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SUCCESS? REALLY ? YES!! You can have it too !
The following letter, describing success in the face of difficulties, is from one of OnlyUSA.us's most prolific participants. This colleague has faced many obstacles; but he still fights until he achieves his due benefits. Please listen to the success story of one of your Veteran allies.
If you are a Veteran and have a service-connected condition, you will find help at the VA. Getting the said help sometimes be challenging.
The claim process will be long, mostly due to so many fraudulent claims filed. One source suggested that over 90% submitted are fraudulent. Fraudulent claims slow down the system. The VA is criticized for being slow rather than being overwhelmed by the Veterans filing false claims. Finger-pointing does not help anyone.
I am happy to explain the path you, as a Veteran, need to travel.
As a Veteran, you need to be your advocate, and not rely upon over tasked service groups, or VA advocates.
Example of a roadblock.
A Veteran files a claim for a heart condition secondary to an approved rated condition, PTSD. You will be required to have a C&P exam. The C&P is often an MD rather than a specialist like a Cardiologist. The MD is often not current with the latest findings in the correlation between stress (PTSD) and the heart. As a Veteran, you need to find a specialist qualified to refute the VA Doctor.
The ones I used were from the articles or publications used by the VA Doctor. I would speak directly to the author of the research. My finding is the Doctor often used a snippet from the release. Then add their understanding of the study.
I would call the author and ask. Often there was a large gap between the author and the VA Doctor. One researcher told me she was sick of Doctors making an incorrect interpretation of her work, and other published works. She offered to send me her complete study that the VA Doctor used to pick snippets to support the Doctor's interpretation. The subject line read, "Good luck with your battle against ignorance."
The VA Doctor who offered her opinion on my claim is an outside Doctor of Family Pratice for five years. Her exam refuted the expert source I used to present my evidence.
My next step in this example was to find a highly creditable Cardiologist who understood my claim. I had to take an exam. And then, the Doctor wrote his findings of my condition plus the correlation of stress.
I will continue only to show the work can be extended as new information is tested. The Judge had me scheduled to be examined by another VA Doctor. The Doctor used excerpts from "The Harrison Principals of Internal Medicine."
I found the opinions of the VA Doctor confusing. Especially findings from The Harrison Principals, my next action was to call the Chief Editor of the Publication then ask for his opinion as to why there was nothing written referencing a correlation between stress (PTSD) and the impact on the heart.
His answer cleared the confusion. He pointed out that a publication like The Harrison Principals of Internal Medicine was already five years behind medical studies when released. Then it was laughable the edition used by the VA Doctor was several years outdated. He continued by pointing out the recent publication referenced a High Correlation between stress from PTSD and heart conditions.
My appeal went back to the same Doctor with instructions for him to read the current copy of the Harrison publication.
The Doctor responded that "high correlation did NOT mean causation." Something that could not be disputed, and my claim was denied again.
Before I continue, I need to say that I have a lot of respect for the content of "The Harrison Principals of Internation Medicine." Also, the Doctors at the Va who examined and opinioned on my service-connected condition. To err is human.
To continue with the example. The example is not to discourage you from filing a claim, but to make you aware; you must go through the effort of being your advocate.
Correlation and causation are not the same. However, a Veteran does not need to show causation (100% the cause) but the correlation (50% threshold). As many knows, John McCain attempted to change the wording of a claim to read must show causation. Changing the text to include causation would have prevented many applications from being approved, including PTSD, because it is impossible to show 100% a trauma is an absolute cause.
I showed in my appeal that causation, as the VA Doctor used, is not a requirement of approving a claim. Many citations use the wording of correlation.
The next denial was based on a letter from a Professor of a major University. His letter pointed out the flaw of the Veteran (me) to rely on the Harrison Principals could be misunderstood by a layperson (me again). This Professor went on to offer other situations that made my claim invalid and used his signature over Major University.
What the Professor failed to see it was the VA Doctor who relied on the Harrison Principals, not me. The examples this Professor used were not relevant to my claim, and he failed to reveal was that he was a C&P VA Dr working at a VA facility.
The claim was granted.
Bottom line the filing of a claim can be tedious, but necessary.
You have the right to present your case, and when doing so, be sure to research your evidence.
The VA is Your Friend_March On_ Semper Fi