Very Handy Pamplet

[63SIERRA]

This simplifies the claim and appeals process its easy to understand. I put it on my desktop for future reference .

http://www.bva.va.gov/docs/Pamphlets/010202A.pdf

[GatorNavy]

well what happened to me I filed the NOD, thinking it would signal an appeal. I wait a few months, check ebennies, no appeal on status. I call DAV rep, and ask what is going on and why they dont have my case on appeal. DAV rep informs me that the requested a REOPEN of several denied claims, but not all. He seemed quite confident in his plan. that was MAY of last year. So what im going to do is hold tight, until around march of this year, im watching the calender. If they dont make a descision on the reopen, by march, im likely going to first request a Appelate review, by asking for a soc and file a form 9 at the same time, (ive requested the codes they used to initially deny my case and theyve ignored my request),, and write a nastygram telling them they have molested my case long enough, the love is gone, and we are parting ways. then I will get in line, to go see the wizard.

You are right they don't follow the rules. The M21 is terse enough that they can skirt around the issues quite a bit. I think being familiar with the M21 helps to figure out the madness though. Senior VA folks will tell ya that if you don't have air-tight new and material evidence that should absolutely change the outcome of the decision, then don't bother with a reconsideration (a re-open within the one year). The clock starts ticking one year from the decision date and does not stop when a reconsideration is filed. As long as your NOD was submitted within a year of the decision date and before the VSO's recon it's just a guess on my part that you should be able to hound them into sending you a SOC. If the recon went in before your NOD then you could have a problem if the year has passed. I submitted a recission of the VSO's POA and then a recission of the reconsideration and then re-submitted the same NOD before I actually started seeing some movement (ie a SOC). But I hounded the VARO constantly and ended up with a couple of months left on the one year clock. They should send the form-9 with the SOC and then you have 60 days to get your form-9 submitted for an appeal.

Oh and by the way thanks for the appeals presentation. I've got my first BVA hearing scheduled now.

[63SIERRA]

Heres the bottom line of what I feel really happened to my claim. My DAV rep had good intentions, he submitted my release of information to the va, instructing them where to get my medical records and ASSUMED they would go get them ALL. look thru them ALL and use the information needed to properly work my claim.

Is that how things are supposed to work? maybe is that how things used to work? maybe. Is that how they work now/ ? HELL NO.

The VA evidently has taken a stance of..... if you dont SPECIFICALLY send us the exact evidence needed, we will deny you. we have no time to fart around with your case, weve got millions of veterans to screw, and the water is just rising even higher. VA s opinion of duty to assist, is to feed evidence that they decide they want to feed into m21, if you send it to them.

Like I peviously said the big insurance companies are trying to do the same exact thing with a computer program called COLLOSUS. The technician feeds info into the system. the technician knows what pays and what doesnt. For instance. has the driver recieved treatment from a medical doctor. if you went see a chiropractor, which will SAVE them money, they will downplay your treatment and try to low ball you.

If there is a quality control check, and someone feeds aLEGITIMAE, ACCURATE info into the system, it will spit out a fair claim amount.

They know what they are doing. I was in an accident and REFUSED to use the COLLOSUS system. there already is a lawsuit against them. several matter of fact/

So in closing, sometimes I wonder, maybe the claims backlog is all a manufactured crisis. Time is on the govt side, the govt will go on forever, a veteran will not. do they know what claims should be approved the minute it hits thier desk, with thier 100 plus years experience, yet deny it anyway, in an effort to stall the claim, hold the money a little longer, until they " figure things out"

What do all other big entities such as insurance companies that deal with claims do, and are not required to pay interest? they sit on your claim, hoping you die, give up, settle for less. THERE IS NO INCENTIVE TO PAY YOU FAIRLY OR TIMELY.

If that were to change, they would take the longest running, largest owed claims, and get them done.

So all this talk abt change, maybe put a bill before congress saying the govt must pay interest on wrongfully denied claims, at the rate they charge. 33. percent.

Edited January 26, 2014 by 63SIERRA

[GatorNavy]

You've pretty well hit the mark....all of the guvernmint agencies are like that. Social Security Disability, DOL-VETS just about any agency that has any type of "laws" for Veterans. DOL-VETS is another scam. In some states the VRE takes input from DOL/VETS to deny IU. In my state it's a fact. The USERRA laws are a sham too. At least we have some good Veteran attorneys that can make a difference for us. I know what the "system" is designed to do and I won't waste any energy trying to change it. All of my energies are focused on "beating" the system at it's own game to get what rightfully belongs to me. The main tactics they rely on is to delay and deny until one gets frustrated, sees no light at the end of the tunnel and gives up. Maybe a Vet just waits on a "hamburgered" claim to fix itself and then misses the appeal timelines. From what I have seen, it happens all of the time.

"maybe the claims backlog is all a manufactured crisis"

You can bet that it is. You mean the government doesn't know about the wars being fought for the last 10 years? Or that AO doesn't cause cancer or a slew of other ailments? The effects of ionizing radiation after 30 to 50 years. Allison Hickey has pronounced that they have now "crushed" the backlog. Well now, did more Veterans get their compensation approved? Me thinks that the appeal elephant has consumed the backlog!