CKHodges

@georgiapapa Thank you. I still feeling rather stupid for my email, but I assume that the VA has gotten much worse than me asking them to double check their math regarding bilaterial computations. So you are right, I need to relax some. I just didn't want to come across as a "whiny" vet who wants and wants. I am very appreciative of Allison and the Houston RO for taking the time and energy to quickly resolve my claim. I needed this in so many facets of my life right now...my health, PTSD, financial concerns..etc. All the things we vets deal with...so to have this closed is a very positive thing. So I need to simply appreciate what has happened. I checked E-benefits and my overall rating has indeed increased. Now the wait for my retroactive pay begins. But ultimately, it is a good feeling knowing that I was right and my efforts were not wasted on this. And I really believe that the VA, with Allison at the helm, will turn course and become the organization we all need it to be. So if Allison, James (and his Houston team), Melissa or anyone at the VA reads these posts...thank you.

SUCCESS! Today I received an email from the Houston RO advising me that my claim was now complete. And as such I would be receiving $XXXX in retroactive pay and that my rating was adjusted up to XX%. Suffice to say I was an emotional wreck upon receiving this, but that was a two-fold reaction. First and foremost I was elated to know my case was finished. But I unfortunately had it stuck in my head that my rating was going to be back dated much further, thus garnering a much higher retroactive amount. And this is when my fingers kicked in before my brain had time to double check my math. I quickly responded with an email (which cc'd Allison and a few other people) asking the Houston RO to check their math and to include bilateral computations in their formula. I was polite in my request but in my haste I included some erroneous data. About ten minutes later I noticed my error in my response and sent a second email correcting that mistake. Again I was polite, but stuck in my head was this retroactive amount that I thought was correct. I then started to look at my stack of documents and doing the math one last time...and I should have done this first. The VA math was correct! Argghhh...so here I had sent off two emails asking them to double check their work and they were correct all along. So off goes my THIRD email in about two hours...telling them that they were correct in their math and I fully agreed with their findings. Suffice to say I feel like an ass. After all this time and now with Allison's support I was given an answer. But instead of simply accepting what they provided me (which was correct) I allowed my emotions to control the situation...damn PTSD and my impulse control! So now instead of looking like a grateful vet who was appreciative of what Allison did for me, I may have come across as an unappreciative ass. I apologized profusely in my last email, but still can't shake this feeling of appearing both stupid and ungrateful for her support. In the end, my email to Allison worked. It took less than one month from initial contact to resolution. For me this ending is bittersweet though. While my rating is finally corrected after three years and I am receiving the correct amount of retroactive pay, I suddenly find myself feeling guilty for how I came across in two hastily sent emails. I wasn't rude at all...in fact my tone was rather professional. But I still feel as though I could have handled this ending to my three year wait much better. So for those that are thinking of contact Allison...you need to do it! She really does care about us and will help you get the right answer.

More forward progress. While I expected a phone call from Mr. Hedge yesterday (Mon 1/12/15) to discuss my claim, it didn't happen. He had an unexpected absence from the office, which I full understand. To alleviate my concerns I decided to call the 1-800 at around 1630(EST). After the usual 30 minute wait (please VA change your hold music) I got through to a very helpful and friendly customer service rep called Melissa. She spent the next 20 minutes explaining in great detail the how, why, and where my claim was in the process. I couldn't believe the time and energy this young lady put into explaining my case to me. In short summary, my three year old claim has a decision! She told me to expect my notification letter shortly. Of course she wouldn't tell me the results of my claim, but the simple fact that my claim moved through the process and now has a determination is proof that the system can work. The solution to having my case reviewed was contacting Allison Hickey and having her staff look directly at my file. Though I am still waiting to see the results, I am more than pleased that she took the time to listen to me, understood my concerns, and then introduce a solution to the VA system. Or simply put...she light a fire under someone's butt! I'd like to add that the 1-800 gal was not the typical Peggy offering the standard canned answers. She was by far the most helpful of all the 1-800 reps I have ever contacted...and I call twice a month. It would be nice if the VA would assign a unique ID to each call center rep so we could provide them some feedback on both the good and bad of our interactions. I did leave a note for her boss, praising her efforts. My spark of hope has turned into a small fire...hopefully my big brown envelope comes shortly and with good news.

Some additional movement. 9 Jan 2015 (Friday) 1230 EST - I received an email from James Hedge, the Acting Director of the Houston Regional Office. From his email he said he would like to discuss my claim with me on Monday. I replied saying that I would be available anytime on Monday to discuss my concerns. I considered telling him, Sir...I would crawl across broken glass to have anyone at the VA tell me where my file is, so anytime you have to talk with me is good...but I opted against that comment. 11 Jan 2015 (Sunday) 2000 EST - I was preparing my files/documents to speak with Mr. Hedge in the morning and logged into E-benefits to double check my claim dates. As I was scrolling through my claim, I noticed my appeal was no longer stuck at the first step of the appeal process Appeal Pending but had suddenly moved to Decision & Claims File Dispatch phase. The Current Progress Description for my file now reads: Your case has been received at BVA, and BVA has mailed your decision to you (and your representative, if any) and will be returning your claims file to the VA Medical Center. Please note that transit times vary, and there may be some lag time between when BVA forwards your claims file to its appropriate location and when that location receives it. I'd like to note that I had checked E-benefits on Friday and my claim was still in the Appeal Pending stage. I have a few theories on what may have happened with my file and the sudden change in disposition, but only the VA understands why they respond like they do. 12 Jan 2015 (Monday) 1000 EST - I have not received any indication of when Mr. Hedge would like to discuss my file with me. However the sudden change in my claim/appeal status does have me further concerned. That is where things are at this morning, but things certainly seem to be moving in a direction...though I am not sure what direction that is. Further updates to come. Chris

Thanks for your advice. I will simply wait...in the scheme of things another 2 or 3 weeks isn't much compared to the many years ALL of us spend waiting. Though with each passing day, a little of my optimism fades away. i did call the 1-800 number yesterday and got the standard canned response. Has anyone ever talked with someone calling that number and actually gotten more than the standard..."Your claim is in the XXX stage of being processed...on average it takes your regional office 650 days to complete this type of claim." Because that is all I ever get from them.

@NavyWife - This was actually the third email I sent out that got her response. I sent one once a month for three months. It's been three years and I've sent in several inquires, multiple phone calls and IRIS requests, and even an email to Bob. The correction to my claim is fairly straightforward but after reviewing ebenefits and all the supporting documentation I could find, it became clear that my case (like so many others) was being mishandled and probably lost in the system. I tried every number I had and every vector could think of, to contact someone to correct my issue. Sometimes you have to go to the top to get things done. Still amazes me that Allison has time to write a simple email when none of her 10,000+ employees could give me a status update. It's almost shameful that the head of benefits has time for us but NONE of her workers, at any echelon, can even respond to me. I imagine with the Christmas/New Years break no one has looked at my file, but I will probably follow up on Wednesday to get a status check from her. I'm keeping my fingers crossed and remain optimistic that my claim will be resolved shortly.

Wade, I also sent a pdf file once she initiated contact with me. I am hoping that data I sent would clear up my claim as well. I have a second file of information waiting to send upon any contact from the regional office or her representative. Figure if I don't hear anything by the end of next week, I will send another email. She must be a busy lady, so I will stand by patiently. Figure I've waited three years, another week or two won't hurt my claim. And yep, 2015 has to be better than 2014!

Mojo13...I sent the email to allison.hickey@va.gov

It's been a couple days since my email response from Allison. I know several other folks have commented about their immediate response from a regional office representative, but I haven't had that luck yet. I can only assume that most government employees are off this week due to the holidays. Still keeping my fingers crossed that with 2015 comes a speedy resolution to my claim. Hope all have a wonderful and safe New Years!

On Dec 29 at 0949(L) I sent Mrs. Hickey a very short email asking about the status of my three year old claim. Please note I had emailed her twice before having tried/failed with numerous phone calls to the 1-800 number as well as several IRIS status requests. On Dec 29 at 1401(L) I received a response from Mrs. Hickey stating she would look into my claim. Additionally she cc'd several additional VA folks whom she instructed to take a look at my claim and expedite the process. Suffice to say I am pleasantly surprised in the response and her willingness to assist. I find it amazing that the Under Secretary for Benefits can find the time to send a 30 second email when none of her staff that are directly supporting us vets can do the same. In just over four hours, she gave me more than the canned "your claim is in the (BLANK) phase and on average it takes your Regional Office 630 days to complete." She has given me the slightest glimmer of hope in a system that is drowning in bureaucracy. I certainly don't want to jinx myself or get my hopes too high, but I do want to give credit where it is due...and Allison certainly deserves some credit for simply taking the time to reply to me. As my claim moves along in the system I hope to keep everyone abreast of the results. Fingers crossed at this point. Chris

Thanks both of you. No my appeal hasn't been finalized, but I figure I will try and educate myself to the best of my ability now. That way when my appeal is denied/closed I will already be cognizant of the issues/pitfalls and have a good plan on how to move forward. I don't want to wait until after the appeal closes to begin my education process. Or put a different way, I'm a slow learned and this VA stuff reads like Ikea furniture assembly instructions...so i had better start learning now! Rule of nine is pretty familiar to me, it is the same standard we use for calculating percentage of burns to the human body...I've been a paramedic for years. My body surface area isn't excessively high, because I am taking my medicine and will continue to take it. Others have suggested I go off it to prove my point...I'd rather avoid that and the subsequent medical issues that come along with it. Truly, if I have to place my health at risk and stop my meds to prove that I actually have a serious condition...then the VA is more broken that I think it is. Again, thanks to you both. I am certainly learning as I go along!

This is pretty much what I am trying to convery: http://www.va.gov/vetapp14/Files4/1430655.txt I was rated in 2011 under CFR 7806...so none of the old provisions or rating schedules apply to my claim. My service medical records clearly show systemic therapy for acne (for years) and my C&P exam stated I was on systemic therapy. Looking at this CUE, it seems if I followed a similiar construct I would have some success...obviously one case isn't gospel but it does give me hope.

Thanks for looking at this for me. I reviewed 38 CR 3.156 and could see how that would apply if my medical records were not used during my initial rating. However, my medical records were used and clearly my history of systemic therapy was overlooked. In fact, even my C&P annotated that I was on systemic therapy during my active duty time. Again, I simply think that the RO missed this clear fact of the case. It isn't new medical evidence, as what I listed was all used in determening my initial rating. So under that premise I think it meets the criteria for a CUE. The CFR states that 60% is garnered for folks on systemic therapy for 12 or more months. My medical records that were used to give me a 10% service connected rating show that I was on systemic therapy for years. That is where I think the regulation was not followed correctly and why this is a CUE. But this is my initial attempt to understand this process, so I very well might not have my thoughts correct. I did "google" several CUE's online and didn't find any matches for my specific case. Seems I need to broaded my search topic a little. I did however review several CUE's regarding other matters, so at least that is a start in understanding the verbage for my case. I really appreciate your thoughts on this. The VA certainly doesn't make anything easy, nor is this is timely process. I feel like a red shirt guy on Star Trek, getting ready to beam down to a planet...

Thanks so much for your replies. This was the document that I sent back in July 2014 and also October 2014 in the hopes that the RO would fix my claim without going through the lengthy BVA process. I know that is rather idealistic of me, but I had to try. I actually attached the copies of my service medical records that I referred to. This was not new evidence, it was evidence that should have been reviewed with my claim. I simply think that the claims officer was unaware of the 60% systemic therapy policy and that my medicine (which I was on for years while in the service) counted as a treatment therapy that garnered a higher rating. I am trying to show via my service medical records that I was on systemic therapy...and I think by listing the items in a chronological order and including my medical records I did that. Simply put, I was on the medicine for well over the required 12 months and remain on it to this day. I did not include the 60+ pages of my medical records here...didn't want to clog up the server, plus I would have had to cross out lots of other data. Great catch on the 2001 vice 2011 date. I actually had fixed that on the letter I submitted to the VA but mistakenly used that one as my uploaded document. I am indeed asking to be back dated to 11/01/2011. Putting this into a CUE format is what I am trying to do. I realize I need to quote the appropriate CFR's and thanks for including other forum areas for me to research. Before I go through that process I am still wondering if a CUE is the best approach on this? I know that is going to require a looking glass and some hocus pocus to figure out, what the ideal way to deal with the VA is. But still knowing that I have a two year wait with a BVA or what I feel is a pretty simple and clear cute CUE, I am leaning towards redrafting this in CUE language and submitting via that process.

I spoke with length to a 1-800 rep on Friday. According to her data and my recently received (10 Nov 13) Supplemental Statement of the Case, the Regional Office completely disregarded my request to review my skin condition. They did complete a review on my PTSD and increased that rating. However, after speaking with the phone rep my case will now go before the BVA and sit for 656 days...or she said I could file a CUE. I've attached documentation that the VA has received on numerous occasions regarding my case. I fully believe that clear medical evidence, case law, and the CFR supports my claim and the initial rating date. My question is how do I proceed from here? Do I file a CUE or sit for two years waiting on the BVA? Any thoughts would be welcome. Thanks! Chris Should I CUE.pdf