Improper handling of 1999 VA Compensation Claim

[ardodd]

Improper handling of 1999 VA Compensation Claim

I will do my best to present this in a short and respectful manner. I will do my best to truthfully represent all facts and evidence as it was presented in 1999 VA Claim. It is therefore I am seeking help in identifying any missing documents, missing evidence, non compliance of VA Regulations, etc...

I will post the photo copies of the record on my C-file which I received in 2015. I will present the Claim as it was filed through the local VSO in Farmerville, Louisiana County/Parish: Union

 

Subject:

VA Compensation Claim for Albert Dodd

Dated: 15 June, 1999 

Copy of Claim Submission: ** ( All files are in PDF format and saved to my Google Drive ) ** ( View Only ) **

https://drive.google.com/open?id=1d9HHYJHe3fgLuItJ6INugPqWLAZDg1am

VA Claim submitted on: 15 June 1999

VA Claim Received on: 18 June 1999 ( Dept of Veterans Affairs New Orleans, LA )

ATTACHMENTS:

VA Form 21-526 Pg. 7

https://drive.google.com/open?id=1bHb95IPMv6DGTVftK2qLeoYo-rv1miAv

VA Form 21-526 Pg. 8

https://drive.google.com/open?id=1cWw-3sJygTIhnCgrRZFl4B7XSXC0nnE-

VA Form 21-526 Pg. 9

https://drive.google.com/open?id=1P8tgJ0rcUz8MJoInHEMLuv06raHckdZK

VA Form 21-526 Pg. 10

https://drive.google.com/open?id=15P1YoMfREici-kHFHgbz1TttyuzCMLim

Authorization and Consent Included: 

VA Form 21-4142 Pg. 1

https://drive.google.com/open?id=1YXTaDasjAdrfXN8abclQX9a_8v7kM5G4

VA Form 21-4142 Pg.2

https://drive.google.com/open?id=1Ux9UvrEplp2tTkKc6xrZsMCkUSi2e0z4

 

** ( Notes of Interest ) **

Supporting Evidence Attachments:

1) Certified copy of DD 214

2) Copy of Discharge Account Summary ( Severance Pay ) ** ( My Certified True Copy from SMR ) ** 

3) Copy of Findings of the Physical Evaluation Board ** ( My Certified True Copy from SMR ) **

4) Copy of SMR's to support S/C Claim

 

** Physical Evaluation Board Decision **

Pg. 1

https://drive.google.com/file/d/1Ius0W2ZDp-Ls1_fiQxoqfxRWBSor_viU/view

Pg. 2

https://drive.google.com/file/d/1fYqy9fh6kjD0-cXAfK_T6KGoyszVeJNP/view

Pg. 3

https://drive.google.com/file/d/1DsAwqqLecFc6C_HsZghIaZ7D33E37Qf6/view

Pg. 4

https://drive.google.com/file/d/1UJOIGk1DJuNKNR-RRgfXIswVjWLex_jF/view

Pg. 5

https://drive.google.com/file/d/1h6GgoGlDbJ9sEOT7V1CXorWXEKB5rxG4/view

 

All Evidence and Supporting documents where sent in along with the Authorization and Consent ( VA Form 21-4142 ) for Release of Medical Records on June 15, 1999

 

**** Dept of Veterans Affairs New Orleans, LA ****

Intake of Evidence for VA Claim for Compensation for Albert Dodd

Dated: 18 June 1999

**** Timeline for Review of Evidence and Decision ****

June 18, 1999 VA Claim Received

 

June 25, 1999 VA Claim Reviewed

https://drive.google.com/open?id=1LaYkJdHDmZ9ofzA8CJD7ZTCNwOqzVX9N

 

July 08, 1999 Rating Decision ( R.M. LaCOMBRE, Rating Specialist )

Rating Decision Pg. 1

https://drive.google.com/file/d/16cS_DJ6QCut61LVj-jbzolQghHh4StDF/view

Rating Decision Pg. 2

https://drive.google.com/file/d/1MfG-kcASP_2lruDY22eSMGCgKbI6x-_b/view

Rating Decision Pg. 3

https://drive.google.com/file/d/1pUJXAHT_Zguk0WR2R4xTEi8c0EAXLgHs/view

 

July 10, 1999 Compensation and Pension Award **( VA Form 21-8947 ) ** Signed into record

https://drive.google.com/file/d/1JP-MXHlCsjsGlL9M9qP09XSK_OJJC14P/view

 

July 12, 1999 Notice of Decision mailed out  **( Cover Sheet ) **

https://drive.google.com/file/d/1OG7fNoJWMzF79NQ1AI04Z-wz5QrspY7g/view

 

**** Questions for CUE ****

1) Duty to assist **( Did not attempt to help get copies of Hospital stay )**

2) Duty to assist **( Failure to assist by not scheduling a medical exam for current medical condition(s) )**

3) No Development Letter **( Failure to Notify Veteran of any further evidence needed to substantiate Claim )**

 

I Albert Dodd do swear that all information is correct and included. If you or someone you know has information that would help me in getting the VA to correct this wrongful Decision please post your comments. 

 

 

[Berta]

Anyone else having problems with the unreads and also with posting here in last 2-3 days?

I sure am.

There were 4 denied claims in the 1999 rating.others can chine in on the last 3 but I will focus on the Bilateral 

# 1 AND  2  Do not raise to the level of CUE.

I assume # 3 meant the VA did not consider this as a 'well grounded claim'.

After the VCAA, our DTA rights were enhanced. Still that meant we needed to provide (or make sure the VA obtained) any relevant other records.   and/or info that a well grounded claim could be adjuducated on.

Page one of the  rating decision states that you were diagnosed with bilateral -patellofemoral syndrome and "received severance pay", and then  states 

"He has not submitted any evidence of any current residual disability.”

The VA did stamp this form as received on June 18,1999 and the 21-526 was also stamped as received that date.

When did you send them medical proof of your current residual disability within the appeal period for that specific claim? What was the VARO date stamp on it?

Do I understand that you still receive the 10% for this disability? Or did the statement as to lack of reiduals cause them to reduce you to "0" for this specific disability?

Have you  formally claimed an increase in the 10% rating?

Do you expect a C & P exam in the near future, per any VA notice, on this same disability?

I thought you mentioned that in the other thread.

If so, that could change everything....maybe...was this for a higher rating on the knee condition ,

and that might change   the 1999 decision....but which would still require a formal CUE claim on the 1999 decision being Cued.

I had to blow up the rating sheet and the dates looked like 1996, or 1998 but I seem to think the date was 7/8/99..up top to the right of the page .

20 days -less the weekends in June ,July 1999-for a decision???? heck it often takes that long for a 21-526 to get out of the Mail room into the actual VARO offices.

Obviously something was wrong with this decision....

a violation of 38 CFR. 4.6,if you have proof of this:

'When did you send them medical proof of your current residual disability within any deadline they gave you  for that specific claim? What was the VARO date stamp on it?"

 

 

 

 

Edited December 2, 2017 by Berta

[Lemuel]

What happened to the Hip pre service aggravated by service claim?  No mention?

Were the knee problems in any way the cause of the MVA for the back problem?

[ardodd]

@Berta that is what I have been trying to say ( maybe not in the correct way ). What you see is the complete Claim for 1999.

1) Medical Evidence: 

 a) VA Form 21-4142 I requested help with obtaining medical records from 1993 In Hospital stay. 

 b) VA Form 21-526 I highlighted in Red Pg. 10 Block #40 Remarks: **( Vet is willing to be examined at VAMC - Shreveport if scheduled by DVA )**

**Notes of Interest**

There was no medical evidence submitted by myself. I asked for help in obtaining a copy of the medical records using the VA Form 21-4142

 

8 hours ago, ardodd said:

Authorization and Consent Included: 

VA Form 21-4142 Pg. 1

https://drive.google.com/open?id=1YXTaDasjAdrfXN8abclQX9a_8v7kM5G4

VA Form 21-4142 Pg.2

https://drive.google.com/open?id=1Ux9UvrEplp2tTkKc6xrZsMCkUSi2e0z4

I was not working and no health insurance so I could not afford to get a medical opinion from a doctor stating my medical conditions. That is the reason for requesting a exam to show a current medical condition.

8 hours ago, ardodd said:

VA Form 21-526 Pg. 10

https://drive.google.com/open?id=15P1YoMfREici-kHFHgbz1TttyuzCMLim

Hopefully i am not confusing you or anyone else. Because I know you and others will say that it is our responsibility to get a medical records related to my claimed disability and submit it.

Am I at fault for not being able to afford to get a medical opinion? 

Am I at fault for not getting the medical records from 1993 and submitting them?

And that is exactly what I see that the VA said and did. 

Did the VA request or send a letter notifying me of further evidence needed to substantiate the claim? NO

Did the VA request a copy of the medical records? NO

Did the VA assist in helping me get the medical evidence for a current medical condition? NO 

Facts supporting that the VA did not fulfill its obligation under 

§ 21.1032 VA has a duty to assist claimants in obtaining evidence.

 

Reasonable doubt

If the VA would of fulfilled the Duty to assist, the claim decision would of been delayed 60 days to allow for a response. A Second attempt then would of took another 30 days.

If the VA would of fulfilled the Duty to assist, they should of sent a development letter notifying me that I needed to submit medical records to support my claim. If I was not able to obtain medical evidence then the VA should of scheduled me an exam for a current medical condition.

**Claim was Decided in 23 days with weekends and holiday included**

 

Conclusion

The VA Regional office in New Orleans, LA. wrongfully Denied the 1999 Claim for Compensation. 

Violation of Due Process Rights 

Violation for Failure to Duty to Assist

Violation for making a Decision without following Protocol

When the VARO New Orleans specifically disobeyed Protocol by Denying a medical exam to prove current medical diagnosis. They disobeyed protocol by not fulfilling the Duty to Assist in obtaining medical records using reasonable efforts. Then the VA disobeyed protocol by not notifying me of any documents needed to approve my claim.

Although the VA rating Specialist made reference to (NWG not found on last exam) the VA failed to identify the date and medical examiner report used in making their decision. 

It is therefore that without a reasonable doubt that the VA Rating Specialist and VARO New Orleans, LA if at least as likely would of used reasonable effort to follow protocol. The outcome would of been in favor of the Veteran. And it is as likely as it is as likely not that if the VA would of followed protocol in aiding the Veteran to obtain the evidence necessary to substantiate their claim for service-connected disability.  

 

 

[ardodd]

1 hour ago, Lemuel said:

What happened to the Hip pre service aggravated by service claim?  No mention?

@Lemuel I have never had any pre service injuries. All injuries where incurred during active duty and post service.

1 hour ago, Lemuel said:

Were the knee problems in any way the cause of the MVA for the back problem?

@Lemuel in my non-medical opinion the knee's are the basis for improper alignment of all muskoskeletol conditions. 

When looking at the knee's it is conclusive that any kind of injury can result in misalignment of ankle - hip - back. My knee's where not properly aligned after being injured. 

The misalignment of knee's caused the hips to rotate out of balance. Thus it is connected to the in service disability.

The misalignment of the hips caused misalignment of the spine. Thus it is connected to the in service disability.

**Note**

Although I was injured in a chemical plant explosion which caused the back condition. Reasonable doubt is established if the service connected disability in any way shape or form from my knee's misalignment caused my hips and back to become misaligned as a result.

The VSO filed them as service connected. And it was not until my Appeal was Denied this year that i realized that it was listed as service connected and not secondary to the service connected disability.

[ardodd]

I am only asking these questions so I do not waste others time on things that can not be changed.

My Questions are:

1) Is it an actual CUE if the VA does not assist the Veteran **(Prior to 2000 Duty to Assist)**?

2) Is it an actual CUE if the VA did not do a Development of Claim **(NO Notification Letter - NO request for further documents)**?

3) In my Claim for 1999 the VA Denied it for Not Well Grounded. The VA did nothing to help assist in my Claim and in 23 days time sent it back to me, stating I had not provided any evidence of any current residual disability.

When I look over the whole Claim what I get from it is that the VA is telling that if you can not get your own evidence. And send it to us so we understand that you were injured in service - Discharged because of it - Have a current medical diagnosis that connects it to your claimed conditions. That we as the VA do not have the time to help you even though you were discharged with it. 

I feel as if the VA slapped me in the face and told me to go do their job so all they have to do is look and say: Yes ( Discharged with it ) Current Disability ( bla-Bla-Bla ) They are connected/not connected. So go back home and do our job and send us a Completed Claim and send it back. Then we will let you know if you are or are not Approved for your Claim.

Of course i feel if that would of been the case when I did all that and sent it back in they would of sent it back stating that my evidence did not support my claim so try again.   

[ardodd]

@asknod and @Berta I value both of your opinions and suggestions as Elder's. I have tried my best to focus just on the 1999 Claim and not go wondering around about other circumstances.

All I can ask is if either one of you when looking at the time it took to process the claim and give a decision. Does any part of it even arguable?

I know that 20% disability is not a major money claim, at most it is a penny claim. But this has been going on and on what 2 surgeries that the VA did not do. My wife and i have raised 2 kids that would of been affected by any Claim.

Surgeries in 2001 - 2005 - 2010 - 2017 would of greatly affect the overall disability rating and back pay. But with this Claim Decision being held up since it is finalized i feel completely drained.