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Denial Letters

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38 topics in this forum

  1. Blaze99

    HLR Denial. Need guidance for Low back and Radiculopathy for Legs

    by Blaze99

    Hello, Last year I filed two supplemental claims for GERD, tinnitus, and bilateral radiculopathy for legs, and later filed an increase for low back strain and a new claim for neck condition. For some reason, all claims were combined in one decision letter, and they were all denied. I immediately filed a HLR and requested an informal conference. I never received a call, but a decision was made denying all claims again in August 2022. There were so many discrepancies with the letter. I was overwhelmed and put off addressing the decision due to other life matters. Between moving overseas and traveling for work, I finally caught a break to focus on gathering what I…

    Rattler
    Last reply by Rattler,
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  2. radarguy

    Dermatitis denial using phototherapy

    by radarguy
    • 1 reply
    • 244 views

    I submitted a claim for increase from 10% to 60% based on DC 7806, Constant therapy including phototherapy, in which I began receiving UVB treatments 3 x week since 2019 when the phototherapy unit was issued. Attached is a “sanitized” copy of the skin DBQ with “REASONS FOR DECISION” page. For ease of finding information in the DBQ, the areas of interest are enclosed by red rectangles, On page 13 of the DBQ (not included) the physician’s specialty was Internal Medicine. dbq.pdf

    broncovet
    Last reply by broncovet,
  3. GulfWarVet1990

    IMO was very Comprehensive but OSA Supplemental Still Denied 1 2

    by GulfWarVet1990

    Good afternoon, I just received the denial letter from VA for OSA supplemental claim (added new evidence). Even with a very comprehensive IMO from Dr. Anaise, OSA diagnosis and CPAP prescription VA denied. I am SC for Chronic Sinusitis (10%), Tinnutis (10%), Allergic Rhinitis (0%), and PTSD (50%), the IMO included these conditions linking to OSA. No go, the VA still noted the VES Examiners write up was more persuasive. Also as usual, they state no evidence of OSA while in service. The supplemental denial letter also indicated a DBQ review on June 3, 2022 which did not require my attendance. Just disappointing how the VA keep taking the cheap route hiring the lo…

    broncovet
    Last reply by broncovet,
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  4. Steve C

    VA has spoken

    by Steve C

    This past week I finally received a decision letter. While the VA does acknowledge that I lost a kidney in service due to a botched surgery, I was given a zero percent rating. I am enraged and dumbfounded. SERIOUSLY? Had this been a civilian surgical mistake, the settlement from a lawsuit would be huge for the loss of an organ due to a surgical "mistake". I know too well because I worked in surgery 17 years. I intend to appeal. Which option for appeal? I don't know yet. This is the most absurd thing that I have ever seen. I am still trying to collect my head enough to begin the appeals inquiry and proceed with whichever method might be best for me. My claim was rock solid…

    Vync
    Last reply by Vync,
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  5. Corwin

    VA Claims reviewers deferring claims involving IMO support??? Anyone see a pattern? 1 2

    by Corwin

    I recently (March 2) put in a claim for OSA secondary to CAD and tinnitus. I included an independent medical opinion (IMO). I received a minimally worded denial on April 11. It contained no opinion or even reference to the contents of the IMO. A C&P was never asked for nor did the reviewer even mention the tinnitus part of the claim. The reviewer also stated that they reviewed the most recent 18 months of medical records and stated as a fact that my OSA was DX'd ..." Your VA examination conducted on March 8, 2022 confirmed an active sleep active diagnosis". "Active sleep active"??? No surprise I am sure to most, but I was never at the VA on that date which…

    Mr cue
    Last reply by Mr cue,
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  6. mwillis71

    Denied Rhinitis, Sinusitis although was deployed 3 times to the areas of exposure (Southwest Asia). Was denied GERD secondary toy PTSD/Anxiety/Bipolar 1. Got denied erectile dysfunction secondary to meds and PTSD/Anxiety/Bipolar 1

    by mwillis71

    So as the title says, I've been denied SC for 2 presumptive illnesses that I have medical documentation of and was deployed to the presumptive areas 3 damn times! I was denied ED secondary to PTSD/Anxiety/Bipolar 1 and corresponding meds (when they fricking prescribe me the VIAGRA and diagnosed me)! Finally, denied GERD as a secondary to PTSD/Anxiety/Bipolar 1, corresponding meds and sleep apnea when they diagnosed me as well! I mean what in the actual F@ck are these fools thinking?! I just got out of 5 days in the hospital for relapsing after 3 years of sobriety, father in law (Gunny Marine Corps) died the day I got out and now this shit!? 1. I will be putting in a…

    MilvetHD
    Last reply by MilvetHD,
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  7. SergeantQ

    Supplemental claim denied ‘gerd’

    by SergeantQ

    post removed

    SergeantQ
    Last reply by SergeantQ,
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  8. Whodat

    I have hadit 1 2

    by Whodat

    Denial Letters are in a rise again. 2019, I had filed a Supplemental for Migraines, Bilateral knee condition, and ED. All was filed as primary, and as a secondary for my already SC conditions. DENIED. Filed the HLR. Then I get a letter for DTA. Not sure what the error was for but was sent back to Supplemental. Had more C&P exams in Feb 2022. 05/02/22 today, got another denial letter. Evidence shows my injury in service. Shows my current Diagnosis. C&P examiners can't find a link. Of course, LHI examiners can't find a link. But the letter states, VA examiners can't find a link. Makes me wonder. Some people says that you need an IMO some…

    Whodat
    Last reply by Whodat,
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  9. Riplip

    Denied for Meniere's

    by Riplip
    • 2 replies
    • 515 views

    Well my VSO said they denied my claim stating it wasn't service connected Meneire's. I checked Ebenfits and sure enough denied. Here is an attached note from my DR. Just figured maybe others could read it and should I appeal? So I am already connected for hearing loss, and vestibular dysfunction and I' diagnosed with Meniere's. Pretty sure Meniere's is Vestibular function as well. Hoping the new changes will do something about this. Its pretty confusing to me Mass Eye and Ear notes.pdf

    Riplip
    Last reply by Riplip,
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  10. Rattler

    Denial of S-DVI Insurance

    by Rattler

    I applied S-DVI Insurance on 11-27-21 due to my new PTSD ratting on 11-18-21. As I didn't hear anything from them at the end of March I called there 800 number. (not 800 Betty) They said that it was denied but could not tell me the date it was or why. So the person said they would have someone call. So around the 4-7-22 I get the attached letter of denial with no date. What it appears to me is they are denning id due to " requires that you meet good health requirements except for conditions that are rated by VA as service connected." Has anyone heard of this? Rdacted of Denial of S-DVI Insurance Ltr 3-4-22.pdf

    Richard1954
    Last reply by Richard1954,
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  11. ButtonAce

    Sleep Apnea as secondary to PTSD Denied

    by ButtonAce

    Hello all I could use some guidance, I'm OIF and OEF veteran with 70% service connection for PTSD. I recently filed a claim after the VA diagnosed me with severe sleep apnea. The C&P examiner never even called me for my telephone interview. I thought I was good to go. Than I got denied. In the decision letter, the C&P doctor said my sleep apnea was less likely than not proximately due to my service connected disability. Favorable findings: my primary disability is service connected, I have a diagnosis of sleep apnea, and evidence shows that a qualifying event or injury had its onset during service. IE treatment/complaint of snoring. I didn't use a nexus …

    broncovet
    Last reply by broncovet,
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  12. Aquaria

    Specially Adapted Housing grant Denied

    by Aquaria
    • 1 reply
    • 288 views

    I have applied twice for the SAH grant and both times been denied (1 application & 1 appeal). I have provided documents from my doctor that I have loss of use of my limbs that leaves me having to utilize a wheelchair prescribed from the VA. I was recently service connected for both arms (incomplete paralysis) and both legs (incomplete paralysis). Should I appeal again using the new service connections? What am I missing here as the latest denial letter states I'm not eligible but by what I read I actually am eligible. I own the house I live in FYI. Service Connected for 50% migraines 10% Costochondritis 40% Fibromyalgia 100% PTSD 4…

    Richard1954
    Last reply by Richard1954,
  13. GulfWarVet1990

    Just found out today Denied Sleep Apnea Secondary to PTSD - Disappointed 1 2

    by GulfWarVet1990

    I just checked VA.gov and ebnefits today (letter not sent) and noticed under my disabilities I was denied service connection for OSA secondary to ptsd. Talked with my VSO (they can view the letter) - they told me the VES examiner opine carried more weight than my IMO. The VA examiner stated sleep apnea is not secondary to ptsd and OSA physiological where PTSD is psychological. I have three options- Submit a Supplemental with new evidence - statements, new evidence. Request an HLR Appeal to Veterans Law Judge - (honestly prefer not to go this route due to the length of time) I am sc for Gulf War presumptive conditions such as chronic rh…

    Gulfvet45
    Last reply by Gulfvet45,
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  14. Myodie

    Denied Service connection for Dry Eyes, Halos in eye (Had PRK) and Wrist arthritis

    by Myodie

    I just filed my 1st claim after 20 yrs in for disability. I was denied for dry eyes and halos in the eye (night time driving issue). I was also denied for the corneal tear I had due to the the dry eye (happened on active duty). While I did have the PRK done while I was in, I have been on lubricating eye ointment for 5 plus yrs now (discharged dec 2020). I was denied due to the elective PRK surgery. However I found case law that states residuals from the surgery (halos and dry eye and in my case the corneal tear) should be service connected even if the surgery was elective. I also was denied connection for my wrist I injured and have been on profiles and physical therapy …

    Dustoff1970
    Last reply by Dustoff1970,
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  15. pascoz28

    Reopening back claim after Saunders

    by pascoz28

    SO...it seems to me that they basically said because I had no diagnosis that I was out of luck. They admit that I was seen for my back as far back as 1992 and that I've had treatment since discharge. They didn't mention that 'chronic back pain' is listed as an active problem in my VA health record and that I've been on medication for back pain since 2008. Now that Saunders v Wilkie has reversed the need for an underlying cause, how do I reopen this claim since the pain is in and of itself is now considered a disability? Thanks!

    Dustoff1970
    Last reply by Dustoff1970,
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  16. Cloudbuster

    Headache letter

    by Cloudbuster

    Hi, So what do you understand from this? photo in the Link - https://ibb.co/5Wm84vD I already got a diagnostic recently after the letter, So if I send the Diagnostic as a supplemental would they come back denying due to no nexus letter? Or is the nexus already covered? Also 3rd paragraph - the medical evidence support the conclusion that a persistent disability was not present. - would this be the next reason for a denial? how you overcome this? Around November 2007 I was in Afghanistan in the process of being medically transported to Germany and then WalterReed for another condition, I believe I left WalterReed around January…

    Whodat
    Last reply by Whodat,
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  17. VetNY12

    After 1 yr 6 months going through the same CP exams twice for 7 claims, returned decision of NOT SERVICE CONNECTED for all

    by VetNY12

    Almost took two years to finally get a decision I have been given a rating of NOT SERVICE CONNECTED for all 7 of my claims. I'm hoping others are receiving better outcomes, this time around I had gone through a lawyer thinking that may help, but at this point not really. Next steps will be to appeal unfortunately since there is a massive backlog of claims. But when the VA cannot make a reasonable determination, this is what happens. One thing I will point out if it helps others, these claims did not have to do during a time I was deployed over seas. Could this be a reason why I was denied completely, who knows this game is very subjective. My other disabilities …

    vetquest
    Last reply by vetquest,
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  18. gangof4

    How do I exit this endless loop?

    by gangof4

    I have a service connected hearing loss at 0%. I've had a C&P as well as private hearing tests mfor the sake of some compensation. My sensorineural (tone) testing reveals moderate to profound loss of hearing at different decibels in both ears, but I do well on the speech recognition test, so I get denied. So, on the basis of the speech recognition test, my claim was denied. Problem is, I can't hear very well. My wife gets frustrated several times each day, repeating herself (two or three times), I need closed caption on television, I can't hear my phone ring, or the microwave or dishwasher beep. I can't hear traffic approaching behind me. I have to sit in the f…

    richjh
    Last reply by richjh,
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  19. harry59

    Weight-Related Claims Denied ??? 1 2

    by harry59

    I submitted claims at the end of Sept of 2021. I just received, and read, the VA decision letter that I received today. The claims I submitted that were related to my already service-connected back conditions were approved. I am now at 80%. However, even though the VA confirms the diagnosis of all my secondary conditions that I submitted, all of my secondary claims (Obstructive Sleep Apnea (OSA), Hypertension, and Abdominal Hernia) that I submitted and associated to my weight gain, due to my SC back condition, were denied. I specifically stated in my veteran statements that I was connecting these secondary conditions to my SC back conditions, since I am effectively unable…

    Riplip
    Last reply by Riplip,
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  20. Christopher Robinson

    HLR Found Duty to Assist Error but still denied my claims

    by Christopher Robinson

    I had my degenerative disc disease and flat feet bilateral claims denied, submitted a higher level review and a duty to assist error was found. The letter said there was a favorable finding for both and that a qualifying event, injury had an onset during my service and my service record shows I had a profile for both but yet still no increase in my percentage. They couldn't find really any of my records from when I was in the Army or from my deployment to Iraq and said my records were minimal at best. How is it my fault that the Army lost my records! I'm so sick of the VA and it's very discouraging to have to go to the next step of hiring a lawyer apply for the board appe…

    ArNG11
    Last reply by ArNG11,
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  21. SANUSCG

    EARLIER EFFECTIVE DATE 1 2

    by SANUSCG

    I put in a claim back in 2009, and it was denied, due to no diagnosis of the disease in service. I didn't appeal or follow up on the claim. In 2020 I found new "material evidence" for the disease during my service. The VA approved my claim, that was denied originally and granted me 20% disability for it. Should by effective date of the claim be when I first claimed the disability back in 2009 and not 2020? I put the claim in within 1 year of my separation of service. Both the VA and the higher level reviewed denied the reopen claim. Let us suppose that you left the service on January 1, 1990, and applied for benefits. The VA, however, denied your claim.…

    Mr cue
    Last reply by Mr cue,
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  22. WARREN WHITE

    BERTHA

    by WARREN WHITE
    • 6 replies
    • 1.1k views

    BERTHA HELPED ME ON THIS SITE ABOUT FIVE YEARS AGO ON MY AGENT ORANGE CLAIM FOR PARKINSON'S AND I WOULD LIKE TO HEAR FROM HER CONCERNING MY POST ON AN EARLIER EFFECT DATE FOR LOSS OF USE ON ALL FOUR EXTREMITIES THAT I POSTED A FEW DAYS AGO. THANKS HARRY WARREN WHITE

    broncovet
    Last reply by broncovet,
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  23. SANUSCG

    dermatitis denial

    by SANUSCG

    I put in an increase for VA compensation for dermatitis from 30 to 60 percent, and it was denied, by them. The letter stated that only 20 to 40 percent of entire body affected. The second part of the 60 percent rating states that you have to have used constant or near constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12 months. I have used various topical ointment constantly for several years now to treat my dermatitis. Why would they not have rated me at 60 percent Thank you

    SANUSCG
    Last reply by SANUSCG,
  24. Ken Dillon

    Supplement claim

    by Ken Dillon
    • 1 reply
    • 908 views

    I had a claim denied, I submitted a NOD with in a few months of claim being denied, on VA.gov never showed it was accepted, so I waited, finally called 1 800 and sent email . I was told to put in Supplemental claim which I did, I also included a copy to the NOD that I signed and dated. Now VA,gov shows the supplemental claim but it says status unknown. So I am now in a holding pattern for how long. Anyone have any suggestions? Thank you

    pacmanx1
    Last reply by pacmanx1,
  25. Cat4Christ777

    Diagnosed w/early Menopause in service, but BVA denied my claim for it TWICE now, despite clear medical evidence, and consequent loss of creative organs (hysterectomy). What now???

    by Cat4Christ777

    Served in the USAF from 1990 to 1998, in law enforcement. Diagnosed with early Menopause in 1998, which sparked an unfulfilled Endocrine consult. Blood test revealed pituitary gland/endocrine issue. Claims in both 1998 and 2021 were both denied, with the VBA claiming it wasn't 'Menopause,' but "oligomenorrhea" (menstrual irregularity)--completely disregarding medical evidence to contrary--subsequently suffered uterine prolapse, which required full hysterectomy in 2016. I know the early menopause was due to extreme stress (19+ hour shifts, very little sleep, sick all the time, etc.) in service. Menstruation stopped completely by May 1999. Regardless, there was actual …

    Cat4Christ777
    Last reply by Cat4Christ777,
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