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    • Case manager's job us to assist the rating specialist with delaying your claim as long as possible, especially if the rating specialist can not think of a valid delay tactic.    Sometimes rookie raters can not think of a reason in the world to delay, and need help from CM.   In the event both can not figure out a valid dely method, the next best is to figure out an excuse to deny.   With Social Security, the CM is on the employee (social security) if the claim is delayed over 90 days, with VA, the CM complains to the VA employee if he gets too many claims done timely, and recommends retraining in the fine art of shredding Veterans evidence, then lying about it. 
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    • What role do case managers play in VA claims? I had a meeting with one about a month ago and they just asked simple questions about where I live and where I worked. Afterwards I began wondering exactly what they do in the process because I had never met with one until I filed for an increase in a claim.
    • Okay first off congrats on the 30%.  What was that for?  Secondly, the grinding of the teeth is going to be next to impossible since the VA rarely s/c teeth.  I filed s/c for my teeth due to my eating disorder and was denied.  Unless you have concrete evidence in your SMR's indicating the grinding of the teeth it's a crap shoot.  As far as the PTSD/MST since it is says "deferred" that simply means they are still working on it but they went ahead and at least s/c you for the 30%.  That is exactly what happened to me.  I was awarded 40% in June 2014 with my MH deferred and then in November 2014 they decided my MH and I went to 60%.  You will get the PTSD/MST I am sure....they are at least doing what I think they should be doing and getting the DBQ for the bladder issue associated to the MST.  Keep us updated!
    • I have a question and need some advice. I put in a claim for OSA in 2014 and per the award letter received in April 2015 I was denied. After the denial for OSA, I initiated a NOD to keep the claim open. On 18 August 2016, I looked in ebenefits and noticed they had given me a non-service connected (NSC) (pension) rating of 50% for OSA as a secondary to my service connected (SC) Sarcoidosis and Asthma. This rating didn’t appear until 18 August. Check ebenefits weekly. I called the regional office (RO) in Montgomery Alabama on the next day and I was informed that I had received the award in April 2015. The RO then explained that the VA says in their notes that they agree that I have OSA, but not due to my SC disability of Sarcoidosis and Asthma. I am SC for 3 disabilities, Sarcoidosis with Asthma, PTSD, and GERD. I have conducted research in the Board of Veteran Appeals (BVA) and found appeals g showing that other veterans had been granted SC for OSA for each of the disabilities that I have. In my opinion VA has acknowledged that I have OSA by giving it a rating of 50%. My goal now is to have it changed from NSC to SC. Is there anyone with experience in do so? If so, please lend me some advice.





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NJ_Devil_Dog

Dd-214 Omission As Basis For Cue?

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Hello all,

I have a question regarding my claim and military awards.

I am currently appealing a denial of a 1995 claim for PTSD. I reopened the claim in 2003, and I sent the VA a copy of my DD-215. The reason being that I was awarded the Combat Action Ribbon for my service during the Gulf war. The award date was actually after I seperated in January of 1992, therefore the award didn't appear on my 214... (it actually wasn't an omission, it just hadn't been awarded yet) I received the 215 in after I returned from Afghanistan in 2003.

So here's my question.

Because the award is considered evidence of a combat stressor, would the 'constructive notice' ruling apply to the failure of the VA to consider this award as evidence? Therefore a CUE commited by the VA? There is a direct connection between my combat experiences and PTSD.

The other CUE I am persuing is because I believe, in the 1995 decision, the VA did not consider my outpatient records that include my diagnosis for PTSD.

I appreciate the feedback.

Gerald

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If the VA did not have or was unaware of the DD 215 and/or the Combat Action Ribbon Award when they made their decision in 1995, then this does not constitutre CUE. Evidence has to be in your VA records at the time of their decision for something like this to be considered a CUE.

Same thing with your outpateint records. Were these outpatient records from a VAMC or a private doctor? Even if there was a diagnosis of PTSD, but there was no record of a stressor, the VA had no choice but to deny the claim.

It's also a good bet that your two issues are "inextricably intertwined." See Harris v. Derwinski, 1 Vet. App. 180(1991).

Back in 1995 a claim had to be 'well-grounded' before the VA would assist in retrieving records. For example, if there wasn't a record of a streesor ect..., then the VA probably wouldn't set up a C&P exam to see if the veteran had PTSD.

Hope this helps!

Vike 17

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But Vike- under Bell V Derwinski- it had to be constructively in VA's posession- didn't it?

I mean a DD 215 is a correction of a past error-

by the Gov -so therefore -I agree with the Devil Dog-

and believe he must make this point with the VA- if they are looking for combat award as proof of stressor-

I think this is a bonafide CUE.

On the DD 215 issue-

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Thanks Berta and Vike,

I tend to agree with Berta on the constructive notice rulin of Bell. I believe it may be applicable.

I did have a C&P exam in '95, however the VA claimed that I was a no-show for the appointment, that's why I'm still waiting for my c-file (over a year now) to ensure that I'm not mistaken.... it's been so long ago that I cannot remember. However, if I did miss the exam I most surely re-scheduled within a years time!

I think that the issue of 'Not Well Grounded' may have something to do with this as well... from what I understand, it was somewhere around that time that the VA had to drop the well grounded claim and replace it with the 'Duty to Assist' policy.

The outpatient records were from the VAMC, so I believe they are covered by constructive notice...

I'll have to check out the Harris v Derwinski issue...

I just remember back in '95 when I got the denial letter, that I felt like they just did a shoddy job with my claim... a few months afterwards when I returned to the Lyons VAMC for treatment for PTSD. I was talking to the nurse who mentioned that from here observation, that my symptoms would be compensable. When She asked me if I had applied for disability, I said, "I did, but they denied them."

This was her response verbatum, "Oh, they always deny PTSD claims the first time around."

Needless to say I became so disenchanted with the whole system that I stopped persuing it until I came back from Afghanistan in '03. (I'm a retread from the Marine Corps with a 9 year break in service, then Re-upped with the National Guard in '01)

Anyway, thanks for the input, and as always I appreciate all the feedback.

Gerald

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Gerald- the VCAA replaced the not well grounded stuff-in 2000.

As long as you did get that C & P-I feel this is a CUE.

(Lyons----My Volunteer VA ID card is from Lyons Hosp.I think they took my fingerprints and all that too)

How can a vet with a CAR have a PTSD claim that is not well grounded?

ridiculous -

I posted some CUE claims susccess here- BVA and the CAVC. they should be found under the search feature

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Is it true that the majority of soldier in Iraq get the CAR. In Vietnam there was no such thing just CIB and some other very specific combat awards like Air Medals with V and brone star with V. Many soldiers were in combat but never got any combat awards. I am trying to get CIB since I was assinged that MOS while in Vietnam. It means nothing except my own pride. The assignment to 11b is right in my personnel records along with an evaluation.

John

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