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Third Class Petty Officers
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Everything posted by danangmonkey

  1. Hi: Have had four separate claims on appeal to the DRO for several years. I received a DRO denial (after 4 separate C&P exams) in late September on all four claims conditions. As usual the SOC was as flawed as the original decision; evidence not considered, incorrect diagnosis, conflicting opinions with board certified physicians that provided a IME, etc. . I think I have a very good chance of winning all four on appeal, if I can spot the easy errors an attorney should have no problem. HERES THE PROBLEM: I had major surgery in late August and was in no condition to take care of business for a few months. Now I only have 18 days to file an appeal or the clock will run out. I have sent out messages to several local attorneys to try to move this forward but concerned I will miss deadline. Yes, my fault for waiting, but there was a valid reason for the delay. HERES THE QUESTION: Do I have to file a FULL appeal, or can I just send in the Appeal Form with basic information to stop the clock and then have the attorney send follow up with the complete appeal package? I doubt an attorney can provide an intake interview, and prepare and send a formal appeal in just a few weeks. or can I send a request for a delay myself, and if so is there any special format for the submission. Appreciate ANY and ALL responses !!
  2. Exactly what I wanted to hear ! Doesn't mean it will happen in my case, but at least its not prohibited. Thanks
  3. Hi: I have an upcoming C&P for a cervical condition. My question; are they tied in scope to only rating the cervical condition itself? When I submitted the claim I only listed the cervical condition, however this condition is also causing moderate-severe radioculaphy in one arm. When I filed I mistakenly though that a primary condition has to be diagnosed and rated before a secondary can be filed. Now that I realize my error, does the physician have the power to add a secondary condition if its identified during the C& P for a primary condition ? During my last C&P the physician actually changed the diagnosis from what I had filed, so they do have some leeway. **For Berta - If you remember you were helping me file a CUE on this case... Wow, I followed your advice and do I have a story to tell you! More to follow later.
  4. Thanks Berta... I will try emailing the Sec of the VA... His email would be read by a staffer that has authority to take action. I don't want to involve the VARO Director (Yet), that will be my nuclear option.
  5. Berta: My Apologies...but not quite sure what I am going to say when I call these people? Not trying to have you hold my hand, and I'm fairly savvy with Federal Agencies, but am a bit nervous about calling some GM15 to discuss my personal case without an invite. Rather than beat around the bush, please help me clarify my options so there is no confusion on my part: 1. Re-Open the case and explain that my IME was ignore don the first go-round, and therefore is "new" evidence. 2. Re-submit the IRIS complaint, and hope that this time its read by someone that understands the "CUE" process and takes appropriate action with the VARO 3. Actually contact the VARO (Again, need your help in what to say). I would prefer emailing them if possible as its less intrusive. The goal is to initiate the CUE, not to piss anyone off and make the situation worse. 4. File a traditional NOD My Preferences are from #1 to #4 in that order ...... I would like to move #3 to #1, but definitely need some diplomatic guidance from you, Thanks !!
  6. Berta ---- here is their IRIS response...I cant blame the VARO...doesn't look like they sent it to them.... Just for he record, I DID file this as a COMPLAINT...I did use your format for the CUE in the Complaint... Here is their response (PII has been sanitized) This is in response to your inquiry to the Department of Veterans Affairs (VA) dated March XX, 2016. 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. We are unable to accept your request for an appeal via this inquiry system. If you do not agree with our decision, you should write and tell us why. You have one year from the date of the decision letter to appeal the decision. The enclosed VA Form 4107, "Your Rights to Appeal Our Decision”, explains your right to appeal. You begin the appeal process by telling us in writing that you disagree with our decision. We call this note from you a notice of disagreement (NOD). In most cases, you must send us the NOD within 1 year of the date we mailed you our decision. Please use VA Form 21-0958, Notice of Disagreement, when submitting your appeal or NOD. We have enclosed the form for your convenience. Additional copies of VA Forms may be accessed online at http://www.va.gov/vaforms/, if needed. We have provided the contact information, for your convenience, at the conclusion of this response. Thank you for contacting us. If you have questions or need additional help with the information in our reply, please respond to this message or see our other contact information below. Sincerely yours, C. Boyd National IRIS Response Center Manager jes
  7. Yes Berta...Was filed as a complaint...that's why I rolled my eyes when they replied that I need to file a NOD... I will PM the RO/VARO info when I get home from work.. THANKS!!!
  8. Berta: Just received a reply to my IRIS (Three weeks later)... Well, typical response, they misunderstood the intent of my CUE request, instead they interpreted my request as a formal intent to appeal the decision (NOD). They sent me plenty of information on how to "Properly" appeal a decision..!! So now that the "CUE via IRIS" route is closed....I do have one more option to try, would like your thoughts: -- I am going to RESUBMIT my IME as "NEW EVIDENCE" and RE-OPEN the case..... Since the RO NEVER reviewed the IME or listed it as evidence I think I am on solid ground re-opening the case based on new evidence. To prevent confusion I will submit a sworn statement with some verbiage explaining that WHY the IME is considered new evidence even though it was submitted with the original claim. What do you think?
  9. Huh ??? How would it get into the record unless I submitted it? Yes, it was submitted, hence the statement in the previous post that said: "The IMO/NEXUS I submitted "
  10. Not sure what you mean by new claim? This was a claim that was denied because critical evidence submitted was not read/considered. Perhaps you are suggesting that I re-open the same claim and re-submit the "unread" evidence? Not sure if that would be proper, the IME and ER report are not new evidence, they were submitted/uploaded but were missed by the RO. I think Berta is correct on this one, this is obviously a CUE situation. I will wait and see how they respond to the IRIS "CUE yourselves" submission, as Berta said perhaps they will correct the error on their own, if not will be heading down the formal appeal process. The ball is in their court for now.
  11. Berta, no worries....my denial was fairly recent, so shouldn't be a problem unless they ignore my IRIS complaint for the next 11 months. Sorry for the delay in posting the results of my denial letter, I have been in Viet Nam for the past two months and just started catching up on mail. The 1-800 wouldn't give me the results of the letter over the phone while I was in Asia, so had to wait until I had the hard copy in-hand.
  12. It wouldn't have mattered in my case ...... I could have hade a buddy letter from Sun Tzu, doesn't do any good if they don't read your submitted evidence. The IMO/NEXUS I submitted (which was obtained at great expense) and the initial ER room report (which caused the injury) were not listed as evidence being considered. Even more laughable was their statement that there was no evidence of the accident ..... Even though I have a screen shot of those same reports uploaded to their system and attached to the claim, and found both documents contained within my C-File.
  13. Berta ... I went ahead and submitted an IRIS using the format you suggested asking the VARO to CUE their won decision.
  14. Berta: After reviewing 500+ pages from the C-File I found a statement that their was no evidence of a MVA (Motor Vehicle Accident) that occurred in-service that could have affected the upper back injury in the same manner as the MVA that injured the lower back. The Claim was denied. Basically they Denied the claim because of a lack of evidence of a MVA occurred. I checked the evidence submitted with the claim (and clearly available within the C-File), it contains the complete Emergency Room report of the MVA and a IMO clearly defining the NEXUS between that MVA event and the Cervical injury. So they not only ignored the IMO, they also ignored the evidence of the MVA event; by denying that the MVA occurred any subsequent IMO based on that MVA became irrelevant. Bottom Line: 1. The ER Report of the MVA was not considered or listed in the Evidence List 2. The IMO was not listed in the Evidence List or mentioned in the denial letter 3. The basis for the denial was lack of evidence of a MVA occurring in-service I agree that clear documentary evidence submitted was not reviewed, and that the non-reviewed evidence submitted clearly would have resulted in a different outcome. So this is obviously a CUE situation, I still have some confusion on the regulatory mechanics of a CUE, can you fill in some details? A. Is a CUE a formal process such as a NOD or require filing a motion ? B. You mention filing an IRIS for the CUE? Is that initiating/triggering the CUE process internally within the VARO? How should I word such a request using IRIS ? C. The only Template/Example I could find follows: (is this "template" something that is mailed to the VARO, or submitteded via IRIS? Obviously the IRIS process would be the fastest method to get the VA to "CUE themselves", but I want to be careful to do this right, and not get in over my head and cause problems for any appellate review down the road. Are you talking about simply and informally submitting a IRIS On-Line and pointing out the error without invoking the formal appeal process? By the way, I started this thread using the account "AF_Comm_Vet", I replied using my old account "danangmonkey". These two accounts are the same person, I had a technical problem initially with the first account that has now been corrected.
  15. BERTA *** Just go the denied ratings decision in the mail.. Just to refresh your memory- This was for a cervical injury caused by an in-service vehicle accident. I'm already rated for the lumbar spine by the same accident that was SC from that accident. I am currently suffering with severe degeneration of the cervical spine. I had an IMO by one of the 'famous "IMO" docs, he produced and extensive IMO letter with NEXUS (to the vehicle accident) as well as applicable exhibits supporting his opinion. All of this was filed as a FDC during the first week of Feb. The VARO processed the entire claim and sent a denial in the short time frame of 5-7 days from filing (!!!!).... You wanted me to post the evidence list when I received the denial letter. Here is the list (I redacted a bit): 1. VAMC Outpatient treatment records 2. VA 21-526EZ FDC 3. Private treatment records from my Orthopedic Surgeon 4. STR 5. Letter (Affadavit) from the Veteran Please note that MISSING is the IMO, and since the IMO was the entire basis for the Service Connection, its omission made this a easy denial. I also received my CD with my C-File, it INLCUDES the IMO, so they cannot deny that it was submitted with the FDC Whats the next move Berta?? Can I simply re-open as a CUE?
  16. It was complete anarchy in the days before the Mods, wild gangs roamed the forum at will
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