making a claim. I don't know about anyone else, but I review all available records IN DETAIL. And keep in mind, that it is the veteran's responsibility to get outside records. There are many veterans with valid claims who have been misdiagnosed, or gotten the brush off, but for each one of them are ten more whose claims are bogus.

  21. michael weatherford says:

    I was injured during my service in 1970. While still in the army I took leave returned home and saw my family doctor. He stated I needed surgery to repair the defect. This fell on deaf ears. Upon my release in 1972 I filed a claim with the VA. My claim was denied .I tried again approximately 1984 was told same claim and I didn't file an appeal so they wouldn't even look at it. In 2013 I discovered the letter my family Dr. had written back in 1970 . I filed again this time I was given a C/P exam and within 10 (ten) days was awarded 40% disability with 1 year back pay. the only difference was the letter. I've had to live with the pain for 43 years. Now the VA says it's to late for surgery. I feel the VA owes me 43 years back pay. In doing my home work on this I've learned of something called a CUE . Clear Unmistakeable Error. would it be worth my while to pursue this avenue?