degenerative arthritis IU being redueced because of VA fast letter 13-13

[Cybernick1]

My benefits are being reduced as of October 1, 2015 going from 80%, being paid at 100% for unemployability, to 70% no TDIU

Main reason. VA fast letter 13-13.  

Currently:                                                                                                                      Changes:

Pes planus, bilateral severe deformity left foot ( prior to surgery)   50%                     Pes planus bilateral, status post Flexor Digitorum Longus      30%

avascular necrosis with deformity, status post fusion, left ankle     20%

Mild degenerative disc disease, lumbar spine                                10%

Osteoarthritis right knee                                                                  10%

degenerative arthritis, right hip                                                        10%

Tinitus                                                                                               10%

 

My application for IU was submitted on June 25th 2013 8 days after VA fast letter 13-13, I had to tell my AMVETS rep about the fast letter he did not know anything about it sent to Chicago.

He reviewed it and concluded that it seems they just wanted to the one main condition that is keeping me from employment. So we in box 7 just put Pes planus bilateral.

That's all they looked at, but if my application would had been 9 days earlier, they normally woul;d have considered all my disabilities not just my feet and I don't think this reduction would happen.

I found out that the VA gave me IU solely on the condition of my feet and that's all they are looking at. Only had C&P for feet. I asked the examiner if that was all he was going to check he said yes.

I contacted my rep and was instructed to wait they will have additional C&P's. It never happened. In August and December 2013 had surgeries. First surgery to reconstruct deformed left foot screws

and plates added to build arch. Tendons move. Second surgery to fuse left ankle.

Was awarded original IU retro to last day worked in September 2012, received award letter July 2014 VA said I was awarded IU soley on my feet, and also in same envelope notice to decrease benefits because of the surgery on my feet.

Received SSDI on first attempt all issues for Social Security are service connected.

Earlier this year after contacting AMVETS they said they did not see any activity to reduce my benefits, again they were wrong.  I received the Final award letter form VA in late June 2015 that says benefits reduction date effective 1 October 2015. I have been franticly trying to get my reps to take action.   All this because of a rule change the VA made abruptly and with no grace period.

I have been and still trying to get more medical evidence and I have some but after contacting NSO in Chicago they say only recorse besides 4 to 7 year appeal process is to quickly resubmit another application for IU  form 21-8940 with all disabilities, and unless I don't want it to take years submit separate DBQ forms from Doctor with it. Example for 21-0960M-5 for feet, 21-0960M-14 for back pain and groin numbness. That form alone is 11 pages. They probably know my clock will run out before I have all the stuff I need.

My SC disabilities have gotten worse. Back is disabeling worse than before causes groin numbness radiating down legs, frequent urination. R Knee has episodes and I ware a knee brace, always use a cane have special shoe inserts and r heel1/4 inch riser, I have a leg length inequality, first diagnosed USAF in 1987.

Ankle and feet still hurt still can not walk far, stand long, sit long and can't sleep and in the last several years have developed depression due to my chronic pain, I have just started seeing a shrink for my problem on Xanax. Have not taken any VA claim action yet on my psychological problems, guess that will come hopefully if they say I have a problem. My psychologist believes I do.

I thought that once on IU to reduce they had to perform another C&P and consider all SC disability issues, Fast letter 13-13 threw that out the door.

Anyways I figured I am just screwed.

What a bunch of  bull VA is

 

[broncovet]

A couple questions:

1.  Did VA send you a 60 day notice of proposed reduction?  If VA did send you the 60 day notice, did you request a hearing?  

2.  How long did you have Pes Planus?  

     It "might" be in your best interest to re apply for IU with all your disabilities, but I dont know enough yet, to make that guess.  

It actually sounds like you are "grandfathered in", but see this:

https://www.law.cornell.edu/cfr/text/38/3.114   and

Under 38 CFR 3.114(b), VA must provide due process if a new law, regulation, change in the interpretation of a law, or issue requires VA to reduce or terminate benefits that were properly authorized under instructions in effect at the time the award was processed. VA must

 

• send the claimant a written notice of proposed adverse action, and

• allow 60 days for the claimant to submit evidence showing why the change should not be made.

 

Reference: For more information on the due process procedures and requirements, see M21-1MR, Part I, 2.

 

Edited September 3, 2015 by broncovet

[broncovet]

After 1 year, your decision becomes final, and the VA can not change it absent Clear Unmistable Error, or some things unrelated:

 

3.104 Finality of decisions.

(a) A decision of a duly constituted rating agency or other agency of original jurisdiction shall be final and binding on all field offices of the Department of Veterans Affairs as to conclusions based on the evidence on file at the time VA issues written notification in accordance with 38 U.S.C. 5104. A final and binding agency decision shall not be subject to revision on the same factual basis except by duly constituted appellate authorities or except as provided in § 3.105 and § 3.2600 of this part.

(b) Current determinations of line of duty, character of discharge, relationship, dependency, domestic relations questions, homicide, and findings of fact of death or presumptions of death made in accordance with existing instructions, and by application of the same criteria and based on the same facts, by either an Adjudication activity or an Insurance activity are binding one upon the other in the absence of clear and unmistakable error.

[Cybernick1]

The 60 day notice was in the same envelope as the IU award letter, I submitted paperwork my AMVETS rep in Chicago said including statements from the surgeon that repaired my foot and fused my ankle. He stated in his comments that he did not anticipate me returning to any job. Stating that other health issues may cause my overall ability to work but he did not provide care for those issues. He then stated as to regards to foot and ankle I could do sedimentary work probably, that's all VA keyed in on.

I also sent them my disability license plate registration and handicap placard. Pes Planus discovered upon entrance exam 1980, Regan build up err on podiatry in USAF from 1987 till exit in 1994. In 1991 Naval hospital OKinawa doctors removed me from world wide eligibility and stated member will not be able to complete 20 years of service due to my flat feet have developed other issue. Found out years later avascular necrosis talas bone left ankle making it descintergrate

As far as a hearing goes I asked my AMVETS rep the NSO in Chicago he said wait see if the package submitted works.  Feb this year contacted Rep again he said they see no activity no reason for further actions

 

[Cybernick1]

They are sneeky

Both these in same envelope

Proposal to reduce 60 day reply    dated 21 July 2014

IU award letter                               dated 31 July 2014

Final decision letter on reduction  dated 14 July 2015

 

[Berta]

A link to the Fast Letter 13-13 is here

Do you have any medical evidence that could boost any of the other ratings you have?

Sometimes a proposal to reduce is the time to file for higher ratings on other SCs.

I think this Fast letter is why they are reducing another vet here as to her TDIU.

 

[Vync]

The VA zoned in on "sedentary work", but they completely ignored that your SSDI was approved. If SS says you can't work, then that makes you wonder why the VA thinks otherwise.