TiredCoastie

IRIS has worked like that for me for quite a while, probably more than a year. It takes at least three to five weeks for a response. Sometimes, if I'm in a back-and-forth, I'll get something back the same day. Usually it's weeks, though, and usually pretty close to a month.

It's an easy fix, actually, from what the rater explained. Just check off in the electronic system what documents were requested and which were received and when. I don't know a thing about how the systems work, but I imagine it would probably take less than 10 minutes but save countless veterans time and agony. Only twice in my claims' history did a rater click off that they received a document they requested, and that seemed to happen when the claim was closed.

Thanks for the great advice, as always! At this point, I think I'll quietly wait for someone to do something, like forward my appeal to the BVA, which should happen at any time. I've made my point that I'm watching carefully and taking note of what's there and what's not. The other lesson that I hope others take is to not bite on the tangelizing bait of a supposedly quick decision through the "reconsideration claim" process. Honestly, the status of all these contentions and the confusion surrounding them isn't the RO's fault. It's the VSO's. He created a three ring circus. Send in the clowns...at this point, I need the comic relief.

I've been trying to figure out what happened to my second NOD which seems like it disappeared from my C-file. I was told by phone by the RO that because my second NOD appealed decisions that were already on appeal from my first NOD that the second NOD was either cancelled or combined with the original appeal. I can only have one appeal in play for a particular contention was the explanation. Is this right? Confused? I am and certainly the RO is as well. This is the result of listening to the VSO who talked me into submitting a "reconsideration claim" (before I found Hadit). My story ought to be as good an argument as any why veterans should not pursue this avenue. It's a three ring circus. Just appeal...but I digress. So here's what happened. I filed a claim for SC of TIAs and a rating increase for migraines back in 2012. These were denied and the claim date missed the informal claim the VSO had submitted ahead of the FDC. The VSO told me that I probably had a bad rater and that trying it again was the surest and fastest way to fix the problem, even the missed informal claim date. So he had me compile N&M evidence and submit it with a "reconsideration claim." Of course, the RO didn't complete the claim before the one-year appeal deadline would pass for the original denied claim. So, in order to protect the original claim date, I filed a last-minute NOD appealing both contentions which got lost within the RO. Meanwhile, the "reconsideration claim" continued to process. In March 2013, I got an answer back on the "reconsideration claim" increasing migraines to 30% and continuing the denial of SC for TIAs and the underlying condition. I appealed these two contentions again through this second NOD, which is the one missing. In Big Top Ring 2, I finally won the battle over whether or not I had filed a NOD and had filed it in a timely manner (thank God for that certified mail hand stamped receipt from the post office counter!). This appeal was opened and processed within the RO. I was granted the earlier effective dates based on CUE determinations. The SC for TIAs/cerebral thromboses and increase in migraines to 50% were denied and will move on to the BVA. My Form 9 is in on these two. The SOC referenced and included decisions made in the reconsideration claim's decision but not the second NOD. In Ring 3 is this second NOD which never appeared in eBenefits. IRIS back-and-forth showed that it had been received and uploaded into my electronic C-file. Then it wasn't there. I mailed a package with a letter to the RO asking for a status update or explanation of what happened and enclosed a copy of the NOD and proof of postmark. Shortly after I mailed it, I got a call from the RO confirming what I was appealing to the BVA via the first appeal's Form 9 and that my Form 9 date was correct within the system. I asked about the second NOD and was told that I couldn't have two appeals for the same conditions/contentions. I did not get a solid explanation over what had happened to the NOD. I feel like I'm fairly well protected by my Form 9 which contains and expands on the arguments I made in the second NOD for those same two contentions. I'm not sure what the second NOD would gain me at this time except for a second RO review of those contentions and several more months of waiting with some low probability of success. But the principle remains. Doesn't the RO owe me an SSOC or at least a letter stating that I cannot have two appeals on the same contentions? I don't feel very comfortable not holding something in writing.

I think one of the potential problems, Chief, is that eBenefits shows what the RO thinks it needs rather than what it actually holds. It's not supposed to work like that, but does due to internal procedure within the RO. Your best bet is to either invest a part of your day on hold with the 800# or send an IRIS email asking if the the RO has the records they requested. I've had this problem in the past. I've provided the RO with a pile of documents, forms, records, etc. Then eBenefits shows up with a list of what they say they need that includes those exact same documents, forms, and records. It seems pretty common. This is one portion of eBenefits that no one can trust, right next to the "expected completion date" which is completely spurious. There was a rater on here at one time that explained that within the RO's electronic systems, the rater creates a list of required documents. But because the rater can see within the file what is there and not there, it is very common to not check off those documents as present. It seems that this internal procedure is the root of the problem. If they would check off those documents on the checklist, eBenefits wouldn't display that they are required and missing.

Outstanding! BZ!

If you have eBenefits access, you might want to check under documents and "benefit verification" to see what you've been rated and when. That might have some clues for you. You received your SOC/grant on Jan 5th, but when was it dated? Was the decision after New Years....on Jan 5th? If so, seeing as you were already paid back at the end of December, you wouldn't expect to get a regular monthly increase until sometime around Feb 1st anyway. If the decision was in December, it's hard to understand why you didn't see 100% compensation in that last payment unless it was so close to New Years that they somehow couldn't change the payment already queued up in the system. Check the grant decision and discussion carefully; there may be clues there as well. When my effective dates were granted through the RO's review of my claim contensions, those changes happened immediately or at least it seemed that way to me. Retro is always a problem, IMO. If you're also military retired, it may take a while to make it through DFAS and back to the RO for CRSC/CRDP determinations. It seems to come much faster if you aren't retired.

I sent a letter to the VSO telling them that my POA was rescinded and got a letter back from the org acknowledging my direction and stating that the appropriate action had been taken. It was pretty easy. I have seen that the RO has listed the DAV as my POA since then, but didn't make a big deal of it. I've got the letter from the VSO and will use that as a weapon if my appeal winds up sitting on someone's desk within that organization at any level.

I've double tapped submissions in the past without causing too much confusion. They're pretty good at sorting out duplicates. Biggest issue seems to be the date they use if the submissions arrive on different dates. I'd watch eBenefits and if you don't see the claim pop up as active within the next 3 weeks, submit it yourself. That is unless you're up against a deadline. Hate to say this, but there have been extensive discussions on HadIt about the cost-vs-benefit of going with a so-called "reconsideration claim" against an outright appeal. Worried about confusion? I listened to the VSO who talked me into a reconsideration claim. It turned into a mess because I wound up firing the VSO, filing a NOD at the deadline to protect the original and earlier effective dates, and then appealed again once the reconsideration claim was decided several months later. Now that second NOD has disappeared within the system, and I was told recently that because the conditions I had appealed originally were not different than the ones in the second NOD, it was somehow informally combined with the original appeal. Of course, none of that is in writing, which I have requested. However, if you have additional contentions or increases beyond what you've requested to be "reconsidered," you don't have a lot of choice. Be ready to fire a NOD off, though, to protect those original dates if necessary. The appeal process includes a re-look at the decisions made anyway, like a reconsideration claim, but queues up the veteran to take it to the BVA in DC immediately upon a re-denial.

What does it cost for a non-SC vet or less than 50% for glasses and hearing aids? Just curious. The reason I'm asking is that I was once warned to stop pursuing a losing argument over SC hearing loss because the VA might then bill me for my hearing aids. I gave up my fight for SC of hearing loss because the bad entrance exam hearing test made it look like my hearing loss was relatively stable across 20+ years of service after a second look by our family ENT who's a top guy in the region. He advised me to drop it before the VA started charging me for the hearing aids they issued me. I quit not due to fear of the VA billing me but because, without his backing and nexus, I was sunk. (Just for the record, he'd actually changed his opinion but did not mark the original DBQ as having reviewed my SMRs which he did...for lack of a check mark, I probably lost the war on this one.) Now he doesn't understand VA medical or that I'm rated above 50%, medical is without cost to me. But what if I was less than 50%? Would I have had to pay something for them? Is it the same deal with glasses? I agree that they take very good care of me (but wouldn't issue me a pair of progressive lenses w/out the line). However, back before I was SC and waiting on that initial claim, I wound up paying the VA $50 a visit when I had an acute eye problem. Of course, I eventually got that money back. But I did not attempt to obtain new glasses before I was SC.

Gastone is right. Don't rely on VA doctors to get this right in terms of service connection. You're going to need an outside ENT seeing as you had a roto-roooter treatment back on active duty. Our family ENT treats OSA as well as a host of other issues. Actually, I see an outside pulmonist for my OSA. With your claim moving down the pike and on to the C&P, you'll need to get this nailed down with outside specialist relatively quickly and get the new-and-material evidence into the RO ASAP before they deny you and make you fight about it. And that's a whole other topic...

In my case, it took several months to get through the rating process. I think they started sometime in June or July and generated a SOC mid-September. You get a free relook at the claim decisions you disagree with as part of the appeals process as the first step. So that's what's going on. It's not completely a rubber stamp of the previous decisions. The RO gave me an EED on several contentions based on CUEs that they declared after I explained the proper dating of the evidence using 38 CFR.

I had a phone consult once after I had a C&P and somehow the examination notes got lost, so the doc called to redo the exam, basically, over the phone. It was no big deal. A C&P for OSA is really Q&A anyway. When I had mine done, although it was in person, the examiner asked me if I had OSA, when I was diagnosed and how, and if I used my CPAP. So it wasn't as if he actually examined anything. In terms of nexus for service connection, that's a tougher question. The safest bet is to get a doctor to make the nexus connection for you and the RO in writing. What could have started as, say, a condition requiring septoplasty, is now OSA. Or the OSA could have been misdiagnosed back on active duty as you think it probably was. Unless you are a medical doctor, you are not qualified to make this connection - which the RO will wave about in their denial. Don't count on the VA making the connection either...and it's been more than 10 years since you were on active duty, so the VA has an easy out to say that OSA developed since discharge.

And seeing that you've got a 50% combined rating, there is completely no cost for you. Otherwise, each visit for a specialist is something like a $50 co-pay if you don't qualify as low income or have a service connected eye issue. You probably need a referral from a VA PCP, though, so you'd have to enroll in the VA Medical System as a patient, be assigned a PCP, and get your PCP to give you a referral. Some Community Based Outpatient Clinics (CBOCs) have an eye clinic, so you may be able to be seen closer to home without the potential hastle of the big VAMC. Eye glasses and hearing aids are the two main things I use the VAMC for besides being a way to keep the VA informed as the status of my service connected conditions. Otherwise, I use our outside insurance for everything else.

Snake Doctor, seeing as you were diagnosed on active duty at an MTF, there should be sufficient records in your SMRs to establish a nexus. W/ CPAP, the rating is 50%. W/out CPAP, it's 40%. Seems like you're on CPAP still, so that's 50% right off the bat, making you eligible for VA medical care without charge to you and ensuring you actually get both your retirement and disability payments. That's a cause for both congratulations as well as condolences. At least you had the presence of mind to get to sick call while you were on active duty and get this condition diagnosed and in your SMRs. So many vets are struggling to develop a nexus through inference, buddy letters, spousal statements, etc. Key thing for you at this point is to get on a CPAP system that works for you and stay on it, or like John, get something else that works. Not sure who or where your current treating physician is, but get something that works for you. I just learned that my heart has been damaged most likely by OSA (not the point of having a ratable secondary condition, though, fortunately!).

Been there, JM, and actually there again. Start with an IRIS inquiry. If they respond to you like me, you'll have an answer in a month. Maybe they find it. Maybe they don't. But if it's in your C-file, they should see it. It does take time to get through the upload process and then opening an appeal isn't automatic, so it does take a while. But somone ought to be able to find it. Yes, you could invest an hour on hold rather than weeks waiting for an email, but you won't have written response giving your status. If the National IRIS Response Center cannot find it, write a letter to the RO asking for their assistance in finding your NOD. Include a copy of your NOD and -- very important -- any proof you have of timely receipt or postmark. This is where the handstamped receipt at the RO or handstamped certified mailing receipt and proof of payment along with the green return receipt card become as valuable as gold. This is particularly true if you were up against the deadline. It saved me once. I've also tended to enclose copies of the responses from the IRIS Response Center showing that there's a problem somewhere. Goes without saying, but you're not going to win any points by speculating on their motives or moral constitution. I've kept my letters to them as professional as possible with tone that leans friendly. Guess you'll have to send your package through the Evidence Intake Center. NODs do disappear. My second one did like my first one, and my letter and package asking whatever happened to it will be in the mail today.

That's your best bet. Without the specialist making the nexus for you, you don't have much to stand on with the RO. Even if your PCP gave you some sort of diagnosis, the system would probably send you to a neurologist for a C&P exam anyway. Having a neurologist's opinion will make a difference. It's good that the MRI and EEG didn't show anything up in that the migraines aren't being caused by some structural damage like a stroke, etc.

I would wait to make any decisions on how to file for migraines until you see the neurologist. Then go with whatever the neurologist tells you. You'll need to ask those leading questions about causation or service connection - SWA related or fibro related? In my experience, my migraines can be triggered by other conditions but do not have to be - for instance, if I get sick, I'm more likely to have a debilitating migraine. You do have a statement in your SMR, in your exit physical, that headaches are a problem. Now they are a real problem. That can be a nexus right there, meaning you don't have to reach back to the SWA service presumptive. However, the neurologist can also determine that your migraines are secondary to fibro. If he or she does, then file that way. And, the neurologist may uncover something on the CT scan, MRI, or MRA that's of concern...which would lend then toward a different cause. In order to determine how much to rate you, the RO will need your log and any statements from employers, school officials, etc stating how badly you are impacted. I personally use the medical events log within MyHeatheVet. Don't count on the rater sorting through your log to see how many of them laid you out flat in a quiet, dark room. You'll need to compile that. I average between 2 and 3 days a month for the last several years. Because the disability system isn't necessarily about how much it impacts your life but how much it impacts your ability to work, you'll need to show how many times per month you are flattened. Getting actually "prostrated" on average of once a month is 30%, once every two months is 10%. To reach 50%, you need to show "With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability." The reason to specify is, if you're like me, some months, I have migraine pain more days than not but they don't always put me in bed. I'm at 30% and arguing for 50%. Hang in there with this. There's nothing worse than having a disabiling disability that impacts your ability to think and reason, like migraine, and then try to sort out how to deal with it medically and from the disability standpoint. The whole thing is a trigger for migraine in itself!

Just as an update on the status of the VA's quest to eliminate the backlog, it appears that since the new fiscal year began on October 1st, they haven't made any headway. If they maintain the forward motion averaged since the big push began in April 2013, the backlog should -- statistically -- be eliminated by the spring of 2016. However, the number of claims on hand nationally and those over 125 days old plateaued since October 1st, which pretty much means that whatever extra effort was being put toward getting through claims more rapidly has ended. We're now in the Holidays, and it is not likely that the extra effort will resume until after New Years, if it resumes. There are two major factors, off-the-cuff, that may have put this political goal on the backburner: 1. There does not appear to be an appropriations bill for the VA, or anyone else for that matter. 2. The recent scandals in health care may have shifted whatever resources were available to the health-side rather than use them within the disability compensation-side. Has anyone heard anything about trying to meet this goal recently?

Good one, Asknod. The key is finding the boss, by the way. However, if you work your way high enough, there ought to be someone who will make the rep do something. Will that something be effective? OK, can't promise anything there!

Just a thought, Elcamino, about your VSO's rep. That guy has a boss. Engage the boss and you may find the "on switch" to getting something done on your behalf. That strategy has worked for me in the past.

These guys are dead on, Bojack. Without a nexus from your SMRs, you've got a terrible uphill battle. Your other option is to try to make OSA secondary to TBI, and I don't know a thing about whether or not that's possible. Either way, you've got some work to do to connect the dots between OSA and something that occurred or started while you were on active duty that was hopefully documented in an official record somewhere. Meanwhile, gotta get on the machine and use it. I'm grateful for my CPAP. Thanks to using it and getting an upgrade more recently, I'm not so tired-a-Coastie as I once was. Using my hearing loss as an example, just because you have it and the VA treats you for it doesn't mean you can prove it happened on active duty. I'm SC for tinnitis but not hearing loss. Yet the VA is paying for my hearing aids thanks to being above 50% overall. Go figure. But that's the VA for you. The main job of the RO is to deny your claim so that you don't take up more of that limited compensation pot. My guess is that OSA is such a big ticket item at 50% to start with then potential secondaries that VA is very reluctant to grant it. I was fortunate. My wife made me to go to sick call after I woke up in the middle of the night gasping for breath. I was diagnosed at a Navy Hospital with sufficient proof in my SMR. When it came time to file upon discharge, it was no sweat proving I had it. But it took my wife getting after me to do something about it while I was on active duty. We really ought to do a better job getting vets to be screened for OSA while on active duty if it seems like they have any sort of symptom. The services aren't going to do it or recommend it, and the VA certainly isn't going to recommend it, so we're going to have to get the word out.

"If in doubt, over route." I almost got burned mailing in my NOD at the deadline and had to argue for it to be accepted as timely. While I had the proof and provided multiple copies of the hand stamped mailing receipts to the RO, it took a lot of effort and time to get them to agree. I'd rather they just decide it's timely by examining the date and time it was received. At least I'll have two sets of proof to send this time around.

Thanks again, everyone! Form 9 filed today via fax and certified mail (automated mail machine helped me). I beat the deadline again, by God's grace. Hopefully within a few years there will be a result worth celebrating.

Faxed my Form 9 to Newnan, GA, this afternoon. Got a really nice automatic fax receipt back from the VA besides what the fax machine usually does when a fax is sent successfully. The guy behind the counter handed it to me as we were walking out and said, "Need more proof you filed today?" Also mailed a hard copy via the automated postal clerk machine at a post office, so have a ceritifed mailing slip, post office receipt, and a green card coming back at some point.