What Does "case Review" Mean?

[SemperAye]

I filed an FDC Jan 2015 in Winston-Salem NC, shortly after I received a letter that it was converted into a normal claim for some reason. I was surprised by this since I had given them everything they needed, and I just had a C&P for another claim a few months ago that was finalized. The estimated completion date for my new claim was September 2015, all was fine.

7 months later....... for two days out of this week, my claim made it to preparation for decision, but it has since gone back to gathering of evidence. I chatted with Peggy and was told "It shows it is a case review, which means that team needed to look at or correct something." Now the estimated completion date is November 2016 LOL!

I'm guessing that since the preparation for decision phase it when a rater recommends a decision, that if it went back to gathering evidence, maybe the person who signs off on it saw an error or something? What does "case review" mean?

Thanx.

Thank you for your service!

Edited August 7, 2015 by SemperAye

[Navy04]

Review just means that the Big Wigs want to Review your case for Accuracy and sign off to finalize, or you may have been granted SC and if it is a Large Retro then the Higher Ups have to sign off. Either way I think that you will be fine bud. Good luck and keep us posted

[Mont36]

SempAye so are you saying that you are back in the development stage? Can you tell me what you are claiming? I want to see what could be the hold up. Thanks

[SemperAye]

SempAye so are you saying that you are back in the development stage? Can you tell me what you are claiming? I want to see what could be the hold up. Thanks

Hello thank you for you interest in my thread.

Yes my claim went back into the development stage. I re-opened an IU claim because back in December (the va put in for IU on my behalf, I did not) I had a different claim open at that time and the rater called me at home and advised me to drop the IU claim for now since I really needed the money and was about to loose our home, he said this would speed things up significantly and he was right.

So in January this year I decided to re-open the IU claim, along for a request for reconsideration of one of my contentions from my December claim. I needed the reconsideration approved in order to have 70% and qualify for IU. It was my understanding that they would defer the IU pending decision on the request for reconsideration. So the VA ended up putting in for increases in all of my service connected disabilities. I am currently 50% for Panic Disorder with Agoraphobia and GAD, 20% for my back/neck, and 0% for Erosive Lichen Planus with a 10% secondary scar. To answer your question what I am claiming is rating in excess of 10% for my scars because I have many of them that they measured but forgot to rate for some reason, they are all painful and might be considered unstable because the scars re-open to become open lesions.

My guess is that even though I didn't request it, they are looking into possible increase in mental health since I have agoraphobia and social and occupational impairments and near continuous panic. Then having the docs that did my c&p's in December check if I qualify for any increases, so they can bring me up to the IU qualifying percentages. I have no idea really...but I think because I didn't yet qualify for IU without extra scheduler that is dragging things out. What do you think? What is weird is that my claim went into Prep. For Decision without any C&P being scheduled, I have since been checking myhealthevet for appointments but have found nothing.

[AFMedic09]

My claim is undergoing Case Review as well. Hopefully that process doesn't take too long, but does take long enough for them to get it right. Good luck!

[SemperAye]

My claim is undergoing Case Review as well. Hopefully that process doesn't take too long, but does take long enough for them to get it right. Good luck!

Did Peggy tell you that you were in case review?

[AFMedic09]

Yes. I spoke with them this morning. My claim (I posted a long detailed layout on this forum earlier today) was in Pending Decision, but then went to Gathering of Evidence when another claim was combined with it. However, ebene. says they need no further information, and "Initial Review Complete". So, I have not seen this before, so I called Peggy. The gentleman informed me my claim is in the Decision phase, and the rater is undergoing a "Complex Exam Review" with the physician at this time. I am guessing this means it was sent for a Decision, but the higher ups had a question and are getting with the physicians to figure it out? I thought I was in the first phase since ebene. shows "Gathering of Evidence", but Peggy said I'm in the decision phase, and even said I should hear something soon. Fingers crossed.