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Everything posted by Buck52

  1. You can file a reopened claim if you meet all of the requirements listed below. All of these must be true: If denied your claim at least 1 or more years ago, and You didn’t file an appeal at that time, and You have new and material evidence (new supporting documents like a doctor’s report or medical test results) that we haven’t seen before and that’s directly related to your claim For example, you might file a reopened claim if you were treated for pain in your elbow while on active duty, but you were denied disability benefits because your VA health exam didn’t find a problem. Then 2 years later, an X-ray of your elbow showed signs of arthritis (a painful swelling and sometimes wearing down of a joint). In this case, you would need to send your new exam and X-ray results to us as new evidence related to the claim. New Claim—File a claim for added benefits or other benefit requests related to an existing service-connected disability. You can file a new claim to request A shift to Individual Unemployability status (a status given to Veterans who are unable to work because of a disability) Learn more about Individual Unemployability. Our decision on your new claim will be based only on new evidence (like a doctor’s report or medical test results) that you give us to support your claim. We won’t consider any evidence you may have given us related to past claims. (I would say Reopen) just my opinion.
  2. I would say lack of communication on your part ( failure to speak up at a R.O. DRO Hearing .....>usually is this type results. However before the hearing the DRO should go over all the issues with you if you had them in your request for the DRO Hearing?, if not sounds like the DRO just did the issues that you reported... So during the Hearing you should have spoke up and ask about the issues they were not addressed. If you had all the issues in your DRO Request and the DRO never addressed ALL of them.....then your DRO Hearing is Inadequate and you should be schedule another Hearing. Appeal
  3. One of my reasons I don't like RAMP. But I think you can still appeal a RAMP Decision under the The Evolution of the Pending Claim Doctrine John Fussell1 and Jonathan Hager google the above its introduction is in pdf format. its a good read by some BVA court Attorney's if your claims are closed you may want to reopen with new and material evidence.
  4. If your a Veteran wanting to file a compensation claim from injury or disease you received during your military service and was denied and have questions which way to file your claim or claims rather or not to file the traditional way after a denial and your not sure which way to approach your Appeal in legacy or opt to RAMP .= do this Make sure you have all your evidence in stone and check all your conditions for the rating criteria write the CFR Rating criteria # down , most of all have all your probated evidence to support your claim & use the CFR#'s that pertain to what your claiming (we need to remind them of their on Regulations some times!!) ...read up about your condition get Dr's to opine on your condition as to it being related to your military service and the condition and have a good statment in support of your claim, make it's hard for them to RE- Deny...re read your claim before you submit it chances are you forgot to add something. read your denial letter very carefully especially the reason and bases of your denial and concentrate on that for your Appeal to rebut what they mention as to why they denied you. Also in your Appeal make sure you put (small notes in there some where as to where they have to read it number your pages and always put your S.S. #AT THE TOP on every page ....> & do things like high-lite the parts you want them to read or mention something like :Note: see page 3 for Dr Smith Medical opinion on date**/**/**** he/she is a qualified Professional in this field of medicine and he/she has his credentials /phone # address and office hours stated at the end of his letter. ect,,,ect,,, (specialist or certified Physicians are better to use) VA likes them better than just a PA or MD Make darn sure these Physicians are qualified to render their opinion ''as stated is as likely as not'' Also when the VA Sends you anything make extra copies of it and keep it in a home folder (start your on C-file) if you get your C file and find that you have a record missing and you have that record make copy and send it back to the Claims Intake Center and attach a note saying this was not in my C-file please put it in my C-file I have a copy of it here at my home but I would also like a copy of it placed in my C-File for future reference. Most Veterans than have been in Appeals for years and years & Opt into the new RAMP because VA Made a Promise to have their Appeal decision within 125 days...this is still a new program and your appeal may not be decided on the VA Promise , so when you file a claim to Appeal your claim make darn sure you have all your favorable evidence in and check the Dr's Criteria , check everything a couple times before you send it in. Usually when a Veteran has all the facts and evidence that supports his/her claim will be approved..but some times they are denied on some BS from the VA or they tend not to read all your evidence and kick it back with a BS Denial...just do the above and the faster you appeal the faster your claim will be worked...do not depend on this new RAMP program just yet it needs a year or two to be proven its the way to go or if its for you or not.? Remember Medical Evidence in veterans favor wins we just have to make sure they get and read that evidence so make it hard for them not to...and remember to keep everything the VA sends you and you send them, if you use snail mail at The Post Office Always get you a return sign receipt and keep it in your home folder(your personal C-FILE) Never throw anything away the VA sends you no matter what it is keep it you may need it in the future. Just thought I'd put this out here so if any of you elder members want to add something I may have forgot please do so. Where all going to have a great 2019 Thanks Everyone!!!
  5. For a good and very interesting read google these guys The Evolution of the Pending Claim Doctrine John Fussell1 and Jonathan Hager broncovet may find some important information concerning EED. THIS INFORMATION COULD HELP A LOT OF VETERANS UNDERSTAND THE SYSTEM A LOT BETTER. Note: once you google & click this will be in pdf format The Evolution of the Pending Claim Doctrine John Fussell1 and Jonathan Hager
  6. What about the OP IF Her hubby had the free VA Life Insurance ...then why wouldn't she be entitled?After her hubby died??? It seems to me that's what she is asking here? she would still be entitled to her monthly DIC pension. but if she wants her own life insurance then yeah she would be obligated to pay out the premiums. and several ways to choose to do that depending on the Insurance company she pics.
  7. you may want /need to read these CFR 38 Regulations I mention above. 4.16 Total disability ratings for compensation based on unemployability of the individual. (a) Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided That, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. It is provided further that the existence or degree of nonservice-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the veteran unemployable. Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination. (Authority: 38 U.S.C. 501) (b) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue. [40 FR 42535, Sept. 15, 1975, as amended at 54 FR 4281, Jan. 30, 1989; 55 FR 31580, Aug. 3, 1990; 58 FR 39664, July 26, 1993; 61 FR 52700, Oct. 8, 1996; 79 FR 2100, Jan. 13 2014
  8. Here is a pdf link for the NOD (Notice of Disagreement) 21-0958 https://www.vba.va.gov/pubs/forms/vba-21-0958-are.pdf
  9. Remember Filing for I U is filing for an increase, so if you just got 80% they should have inferred the IU then if you repoted that you were not working because of your disabilty now service connected @ 80%. Appeal the decision and request the IU make sure you have a qualified Dr Letter or opinion note that you can't do any type of employment because of your s.c. disability , the Doc needs to examine you and read pertaint records about your now s.c. disability and go into full detail as to why he thinks you can't work. usually veterans sign up for Voc -Rehab And the councilor can write a opinion letter that its unfeasible to retrain this veteran at this time due to his s.c. disability. VA 21-8940 Form for filing unemployability (click the pdf link) https://www.veteransbenefitslawfirm.net/wp-content/uploads/sites/7338/2015/07/VBA-21-8940-ARE.pdf You can file both ways as broncovet suggest. Appeal & request the IU , that youShould have been given/inferred to you at the time they gave you the 80% and or/ file for the IU on form 21- 8940. YOU JUST NEED EVIDENCE THAT YOU CAN'T WORK ANYMORE DUE TO YOUR 80% S.C. Disability. Use a Specialist to opien this that you can't work or do any office work due to your S.C. Disability. They have Regulations for this if your above 60% and can't work but don't meet the 100% rating criteria. CFR 38 4 15 (a) 4.16 (b)
  10. I think she can get his free 10.000 life insurance if they were married a year before his death and he was 100% p&t And took the free life policy. That's what I have in case I go before my spouse she can at least bury me and keep the change. I also have another private life policy that she can cash in after I kick that old bucket.
  11. Roger That jfrei. Thanks and good Luck with your claim/claims.
  12. I don't think we can appeal the lateness of our retro? you can check the status if it seems to be way late... if the retro is the wrong amount you can appeal that... Question to you jfrie Are you filing most of these claims based off your TBI? and the secondaries that TBI can have? or do you have separated conditions related to your military service? I have a TBI Veteran I am helping with his claim and he is only S.C. 40% and was denied on an increase, so were checking with the Dr to see if any of his symptoms can be related to in part caused by his TBI ??? I think he can get some secondaries ?? Note: I am very unfamiliar with TBI Claims???...these type claims is horse with a different color.
  13. It may be just me or my opinion but I think In RAMP they take the easy claims cut an dry to adjudicate claims before looking at others that's opt in Ramp to work before the more incomplete claims if that makes a lick of sense? ..and probably rightfully so to speed up the process but that don't explain why there's a 90% denial rate?
  14. asknod/Alex You have nothing to apologize for, you simple was given out valuable information that none of us Regular Vets can't get or knew about? And you being a accredited VA Claims Agent all your information is welcome here...you can see the V.B.M.S. as we can't, you earn that right becoming a VA Accredited Claims Agent and your well know knowledge with the VA Claims process is certainly welcome here. They are always some we can't make happy and see things to gripe about just because some are more intelligent than others or more experienced in VA Law ...This is how we all learn by information passed on these forums , without it a lot of us would not be where we are today. I say keep up the good work and share any information your allowed to share with us..I & Many other Veteran Brothers take your word to the Bank. RAMP is just to ''controversial debatable'' so -to-speak and has not been fully proven and for a lot of veterans, we'll they just have to do what they think is best for them.
  15. Question For Broncovet How long have you been in Appeals before opt to Ramp? if you had stayed in the regular Legacy system ? was your time line 5.6 years or waiting for 100.000 vets to get their claims adjudicated? How do you know they work the claims as a come first for adjudication? they may take a veterans claim that they can work and not take a long time to adjudicate it....as to the speed UP the process is a lot faster than taking the ones that opt over to RAMP First!!!.....simply if this Veteran was already in the legacy program for years...and was on the verge getting his claim Adjudicated rather then him opt over to RAMP..Looks like to me that would take a longer time or add more time for the adjudication of his claim? say you been in it for 3/4 years or more and opt over to RAMP....and you been in RAMP Now say 6/7 months. WHAT IF THEY WERE ON THE VERGE OF ADJUDICATED YOUR CLAIM AND YOU WAS NOT INFORMED OF THAT ? AND ALL OF A SUDDEN YOU GET WORD THE LEGACY SYSTEM IS LIKE 100.000 VETS BEFORE YOU AND YOU OPT OVER TO RAMP AND NOW YOU BEEN IN RAMP A LOT LONGER THAN THE 125 PROMISE DATE FOR A DECISION? AND TRULY NO PROMISE DATE FOR ADJUDICATION! ''You could lose your place in line at the BVA. If you currently have a docketed claim at the BVA, we highly suggest you keep your place in line. If you join the Rapid Appeals Modernization Program you could lose your current place in line at the BVA. If your claim is denied in the first phase of the Rapid Appeals Modernization Program, the BVA will not even begin to look at your claim until February 2019 at the earliest. There could be a chance your claim gets pushed back even farther than February 2019. The VA is not guaranteeing that denials will even be heard starting in February 2019 – that is an estimate.'' Source: ''woods&woods LLP'' How is your claim moving along in RAMP vs the Legacy system that you was in or had been in for 3/4 years..YOU MENTION YOU HAVE ABOUT 3 MORE YEARS OF RAMP?? ? Do the math here!!!!
  16. The way I look at it I wish we could go to a private Dr when the VA sets up 2 or 3 month appointment just to be seen and then another 2 or 3 months appointment to get any thing done that's the way my VAMC Works its a little better than it use to be ,..>6 months to a year to get an appointment,,,,I mean hell we could die before we get a chance to be seen from a qualified Doc. It seems it just take them to long for the health care with the VA System!!!
  17. @Ms berta ''Ms berta if they pass the privation act does this mean veterans can use the private sector for their medical care and VA Pay?'' not meaning compensation PAY but the payment paid to the private Dr's for treatment render/with appointment or E.R. what about older veterans that are on medicare but do nor have a supplemental to cover co pays or prescriptions? Same here will the privatization act pay for this...or a better way to ask with the privatization act pay for all veterans healthcare in the private sector? Note:With Approval of the VA. Before Veteran seeks the private care... Reason I ask this is I was told by a VA Executive in the Administration part of the VA that if the VA Has the facility and tools and the qualified Dr's to help a Veteran with his medical needs S.C. or not he can seek this service from the VA With little or no cost to the veteran other than they maybe a small co-pay. I Understand that part but its a matter of trust with me ,I do not trust some of those VA Dr's even if they are qualified , some of them can't be over 29 /30 years old and no experience and some are over 70 years old and make major mistakes. eh! I would not want a Surgeon to operate on me that shakes because of his dated age or just to old to pick up a surgical tool or has bad eye sight ect,,,ect,,, believe it or not they are Dr's like this at my VAMC. .I ve been going to this one since 1998 and a certain Dr back then was like 65 and we all thought he was retiring...well he is still there. I and other veterans that know him refuse his care..we either pay out of pocket to private sector or ask for another VA Dr and hope and pray we get a decent Dr that knows what the heck he/she is doing.
  18. I understand what your saying but most RESPECTED VA attorneys that have been dealing with the VA for years are fairly experience in all aspects of the LAW & VA Claims process with years and years of expertise.and educated well with VA lAW AND OTHER PARTS OF THE LAW AND REGULATIONS TO UNDERSTAND THEM A LOT BETTER THAN US NORMAL VETERANS TRYING TO GET OUR BENEFITS. So how long have you been in RAMP and are you satisfied with the results on your Claim? or has it come to an abrupt Halt? no word in months on your claim?. do they keep you well informed? if you still do not have a decision or close to one how long have you been in the RAMP? as to date? if you have not hears anything on your claim status and its past the 125 day promise How long do you expect to wait?
  19. Quote from Ms berta ''This AM about 6 :30 news mentioned that money is being allocated from the Dept of VA, to begin privatization -(the Choice program is not working well- they didn't say that on Fox but we all know it ) but I ony caught part of that news.'' Ms berta if they pass the privation act does this mean veterans can use the private sector for their medical care and VA Pay? what about older veterans that are on medicare but do nor have a supplemental to cover co pays or prescriptions? I did have a supplemental but it was like 140.00 month and I never used it so 12 months at 140.00 (WOW) Well I decided to opt out of the supplemental coverage. its just to expensive and we need the$$ to go for other things maybe a mistake and I might need to get the supplemental again but right now are trying times for my family. I fit that boat , but so for I have used the VA for all my HEALTH CARE and no co-pay. but its getting to where I don't trust these VA Dr's Anymore and I would like to see a private Dr for things I do not trust the VA on.
  20. I am just pulling at straws here but in my opinion most veterans that opt into RAMP are not informed as how the RAMP works Alex has put some of the RAMP guidelines here to hopefully understand RAMP better. The reason I would never choose RAMP we lose to many of our claim rights if we make a mistake or think we have enough evidence and its not we get denied we get pissed so as to how RAMP works we lose a lot of help being prepared for our claims. Well In Formed? IF VETERANS ARE NOT SURE WHICH LANE TO CHOOSE IN RAMP?and opt to the RAMP OK BUT STILL ITS CONFUSING TO THE NORMAL VETERAN ALL THEY SEE IS GETTING THEIR CLAIM PROCESS FASTER & 90% is denied so the 125 day process is not promised if there going to deny 90% of these RAMP Claims. its kinda like the FDC /RTC after you submit your claim then no more evidence can be submitted its a stand alone claim ,but you lose some of the things that were entitled to with unlike the legendary claim system and a lot of time veterans kick them self by jumping in to the RAMP not truly knowing just how this claims program works and it BACKFIRES on the Vet I never trust the VA on promise its better to just wait and see how this RAMP turns out it may not be for you.? I read three different experience VA attorney say they do not like the RAMP ..so with that its part of my reason I would not opt into RAMP. jmo Note to broncovet You have choosen the RAMP for your EED Claim correct? you wanted it decided faster correct? Not sure which lane avn you chose with RAMP,? but from the time you opt into RAMP how long ago was that and is your claim moving right along? or has it come to abrupt Halt? Are you past the promised 125 day limit on a decision?
  21. I got my New C-file In in 2015 on CD Format. A lot of my In-service Records was not in it and also Medicl Records from a prior VAMC I use to use.1982 Big Spring VAMC @ Big Spring Tx I moved to Dallas 1999 ..I contacted that VAMC in 2015 after I recieved my New C-file and they said they don't have any of my medical Records they were sent off and they don't know Where the are to try NRPC in St Louis I tried there too they sent me some old Basic training medical records But I need some from VietNam and Germany,,I don't have any of those. How can I get these Records? Also if I request a New C-file and see if they are in the new one or be the same as I got? Will they treat that as A Claim? When we Request a New C-file? and take years to get it?
  22. I don't use a VSO . I have my new C-file The records that I need are not in it nor do they have them at St Louis NRPC, I've check with all my units I was station at and all the VAMC I 've had healthcare nothing. The Older VAMC just simply say they don't have them and ship them off to a unknown location, they can't tell me where they ship them off too...just suggest what I've already tried I don't have a claim in at this time I need these records first before I file to make sure the evidence is in these records..I make sure I have all my evidence before I file the claim if not then no claim. btw You Request your C-FILE via e benefits yes it will show a claim and you maybe waiting a long time for it . if they don't get your claim application in or if you never filed a claim. If you have not requested it twice you might do that, request it direct to the NRPC in St Louis Attention RMC sign the foia and attach it to your c-file request ( double barrels these guys.)
  23. We need some one to give us IU Vets some insight on this or help break down this age limit of 67? who will be effected and who will not?
  24. I agree with you Vetquest most of us are in your shoes, for me it was 46 years later.2002 I Worked up until my body would not let me...and then some I am hoping the Big 4 Will get this off the agenda and they cancel these proposals to All IU Veterans..it's just not fair at all...especially for the ones that already been awarded IU. As I understand veterans who are age 67 at the time of the proposed effective date 2020..will not be effected but if a Veteran is turning 67 he/she could be on the chopping block/if this is passed that veteran will go back to his original disability's before the IU was Awarded. I turn 67 this year July 2019...not sure if I am safe or not? but this is only a proposal.....so for eh!
  25. I Never had a rater to call me but one time I had a DRO Hearing with a rating specialist present and she called a Dr that I had mention and gave the Dr phone # actually the Dr had put her phone # in her IMO Report and had mention if you have any questions please call me during office hours between 9:00am -5:00pm Mon thru Friday this rater called this Dr to ask her a question about my claim...anyway the Dr ok with the collaboration.as to what was in the report some numbers didn't add up on my hearing chart according to the hearing criteria...but the Dr straighten that out by looking at her copy of the hearing chart she had in her office.

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