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flores97

Senior Chief Petty Officer
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  1. Like
    flores97 reacted to broncovet in The Va Is Has Stoped Me From Getting An Imo   
    The VA cannot "stop you from getting an IMO". You simply go to a private doc that does IMO's and pay him to do it, and submit the evidence to VA.

    However, until/unless you can overcome the "congenital" label, you wont be SC.
    con·gen·i·tal
    kənˈjenədl/
    adjective
    (especially of a disease or physical abnormality) present from birth.
    "a congenital malformation of the heart"
    synonyms: inborn, inherited, hereditary, innate, inbred, constitutional, inbuilt, natural, inherent
    "congenital defects"
    (of a person) having a particular trait from birth or by firmly established habit.
    end of congenital definination.
    The only way to overcome this "tag" is an IME/IMO. You need a doc to opine that this condition is not congenital, but instead, is at least as likely as not due to xxx event in medical service.

    Its a possibility it was misdiagnosed...and conflate with a diseas that is congenital. Va loves to do that.
  2. Like
    flores97 reacted to Tomahawk in 1,000+ Days And Counting...   
    I was medically discharged from the Marines. It took me 6 years to get the VA to give me a 0% rating. After that it took another 5 years to get them to increase it to what it is now. I have now been waiting 6 years since I filed my NOD, and 3 years since I filed my Form 9 to the BVA.

    Anytime I have called the normal 800 number they tell me the same song and dance about it take 1000+ days for appeals to advance, and they are still working my claim.

    I've tried contacting IRIS. Which states you will get a reply in 5 business days. The 3 times I have tried using that I have had to send another request 3 weeks later and reference that one I finally get a response 2-3 days after that which consists of some variation of:
    "Please accept our apologies for the delay in responding to inquiry #. We are currently experiencing a large volume of inquiries and are working as quickly as possible to respond to each inquiry in a timely manner.
    We received your VA Form 9, Appeal to Board of Veterans’ Appeals (BVA), which formalized your appeal on XX/XX/XXXX. At this time your appeal is awaiting review for any further action or necessary development.
    If no further action is necessary, your file will be certified to the Board of Veterans’ Appeals (BVA) for their decision on your appeal. If any further action or development is needed, we will notify you.
    The processing of most formalized appeals takes an average of 1,036 days.
    The length of time it takes to process your VA Form 9 depends on the specifics of your case and VA’s pending workload.
    We are currently processing a large volume of appeals, and we are doing our best to process these as quickly as possible. We generally process appeals in the order received. Due to the backlog of appeals, we cannot provide you with a better timeframe or inform you of when your appeal will be completed. We apologize for the delay and appreciate your continued patience.
    Hiring an attorney, writing your congressman, or even obtaining a Veteran Service Organization, is always your option, and our recommendation, should you need assistance when following the claims and/or appeals process."
    I have tried calling the BVA 800 number. Most times the line just rings and rings and rings. The handful of times over the last 3 years that it has actually been answered they tell me the exact same thing: "Your file is still with your regional office. We don't begin working on it, or have any information to give until we have the file."

    I have tried writing 3 different congressmen/women as well as both of my state senators. All to absolutely no avail in figuring out if they are even working my file correctly much less at all.

    After reading a few of the success stories about emailing General Hickey I took that route on Monday, and as of yet have not heard anything from her. So I'm not getting my hopes up that anything will be done in the near future.

    So to answer your question. In my experience there is absolutely nothing you can do to speed anything up. Don't give up. It's an arduous process for sure, but I have to believe the fight is worth it, and the VA will eventually make shit right.

  3. Like
    flores97 reacted to broncovet in 1,000+ Days And Counting...   
    Volley
    Those numbers include DRO review, which is the same as a SOC. SOC normally means your claim is denied by the DRO, or at least part of your claim was denied. The 2014 average for DRO review is 330 days. I will guess if you requested a hearing, then cancelled it, it will start all over from day one, but can not confirm.

    Mostly, remember the VA is not a "unified body". One VA employee will tell you x and anther will often tell you y. When it finally happens, it happens as z. Its frustrating and even more frustrating not knowing.

    A DRO is unlikely to be productive unless your "new evidence" was compelling. Example:
    You got denied as Doc A opined it was not related to military service. You get Doc B who opined it was related to service. But...if Doc A read your service records, and so stated, and Doc B did not, expect it to be denied again.

    Hopefully, you did a great job with your NOD. I suggest you keep "your opinion" out of it. They dont care what your opinion is. For example,
    hopefully your NOD looked something like this:
    While Doc A did opine this was less likely than not due to military service, BOTH Doc B and Doc C opined this was at least as likely due to military service. (Doc B and Doc C exams are enclosed.) Further, CAVC case Joevet vs Shinseki, indicated, " ........".
  4. Like
    flores97 reacted to bluevet in Need an IMO   
    Sounds great, what's the name of the company and what city are they in? Also, before you pay for any IMO/IME, make sure you have all medical records that the Va has and make sure that the examiner lists them all. This is a huge factor in the weight that the VA rater will give to the opinions. Secondly, make sure the doctor understands that every claim he makes needs a clear rationale. When you get them back, review them and if you don't think the rationales are adequate, don't be afraid to request an edit. 
  5. Like
    flores97 reacted to K_C in Date of Claim - Started vs Submitted on eBenefits   
    Just some documentation supporting the idea that the date of opening the claim is more the Date of Claim than is the date of submission.
     
    First, NOLO (http://www.nolo.com/legal-encyclopedia/how-va-determines-effective-dates-disability-compensation-when-veterans-back-pay-starts.h):
    Can I Get an Early Filing Date?
    If you have not yet applied for benefits, it is to your advantage to notify the VA as soon as possible of your intent to file an application in order to preserve the earliest possible effective date. Filing an informal claim before you officially file your application will give you the largest possible retroactive payment if you are awarded benefits.
    Notify the VA in writing or using a Statement in Support of Claim form of your intent to file for disability compensation. Include your name, dates of service, and Social Security number.
    After you submit an informal claim stating your intent to apply for benefits, the VA will send you an application form for disability compensation benefits. You must complete and submit this application within one year of receiving it or you lose your right to the earlier effective date based on your informal claim.
     
    This leads me to the VA 21-256 (http://www.bcvets.org/pdf/VBA-21-526-ARE.pdf)
    Page 2, Top-Right: VA Form 21-526 has four parts. Everyone has to fill out Part A of the form. 
    Which is "VA Form 21-526, Part A: General Information". Part A has several sections, all consisting of the same type of basic information you submit when starting a claim on eBenefits but prior to submitting it. e.g. Name, Address, DOB, what you intend to file for, basic Dates of Service, current service status, deposit account information, signature, etc.
    The nail in the coffin for me is the email I received from eBenefits upon opening the claim. It states:
    We received notification that you initiated a claim for compensation benefits on 07/21/2014. You must finalize your application within 365 days, or your application will be closed and no further action will be taken. If you are a Service member, you have up to one year from your date of discharge from active duty to finalize your application.
    You can access your in-process, online application at www.ebenefits.va.gov.
     
    I'm convinced that the Effective Date would defer to the date you open the claim and receive this email (barring any situations where you weren't eligible/diagnosed/etc. upon this date of course).
     
    Just thought I'd share what I've gathered and where my reasoning stems from.
     
    Thank you again!
  6. Like
    flores97 reacted to K_C in Date of Claim - Started vs Submitted on eBenefits   
    Apologies if this has been answered somewhere already--I looked here and on Google but can't seem to find a clear answer to what seems like a simple question. Thank you in advance for any clarity!
    So, Date of Claim generally becomes the Effective Date on approved claims. But, what is the Date of Claim when filing on eBenefits?
    My understanding has been thus far that the Date of Claim is the date in which you opened/started the claim on eBenefits. In other words, the date you filled out the first form of the series. Once you do this, they email you a receipt with yada yada yada you have 365 days to complete this claim. On my last claim, this is what they counted as the Date of Claim.
    On my second claim, they appear to be treating the Claim Submission Date, i.e. the date in which I completed the entire set of claim forms, uploaded my evidence, and submitted.
    For example, in this particular case I started the claim in July 2014 by submitting the first few parts of the form. As soon as I submitted the first page of the form, I received the you-have-365-days email. I then proceeded to compile evidence and produce documentation until March 2015, which is when I uploaded my evidence and submitted the claim for processing. They approved part of my claim (yay) but have set the Effective Date to April 01, 2015, whereas I would have expected either July/August 2014 or December 2014 (COLA date).
    What am I missing here that leads me to believe they made a mistake? If I'm not mistaken, is this something that can be questioned in a local hearing, which I will be requesting anyway for the part of the claim they denied? Speaking of, how do you deny a painful scar that clearly happened in service? They didn't even give me a C&P for this claimed condition. Very confusing. Off topic I know, but maybe someone already reading this has an opinion on it.
    Thank you all for your help!
  7. Like
    flores97 got a reaction from Gastone in Waiting on Rating at Winston Salem VARO   
    Pwrslm,  VHA Directive 2013-002 IS the one your looking for.  Google yuku forum topic VHA DIRECTIVE 2013 Requesting a DBQ from your PCP, there is a link to the directive, which states that if a vet requests his PCP OR SPECIALIST  VA Provider to complete a DBQ for a condition the veteran is already being treated for, the DR is LEGALLY obligated to do so, if the DR cannot complete the form the same day, they must schedule a follow up appointment specifically to complete the DBQ, just as Gastone stated earlier.  
  8. Like
    flores97 reacted to Gastone in Waiting on Rating at Winston Salem VARO   
    This may be it, VHA Directive 2013-002. Instructions for VA Staff Dr's, when requested to complete a DBQ by a Veteran.
    Same Day Service!
     
    Semper Fi
  9. Like
    flores97 reacted to Gastone in Waiting on Rating at Winston Salem VARO   
    10/2013, I got a New DX that I thought was a Secondary CAD issue and filed a FDC 01/14. VA jumped on it and scheduled a C&P for 04/14, PDQ, right. Meanwhile, I determined that the New DX was not 2ndary to CAD but more likely to my SC SA. Filed New FDC right away.
    Sooooooo, went to the C&P and VA Staff Dr starts discussing something all together different than both my recent FDC's. He's sitting there with a Hypertension DBQ requested by the VA Rating Dept. My FDC was for Pulmonary Hypertension, not regular Axx Hypertension, BIIIG Difference. Then I told him I was wrong regarding the New DX being 2ndary to CAD, it was more likely due to my SC Sleep Apnea. He agreed!
    He proceeded to tell me that he could only address the issues requested by the VA Rating Dept and had to complete the VA Rater's requested Hypertension DBQ. Catch 22, that wouldn't help me at all, right.
    At that point we discussed the VA's NEW DBQ policy regarding requirement of VA Drs to complete a Condition Specific DBQ when requested by a Veteran, at the time of the appointment. He concurred, if I were to request a Pulmonary Hypertension DBQ addressing a 2ndary linkage to my SA, he would be required by VA Regulation, to complete it.
    I Did, He did and I was awarded a PH SC 2ndary to SA 08/14. The SC Award arrived about 4 days after the Denial arrived for the 1st FDC. The Award listed the C&P PH DBQ as the deal maker. In the end, the rating Dept still got the rating wrong, used Hypertension guidelines rather than PH.  I got the IU award 06/14 so there's no real $ involved now but I'll wrestle with them for the correct PH SC % over the nest year or so.
    Semper Fi 
  10. Like
    flores97 reacted to Gastone in Waiting on Rating at Winston Salem VARO   
    I decided on an "Informal Hearing" and Both the NOD from 09 as well as a 2012 NOD for IU were addressed. I walked out after about 35 min knowing all major $ issues from 09 and IU from 11 were awarded. That probably is 1 of the benefits of the "Informal," DRO told me the only thing he needed to check out was the Retro Dates. That afternoon, I had a faxed copy of the DRO Award for IU T&P No Future Exams. Retro Chk hit my account about 2 weeks before the actual VA Award envelope arrived, EO 7/15.
    A friend just had his official DRO Hearing last Thursday after waiting about 3 yrs. He and his attorney both attended the hearing. Standard Hearing procedure, Recorded and Transcribed. After DRO did the into and advised regarding what issues would be covered, she did not ask another question. My friend's attorney asked him questions they had decided would support his claim.
    At the end the DRO said a Decision would follow in about 30 days. She did address a 2013 Pending NOD DRO Hearing for IU. Told him that his VA Sleep Apnea DBQ didn't get the job done. Gave him 30 days to get a Medical Statement on record as to his SA being Secondary to his 70% SC PTSD. The all important "As likely as not," or better yet, "More likely than not;" was missing.
     
    Semper Fi
     
    Gastone
  11. Like
    flores97 reacted to Gastone in Waiting on Rating at Winston Salem VARO   
    Now it's just the "Hurry up and Wait Game."
    BVA did move the speed of light. Maybe that will become the rule rather than the exception.
     
    Semper Fi
  12. Like
    flores97 got a reaction from Gastone in Waiting on Rating at Winston Salem VARO   
    Gastone, my Form 9 was filed in May 2014, certified to the board in August 2014, and i elected the video teleconference hearing which i had at the RO on June 2nd, 2015.  I received the official decision from BVA granting service connection for the systemic lupus and memory loss/mood disorder LESS than 2 and a half months later, on Aug 17.  I had filed the original claim Jan 7, 2010.  I think one reason my appeal was certified so quickly was contacting local congress members, but that can sometimes be touch and go.  I dont know if you've heard of the mobile crisis command centers that are traveling around most states, they are mainly visiting local VA hospitals every three months or so in conjunction with town hall meetings, and they are teams from local ROs for each state that help with disability claims and they do have the authority to get things done.  I attended one myself, was told my appeal would be expedited, when i didnt hear anything for several weeks i drove down to the RO and explained what i had been told at the center, and they scheduled my hearing on the spot.  Of course, i think the reason they are going above and beyond right now is from all the bad press, my claim took almost six years and i was extremely and obviously symptomatic during active service, as are many other vets, but it is a start.  I hope your hearing was successful, and hopefully some of this info will help a vet.
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