VAC Doctor does not agree with my Doctors

[rand_d]

In 2010, I had a form of Brain Surgery to release cranial fluid pressure on my brain. Since then, I have various symptoms that started after the surgery, and I am being medically released because of them. SISIP has deemed that I will be on LTD until I am 65, and due to my mental state, I will be unable to do any Vocational Rehab. I just received my decision letter from VAC, and according to their Medical Adviser, my surgery had nothing to do with my disability. In their explanation, the adviser seemed to only use only the medical records that supported her diagnosis, but seemed to gloss over the records that supports my claim. Does this happen often?

 

[Fishbone Jones]

It happens all the time. You've just started down a long, administratively burdensome but well travelled road. Get to your nearest Legion and engage the VAC Service Officer.

 

[maniac]

yup, recceguy that's good advise.

 

[rand_d]

I was told that I would get a lawyer to fight the decision, is this good enough, or should I go to the legion? Recceguy, how long are we talking here?

 

[George Wallace]

I was told that I would get a lawyer to fight the decision, is this good enough, or should I go to the legion? Recceguy, how long are we talking here?

Try the Legion.  Lawyers cost money.

 

[rand_d]

Thanks George Wallace, I didnt think of that.

 

[Occam]

Try the Legion.  Lawyers cost money.

If he was told he would get a lawyer, then it's a pretty safe bet that they're talking about a BPA lawyer - which I would take any day over a Legion Service Officer.

rand_d, has BPA (Bureau of Pensions Advocates) been in touch with you? 

 

[Fishbone Jones]

I was told that I would get a lawyer to fight the decision, is this good enough, or should I go to the legion? Recceguy, how long are we talking here?

That lawyer you were promised works, and is paid for, by Veteran's Affairs.

It kinda like being charged for a crime by the Crown Attorney and then asking him for advice on how to beat the charge. You figure out if that's good enough for you.

You can, literally, be fighting this for years. Especially, if they decide after the first couple of appeals, to dig in their heels.

 

[Occam]

That lawyer you were promised works, and is paid for, by Veteran's Affairs.

It kinda like being charged for a crime by the Crown Attorney and then asking him for advice on how to beat the charge. You figure out if that's good enough for you.

You can, literally, be fighting this for years. Especially, if they decide after the first couple of appeals, to dig in their heels.

That's an awfully cynical view of BPA lawyers.  It's their job to represent you to the best of their abilities.  I don't know if Legion Service Officers have access to VAC's computer network, and to decisions databases or whatever other legal resources they have, but I can tell you that BPA lawyers do. 

My personal experience with Legion Service Officers (at least at the branch level) can only be described as craptacular. 

However, BPA lawyers have, over the last 6 years, successfully increased my disability pension from 5% to 15% through the Departmental Review processes and one VRAB review hearing.  Whenever VAC threw up a roadblock or botched paperwork, BPA did as advertised and tried to find ways around it.  I have nothing but good things to say about them.

 

[the 48th regulator]

In 2010, I had a form of Brain Surgery to release cranial fluid pressure on my brain. Since then, I have various symptoms that started after the surgery, and I am being medically released because of them. SISIP has deemed that I will be on LTD until I am 65, and due to my mental state, I will be unable to do any Vocational Rehab. I just received my decision letter from VAC, and according to their Medical Adviser, my surgery had nothing to do with my disability. In their explanation, the adviser seemed to only use only the medical records that supported her diagnosis, but seemed to gloss over the records that supports my claim. Does this happen often?

Was the original injury caused by Service.  If not, are you saying that your Doctor's are accusing the Surgeon, who operated on you, and was contracted by the CF caused further injury, and now you suffer these symptoms?

These are the things VAC is looking at.  Just because you become ill, does not mean that you are entitled to VAC coverage.  Can you please give us more information.

dileas

tess

 

[Fishbone Jones]

That's an awfully cynical view of BPA lawyers.  It's their job to represent you to the best of their abilities.  I don't know if Legion Service Officers have access to VAC's computer network, and to decisions databases or whatever other legal resources they have, but I can tell you that BPA lawyers do. 

My personal experience with Legion Service Officers (at least at the branch level) can only be described as craptacular. 

However, BPA lawyers have, over the last 6 years, successfully increased my disability pension from 5% to 15% through the Departmental Review processes and one VRAB review hearing.  Whenever VAC threw up a roadblock or botched paperwork, BPA did as advertised and tried to find ways around it.  I have nothing but good things to say about them.

I've had the same experience with VAC lawyers as you've had with the Legion.

You know nothing of my cases. I'm entitled to be cynical.

The OP asked for advice. He's entitled to hear it, warts and all.

Now he has more than just your option and can decide for himself.

 

[blackberet17]

From the VAC guy:

Legion Service Officers can represent you. However, they are not necessarily the best people to do so.

They can be like the blind date. Nice personality, but do you really want to take her home, let alone home to mom?

LSOs don't have the experience with the disability application process. Far too many a time I have seen LSOs lead people down the wrong path. It wasn't intentional, it was simply good intentions backed by little to no experience.

Yes, Bureau of Pensions Advocates are laywers paid by VAC. However, they ARE lawyers. There is a fair amount of legislation and procedural wrangling involved in the process. They also have far more experience with the process, more often than not (we hope) can quickly and easily determine what is missing from your claim and help you figure out how to get it, and, as someone else pointed out, have access to our internal database, which can be a useful tool.

BPA lawyers can also turn out to be the blind date you don't want to take home. But at least mom might like her.

 

[maniac]

You should be advised that the RCL Service Officer are co-representing you with the BPA.  The are acting as one and the Service Officer does hold the BPA Office's feet to the fire.

 

[rand_d]

My condition is not military related, but any doctor I talk to says it was aggravated by the military. I was misdiagnosed in 1991, and I had been asking for a MRI since 1995 to clarify my condition. I finally got one in 2008 which proved that I did not have what was diagnosed in 1991, and it took until 2010 to finally come up with the proper diagnosis. My symptoms got so bad that surgery was required, the surgery was considered risky, but I decided to go for it anyways. The surgery cleared up my symptoms of severe vertigo, constant migraines, and co-ordination symptoms. But since the surgery, I have become severely narcoleptic to the point that my drivers license was taken away within 8 months of the surgery.  I also cannot tolerate any cold temperatures, I get severe headaches and severe tinnitus under any temp below 10C. I have problems concentrating on mental tasks, and most physical tasks cause headaches and vertigo symptoms.  All of these symptoms that appeared after the surgery, I did not have before the surgery. Even with all the new symptoms, I am in better shape than before. On my last MRI of my head stated that my brain seemed to sag lower than normal, and my specialist seems to think this is the cause of my symptoms. I have not been contacted by anyone, since I just got word of the decision Friday.

Thanks for all the comments.

p.s.  Just typing this has given me a headache.

 

[the 48th regulator]

My condition is not military related, but any doctor I talk to says it was aggravated by the military. I was misdiagnosed in 1991, and I had been asking for a MRI since 1995 to clarify my condition. I finally got one in 2008 which proved that I did not have what was diagnosed in 1991, and it took until 2010 to finally come up with the proper diagnosis. My symptoms got so bad that surgery was required, the surgery was considered risky, but I decided to go for it anyways. The surgery cleared up my symptoms of severe vertigo, constant migraines, and co-ordination symptoms. But since the surgery, I have become severely narcoleptic to the point that my drivers license was taken away within 8 months of the surgery.  I also cannot tolerate any cold temperatures, I get severe headaches and severe tinnitus under any temp below 10C. I have problems concentrating on mental tasks, and most physical tasks cause headaches and vertigo symptoms.  All of these symptoms that appeared after the surgery, I did not have before the surgery. Even with all the new symptoms, I am in better shape than before. On my last MRI of my head stated that my brain seemed to sag lower than normal, and my specialist seems to think this is the cause of my symptoms. I have not been contacted by anyone, since I just got word of the decision Friday.

Thanks for all the comments.

p.s.  Just typing this has given me a headache.

Now, I am going to play Devil's advocate here, as these are the questions they will ask you in the appeal. 

My condition is not military related, but any doctor I talk to says it was aggravated by the military. I was misdiagnosed in 1991, and I had been asking for a MRI since 1995 to clarify my condition. I finally got one in 2008 which proved that I did not have what was diagnosed in 1991,

How many times from 1991-95 did you request for an MRI?  Are these requests documented, and are they on your medical file?  If so, what was the reason given to you for a delay in receiving an MRI?  Who misdiagnosed you, a CF medical officer, or a Doctor contracted out by DND/CF?

You see where the crux of it all is?  VAC wants you to provide evidence that the Government is onerous in aggravating your injury/illness.  If not, sorry mate, but I agree with them.

You do not have a service related injury, and unless you put in an aggressive effort to have this cared for, and the CF put road blocks in your way, which you can prove you do not have a case you will win.  That is my opinion, based on many years fighting the system to prove my Service related injuries deserved to be dealt with by VAC.

If you have the evidence, start getting it all together.

dileas

tess

 

[blackberet17]

Demonstrating the CF aggravated a condition is not very easy.

It's also not very easy to prove medical mismanagement, which is what 48th's questions are getting to...

Rand, if you want to chat more specifics, feel free to pm me, I may be able to provide some direction. Your case sounds complex, and I can't look into your VAC file without getting myself in trouble Do you know what your DO is? I know a number of the BPA lawyers, I may be able to recommend one over another depending on your VAC DO...

 

[rand_d]

Yes, my case is quite complicated. I had asked multiple times for an MRI, but was told that my original diagnosis was accurate. My diagnosis was done over the phone and by snail mail, I did not even see the specialist who came up with the diagnosis.  I had issues with pain medications that I told the surgeon that I had severe reactions to, but was given them anyways (Oxycontin) that aggravated my condition. I could go on, but you get the idea. Blackberet17,  my application was for medical mismanagement, but the reply I got back was " The department does not officially investigate the medical care provided by the CF".

Blackberet17 , as for my VAC DO, I have no idea. I will pm you.

 

[FJAG]

Demonstrating the CF aggravated a condition is not very easy.

It's also not very easy to prove medical mismanagement, which is what 48th's questions are getting to...

Rand, if you want to chat more specifics, feel free to pm me, I may be able to provide some direction. Your case sounds complex, and I can't look into your VAC file without getting myself in trouble Do you know what your DO is? I know a number of the BPA lawyers, I may be able to recommend one over another depending on your VAC DO...

I'll echo this post. In my private law practice I was frequently contacted by members and former members with VAC issues and I always referred them to the BPA for two key reasons. 1) These types of issues are very specialized and the BPA has the expertise to handle these claims and 2) Legal representation on these types of claims can be very time consuming and therefore be very expensive if a private lawyer is involved on a paid basis.

Regretfully my contact in Charlettetown is no longer with the BPA and therefore I can't assist you with any referral but from the sounds of it blackberet17 may be in a position where he can make a recommendation.

Don't delay. In my experience no claim gets better with time and there may be some time limits that you need to deal with.

BPA lawyers are something like "legal aid" lawyers: qualified members of the bar but paid by the government to represent individuals who have an issue with a government agency. They are bound by solicitor / client confidentiality and are there to represent your interests. I would not hesitate to use their service but do remember that every individual is different and some might be better than others. If you have a choice of which one you can go to and you can get a positive recommendation, go with it and let him or her help you evaluate your case.

Best of luck.

 

[blackberet17]

I did a quick search of the VRAB Web site for some of the medical mismanagement cases we may have posted for reading.

Here's one, to give you an idea of some of the difficulties inherent with med mis claims:

http://www.vrab-tacra.gc.ca/Decisions/Leading-sub-MedicalMismanagement-eng.cfm

I've only worked on two, maybe three max, in over five years, where medical mismanagement was claimed. The burden of proof is quite high...

 

[rand_d]

I got contacted by BPA yesterday, and I was surprised at the tone. The lady was pessimistic, and kept saying that  it was hard to prove medical mismanagement. We got talking, and she was surprised to learn that I am being medically released on the same issues that the VA decision dismissed.  I also told her that SISIP reviewed my case and that I would be on LTD until I am 65. She seemed more optimistic then, and suggested that I get my neurologist to write a letter supporting my claim. A lawyer will contact me next week, so hopefully she will think that I have a case.