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usmcthysin

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I was honorably discharged from the USMC last year on April 7th and filed a claim for disability in May of 2008 for: Left shoulder instability(had 8 anchors put in while AD to keep from dislocating, right shoulder instability(subluxates), pain in upper/lower back, flat feet(went in with full arches came out with none), and tinnitus. Everything was goin good for a bit but eventually I got extremely depressed and started drinking constantly so when my C&P exam came up, I didn't show(stupid!). In September 2008 I got a letter from the VA stating that they denied my claims due obviously to my absence at the exam. In the letter it also says that each one of my claimed conditions were supported by my medical record and if I showed a willingness to be examined they would reconsider the claims.

When February came along I had deteriorated a lot mentally, I walked out on my job and never came back, almost lost my wife and was arrested once for disorderly conduct(case deferred as long as I sought help with the VA). So I proceeded to call back into the VA and get the claim going again. I told the guy I got on the phone about what all happened and he said that it would be best to just open a new claim with those disabilities and close the old one as opposed to appealing because that would take much longer. He typed it all up and told me to go to a VSO near me and tell them what was going on and they would help me. The new claim had PTSD added because of my mental state(was diagnosed at my exam with PTSD). Now I got a letter in the mid-last month saying they were working on my new claim with that listed bilateral hearing loss(never claimed that but I guess the guy on the phone did that), PTSD, bilateral knee condition, and shin splints(didn't say this one either). The second part of that letter had all the disabilities from my first claim and said I had been denied those and that if I wanted to get reconsideration I would need to show further evidence. I went down to the VSO I was talking to and showed him all of this and he just said 'don't worry about it'. I also submitted a claim status request on IRIS and got the same reply about appealing the first claim, they also said I would only get backpaid to the day of the claim, not the day after I left AD. Also I should mention that I've already went to my C&P exams for the new claim and everyone there at the hospital was checking me for everything from my new claim and my old one.

The IRIS guy also said this:

Since these conditions have previously been denied, unless you appeal these conditions, your new date of claim will be January 30, 2009, as the date you opened a claim with the above mentioned conditions, as well as for bilateral hearing loss, PTSD, bilateral knee condition and shin splints. (The four 'new' conditions are not retroactive to your Release from Active Duty (RAD) date as only the claimed conditions the VA receives with your first claim filed are retroactive to your RAD date.)

1--You may appeal our decision as noted in our decision letter to you dated September 29, 2008. Please note the appeals process may take a year or two for the decision to be rendered. If the evidence and decision is found to be in your favor, you will be paid retroactively to the date of the claim.

2--You may fax in a letter to your Phoenix VA Regional Office requesting that you would like to request that the current claim that is open REMOVE these five conditions and REOPEN the claim for left shoulder condition, right shoulder instability, bilateral flat feet, upper and lower back condition and bilateral tinnitus. Please mention in the letter that you would like this reopened as you were unable to make the C & P examinations at the time. If the evidence and decision is found to be in your favor, you will be paid retroactively to the date of the claim.

So basically I'm fairly confused and wondering what I should do, any help/insight would be greatly appreciated.

Thanks,

Greg

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Just talked to my VA Case Manager and explained the whole situation and she told me to call the 800 number early in the morning and tell them what's going on and then to call her afterwards whether it gets rectified or not. If it doesn't she's going to, as she said, get ahold of her 'connections' and pull some strings to get it fixed so I can get the old claim and new claim merged and allow that if I get connected with a % that I will get backdated to the day after my EAS. She seemed really genuine about helping me so and I trust her to the extent but will be watching to make sure it all goes right.

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I called the VA 800 number today and spoke with a lady who informed me that everything is O.K. because in her records everything shows that they are checking for all of my conditions. She said that my denied claim will also be sent to the ratings board with my new claim since in the denial letter it said if I showed for a C&P exam they will reconsider it and since she saw notes from all the doctors showing they checked me for the previous claim's disabilities that I am good to go and the ratings board will re-evaluate the decision on the first claim while evaluting my second claim. She also said since they will be doing this both claims will backdate to the day after I got out, I told her about the IRIS reply and she said it was wrong about them not going back because it was a 'second' claim, she said it'll be ok since it was still within that year.

Gonna call my case manager and VSO this afternoon to inform them of all this and see what they all say. And now that I re-read the replies, sharon you seem to have been right on the money, thanks again ;)

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  • HadIt.com Elder

Good Luck on your claim. Noce to have a VSO that is actuallly proactive. Keep her she is a rare bird.

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usmcthysin,

Thanks for your service and welcome to Hadit.

What or who are you referring to when you say,

"your case manager" ?

1) I always suggest to NOT believe what your told by the 800 #.

2) If you don't request XYZ from VA in writing - it never happened.

jmho,

carlie

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This is her title in the emails she sends me

"Operation Enduring Freedom/Operation Iraqi Freedom Program Manager

OEF/OIF Transition Program & Post Deployment Clinic"

On the phone she called herself my case manager, seems nice enough. I will keep in mind what you said, I go down there tomorrow and if she says the same stuff I'll ask for some sort of documentation for my files.

Thanks,

Greg

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