Tampabud

Yeah:
I'm so glad for you..this waiting game is very tough on many of us - and some like me that are not very patient people. Despite a lot of the consternation, I belive that most VBA Rating folks have been working very very hard to take care of our claims? I've read that there's a lot of overtime for them and there's a point where it can be counterproductive? Especially, when they get pressure from both ends from their bosses and vets wanting their own claims done as soon as possible and as accurate as possible -as they rightlfully deserve. I think, a lot of it is about obtaining the proper level of resources and reaching adequate training & manning levels. Also, like training a soldier, airman, sailor, coastie or marine, it takes time to grow and train VBA rating officials. It's interesting because I've learned a lot from this website and am very thankful for those who set-up Hadit.com and the countless contibutors that are assisting us with our claims. I'm an analyst and have really dug into the issues and one thing is for sure is that this disability claims business is an incrediblity complex one. So, when someone like you is happy about their rating and final outcome, it proves despite all of the problems that the system can and does work for vets. Again...congrats to you and yours...

"The subsequent effects of my failed surgery with the V.A. resulted in a reasonable accomodation, which effectively dropped my annual pay by $15k."

John is Right ( it is explained under our FTCA forum.

And/or you can file a Section 1151 claim, that is explained in both FTCA forums and 1151 forum here.

But "failed" surgery may or may not be the VA's fault.

If it arose from negligence/malpractice, the VA will compensate you for it.

FTCA settlements are a lump sum payment that is offset to any 1151 VA comp award.

Or do you mean you filed for a secondary condition due to the 'failed' surgery?

Do you get the 20% for the same disability the surgery was on?

If not you might well have to file 1151 or FTCA if the surgery was for a NSC disability.

In any event you will need medical proof ,in the form of a strong IMO, that you incurred additional disability at a ratable level ,due to the failed surgery.

If the C & P was done at a VAMC you can get a copy of it. It will reveal what the VA's decision might be.

With a copy you have time to get an IMO if you feel the C & P will cause the claim to be denied.

This is my copied/pasted IRIS inquiry:

I requested an increase in rating for my left shoulder after an MRI revealed damage not previously documented by the VA, but had existed since my active duty days. My claim was inexplicably closed in February 2014 without a rating or decision on my left shoulder claim. After several phone calls and visits to the VA offices at the Federal Building, it was explained to me that the closure of my claim was a clerical/administrative error. My claim has since been re-opened, but shows a new expected closure date of mid-2015, which is entirely unacceptable as it was an internal error on the VA’s part. It has already been one year since the initial opening of the claim; I have already had my C&P exam and submitted all evidence necessary. I would like my case to be forwarded to the examining/deciding official so I may get an answer for my request for increase.

I consistently get the same canned response from the VA.

Thank you for your service to our country.

We apologize for the delay in responding to your inquiry. We are currently experiencing a large volume of inquiries and are working as quickly as possible to respond to each in a timely manner.

Your claim is currently in the development phase of processing. This phase is where we gather all the evidence we need in order to make a decision on your claim. We will review your claim and inform you of any additional information that is needed.

Currently, claims at the regional office (RO) in Los Angeles are taking about 14 months to complete. Please udnerstand that these time frames are only averages, and that your claim may take longer based upon the specifics of your claim and VA's pending workload.

We apologize for the length of time it is taking to process your claim; however, we are currently experiencing a backlog of claims and are working to get them decided as quickly as possible.

The RO will contact you when a decision has been reached or if any additional information is needed. We appreciate your continue patience.

Thank you for contacting us. If you have questions or need additional help with the information in our reply, please resopond to this message or see our other contact information below.

Sincerely yours,

C. Boyd
National IRIS response center
Manager
jnb


I get this same response almost everytime. These guys suck. That is all.

You can review your C&P exam but you can't change it except by showing gross flaws and demanding another exam. Usually, the best course is to get IME/IMO to destroy a bad C&P exam. I spent a couple of years trying to get a new C&P. I got a new one just as bad as the old one. Then I got wise via Hadit and got private IME's and I won big.
Think of the money you spend on an IME as an investment that can pay off 1000% immediately.


John

Can you possibly scan the decision and evidence list and attach it here.

I dont understand---you requested upgrade to the shoulder comp you have now, but

"Manila envelope that came mentioned absolutely nothing about my shoulder."

I dont see how you can prepare a NOD if the decision is not for the claim you filed. Was the manila envelope for the temp convalescent pay?

If a veteran is buggered medically by the VA, to the point that tythey have incurred additional ratable disability, then the VA has to compensate the veteran under Section 1151,38 USC.

These types of claims have to be filed formally and need
documented proof of additional disability directly due to VA negligence .
You can receive successful 1151 comp money in addition to direct SC comp benefits, in many cases (if not all)

I am a 1151er.We have a wealth of info on this type of claim in our FTCA/1151 forum.

You can consider filing FTCA claim as well......

"Do I need a lawyer? Recommend one!"

I recommend Doug Rosinski---contact info here under a search BUT first you need to find out why the VA failed to send you a decision on the actual claim you filed.


Was it clearly spelled out along with the temp convalescense claim as a separate claim for higher rating of the shoulder??

Even though it would be obvious to anyone that your SC shoulder got worse then it was, the VA does not use common sense or consider the obvious.

Did you have a C % P exam that covered both the temp comp and the upgrade claim?

Do you have a copy of the C & P exam?

Have you sent them a IRIS inquiry asking them what about the shoulder higher rating claim, via the main www.va.gov Contact Us area on the main VA page?

There is a drop down IRIS box for complaints and I sure would send this as a complaint.

There are many vet lawyers who can help claimants if they are denied and need to file a NOD but as I see this, you were not denied yet so I dont know what, at this point, any lawyer could do.

I assume they didnt say in the letter that they have defered the should claim....????

I think any vet lawyer might ask you these same questions because at this point, you cannot disagree with a decision you dont even have.( actually it would sure surprise me if they denied the shoulder claim for a higher rating and I really dont think you would need a lawyer for that unless you pursue the 1151 issue as well.).