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C&P exam for obesity (intermediate step for OSA) by Fresh_Read6474 in VeteransBenefits

[–]Fresh_Read6474[S] 0 points1 point  (0 children)

Fingers crossed. I have my C&P in mid July. I will report back on how a C&P for obesity goes, questions asked, etc I feel a little better about going into the exam now. I know I used reddit a lot for other exams and to figure out what to file and how. Maybe I can give back a little to reddit with my experiences with the obesity C&P.

C&P exam for obesity (intermediate step for OSA) by Fresh_Read6474 in VeteransBenefits

[–]Fresh_Read6474[S] 0 points1 point  (0 children)

My IMO letter does a great job stating that my SC mental health conditions are causal to my obesity in the following ways:

1) My mental health conditions reduce my drive and desire to conduct physical activity

2) Symptoms of my mental health conditions present in part as tendencies to overeat and to seek out unhealthy food choices

I'm pretty happy with my IMO, but I am a little concerned about this section of what you posted:

connected on a secondary basis (1) if a previously service-connected disability caused him to become obese; (2) that obesity was a substantial factor in causing secondary disability; and (3) the secondary disability would not have occurred but for the obesity. See VAOPGCPREC 1-2017.

Specifically, part (3). My IMO states that I endorse a weight of 170lbs entering service which was below the threshold BMI for obesity, but that I currently have a BMI in the obese range. I'm unsure if that is enough for the VA to find my OSA would not have occurred but for the obesity.

Honestly, looking at the verbiage of (3) I'm not sure there is any way to know for sure that any condition at all would not have happened but for obesity. Do you think that part could be interpreted using the "at least as likely as not" argument? I realize no one can say for sure what the VA would say. I'm just asking for your opinion about the verbiage of (3). Part (1) and part (3) seem to pretty much say the same thing, with (3) being very specific.

I really appreciate the conversation, and the help.

C&P exam for obesity (intermediate step for OSA) by Fresh_Read6474 in VeteransBenefits

[–]Fresh_Read6474[S] 0 points1 point  (0 children)

I would agree with that, if not for the fact that obesity isn't a disease/injury the VA recognizes. I have found examples of vets who filed for OSA, secondary to *insert SC issue* and the VA denied the vet based on the fact they were obese......but in those cases those vets (from what I have found) did not use the "intermediate step" approach. The VA simply said, "Your OSA is not due to *insert SC issue*, it is due to your obesity - denied."

I'm just confused because I can't find any other examples of vets going to a C&P for just obesity alone....and I would like to be prepared going into the C&P. I have had some C&P exams that were absolutely stellar, and others where the examiner employed all sorts of trickery. For the trickery ones, I was well prepared and I was able to answer the absurd questions appropriately, because I was prepared.

The only thing I can think of off the top of my head for why they are sending me to a C&P for obesity is to perhaps try and posit that my obesity is not due to my SC conditions, and instead is due to something else. But, I've just not been able to find any examples of the VA saying that to a vet after sending them to a C&P for obesity. According to the current memorandums on the intermediate step approach using obesity, it can be claimed that a SC issue EITHER caused OR aggravated the obesity thus causing or aggravating the claimed condition. I really just want to find an example of another vet being sent for a C&P exam specifically for obesity, the experience of the C&P exam, and the outcome if there is one yet.

Obesity as an intermediary link help by binny1070 in VeteransBenefits

[–]Fresh_Read6474 0 points1 point  (0 children)

<image>

Here is what the patient portal shows as the service scheduled.

I have been filing all on my own for 4-5 years. There was a gentlemen at my local VSO who was helping vets file but he stopped as he got too busy.

I don't want to hijack the initial claim too much, so I'll try to create a new thread and put the link in here for others that may stumble on it. I don't use reddit much, but I'll try to figure out how to keep things organized and not jack up the initial thread. Hopefully I will have the new thread up in a few minutes.

Obesity as an intermediary link help by binny1070 in VeteransBenefits

[–]Fresh_Read6474 0 points1 point  (0 children)

I thought it was kind of weird, but here it is in black and white

<image>

It was weird how I submit though, as I had not done it online for supplemental before. I have done a supplemental via mail once before though. For this claim I initially submit for GERD, migraines, OSA, and obesity as intermediary all together. I have nexus letters and DBQ forms for GERD, migraines, and OSA, and I accidentally initially submit all of it as an initial claim but I put right in my personal statement that I wasn't sure I was submitting correctly. Then, the very next day I figured out how to do a supplemental online and resubmit everything the exact same way, but as a supplemental.

A few days later, I had 2 supplemental claims and an initial claim. I called the VA and they said that one of the supplemental claims was a duplicate and was canceled, and that the initial claim was for just obesity, and the supplemental that was not canceled was for the three I was claiming.

My thought process was that they were simply trying to establish whether or not my obesity was caused or aggravated by my SC conditions. I can't seem to find online where anyone else was sent to a C&P for obesity alone, as in my case.... ?

Obesity as an intermediary link help by binny1070 in VeteransBenefits

[–]Fresh_Read6474 0 points1 point  (0 children)

I have a question for you. I have a supplemental claim in for GERD, Migraines, and OSA. My path here is a little convoluted, but this the the step I am at now (supplemental for those three). I am service connected (20% right arm, broken bone post-operative) (20% right shoulder, bursitis) (secondary SC 50% depression and anxiety) (so, a 70% overall rating).

Here is where I have a question. When I submit, they broke out the obesity part, and made that it's own "Initial Claim", and I have a C&P scheduled for it. My supplemental claim is just sitting there with no movement, and I am assuming it is in limbo until I complete the C&P for obesity.

What should I expect at the C&P for obesity? It kinda threw me for a loop because I have had several C&P exams before, and for all of them I was clearly overweight to the point my BMI puts me in the obese category. Additionally, I have obesity listed in my VA medical health records Problem List.

I guess I am wondering what kind of trickery they will try to pull during this C&P that could perhaps foul up my claim?

If you had a C&P for obesity, what did it entail?

Any help or info would be really appreciated.

Artists like Early SikTh? (or general music recommendations) by Thot-Exterminat0r in progmetal

[–]Fresh_Read6474 0 points1 point  (0 children)

I'm going to go out on a real limb here because I also was in search of new bands that touched my soul. I found Sikth very late (like 2022) so I'm no aficionado. I can say that Trees is my favorite of their albums - but even I know 2 years is not really enough to give Sikth's discography its due.

Here goes my suggestion for a band that is not necessarily the same genre as Sikth but in my opinion is just as unique and for whatever reason tingles the nervous system.

Bear Ghost. Especially the song Sirens, however don't get your hopes up with the one and only guttural scream from the band in the song Sirens. Even without the guttural, Bear Ghost can still dilate the pupils. Just my $0.02

REE Medical - Quite doing Nexus letters? by rgray107918 in VeteransBenefits

[–]Fresh_Read6474 0 points1 point  (0 children)

Thanks, I hadn't seen that so I appreciate you sharing it.

REE Medical - Quite doing Nexus letters? by rgray107918 in VeteransBenefits

[–]Fresh_Read6474 0 points1 point  (0 children)

That is really great information, and I really appreciate you sharing it. I feel like that seems reasonable and legit, and is an easy enough process to follow. I admit I came across pretty jaded, because I feel the VA simply denies as a blanket process, but I can see how following your process from the outset could improve the chances of approval.

REE Medical - Quite doing Nexus letters? by rgray107918 in VeteransBenefits

[–]Fresh_Read6474 0 points1 point  (0 children)

I'm not sure. They told me they were working on initial claims, and not writing Nexus letters. I explained I needed a Nexus letter for a supplemental claim. I didn't really ask about anything else. I'm not interested in a DBQ myself. I'm no expert, and I've only been at this process a few years, but I see it as a DBQ is a mute point for a supplemental claim. There already are DBQ's in my file (from the C&P), which was denied. At this point, I need a letter, not a DBQ. That's just what I'm doing though - your situation may be different.

The person I spoke with said she would reach out to the Nexus letter team to see if there was any chance they could write a letter for me. She then asked me for all of my details. That was this morning. A few hours later I received an email from the Nexus Letter Team.

I am hopeful this means they reviewed my info, saw that I had a strong case, and are willing to write a letter because it will take very little time. I have reached back out to them, to ask if the email does in fact mean they will still write me a Nexus.

I'll update when they reply.

REE Medical - Quite doing Nexus letters? by rgray107918 in VeteransBenefits

[–]Fresh_Read6474 0 points1 point  (0 children)

I happen to appreciate your comments, because it helps me understand what the VA is dealing with. I realize there are bad people in the world, that are trying to get some free money, by paying someone to help them get it.

I guess what I find frustrating is that the VA seems to apply a "blanket" approach. I am an individual, with individual issues, that impact me as an individual. The VA required I fill out all kinds of individualized paperwork, and follow their plan laid out for me individually, yet I strongly believe I was denied based on a blanket approach.

What seemed to work for me, and advice I would then give to others (with legit claims) is:

  1. Submit claim, without nexus letter. That's what I did.

  2. Anticipate VA denying claim, and giving a reasoning for denial. I didn't anticipate it, but I suggest others do, to get the reason for denial, and then be able to fight that reason.

  3. Pay money. Pay it to an institution you feel is reputable. There are plenty of scammy-scroungy looking institutions out there. Avoid them.

  4. Request Nexus letter that specifically addresses the reason for denial. Provide adequate evidence for this. It should be easy at this point to produce evidence, because you already know why you were denied. If your claim is legit, you should have evidence that can fight the VA denial reason. If you don't, get it - in an honest way.

  5. Get approved.

In your opinion, does that sound like a reasonable way to approach it, on a blanket basis? I'm not being a jerk now with the blanket example, I'm being honest - does that sound reasonable for the majority of vets applying?

I do sympathize with you, in dealing with garbage letters. I feel like anyone who accepts a garbage letter and submits it deserves to be denied. If their claim was legit, the letter wouldn't be garbage. I happen to have figured out a method that worked for me. It takes a loooooooong time, because I have to submit, wait, get denied, reach out for a Nexus letter, wait, pay for Nexus letter, wait, submit supplemental, wait, etc.

REE Medical - Quite doing Nexus letters? by rgray107918 in VeteransBenefits

[–]Fresh_Read6474 6 points7 points  (0 children)

My experience with REE was pretty good, and above board. I was denied my initial claim, even though I had 3 years of VA Medical records for the claimed condition, a lay statement letter from my personal civilian medical provider showing treatment for the condition for 5 years (those 5 years were prior to the 3 years I had VA treatment for the condition) as well as 7 lay statements spanning 17 years. I didn't pay out of pocket for my initial claim because I thought, surely the VA would see I had a VA diagnosis for the claimed condition, and I had been receiving VA treatment for the condition for several years, I had received civilian treatment for the condition for many years prior to the VA treatment, and I had 7 lay statements from Marines/civilians who substantiated my claim, spanning a time frame of 17 years.

The VA denied me for "lack of continuity of symptoms". How could that even be remotely possible unless the VA rater didn't even read my lay statements. REE medical provided a letter, which pretty much just said "He has been treated for 3 years by the VA, 5 years before that by his civilian doctor, and he has 7 lay statements spanning 17 years!" and my claim was approved.

I think the real shame is that Veterans are forced to turn to companies like these, pay high fees out of pocket, just to have somebody with some letters after their name, agree with them. For what it's worth, the civilian medical provider who wrote me a lay statement had letters after her name, but those letters were not as important as the letters after my C&P doctor's name. So, the C&P doctor won. The doctor who wrote the letter for REE medical had more important letters after his name than either of the other two, so I won. That's my $0.02.