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    • Hi - Just want to let everyone know there is hope if your claim is stalled. They are working at the Houston RO.  I got a call from DRO today, and told me I was granted IU with back pay. (PTSD/MST Rape & ATT Murder)  I have my Navy retirement too,  so I think this is the end of the road for me as far as claims go.  I will continue to pray for adjudication with other claims. This was exhausting.  Graduating in 72 days with my BS in Criminology- Thanks Voc Rehab.   
    • Well I suppose its ok for Lady member like MS berta  but I was referring to the lady members that have Endured MST/PTSD.  I can only imagine they don't care to hear about this type of talk..although were discussing it as  Male Health problem and for the wifes. If its ok with everyone  then OKIE-DOKIE.
    • TLDR: Had Mono and after a Live Flu Vaccine, got extremely sick and haven’t been the same since (going on 7 years). Was medically retired last month but backpay only from this past Feb (No TDRL or light duty), and other related conditions stemming from the same illness rated at 0% and Not Service Connected.
      So I’ve been meaning to write this for a little while and finally here I go.  I’ll try to make it as brief as possible because Lord knows I could probably write a book on it. Background:
      - 4 years enlisted AD USAF
      - After being out for a couple years (IRR) went into the USAF Reserves for a little while and got out as a SSGT
      - Went into the Army National Guard and commissioned as an Infantry Officer.
      - Total time is 15 years (they included my IRR time on my LES, AD time is much less)
      - Not sure it’s relevant, but I’m also Civil Service for the Navy (GS type).  Was a GS before I even went into the National Guard. So I did OCS, drilled regularly for a year, then went to the Basic Officer Leadership Course and Infantry School in Ft Benning.  I was on Active Duty in Ft. Benning for about 6 months. When I was at Ft. Benning I was in great shape and all that.  A couple months in a noticed that I was a little slower on some of the ruck marches, like one of the last ones; I thought I was just getting old, lol.  I was maybe 28 at the time and just about everyone else was right out of college.  One Sat night I went out and had about 3 beers, I was so sick the next day I went to the ER, I was puking and stuff.  I didn’t think I was hungover, I thought maybe food poisoning.  In hindsight, it was probably because my liver wasn’t functioning properly (more on that later). Continued on and about a month later I was on a 12-mile ruck and I was having real problems. Couldn’t keep up at all, one of the guys even took my weapon because I was having trouble carrying it and I got separated from my team.  I couldn’t think straight, was achy, out of breath, etc. Again, I thought I was just getting old.  When I got back to the barracks I was climbing the stairs to my 3rd floor room and couldn’t make it up half a flight without having to stop to take a break. At this point I realized it wasn’t just me “getting old”. I went to the ER the next morning, they didn’t really do anything and sent me home. By evening I felt so bad, I went back.  They did some tests; I was anemic and jaundice (liver not functioning), kidneys weren’t working properly, internal organs were swollen, glads were visibly swollen… I was a mess.  They diagnosed me with Mono and said I had had it for at least a month or two. Now a lot of people get Mono and don’t even know it because the symptoms can be mild.  I think this was the case with me.  In hindsight, it didn’t get bad until I had the Flu Vaccine.  I believe it was the same day that I got real sick I had the Live Flu Mist, which you may know, you can’t get if you have a compromised immune system (you can’t even get it if you’re going to be around people with a compromised immune system).  Having Mono, my immune system was compromised. They wanted put me on a medical hold, but me wanting to “soldier through it”, and also not wanting to delay me being away from wife and kids at home, said I wanted to continue on (I only had about a month left).  So I continued on and eventually they dropped me for a failure to perform (whole other story, but probably not pertinent).  I was taken off orders and sent home.  I drilled for the next couple months until my unit said I had to get my health back and put on a medical waiver.   Now I was out of my regular job for about a month after coming back, but honestly I probably shouldn’t have worked for the first couple years.  I was fortunate enough that I was able to finagle it so that I could work from home.  Had I not had a Fed Gov job and been able to telecommute, I have no doubt I would have been unemployed and possible ended up homeless. Of course with Mono, I thought a couple months and I’d be back to normal.  Then a year went by, then 2, then 5, then 7 (now).  At first there was nothing really tying my medical situation on Active Duty to my need for a medical waiver for drilling.  After talking with my unit, they said that the Active Duty side should have done a Line of Duty on me. Active Duty side said that my unit should fill out the Line of Duty.  I fought real hard the first couple years to get it sorted out.  I went to the county VA Rep, contacted the Adjutant General’s Office, the VA, etc.  In fact among other things, I couldn’t even get my per diem and other expenses reimbursed for the 6 months I was TDY.  I think mine was a weird situation because I was on State training orders when I got sick, but the length of time is longer than most training orders.  The County VA Rep wasn’t even sure if I’d fall under the VA, said because it was State orders, I may have to go through workmen’s comp. So after the first couple years fighting to try to get it sorted out, I kind of gave up.  They kept on renewing Medical Waivers for 6 months at a time.  I’d get orders every once in a while assigning me to a different section or unit.  In speaking to someone who used to be personnel there, they told me that the different units in National Guard were basically just shuffling me around on paper so they did’t have to deal with it/the situation. I think it was Nov of 2014 they wanted to separate me and asked for my medical records and all my info.  I gave it to them and then was told there’d be a delay and to touch base after the holidays.  I touched base early in 2015 and it didn’t really go anywhere.  In Feb 2016, kind of out of the blue, I was told they were going to process me for a medical separation or medical retirement.  I made the appointments and went through the IDES process. Weird thing is, my IDES results the Army rated Chronic Fatigue Syndrome at 40%, the VA rated 0% and said it wasn’t service connected. I had gotten a military lawyer for the process and he said they could only work on the disability that caused me to be unfit for service.  He said rather than taking a chance getting the 40% changed to something lower, or even 0%, to accept the findings and appeal for a reconsideration for a higher rating.  I appealed for higher than 40%, but was denied. 
      So I ended up with: - Chronic Fatigue Syndrome - 40%
      - History of Mononucleosis - Not Service Connected
      - History of Fibromyalgia - Not Service Connected
      - Unspecified Anxiety Disorder - Not Service Connected
      - Gastroesophageal Reflux Disease - 10% (back from the USAF days).
      Military 40%, VA Rating is 50%.  They medically retired me from the Army in Aug 2016.
      Now I got backpay going back to Feb 2016.  I guess I have a few questions. 1.  Backpay from Feb 2016 because that’s when I officially filed; what about the previous 6 years.  My understanding is that I should have been kept on AD on light duty or put on the Temporary Disability Retirement List when I first got sick, not just taken off orders and sent home. 2.  What should I do about the other conditions rated at 0% and Not Service Connected.  While I see these as all parts of the same illness (and they are all symptoms of CFS), I understand the VA breaks them out separately.  Thing is, they all happened on AD, from the same illness, at the same time.
      I’d appreciate any advice, insight, opinions, or whatever else you can give. I really really tried to limit all the information, but if you need anything else or more detail, I’ll be more than happy to provide.  Unfortunately I’ve learned more about CFS than I ever hoped to be.  I’m pretty well read into the history and aware of most of the latest information, theories, and trials regarding the disease. On a side-note, the Physician’s Assistant at the IDES process said that they had a retired Doc that held a CFS clinic once a month or week and asked if she wanted to see if she could get me in.  I’ve been able to see him since that time and it’s given me great hope. He’s an expert in the field, having published papers, conducted clinical trials, and has worked with the NIH/CDC. Again sorry for the long write-up and I appreciate any responses.     Aaron :-)
    • What does "non forensic DX of ptsd" mean? What I am saying is that the dx did NOT come from the c&p doc but rather my va psychologist. Make sense? im just trying to see if theres a chance with that info. Im pretty confused. I know the ptsd dx is required by a va doc per regs but just dont know that a diagnosis prior to the non favorable c&p would help.

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Does Anyone Know Why Its Longer For More Complex Claims?

16 posts in this topic

I recently retired and submitted my BDD claim. There were multiple items claimed and from what I have read it will take longer to get my claim processed. As a matter of fact they estimate late Dec 2012 to April of 2013 and I filed and had my C & P exam in February but my retirement date was 01 May. I understand that it will take longer for my claim because there are more items and its more difficult, but do they take the easier claims and put them on top of the pile? Don't they process claims in the order in which they are received? If so this would mean all claims would take about the same amount of time.

I am a patient man so I understand it will take time, just curious about the process.

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Not to be a smartass, but the title to your post answers the question it asks...In my experience though, they're not "supposed" to put more difficult claims at the bottom of the pile, they work them in order in which they were received. Now, I know many members here may flame me, but remember, that's how it is "supposed" to work!!

Semper Fi!

P.S. I've been waiting on a very simple dependents claim now for the better part of a year, so I hope you are a vvvvveeeerrryyy patient man...!

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Complex = lots more to do!

I initially filed with help from the state commission on vets affairs, and the guy wrote it up with a whole lot of claims... depression, anxiety, back problems, sleep problems... on and on. This was not smart, it just confuses the raters (it shouldn't but it does...) I eventually filed for reconsideration after being denied outright. On the second round, I had some assistance from a social worker in the PTSD unit who focused on this.

When I was finally awarded, it was for PTSD solely. All else either fell under this category or was ignored. So, yes, simple and bare bones probably stands a better chance. If the rater is very responsible and attentive, and there are lots of contentions, then they have to follow through on a number of things, C&Ps for several issues, etc. If they are NOT as responsible as they should be it just looks like work!

I would say, don't ignore serious issues, but it is probably to your benefit to keep it as simple as possible.

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This is what I thought was happening. It's an extract from the NY Times article from June.


"The employees also complained about the performance review process used to measure their productivity, saying it reduced the quality of work and hurt morale. The process requires claims processors to complete a certain number of files per day. People who fall short can be denied promotions or fired. Those who meet or exceed quotas become eligible for bonuses.

The workers said those quotas encourage processors to take shortcuts that often lead to mistakes, or to focus on easier cases over complex ones. And when in doubt, processors tend to deny claims, the workers said, because denials are generally faster."

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Yes, I saw this. On one of the other well known websites, a moderator who alleges he was a DRO trainer gave an entirely different view point suggesting that Va employees erroneously award benefits because its faster than a denial.

While I knew this former DRO was feeding us with KRAP, I was pleased to get it refuted by employees who work there. It makes me wonder what else this DRO posted when he knew it was false.

A denial has to be faster. There are no calculations and retro to figure out, and multiple signatures are not required for a denial. They simply "cut and paste" the letter, and fill in a reasons and bases for denial. While awards also have a "reasons and bases", a Veteran is unlikely to ever dispute the "reasons" your benefits were awarded.

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Yes, that the more you claim the longer it takes to get the claim settled. Claims are worked first in first out... but that does not mean that a claim that was submitted after your claim is decided after your claim.. it means you claim is started first and however long it takes to connect the dots is how long it takes to get a decision. It happends a lot that a newer claim is decided before older ones and this happends because some claims are submitted with everything necessary to decide it. while other claims are received with no information and the VA has to get medical records, and request c/p exams.

As to a denial being harder than an approval.... this is true!

Approvals are really easier because to get an approval all the facts are know and the facts justify the award

Denials however must be justified......they are not faster....

And I doubt that few awards are ever given if a denial is warranted, but ironically many denials that turn out to be incorrect.....

Just like that effeciency report we got in the Army (EER, SEER etc... ) the rater must justify his comments with facts, it is a lot eaiser to tell the truth and rate correctly that it is to make something up and rate down....

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