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Claim Denied

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michael09070

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After 2 years the Chicago RO denied my claim for multiple sclerosis. I had the medical nexus,buddie letters,solid medical evidence and a written time line of events. my claim was in Chicago since June 2011and around feb. 2013 they outsourced my claim to the Des. Moines Iowa RO. And within a couple of weeks my claim started to move but in the wrong direction. Talking to them it was oblivious they just pushed my claim through without weighing all my evidence. I have zero faith in the Chicago RO or any for that matter. Now I was told the appeals will take 3-5 years to even be seen by a human again. Way to go government, taking care of those who afforded you the job you have..

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After 2 years the Chicago RO denied my claim for multiple sclerosis. I had the medical nexus,buddie letters,solid medical evidence and a written time line of events. my claim was in Chicago since June 2011and around feb. 2013 they outsourced my claim to the Des. Moines Iowa RO. And within a couple of weeks my claim started to move but in the wrong direction. Talking to them it was oblivious they just pushed my claim through without weighing all my evidence. I have zero faith in the Chicago RO or any for that matter. Now I was told the appeals will take 3-5 years to even be seen by a human again. Way to go government, taking care of those who afforded you the job you have..

Sorry for your long wait and negative decision.

Please post exactly what is stated in the Reasons and Bases Section of the Rating Decision.

Thanks

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dont give in, dont give up, thats what they hope for. engage that warrior spirit, make a commitment to yourself to never quit , and fight on., ive been fighting for 20 years. I wont give them an inch if I can help it.

also you may be able to request a reopen if you have a good arguement or good evidence. have you got your c-file yet to see what they have?

Edited by 63SIERRA
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  • HadIt.com Elder

You must give us the exact reason you were denied. This is what you must address in appeals or with IMO's. If you feel you are in over your head hire a lawyer.

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The denial language is the meat of your future success. Because this an ex parte process, you submit and they deny. You learn from the denial what it is you lack and fashion a repair order. Yes, you will need to appeal but you are experiencing what 85% of us do so don't be disheartened. Winning at the VA is akin to Las Vegas. The odds are not in your favor. Chicago or Des Moines is immaterial. It could just as easily have been sent to Ft. Harrison, Montana and suffered the same fate. The important thing is to post the denial language verbatim as Carlie suggests. This enables us to identify what went awry and suggest possible ways to correct it. You can win but you have to learn how to play the game with their rules. And Michael, trust me when I say they have rules you can't even conceive of nor will you ever.

I have had Vets send me copies of their nexus letters that would floor you. The absolute worst one was a compendium of "might have", "could have" and "quite possibly". Your nexus letter will be the most important item you submit. In that regard, it must be flawless or VA will cut it to ribbons. Buddy letters, while valuable, must be accompanied by their DD 214s showing proof that they served with you. Some DD 214s like mine were purposefully vague due to the nature of my work. In that respect, a buddy letter would be pointless. In spite of jurisprudence that states it isn't a prerequisite for a doctor to view one's contemporary service medical records, failure to do so can be the difference between success and denial. The VA examiner will be sure to point out that s/he did and you didn't- thus making their "nexus" more probative.

Most Vets view their claim from their own perspective and, as such, seem to think everyone else can see it's validity as clearly as they do. VA purposefully tries to misinterpret what you present. Remember, just as in the military, you are guilty until proven innocent. Eliminating all the negative possibilities in which to view the evidence is the first step. When all that is left on the table to view points to service connection, VA will acquiesce-but not a moment sooner. VA calls that "the benefit of the doubt" and applies it to your claim when they run out of reasons to deny.

Communication of a thought, an idea, or evidence often requires a measured, pedantic approach. VA raters are not the brightest lights on the Christmas tree. Thus you have to put a halter on them and lead them to water. Sometimes it entails sitting on their heads to get them to drink. Always remember, they are a large insurance company and are paid to deny claims. This mindset means they view everything differently from us. If you are traveling through an intersection with a green light and get t-boned, you are in the right. VA automatically assumes the light was red and you are at fault. You have to build your claim from the bottom up and prove it was green. Sometimes that is no easy task when it happened 20 years ago and the traffic cop who wrote it up is retired or dead. I have had VA attack two buddy statements saying no one can remember what happened in Da Nang 45 years ago at 2 AM in the morning (a tattoo). The Vet won on appeal because both buddies' 214s showed they served with him on the USS Long Beach and one was a medic.VA had also maintained there was no proof they served together.

In sum, each claim is unique and requires a unique approach. I doubt there is a "one size fits all" method to this business. If there was, we'd have no need for T-bird, Hadit.com, or for that matter, my site over at Asknod.org. The beauty of Veterans' experience in this new internet world is that someone out there has suffered a similar event or set of circumstances that provides guidance on how to help those who follow after. And so we pay it forward. Yes, in all reality, you will have to appeal. This will give you the opportunity to fix what was defective and produce a bulletproof win. It's a shame you have to be treated like a welfare cheat but that is the cross we bear. Happy Veterans Day. Be glad you're alive to celebrate at Applebee's next Monday. Attached below is a NOTAM of a few of my friends who won't be there.

a

The hell with the propeller. Beware the Vet.

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  • HadIt.com Elder

After 2 years the Chicago RO denied my claim for multiple sclerosis. I had the medical nexus,buddie letters,solid medical evidence and a written time line of events. my claim was in Chicago since June 2011and around feb. 2013 they outsourced my claim to the Des. Moines Iowa RO. And within a couple of weeks my claim started to move but in the wrong direction. Talking to them it was oblivious they just pushed my claim through without weighing all my evidence. I have zero faith in the Chicago RO or any for that matter. Now I was told the appeals will take 3-5 years to even be seen by a human again. Way to go government, taking care of those who afforded you the job you have..

You need a copy of your Claims file - (or C-file as it is often called). There you can see what evidence they had, that you submitted and what is missing. Without the C-file you're in a gun fight, armed w/just a rubber knife. They may not have seen evidence you've submitted, as it could have been lost/misplaced, a favorite trick of the VA.

As stated, we need why they denied you, as quoted in the "reasons and bases" section of your decision letter, in order to help.

pr

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MS is a chronic presumptive under the chronic presumptive regs here:

“(4) multiple sclerosis developing a 10 percent degree of disability or more within seven years from the date of separation from such service; “

Often MS is symptomatic in SMRs but never diagnosed until many years later. The 7 year leeway for the required 10% degree is the most favorable chronic presumptive regulation,timewise and must be proven with medical evidence.

I dont know how you claimed the MS and the Reasons and Bases will tell us more if you can scan and post that info here (cover your name, address, and C file number before you scan it).

If you need a strong independent medical opinion for this claim, I highly recommend Dr Craig C. Bash.

We have done many SVR shows with him in our SVR archives here and not only is he a Neuroradiologist, very familiar with doing IMOs for VA claims, he is also a veteran and also has Multiple Sclerosis himself.

He helped this hadit MS vet:

and he has some of his cases on his web site:

http://www.veteransmedadvisor.com/list2.html

He would need your complete SMRs, and all available additional medical records, VA and/or private, as well as your denial letter and the VA's Reasons and Bases.

If it wasn't for Dr. Bash, doing 2 IMOs for me, I could not have prepared the IMO criteria here at hadit in our IMO forum.He knew the exact way to word his opinion (he used to be a VA doctor as well)

I have no idea what his fee would be but ,with the denial letter he would be able to determine your chances and determine his fee.

We can help more if we can see the complete denial. And I am assuming you claimed the MS under the chronic regulations, but not sure.

Edited by Berta
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