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bufloguy

Request For Reconsideration

Question

Not to sure how to wrtieup the request for reconsideration, any assistance would be greatly appreciated.

May 5, 2010

IM A Vet

My Town USA

CSS: 000000000

Dear Sir/Madame;

I ask that the VA to reconsider the decision of November 12, 2009 for the below conditions.

If my request for reconsideration does not properly resolve my claim issues, please consider this as a formal Notice of Disagreement.

1. Cervical condition rated at 20%.

-I feel that I should have been rated 30% for this condition due to frequent occipital headaches and the extreme pain that radiates into my shoulders and arms.

2. Right C7 radiculopathy rated at 0%.

- I feel that I should have been rated 20% for this condition due to the frequency of my hands becoming numb after only sitting or driving for 20 minutes. Furthermore I have lost hand strength.

3. Left C7 radiculopathy rated at 0%.

- I feel that I should have been rated 20% for this condition due to the frequency of my hands becoming numb after only sitting or driving for 20 minutes. Furthermore I have lost hand strength.

4. Denial of Post Traumatic Stress Disorder.

- There are several issues with the denial:

1. The claim was well grounded and plausible, but the rater failed to consider all the evidence presented. Furthermore, the rating authority failed to explain why they did not consider the evidence of record in the file which was favorable to my claim. Case law from (10-12-90) establishes in Gilbert v. Derwinski VetApp. 49 (1990) that the VA is mandated to explain its reasons or bases to the veteran its factual finding and its conclusion why the veteran was not entitled

2. I was not afforded a Compensation & Pension exam as stated in 38 USC 5103 - Sec. 5103A. Duty to assist claimants;

(1) The Secretary shall make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate the claimant's claim for a benefit under a law administered by the Secretary.

(2) In the case of a claim for disability compensation, the assistance provided by the Secretary under subsection (a) shall include providing a medical examination or obtaining a medical opinion when such an examination or opinion is necessary to make a decision on the claim.

Attached is a letter from Craig N. Bash M.D. which provides strong evidence for a favorable decision in this matter.

Respectfully,

I'm A Vet

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I suggest you type Request For Reconsideration at the top of this letter.

Also make sure-if they do not act on this within the year NOD time frame-that you formally file a NOD.

Just in case they try to get out of this request as a formal NOD too-(I have seen them do that)

Also -can yo refer them to specific medical evidence and attach copies of it for all points you have made?

Do you have any buddy statements from family members , employer, or any doctor to verify the numbing of your hands?

PTSD claim- no C & P? I don't know what to say here on that without more info as to why they denied the PTSD claim.

If Dr. Bash supported the rest of your claim-make sure they have copy of the IMO.

He does not do PTSD claims but his opinion should be considered on the rest of the claim.

Did they have his IMO but they ignored it when they made the decision?

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Bertha,

Thanks for your comments and questons. Was the Language of the letter ok? I'm not a very good writer.

1. Also -can you refer them to specific medical evidence and attach copies of it for all points you have made?

Good point, I can do that.

2. Do you have any buddy statements from family members , employer, or any doctor to verify the numbing of your hands?

I guess I can get some, I have an EMG that is positive.

3. PTSD claim- no C & P? I don't know what to say here on that without more info as to why they denied the PTSD claim.

Claim was based on a serious car accident that happened 20 years ago. Claim was well documented, but rater blew the claim off. At the time the rater acknoldged my nexus from my pdoc, acknowledged the accident happened, but would not acknowledge that I could still be suffering from PTSD.

4. If Dr. Bash supported the rest of your claim-make sure they have copy of the IMO.

Dr Bash supports the claim, stated that I should be 30 for neck, and 20 for each hand.

5. He does not do PTSD claims but his opinion should be considered on the rest of the claim.

He was able to do the PTSD as he claims it is secondary to my 70% TBI which occured the same accident. He provided a few great citations, and and with his training he can connect the dots. So I have a nexus from him & my pdoc.

6. Did they have his IMO but they ignored it when they made the decision?

No they didn't. I decided to hire the big guns after beig refused.

Thanks for everything!

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. He does not do PTSD claims but his opinion should be considered on the rest of the claim.

"He was able to do the PTSD as he claims it is secondary to my 70% TBI which occured the same accident. He provided a few great citations, and and with his " etc

GREAT -that ties in with his expertise- he mentioned to me a few times that he doesnt do PTSD claims so this is why I mentioned here-

Did they have his IMO but they ignored it when they made the decision?

"No they didn't. I decided to hire the big guns after beig refused."

Great- I know he is very expensive but I considered my IMOs from him as a good investment and they were.

VA ignored his IMOs however for over 4 years.The BVA read them for first time- and I won.

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Berta,

Which format is best for the Request for Reconsideration and NOD. Is the 21-4138 recommended or just a plain white piece of paper? And do I have to resubmit all my evidence, or will the Dr Bash letter suffice?

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They are familiar with the 4138 so best to use that

(I should talk- I have never used that form but I do feel that this form catches their attention maybe faster then a letter???? I found it used to be difficult to type onto the form-maybe easier these days)

I would refer to in the 4138 or letter- to the IMO and anything else they didnt consider yet or not list as Evidence in the decision.

On the NOD-I would mark your calendar well for the deadline date-but I would hold off on a formal NOD at this point- others here might disagree -

because if they overlook the recon request-the NOD might not be even read for a year or more.

Do you have a vet rep helping you?

If so have they seen any way the decision might contain a legal error?

Do they (VA) have copy of the EMG test?

I hope others chime in on this - would this test definitely show evidence of this veteran's numbing problems- which seems to be a form of peripheral neuropathy?

Edited by Berta

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