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celli

Appealing Decision Based

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Received Decision Letter Today, page inserted that doesnt belong to me and freaked me out

I posted the above a few days ago. I just talked to my Field Rep and he is going to meet with me next Tuesday. I read to him about the conflicting data in my C&P vs my decision letter which states that the Examiner opined THERE IS NOT a total and occupational impairment due to my disorder. However, the C&P clearly states a YES after the question: Is there a total occupational and social impairment due to mental disorder signs and symptoms - YES.

Has anyone else had conflicting data? If so, how did it turn out? Any opinions?

I also informed my Rep (what do you call him, Im still not sure about all the abbreviations used on this site) that there is a page from a Vietnam Veteran which was very upsetting and I told him about my concern for this Veteran and if he may have missing information in his file.

Thank you all for your responses and your help. I am so appreciative of this website and all of you who help fellow Vets. Thank you for your service and for all that you have done to give ME and my daughter the chance to live a life of freedom in this country that I love so much. May God bless you all!

Stephanie

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Received Decision Letter Today, page inserted that doesnt belong to me and freaked me out

I posted the above a few days ago. I just talked to my Field Rep and he is going to meet with me next Tuesday. I read to him about the conflicting data in my C&P vs my decision letter which states that the Examiner opined THERE IS NOT a total and occupational impairment due to my disorder. However, the C&P clearly states a YES after the question: Is there a total occupational and social impairment due to mental disorder signs and symptoms - YES.

Has anyone else had conflicting data? If so, how did it turn out? Any opinions?

I also informed my Rep (what do you call him, Im still not sure about all the abbreviations used on this site) that there is a page from a Vietnam Veteran which was very upsetting and I told him about my concern for this Veteran and if he may have missing information in his file.

Thank you all for your responses and your help. I am so appreciative of this website and all of you who help fellow Vets. Thank you for your service and for all that you have done to give ME and my daughter the chance to live a life of freedom in this country that I love so much. May God bless you all!

Stephanie

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Without knowing the details of your claim for total occupational impairment, I would agree with what you noted ie conficting statements.

This can be remedied by a formal Notice of Disagreement (NOD), or a request for de novo review of your decision by way of VA Decision Review Officer (DRO) at the VARO. This would either be an administrative review or personal hearing (your choice).

The procedure for asking for a DRO is found in M21-1MR, Part I, Chapter 5, Section C. Decision Review Officer ...

On another note, in addition to your favorable C&P Exam, you would need additional eviidence of social or occupational evidence because the C&P can not stand alone on the issue of unemployability. ~Wings

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Without knowing the details of your claim for total occupational impairment, I would agree with what you noted ie conficting statements.

This can be remedied by a formal Notice of Disagreement (NOD), or a request for de novo review of your decision by way of VA Decision Review Officer (DRO) at the VARO. This would either be an administrative review or personal hearing (your choice).

The procedure for asking for a DRO is found in M21-1MR, Part I, Chapter 5, Section C. Decision Review Officer ...

On another note, in addition to your favorable C&P Exam, you would need additional eviidence of social or occupational evidence because the C&P can not stand alone on the issue of unemployability. ~Wings

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Change Date June 19, 2006

a. Definition: De Novo Review

A de novo review is a new and complete review of the appealed issue with no deference given to the decision being appealed. This review leads to a new decision, which may be a full grant, partial grant, CUE, or no change.

Reference: For more information on de novo review, see http://www.warms.vba.va.gov/regs/38CFR/BOO...RT3/S3_2600.DOC

See also 38 CFR 3.2600

b. Who May Receive a De Novo Review

An appellant has a right to de novo review of his/her claim if he/she

files a timely notice of disagreement (NOD) with the decision of an agency of original jurisdiction on a benefit claim, and

requests the DRO review process/de novo review no later than 60 days after the date of the notice sent informing the appellant of his/her right to de novo review.

Notes: The 60-day time limit cannot be extended.

An appellant cannot have more than one de novo review of his/her claim.

d. What May Be Reviewed

Review only those decisions that have not become final by appellate decision, or failure to timely appeal.

The review will encompass only the decision with which the appellant has expressed disagreement in the NOD.

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celli,

Wings gave you great advice.

Conflicting data -- yes, there is a big club for that, many of us belong to it.

carlie

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Veterans: Should you elect a Decision Review Officer (DRO) review after filing a Notice of Disagreement (NOD)? http://www.attiglawfirm.com/blog/va-benefits/veterans-should-you-elect-a-decision-review-officer-dro-review-after-filing-a-notice-of-disagreement-nod/ After the VA Regional Office denies your claim, in whole or in part, you must appeal the decision if you wish to challenge that result.

To begin the appeal process, the Veteran files a written notice of disagreement (NOD) with the VA regional office (RO) that issued the disputed decision. After you file the NOD, the VA sends you, the Veteran, an appeal election form asking you to choose between a traditional appellate-review or a review by a decision review officer (DRO). The VA provides the appellant 60 days to respond to the appeal election form. See 38 C.F.R. § 3.2600 (2007).

DROs are authorized to grant contested benefits based on the same evidence utilized by the initial rating board. DROs review the evidence “de novo” – essentially, with fresh eyes and without deference to the initial Ratings Decision.

I can’t think of a reason not to request a DRO review of the VARO’s Initial Rating Decision. DROs are senior representatives of the VA with considerable experience in handling Veterans’ claims. The DRO will review the case without deference to the VAs initial decision. In many situations, you can ask to meet or talk with the DRO. The DRO process is frequently successful and is generally much faster than going directly to the BVA. If you do not receive a better decision from the DRO, you can still appeal to the BVA.

In a recent claim we handled for a Vietnam veteran with Post Traumatic Stress Disorder (PTSD), the VARO initially denied the Veteran’s claim, finding that there was no evidence of a current diagnosis of PTSD. This conclusion flew in the face of the evidence of record, wherein the VA had actually diagnosed the Veteran with PTSD (and other mental health conditions) as a direct result of his military service.

On behalf of our client, the Veteran, we sought review by a DRO, and within a few weeks, the Veteran was invited to the closest VA Medical Center for an evaluation for the purposes of generating an impairment rating for PTSD. Within a few months of requesting the DRO, the Veteran was service-connected for PTSD. Within thirty (30) days of that decision, the Veteran received a substantial payment of past-due benefits from the VA, and will continue to receive benefits into the future.

Had the Veteran not requested a DRO, I suspect it could have taken 1-2 years – at least – before we got a chance to persuade the BVA Hearing Official of our version of the facts. Even if successful at the BVA, it is likely that we would have merely been able to get the BVA Hearing Official to remand the Veteran’s claim back to the VA for a mental health impairment evaluation and further development of the record.

While not a guarantee that you will get the benefits you are seeking, the DRO process works for everyone. Many Veterans get the benefits they are entitled to earlier than they would have by going through the traditional appeal process. Using the DRO process, the VA is able to reduce its backlog of claims. Surviving issues that need to be appealed to the BVA (computation of effective dates, disagreements over the percentage of impairment rating, etc.) are narrowed for review by the BVA Hearing Official, and are more clean in their presentation to the BVA.

Despite these advantages, all too many Veterans don’t yet know that the DRO process is a very good option to pursue in nearly every type of claim. Perhaps the VA could explain the process better to Veterans. Perhaps Veterans are tired of going through yet one more stage of review of their claim and are “once-bitten-twice-shy” about the VA’s claims of a more efficient process for helping the Veteran. After years of waiting for benefits that should not usually be denied, can you blame the Veteran?

With the likelihood that you will wait many months or years before you can argue your position on a denied claim before a BVA Hearing Official, it makes sense to ask that a more senior representative review your claim.

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