Capt.

Hello Casscytman,,,,,, There may be an issue with the rating because of the pyramiding rules of VA to keep the lung issues to a minumum for the higher ratings. It is possible to have more than one disease of the respiratory system and if you have core pulmonale or Pulmonary hypetension then the COPD jumps to 100 percent so keep an eye out on your heart. You may be able to file an NOD back to your Earliest Effective Date but it may take an IMO linking that to move it. Jbasser and Teac are smmoooooth right. Also some of the problems that many Veterans face with diseases is the possibility that SECONDARY issues can be linked to rateable diseases. That will take IMOs and strong evidence but we have seen that with many of our members so don't forget that track of direction. NEVER GIVE UP . God Bless, C.C.

Hello Boomer and Test Vet. Thanks for the Headsup article Boomer ......kinda lets us a hint . TestVet ,,,,yea its a moot point , but I just wanted to know .....they really don't care about any veteran. NEVER GIVE UP . God Bless, C.C.

Hello All, This is an excellant article that will help to open perspectives and understanding of some Veterans Affairs issues and problems. The article also shows some important BVA and CAVC decisions that a Veteran can look up for the specifics and to use these decisions if related to their own claim. NEVER GIVE UP . God Bless, C.C. 1-Allen-TheLawofVeteransBenefitsPages1-66.pdf

Hello All, Though I have not had much success at the National Archives searching for Documents(because of secrecy issues) there is another service and that is Hiring a Researcher. I have talked to one for the purpose of trying to get records and specific DA forms and DD forms and the initial cost will usually start around 35-50 per hour and a minimum of 5-6 hours so there is some expense. The main advantage is that most are court certified , meaning their study request is admissable in court and their research usually goes beyond what the Veteran is able to do on his or her own. I would like to also say that some records will not be released due to their security clearance position for our nation. I hope this will help one of our Veterans and the Main site is also in this URL. As always ....NEVER GIVE UP. God Bless, C.C. http://www.archives....arch/hire-help/ http://www.archives.gov/

Hello all, Excellant advice Deanbrt and 71. Congressmen and Senators really cannot do much especially early on in the claims process. I would not do anything until the process has moved it somewhere or you get to the point that the VA has it off track. It could very well make someone at Regional Office look at your claim and they might hold a grudge. I think that may have happened with me and do not really know alot of veterans where this has helped a whole lot. I would let your claim "process" as slow as it may take because there is not many veterans that have made it quickly thru the process. NEVER GIVE UP . God Bless, C.C.

Carlie,,,,, Will we ever find out who the enemy Senator of Veterans was that started the block. It sure makes me sick. NEVER GIVE UP . God Bless, C.C.

Hello Troy , I have a 1151 claim filed but waiting ....I hope to find out about the FTCA first . NEVER GIVE UP. God Bless,C.C.

Hello Carlie,,,,,,what is really bad is you found this one story ,,,,but just how many more are out there just like it? I am fast loosing my patience am going to have to probably hold one of James Cripps favorite tactics ........ The Press Conference. James has already been coaching me on how to do it .Jbasser you drive the get away car and break me out . lol.....This is so sick. Folks , C.C. is almost of out of time . Thanks to the VA and government regulations that cannot work. NEVER GIVE UP. God Bless, C.C.

Hello All, I have been studying BVA cases and after finding several that have awarded Pulmonary Hypertension as partial percentages increase , I am finding that these may be incorrect and are not following the 38 CFR 4.96 or 4.97 dealing with Respiratory Conditions and the M21 schedulars. After carefully reading the case , and going over the law there are some important decisions that were USURPED decision authority by the BVA and will bring them problems. Please read the 38 CFR 4.97 and look at the diagnostic code given by this court at 6604. Here is where I see the regulations were violated. There is nothing mentioned about Pulmonary Hypertension until Diagnostic Code 6608 , COPD and the only way that a Pulmonary Hypertension rating can be given is if under Diagnostic code 6608 is that the Diagnosis by Heart Cath or Echo Cardiogram shows a diagnosis of PH. which will cause the rating officer or review officer to rate the COPD at 100 Percent. A Pulmonary Hypertension rating cannot be given or assigned unless you have a Heart Cath or Echo Cardiogram. You can further read down and see where the Diagnostic codes further down also warrant 100 percent but with the same criteria necessary. Either a Heart Cath or an EchoCardiogram showing a diagnosis of Pulmonary Hypertension is listed under the correct diagnostic code or it is not. If it is found there is no such ratings that are to be adjudicated by the BVA. It is automatically 100 percent. WHHOOOOPS.... Oh but read on and see the decision by BVA and how much they steered away from the law. As in the courts findings here the increase was given for the wrong diagnostic code and PH was given in a percentage of 30-60 percent. Nowhere do the diagnostic codes or ratings allow this. Pulmonary Hypertension is a serious disease that is listed at 100 percent by the VA. There is not really anything listed on a lesser percentage award. It was done from the BVA and is erronous and it appears they just pulled this one flat out of the air or made it up as they went along. I highlighted the areas in red to concentrate on and hope others will chime in on this. Now I am suppose to be rated under 6608 and 6845 and have a heart cath and echo gram showing conclusively that I have Pulmonary Hypertension. The way this BVA decision went down but lacks following any diagnostic code.......HUH.....they just do what they want to and may cleverly use this law they quoted in the decision. "Any change in a diagnostic code by a VA adjudicator must be specifically explained. See Pernorio v. Derwinski, 2 Vet. App. 625, 629 ", This is an error on the VBA that should be appealed. I am hoping some others will chime in on this. Now with my claim they did not award the heart cath or echo cardiogram findings for the diagnostic codes 6608(COPD) and 6845( restricted lung disease) with Pulmonary Hypertension TO BE RATED AT 100 PERCENT. It is on an appeal from RO. With this claim above ,the BVA just did what they wanted to. Neither diagnostic code applies to the Ashtma nor is there mention of Pulmonary Hypertension there under the codes for Asthma, So now we have them either ignoring one claim and then making up and falsefying another asthma claim with a faulty decision. I do not think I have interpreted this wrong. It appears straightforward. Oh yes ....I found another decision where they also did it again ...different soldier and different claim. Either the RO is not spotting the diagnostic codes or the BVA kinda hip shoots their decisions. Again our Veterans need to have to deal with these decisions but are sure opening themselves up later to some real problems. I hope some of you can check this out and see what should be done but also to make the board here aware at how BVA comes up with this stuff and no wonder we have to appeal their decisions. It might even be wise to put this to the HVAC or the OIG. A Veteran does not need to go thru these types of decisions. NEVER GIVE UP. God Bless, C.C. Citation Nr: 0335712 Decision Date: 12/18/03 Archive Date: 12/24/03 DOCKET NO. 03-00 902 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Muskogee, Oklahoma THE ISSUE Entitlement to an increased evaluation for service-connected asthma with asymptomatic minimal pulmonary hypertension, currently evaluated as 60 percent disabling. REPRESENTATION Veteran represented by: AMVETS ATTORNEY FOR THE BOARD Christopher P. Kissel, Counsel INTRODUCTION The veteran served on active duty from August 1981 to August 1985. This case comes to the Board of Veterans' Appeals (the Board) on appeal from a July 2002 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. Issues on appeal An issue previously on appeal, entitlement to service connection for sinusitis/rhinitis, was withdrawn by the veteran in writing in January 2003, following the RO's grant of service connection. The veteran's withdrawal of the issue was unnecessary in light of the grant of the benefit sought. It is additionally noted that the veteran filed a claim of entitlement to secondary service connection for pulmonary hypertension in March 2001. Such claim was granted in a July 2002 RO rating decision; pulmonary hypertension, which was characterized as "minimal" and "asymptomatic" in medical reports, was included as part of the service-connected asthma. The claim of entitlement to service connection for pulmonary hypertension on a secondary basis has been granted and the issue is therefore moot. However, the matter of a separate disability rating for pulmonary hypertension will be addressed in the Board's decision below. It appears from a statement of the veteran's representative in February 2003 that additional claims have been raised, specifically entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) and entitlement to service connection for a chronic heart disability. Such claims have not been adjudicated by the RO and they are therefore not within the Board's jurisdiction. In light of the Board's grant of a 100 percent rating for asthma, described below in this decision, the veteran and her representative should contact the RO and inform that agency whether she now wishes to purse any additional claims. FINDING OF FACT The veteran's service-connected asthma disability requires daily use of high dose systemic corticosteroids. CONCLUSION OF LAW The criteria for a schedular rating of 100 percent for the veteran's service-connected asthma have been met. 38 U.S.C.A. § 1155 (West 2002); 38 C.F.R. § 4.97, Diagnostic Code 6602 (2003). REASONS AND BASES FOR FINDING AND CONCLUSION In the interest of clarity, the Board will initially discuss certain preliminary matters. The Board will then address the pertinent law and regulations and their application to the facts and evidence. The Veterans Claims Assistance Act of 2000 The Board has given consideration to the provisions of the Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475, 114 Stat. 2096 (2000) (the VCAA) [codified as amended at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107 (West 2002)]. This law eliminated the former statutory requirement that claims be well grounded. Cf. 38 U.S.C.A. § 5107(a) (West 1991). The VCAA includes an enhanced duty on the part of VA to notify a claimant as to the information and evidence necessary to substantiate a claim for VA benefits. The VCAA also redefines the obligations of VA with respect to its statutory duty to assist claimants in the development of their claims. Regulations implementing the VCAA have been enacted. See 38 C.F.R. §§ 3.102, 3.156(a), 3.159, and 3.326(a) (2003). The VCAA is applicable to all claims filed on or after the date of enactment, November 9, 2000, or filed before the date of enactment but not yet final as of that date. In this case, the veteran's appeal remains pending before the Board and therefore, is not final. See 38 U.S.C.A. § 7104(a). The provisions of the VCAA and the implementing regulations are, accordingly, applicable. See Holliday v. Principi, 14 Vet. App. 282-83 (2001) [the Board must make a determination as to the applicability of the various provisions of the VCAA to a particular claim]. The VCAA alters the legal landscape in three distinct ways: standard of review, notice and duty to assist. The Board will now address these concepts within the context of the circumstances presented in this case. Standard of review The current standard of review for all claims is as follows. Once all the evidence has been brought together, the Board has the responsibility to evaluate the record on appeal. 38 U.S.C.A. § 7104 (West 2002). When there is an approximate balance of the evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each issue shall be given to the claimant. 38 U.S.C.A. § 5107 (West 2002); 38 C.F.R. §§ 3.102, 4.3 (2003). In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the United States Court of Appeals for Veterans Claims (the Court) stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. The Board will apply the current standard in adjudicating the veteran's claim. Notice The VCAA requires VA to notify the claimant and the claimant's representative, if any, of any information and any medical or lay evidence not previously provided to the Secretary that is necessary to substantiate the claim. As part of the notice, VA is to specifically inform the claimant and the claimant's representative, if any, of which portion, if any, of the evidence is to be provided by the claimant and which part, if any, VA will attempt to obtain on behalf of the claimant. See 38 U.S.C.A. § 5103; see also Quartuccio v. Principi, 16 Vet. App. 183 (2002) [a letter from VA to a claimant describing evidence potentially helpful to claimant but not mentioning who is responsible for obtaining such evidence did not meet the standard erected by the VCAA]. The record shows that the RO furnished the veteran a letter in March 2002 advising her of the provisions relating to the VCAA, to include advising her that she could provide the names, addresses, and approximate dates of treatment for all VA and non-VA health care providers. She was informed as well that she could provide VA authorization to obtain any private medical records by completing the appropriate forms (VA Form 21-4142), copies of which were enclosed with the letter. The Board notes that, even though the letter requested a response within 30 days, it also expressly notified the veteran that she had one year to submit the requested information and/or evidence, in compliance with 38 U.S.C.A. § 5103(b). The one-year period has now expired. In Paralyzed Veterans of America, et. al. v. Secretary of Department of Veterans Affairs, 345 F.3d 1334 (Fed. Cir. 2003) [the PVA case], the United States Court of Appeals for the Federal Circuit (the Federal Circuit) held that 38 C.F.R. §§ 3.159(b)(1) and 19.9(a)(2)(ii) are invalid to the extent they provide a claimant "not less than 30 days" to respond to a VCAA notification letter because the regulations are contrary to 38 U.S.C.A. § 5103(b), which provides a claimant one year to submit evidence. In this case, the March 2002 letter sent to the veteran improperly advised the veteran, informing her that she had only 30 days to respond. However, the letter also expressly notified her that she had one year to submit the requested information and/or evidence, in compliance with 38 U.S.C.A. § 5103(b). In addition, the veteran has indicated on multiple occasions that she wants a decision on her case based on the evidence of record. See e.g. Statement in Support of Claim dated in September 2001, Report of Contact dated in July 2002, and her statement waiving the 60-day waiting period on her case dated in February 2003. The Board is therefore satisfied that she was notified properly of her statutory rights. See Wensch v. Principi, 15 Vet. App. 362 (2001) [the VCAA does not apply where there is extensive factual development in a case which indicates no reasonable possibility that any further assistance would aid the claimant in substantiating his claim]. The Board notes further that the factual scenario in the PVA case, which involved the RO sending a VCAA notification letter, as in this case, is simply inapplicable to the specific circumstances of this case. The Federal Circuit was concerned with the "premature denial" of a claim before the one-year period for submitting evidence had expired. In other words, the Federal Circuit wanted to ensure that a claimant had sufficient time to submit evidence before an adjudication was made. Here, the veteran has had more than a year to submit evidence in support of her claim, which was filed in March 2001. It now appears that VA has all the information needed to decide the case. It therefore appears pointless to wait still longer to adjudicate this appeal when it is clear that no additional evidence is forthcoming. Also, the Federal Circuit's concern in the PVA case that a claimant would be unaware of the time he had left to submit evidence is inapplicable in the specific circumstances of this case. The veteran in this case has been made aware on numerous occasions, in response to the various statement/supplemental statements of the case and the 90 day notice of transfer of the claims file to the Board that she had more time to submit evidence. Since this claimant has, as a matter of fact, been provided at least one year to submit evidence after the VCAA notification, and it is clear that she has nothing further to submit, the adjudication of her claim by the Board at this time will proceed. The Board finds that the foregoing information provided to the veteran satisfies the requirements of 38 U.S.C.A. § 5103 and Quartuccio in that the veteran was clearly notified of the evidence necessary to substantiate her claim at issue on appeal. Under these circumstances, the Board finds that the notification requirement of the VCAA has been satisfied. Duty to assist In general, the VCAA provides that VA shall make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate a claim for VA benefits, unless no reasonable possibility exists that such assistance would aid in substantiating the claim. The law provides that the assistance provided by VA shall include providing a medical examination or obtaining a medical opinion when such an examination or opinion is necessary to make a decision on the claim. An examination is deemed "necessary" if the record does not contain sufficient medical evidence for VA to make a decision on the claim. See 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159. The Board finds that reasonable efforts have been made to assist the veteran in obtaining evidence necessary to substantiate her claim, and that there is no reasonable possibility that further assistance would aid in substantiating her claim. The record shows that the veteran has been afforded a VA compensation examination in connection with this appeal, which will be described below. It further appears all known and available service, private and VA medical records have been obtained and are associated with the veteran's claims folder. The veteran does not contend that additional evidence that is pertinent exists and needs to be obtained. In short, the Board has carefully considered the provisions of the VCAA in light of the record on appeal, and for the reasons expressed above finds that the development of this appeal has been consistent with the provisions of the new law, considering the circumstances presented in this case. The Board can identify no further development that would aid the Board's inquiry. See Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991). In addition, the veteran has been accorded ample opportunity to present evidence and argument in support of her claim. She was informed of her right to a hearing and was presented several options for presenting personal testimony. See 38 C.F.R. § 3.103 (2003). It is further noted by the Board that the veteran's representative submitted additional medical evidence in August 2003. Such evidence had not been previously considered by the RO and was unaccompanied by waiver of RO consideration. This evidence was received by the RO and forwarded to the Board for appropriate consideration. In Disabled American Veterans, et. al. v. Secretary of Department of Veterans Affairs, 327 F.3d 1339 (Fed. Cir. 2003) the Federal Circuit noted that 38 C.F.R. § 19(a)(2) (2002) was inconsistent with 38 U.S.C.A. § 7104(a) (West 2002) because it denied appellants a "review on appeal" when the Board considered additional evidence without remanding the case to the RO for initial consideration. However, in light of the Board's disposition of this claim, which will result in a complete grant of the benefits sought, the Board will proceed with a decision on this claim without further administrative delay. Pertinent law and regulations Disability ratings - in general Disability evaluations are determined by the application of a schedule of ratings. 38 U.S.C.A. § 1155 (West 2002); 38 C.F.R. Part 4 (2003). The percentage ratings contained in the Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civil occupations. 38 C.F.R. §§ 3.321(a), 4.1 (2003). Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7 (2003). Specific schedular criteria - bronchial asthma The veteran's service-connected asthma disability is currently rated under 38 C.F.R. § 4.97, Diagnostic Code 6602, which rates bronchial asthma based on results of pulmonary function tests, the required treatment, and the frequency and severity of asthmatic attacks. As noted above, the veteran's asthma disability is presently rated 60 percent disabling. A 60 percent evaluation under Code 6602 is assigned where forced expiratory volume in one second (FEV-1) is in the range from 40- to 55-percent of predicted value, or; the ratio of FEV-1 to forced vital capacity (FVC) is in the range from 40- through 55-percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids. The next higher and maximum schedular rating, 100 percent, may be assigned where the FEV-1 is less that 40 percent of predicted value, or; the ratio of FEV-1 to FVC is less than 40 percent, or; if there are more than one asthma attack per week with episodes of respiratory failure, or; if the condition requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications. Factual background A request for an increased rating must be viewed in light of the entire relevant medical history. See 38 C.F.R. § 4.1 (2001); Peyton v. Derwinski, 1 Vet. App. 282, 287 (1991). In a case such as this, however, where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. See Francisco v. Brown, 7 Vet. App. 55 (1994). Historically, the record shows that in a rating decision dated in June 1996, service connection for compensation purposes was established for asthma and assigned a 30 percent rating under Diagnostic Code 6602. The veteran's present claim was filed in March 2001, at which time it was alleged that her condition included secondary pulmonary hypertension. The veteran was thereafter evaluated on VA respiratory examination in April 2002, which diagnosed her with bronchial asthma, stable; and minimal pulmonary hypertension, asymptomatic, which the examiner felt based on a review of the evidence in the claims file was caused by chronic pulmonary disease and asthma. It also was noted on this exam that the veteran was using an inhaler, alburterol (two puffs as needed), as well as a nasal spray, flunisolide (two sprays twice per day). [With respect to these inhalers/sprays, the Board observes that the veteran subsequently submitted a medical information sheet which indicated that the nasal spray flunisolide is a synthetic (man-made) corticosteroid and that the usual dosage for adults is two sprays in each nostril twice per day, which could be increased to three times per day; a second medical info sheet submitted by the veteran indicated that the maximum dosage for flunisolide was four puffs twice per day]. In addition, a pulmonary function test (PFT) was completed at the time of the April 2002 examination; this PFT was interpreted by the examiner as showing a normal spirometry study with FVC of 71 percent and FEV-1 of 79 percent (ratio of FEV-1 to FVC of 87). The chest X-rays also showed a normal study. In addition to the above, VA and private treatment reports dated in November 2000 to March 2001 time frame showed ongoing medical management of her asthma condition, and these records also showed continued treatment with the alburterol inhaler and flunisolide nasal spray in the dosage indicated on the April 2002 VA exam. Also of record is a VA physician's summary report dated in January 2001, prepared following an evaluation conducted in December 2000, which indicated that the veteran's asthma was moderate in severity and was being treated adequately. A follow-up report dated in March 2001 indicated that her asthma symptoms had improved even without use of medications. Based on the above evidence, the RO denied entitlement to an increased rating (above 30 percent) by rating decision in July 2002. The veteran subsequently perfected an appeal to the Board. During the pendency of this appeal, additional VA treatment records were added to the file. These records, dated through January 2003, denoted in several reports that other treatment regimens for asthma would be maximized. Specifically, a report dated in September 2002 indicated that following consultation with an allergist and implementation of a plan to limit her exposure to known allergens, she continued to have problems with asthma and accordingly, she was instructed to increase her use of the inhaled corticosteroid, AeroBid [trade name for flunisolide] to two puffs twice per day. Subsequently, these reports indicated that she started using an oral pill form of flunisolide in November 2002 in addition to the nasal spray form of this medication, and that she suffered asthmatic attacks in December 2002 and January 2003. These reports also detailed responses to her email inquires to her primary care VA physician, who instructed her in December 2002 to increase her use of the inhaled flunisolide to 4 puffs per day. Based on these reports, a RO Decision Review Officer increased her disability rating to 60 percent by rating decision in January 2003 on the basis of monthly visits to physician for required care of exacerbations of asthma. Thereafter, the record shows that the veteran's primary care VA physician advised her in an email dated January 29, 2003 that 4 puffs of the nasal spray flunisolide twice per day represented the maximum dose of this medication. This same physician also prepared a statement on January 17, 2003 indicating that the veteran would benefit from not being exposed to low humidity environments and that she would benefit from use of a nebulizer [device used to reduce liquid medication to extremely fine mist, useful for delivering medication to deeper parts of respiratory system] at home and at work to prevent further exacerbations of her asthma. Additional records associated with the file showed that the veteran was taking the maximum dose of the inhaled spray-form of flunisolide [4 puffs two times a day] by medication list reports dated January 17, 2003, March 13, 2003 and June 14, 2003; a previously-dated report of January 4, 2003 indicated that her dosage on that date was only 2 puffs two times a day. Analysis Assignment of diagnostic code The assignment of a particular diagnostic code is "completely dependent on the facts of a particular case." See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual's relevant medical history, the diagnosis and demonstrated symptomatology. Any change in a diagnostic code by a VA adjudicator must be specifically explained. See Pernorio v. Derwinski, 2 Vet. App. 625, 629 (1992). In this case, the Board finds that 38 C.F.R. § 4.97, Diagnostic Code 6602 [bronchial asthma] is the most appropriate rating criteria under which to evaluate the veteran's asthma, based on the relevant history, diagnosis and current symptomatology. The Board has not identified any more appropriate diagnostic code, and the veteran has suggested none. Increased rating consideration The Board has carefully reviewed the evidence of record. For reasons explained immediately below, and resolving doubt in the veteran's favor, the Board finds that the evidence supports a 100 percent disability rating. The Board emphasizes that the schedular criteria under Diagnostic Code 6602 are set forth in the alternative, as demonstrated by the use of "or" in the language followed by a semicolon, such that satisfaction of one criterion for the higher rating is sufficient. Cf. Johnson v. Brown, 7 Vet. App. 95, 97 (1994). In the present case, the Board finds that, with resolution of the benefit of the doubt in the veteran's favor, the evidence supports a grant of a total schedular rating [100 percent] for the veteran's service-connected asthma. The recent medical evidence discussed above confirms that the veteran is now taking the maximum dosage of the corticosteroid flunisolide on a daily basis. Although the evidence of record does not establish that she meets each and every requirement for 100 percent disability rating under Diagnostic Code 6602, she does meet one of them, daily use of systemic (oral or parenteral) high dose corticosteroids. Because the schedular criteria are set forth in the disjunctive rather than conjunctive, meeting one requirement is sufficient basis to award the higher rating. See Johnson, supra. The Board observes that the RO indicated in its supplemental statement of the case dated in February 2003 that there was no evidence showing that the veteran was using a high-dose corticosteroid. This assertion appears to have been refuted by a January 2003 email from the veteran's primary care VA physician as well as the medical information sheet submitted by the veteran showing that the maximum dosage for the nasal spray form of flunisolide was 4 puffs twice per day, which is the veteran's current dosage. The Board observes further that the evidence shows an increase in the veteran's asthma symptoms, as demonstrated by December 2002 and January 2003 exacerbations of her condition which required medical treatment and evidently led to the increase her medications and specifically to the use of both an oral and nasal spray form of the corticosteroid flunisolide. The recent evidence also shows that she suffered recent asthma attacks despite her avoidance of known allergens following a consultation with an allergist, and that she has been advised to use a nebulizer at home and at work to help her condition. Hence, although her PFT test scores and frequency of asthmatic attacks does not equate to the criteria for the 100 percent rating, the veteran does meet the criteria for such a rating based on the current medication regimen, namely high- dose daily use of corticosteroids. As stated above, this is an independent basis to grant the 100 percent total schedular rating. The Board therefore finds that the veteran meets the schedular criteria for the 100 percent rating under Diagnostic Code 6602. Accordingly, an increased (100 percent) schedular rating is warranted. Esteban considerations Except as otherwise provided in the rating schedule, all disabilities, including those arising from a single disease entity, are to be rated separately, unless the conditions constitute the same disability or the same manifestation. See 38 C.F.R. 4.25 (2003); see also Esteban v. Brown, 6 Vet. App. 259 (1994). As noted in the Introduction, the veteran's service-connected asthma includes asymptomatic minimal pulmonary hypertension. The Board has therefore given thought as to whether the hypertension should be rated separately. A careful review of the medical evidence of record supports the RO's conclusion that the veteran's pulmonary hypertension is minimal and asymptomatic. As an example, the report of a December 2000 pulmonary consult included the examiner's note that testing had revealed "minimal pulmonary hypertension". No symptoms were recorded. This is consistent with the other medical evidence of record. It is clear from the medical evidence that to the extent that pulmonary hypertension exists as part of the veteran's service-connected asthma, it is asymptomatic. Even if a separate rating were to be assigned, it would be noncompensable. Particularly in light of the 100 percent disability rating now assigned by the Board, assigning a separate rating for the asymptomatic pulmonary hypertension would be an unproductive exercise, and the Board declines to do so. Conclusion In short, for the reasons and bases expressed above the Board believes that a 100 percent disability rating may be assigned for the veteran's service-connected asthma with asymptomatic minimal pulmonary hypertension. ORDER A 100 percent disability rating is granted for the veteran's service-connected asthma with asymptomatic minimal pulmonary hypertension, subject to the law and regulations governing the award of monetary benefits.

Hello Peer, carlie, on 11 November 2012 - 03:40 PM, said: "A C&P examiner does NOT have to accept any paperwork from a claimant. Sometimes if we are real nice - they will." carlie Exactly correct. QTC examiners are given limited amounts of the Cfile or evidence. So the "Due Process" law is definitely violated at this stage of the decision process with VAROs. You may be years before you get a copy of them and how do you file an effective appeal without them??? If the Veteran is lucky enough to get a good examiner with QTC they might ,,,,,MIGHT use your evidence or statements. However this is normally a huge problem for the Veteran. As most of our members will atest to. If you were to get an exam from a VAMC instead, it would mean the records of the Examiners Report/ Progress Reports would be easy to get copies of. But that is sometimes a call on the VARO and not one of the Veteran. I have posted some thoughts in an earlier post on Due Process and the QTC Examination reports , in my opinion are a violation of the Veterans Due Process. Yes , you can show this at a later date , say in the court process of CAVC but that is a long ways down the road. I do feel that you are in some kinda dark waters right now and need to negotiate those waters carefully so as not to loose your timelines or get off track with your claim. Unfortunately QTC was started by ex members of the VA upper eschelon and they know how to stall and delay the system. Another roadblocking system that the VA has put up against the Veteran. You may need to seek some very good representation to continue this correctly. NEVER GIVE UP . God Bless, C.C.

Hello Peer, I do not like anything about this. First , you have gotten a letter from your old RO and from what it sounds like you are now living somewhere else with a new RO. If this means your new RO is being used, did you notify the old RO of your change of address? This could pose a problem because you are still in the OLD system RO office and it does not matter because the letters generated are still going to be activated. I would first contact the old RO as soon as possible. I would also contact the Patient Advocate to get them to help since you will be dealing with VAMCs or QTC Examinations. At this stage of the game you have to get someone to help you correct and start a paper trail that you can verify. I would make sure that both VAROs are notified as to this problem. If you miss the C and P exam then they can move on taking the SC benefits and it could take years to correct this because of the paper trail process. Since you do not have the 10/20 year protection, it may come back to haunt you and making sure the VA does not have an excuse to reduce or take away is the key here. Closing the paper trail is what will stop this process before it gets out of hand. I also do not think it is a computer generated letter , though the wording may be followed as VA protocol between other VAROs. The denial trick is used all the time and we have many members that have been thru this also. I would let someone else that has personally been thru this type of VA nightmare comment here. You are not alone, but please remember to NEVER GIVE UP. God Bless, C.C.

Hello Troy......This is a huge win......and look at the timeframe. Not nearly the long time frame that normally happens. Maybe the VARO you are dealing with is one of the better ones but it also helped to the accuracy of the information you supplied. Well done Troy. I wonder what that VSO would say now. Your claim shows specifically that the Veteran is the only one that really can make his claim understandable. And it helps when you have brothers and sisters here to help cover your back. Your 1151 claim is very interesting to me also as well as others here. Please keep us posted. CONGRATS and you proved that the Veteran can .....NEVER GIVE UP . God Bless, C.C.

Hello Joe, I sure want to encourage you to keep close tabs on your claims, and the appointments for C and Ps. The VA has a habit of scheduling one and then you get the notification for the next day or the day after that. And if you miss your C and P it may take a long time to get it corrected. John999 brings up a very important topic concerning your VCAA letters. Actually if you are not receiving them , then the decisions cannot be valid from the VA. The VETERANS CLAIMS ASSISTANCE ACT is a law that "says" the VA must assist you in gathering evidence for EACH claim you have filed. I will tell you that there is much archived here concerning VCAA and you can search the site. Berta , has done much study on the VCAA and is our resident expert on the VCAA letters and their problems so you can start there. I would make sure that each claim has a VCAA letter and notify the VA thru registered mail , making them sign for it. Don't be afraid to research topics on your listed claims here at Hadit. It is important to note that QTC Compensation and Pension Examinations Reports belong to the VA Regional Office of origin. These reports are not readily available and almost always require a FOIA to get them. I have waited one year and stil do not have a copy of the C and Ps from my exams. I would file a FOIA on each exam and start your files so you can check off each one. I want to point out that you really cannot continue any written response effectively without a copy of the C and P. from QTC. If you try the VA will say that the C and P examiner noted....blah blah blah. So you do not have a copy of the C and P and have no idea HOW to respond to the Examiners report. Now you see that we have more time developing and stalling the claim. All in favor of the VA. Yes you are suppose to be able to set up an appointment at the VARO and request to look at your Cfile and get a copy of that QTC C and P exam or others. However , there is no guarantee that the VARO will keep your file in line for a decision. Possibly more risk for stalling your claim. I would also file for Depression and Pain. Very common with this many injuries and diseases. I would also keep close records and files as this is not going to be easy or quick. DIG IN........ Also , almost every denial from the VA medical will take an IMO to rebutt it. This is one of the Veterans best tools at winning his or hers claims. Another thing to consider that Ebenefits should NEVER considered to be accurate so don't put alot of faith in it or the answers from the 1 800 numbers as far as your claims process goes. Hopefully some others will chime in here. Joe , I want to thank your for your service and welcome you aboard here. You cannot afford to make any mistakes just because of the timelines getting longer. Trying to shorten these claims in the process is your goal and to make sure you don't stay on the hamster wheel forever. A good attitude like you have, will keep you moving. Above all ....NEVER GIVE UP. God Bless, C.C.

Bump

Hello James, Yes ,,,,,, I wonder how the DOD is going to say how it got there. Remember Congressman Lane Evans got so many bases put on the Agent Orange list but then he ran out of time , and Fort Greely , just did not make it to the list. However the fact is that it was used and is still in the remediation process and recorded there at Fort Greely. So now we have to get it to the courts to make it precedence. The real interesting situation is that as far as we know there are no Spraying Records for any base on the list. The DOD and the National Archives will not turn them over. If you try to FOIA them, they will turn you down. Try to get those spraying records for Fort Gordon and you will come up short. Actually the only copy of a spraying record shows up in the Installation and Assessment Report for Fort Greely 1973 which was "leaked" and post on the web. James do you know of any spraying records from anywhere? I believe this to be a huge coverup and keeps the DOD from having to acknowledge all of the places it was REALLY used. Those places show up in the Agent Orange Training Seminar list I posted in another topic. Those are now archived here at Hadit under the Agent Orange Section. These Spraying Records numbers are once again. DA Form 2785 or 2785R and DD 1532. Finding these are like finding GOLD. Thanks again for your help. NEVER GIVE UP. God Bless, C.C.

Hello USMCMAN, You have great advice here ,,,,,remember that your Early Effective date is almost gone. PLEASE do not let your date slip away. I would do as Carlie and PR said and get that to the VA ASAP. PROTECT YOUR TIMELINE. Our members can tell many sad tales as to letting their dates expire and having to reopen a claim, therefore forfeiting your retroactive pay that goes back to your EED. Just like PR said you can add more evidence later after it is posted by the VARO. Also waiting for these decisions requires an attitude of NEVER GIVE UP. God Bless, C.C.

Hello James, Thanks for your post and helping our Veterans community. I just wanted to post this environmental report from Fort Greely Restoration and Advirsory Board. Part of ADEC. In this report you will see undeniable evidence that Dioxins and Furans are being detected in the soil samples. It is a long read but you will also notice other very harmful COC s in the test analysis of several sites. I am service connected from Fort Greely and moving ahead with the rest and am one of the very few to have a claim from Fort Greely awarded. Still the VA got it wrong but have to go thru the system. Now this is evidence that says it is definitely in the soil, at Fort Greely, even though it has been 25 + years since the test in the 1990s . There are some other test I have but this one is long enough so please skip down to the following tables and read. CONCLUSIVE SCIENTIFIC EVIDENCE. This site is the real deal for finding any toxic site including the SM1A and pipeline used for dumping radioactive waste into Jarvis Creek at Fort Greely. http://www.smdcen.us...minrecords.aspxhttp://www.smdcen.us...minrecords.aspx After you go to this site then scroll down to this. It was too large to download 2002 Soil Evaluation and Risk Assessment Sites 85S 85N 133 112 Fort Greely Alaska Rev1 06Dec2002 Part 2 (15.8 MB) Table 5-30 Dioxin Furan Anaylsis Fort Greely Five Training Pits Table 5-230 Table 5-231 Table 5-232 Table 5-233 Table 18-1-18-7 Site 85 N Dioxins Sample Analyticals July 1998 21-22 Archiving this here at Hadit will allow others to see the scientific data that will be able to be used in the claims process. NEVER GIVE UP. God Bless, C.C.

Some of the reasons for that horrendous timeframe, of 883 days, are,in my opinion, that certainly many claims Could be awarded at the RO level but aren't. The fact that MANY claims need IMOs ,as recommended here many times, is certainly one way those 883 days can be reduced.Other reasons are that claimants themselves need to do more leg work on getting their evidence ,whether it comes from buddy statements or from the 'clues' that SOCs and SSOCs often contain (as well as the initial VCAA letter.) yet often claimants don't go the whole 9 yards on gathering evidence. And the VA sure won't do that for them. We claimants all have some real responsibility in reducing the backlog as well as VA. Hello Berta and Bronco, I am glad to see you back Berta, even if just a little. I posted a topic on the 38 CFR 3.103 Procedural Process and Appellant review, discussing this problem in some depth. The EXAMINER is also reminded that an examination is inadequate where the EXAMINER does not comment on the Veteran’s report of an in-service disorder and instead relies on the absence of evidence in the service treatment records to provide a negative opinion. By combining the two quotes above I think this means that the VA should not be able to deny solely on the lack of evidence in the C file, when the credible Vet says that it happened in service. In other words, I think the VA should not be able to deny when the Vet makes a statement,solely because that statement is not corroborated with medical records. In other words the VA losing the medical records does not provide proof the Vet is a liar You have brought this up also and because I was awarded the lung issues as service connected. The evidence VARO gave the C and P examiner was "piecemeal". It did not contain the Pulmonary Hypertension Diagnosis thru Heart Cath. I showed him this report and he said he did not have that. I do not know what he commented on because I still have no C and P reports after a year of taking it. BACK TO DUE PROCESS PROBLEMS. I am still waiting on the NOD and what they are going to do about an increase for the PH diagnosis which must be awarded 100 percent under diagnostic code 6604 and 6845. Berta I hope you read that post I listed above and glean some evidence you can use as you fight for all Veterans rights. Thank you again Berta, NEVER GIVE UP. God Bless, C.C.

Hello Dearman, I have seen Dr. Danny Bartel, North Texas Neurology Clinic,Wichita Falls, Tx, also known as the Agent Orange Clinic. I am enclosing alittle bit about him in the link below. You will count on spending 3 days and extensive testing and schedule, including a top notch Clinical Psycologist, Radiology Imaging and evaluation, and finally EMG, Needle Nerve conductivity test(painful). He is expensive but very thourogh and a great person but he does not understand the VA and its terminology for writing up a real strong IMO. I was not happy with the way the report was left open and lacked in completeness of the final report. It was ok but it could have been done better especially with an impression of AO by him. Dr. Bash on the other hand will close the loops and the doors and is more familiar with VA law. I wish I could have had Dr. Bash's knowledge of VA law on IMOs and Dr. Bartels thouroghness incorporated into one. I am not saying Dr. Bartel is bad,,,,,he is not , actually he is a fine Doctor and does a thorough exam. It is his lack of VA law and what makes a VA IMO different that caused me some problems. If we could get him here on Hadit and let him see why the IMO has to be done their way it would be helpful. Yes I am using his IMO but it is not as strong as Dr. Bash. IF,,,,,and I mean IF you could get Dr. Bartel to write his report to address specifics and to follow the basic IMO information formats required by VA and what we have at Hadit archived. And he would list more his reasonings as supported by "medical rationale" like Dr. Bash does then I would say go with it for sure. You may PM if you would like and I will explain more. Pretty much what this link will show you is what you should expect. It is unfortunate that Rex King and his wife are no longer there to pick you up at the airport and get you to the Howard Johnson Motel(VA discount for seeing Dr. Bartel) and take you to get your discounted meals at some fine restaurants. He has moved to Georgia and may be moving back but don't know when. He and his wife are wonderful people dedicated to serving Vets. Him being a Vietnam Vet himself. Pictures also can be used as evidence and the one you described must be taken into consideration if put into admission by you. So that is a good point. I hope this helps but remember those timelines, and start your counterattack.....NEVER GIVE UP. God Bless, C.C. AGENT ORANGE CLINIC DR BARTEL NORTH TEXAS NUEROLOGYclinic.pdf

Hello All, After looking at the comments below , it seems that the points covered are. .... 1. A decision has been made by your RO. 2. You MUST have an IMO to refute their medical rational. a. As Bronco pointed out it must show medical rationale,,,example quoting accepted peer review, or example that is contrary to their opinion. b. Your IMO is probative and why. c. Show material or evidence that they missed or ignored. 3. Remember my recent post on 38 CFR , 3.103 Procedural Process and Appealants Rights, Part D ,concerning due process and evidence and the WHOLE DECISION PROCESS. As pointed out in this post by several , the VA can do it because they can. Please try to reread what I posted just recently on this and that particular part of the 38 CFRs. It is also interesting to note that 38 CFR 3.102 is the "Benefit of a Doubt " rule. Remembering that the Appeal Process and the Courts are about the only tool a Veteran has to rebutt and stop or correct the VARO decisions. 4. It is my understanding of a CUE , that you must be at the final decision and actually have to reopen the claim or the part in question and have all or some of the elements of a CUE to able to file a CUE. (Elements of a CUE , Archived here at Hadit) I do not think you are there yet to initiate that. This was posted by Bronco http://www.purplehea...3 CUE FINAL.pdf As usual the same tactics are being used by the VARO that have been used on most of us here at HADIT. The advantage you have is to research this here in archives , try to follow some advice as to direction or next move and ........NEVER GIVE UP. God Bless, C.C.

Rdawg,,,,,that is excellant suggestions for our member. I would do that spcdearman. However I would not get a VSO .....I would get a Lawyer for sure and continue with a leveled playing field. NEVER GIVE UP God Bless, C.C.

Hello All, Jbasser,,,that is why I caution every Veteran on using the DAV. They do act like they work for the VA not the Veteran. I fired them years ago after they screwed my claim up so bad and would not use them if my life depended on it. If I had to use a VSO it would probably be Americian Legion, Vietnam Veterans of American and maybe PVA or VFW in possibly that order. Then I would, without hesitation, get a lawyer after the initial decision comes back. This is just another way the VA can "force out" a Veteran and not take care of this countrys Veterans as promised. Oh yea,,,,,that is 38 CFR 3.103 part d......DUE PROCESS.......at its best.... isn't it? NEVER GIVE UP . God Bless, C.C.

Hello All, I have been noticing some old post and some new ones that seem to also show a problem that has come up with VA and the Adjudication Process. I believe most of us here have had problems with their Cfile and or VA decisions because of evidence the Veteran , THOUGHT was in his or hers Cfile and was not. Now here is a couple of things to think about. Most of us are in the process of "waiting" on a decision from the VARO. It has been recommended not only by many Veteran VSOs and Lawyers and Hadit members to not send any evidence to the VARO while the claim is waiting for a decision because of the go to the bottom of the wait list philosophy. Now here is where I see many problems that have developed with not just my claim but many others here. The amount of time to get from an NOD , appeal , notice to reconsider AFTER an initial decision is running about 2-3 years or longer to get another decision. We see by the law listed below that a Veteran is suppose to have due process and that ALL evidence is suppose to be part of the claim. Here is where most of us run into a problem. What we have as evidence may not be there because of the time frame and the fact that the Regional Offices have a very bad habit of not having all of our evidence in the file or getting it to the Veteran. I really don't want to dwell on Shreddergate , which does come to mind , but the amount of faulty decisions that end up being appealed, has a HUGE affect on the Decision Process. Hence the BACKLOG cannot ever go down. This issue is compounded because of the "go to the bottom of the pile" rule that VAROs go by. And because VA does not keep records as well as the Veteran(in most cases). Sooooo, evidence really cannot be sent in during the appeal process while a decision is being waited for. For me , I am in the wait mode on an NOD on some claims and on to the BVA on others. I have hundreds if not thousands of pages of evidence left to turn in. I am not alone. Almost every Veteran will run into this problem because of the process that is oh so familiar with all of us. Yes some Veterans claims are more simple , some not , but this particular law is far and away one of the biggest problems that STALLS a claim and requires the BVA or CAVA to get it right. Now we are talking of 8-12 years or longer..........I know that most of our Hadit folks can look at their own claim and see what I am talking about is exactly right and can relate to this. So when I am talking about faulty decisions from VAROS and having an enormous error rate, it is really because the Veteran DOES NOT HAVE DUE PROCESS because of this little effort to not go to the bottom of the pile. And because there is a problem with how to submit evidence to be considered , DUE PROCESS is already jeopardized and now becomes a long wait. Therefore he or she may not be able to get all of the evidence in during the process. Just think of some of our Veterans who have made the mistake of turning in evidence ever so often during the decision process. Yes , the old saying that if its short and sweet the better, but some of us just have no choice because of security of military places and test or complexity of claims or secondary diseases or illnesses and so forth. I know some of our members will chime in on this one. Oh yes , I have waited almost a year for copies of my QTC ,C and P exams from Regional Office. How in the world can I effectively have due process to add to my evidence without those exam reports. And I also know that the C and P Examiner did not have ALL of the Progress reports because I showed him the Pulmonary Hypertension Progress Report and he said he did not have it. Just one part of the NO DUE PROCESS. See what I mean. Why didn't he have it??? It was suppose to be in the Record from the VAMC Medical Progress Reports. This might be a good class action suit for one of our great law groups concerning violation of due process for all Veterans. A Veteran must have a thick skin and patience and above all.....NEVER GIVE UP. God Bless, C.C. §3.103 Procedural due process and appellate rights. (a) Statement of policy. Every claimant has the right to written notice of the decision made on his or her claim, the right to a hearing, and the right of representation. Proceedings before VA are ex parte in nature, and it is the obligation of VA to assist a claimant in developing the facts pertinent to the claim and to render a decision which grants every benefit that can be supported in law while protecting the interests of the Government. The provisions of this section apply to all claims for benefits and relief, and decisions thereon, within the purview of this part 3. (b) The right to notice: (1) General. Claimants and their representatives are entitled to notice of any decision made by VA affecting the payment of benefits or the granting of relief. Such notice shall clearly set forth the decision made, any applicable effective date, the reason(s) for the decision, the right to a hearing on any issue involved in the claim, the right of representation and the right, as well as the necessary procedures and time limits, to initiate an appeal of the decision. (2) Advance notice and opportunity for hearing. Except as otherwise provided in paragraph (b)(3) of this section, no award of compensation, pension or dependency and indemnity compensation shall be terminated, reduced or otherwise adversely affected unless the beneficiary has been notified of such adverse action and has been provided a period of 60 days in which to submit evidence for the purpose of showing that the adverse action should not be taken. (3) Exceptions. In lieu of advance notice and opportunity for a hearing, VA will send a written notice to the beneficiary or his or her fiduciary at the same time it takes an adverse action under the following circumstances: (i) An adverse action based solely on factual and unambiguous information or statements as to income, net worth, or dependency or marital status that the beneficiary or his or her fiduciary provided to VA in writing or orally (under the procedures set forth in §3.217(b)), with knowledge or notice that such information would be used to calculate benefit amounts. (ii) An adverse action based upon the beneficiary’s or fiduciary’s failure to return a required eligibility verification report. (iii) Evidence reasonably indicates that a beneficiary is deceased. However, in the event that VA has received a death certificate, a terminal hospital report verifying the death of a beneficiary or a claim for VA burial benefits, no notice of termination (contemporaneous or otherwise) will be required. (iv) An adverse action based upon a written and signed statement provided by the beneficiary to VA renouncing VA benefits (see §3.106 on renouncement). (v) An adverse action based upon a written statement provided to VA by a veteran indicating that he or she has returned to active service, the nature of that service, and the date of reentry into service, with the knowledge or notice that receipt of active service pay precludes concurrent receipt of VA compensation or pension (see §3.654 regarding active service pay). (vi) An adverse action based upon a garnishment order issued under 42 U.S.C. 659(a). (Authority: 38 U.S.C. 501(a)) (4) Restoration of benefits. VA will restore retroactively benefits that were reduced, terminated, or otherwise adversely affected based on oral information or statements if within 30 days of the date on which VA issues the notification of adverse action the beneficiary or his or her fiduciary asserts that the adverse action was based upon information or statements that were inaccurate or upon information that was not provided by the beneficiary or his or her fiduciary. This will not preclude VA from taking subsequent action that adversely affects benefits. © The right to a hearing. (1) Upon request, a claimant is entitled to a hearing at any time on any issue involved in a claim within the purview of part 3 of this chapter, subject to the limitations described in §20.1304 of this chapter with respect to hearings in claims which have been certified to the Board of Veterans' Appeals for appellate review. VA will provide the place of hearing in the VA office having original jurisdiction over the claim or at the VA office nearest the claimant's home having adjudicative functions, or, subject to available resources and solely at the option of VA, at any other VA facility or federal building at which suitable hearing facilities are available. VA will provide one or more employees who have original determinative authority of such issues to conduct the hearing and be responsible for establishment and preservation of the hearing record. Hearings in connection with proposed adverse actions and appeals shall be held before one or more VA employees having original determinative authority who did not participate in the proposed action or the decision being appealed. All expenses incurred by the claimant in connection with the hearing are the responsibility of the claimant. (2) The purpose of a hearing is to permit the claimant to introduce into the record, in person, any available evidence which he or she considers material and any arguments or contentions with respect to the facts and applicable law which he or she may consider pertinent. All testimony will be under oath or affirmation. The claimant is entitled to produce witnesses, but the claimant and witnesses are expected to be present. The Veterans Benefits Administration will not normally schedule a hearing for the sole purpose of receiving argument from a representative. It is the responsibility of the VA employee or employees conducting the hearings to explain fully the issues and suggest the submission of evidence which the claimant may have overlooked and which would be of advantage to the claimant’s position. To assure clarity and completeness of the hearing record, questions which are directed to the claimant and to witnesses are to be framed to explore fully the basis for claimed entitlement rather than with an intent to refute evidence or to discredit testimony. In cases in which the nature, origin, or degree of disability is in issue, the claimant may request visual examination by a physician designated by VA and the physician’s observations will be read into the record. (Authority: 38 U.S.C. 501(a)) """" (d) Submission of evidence. Any evidence whether documentary, testimonial, or in other form, offered by the claimant in support of a claim and any issue a claimant may raise and any contention or argument a claimant may offer with respect thereto are to be included in the records."""" (e) The right to representation. Subject to the provisions of §§14.626 through 14.637 of this title, claimants are entitled to representation of their choice at every stage in the prosecution of a claim. (f) Notification of decisions. The claimant or beneficiary and his or her representative will be notified in writing of decisions affecting the payment of benefits or granting relief. All notifications will advise the claimant of the reason for the decision; the date the decision will be effective; the right to a hearing subject to paragraph © of this section; the right to initiate an appeal by filing a Notice of Disagreement which will entitle the individual to a Statement of the Case for assistance in perfecting an appeal; and the periods in which an appeal must be initiated and perfected (See part 20 of this chapter, on appeals). Further, any notice that VA has denied a benefit sought will include a summary of the evidence considered. (Authority: 38 U.S.C. 501, 1115, 1506, 5104) [55 FR 13527, Apr. 11, 1990; 55 FR 17530, Apr. 25, 1990, as amended at 55 FR 20148, May 15, 1990; 55 FR 25308, June 21, 1990; 57 FR 56993, Dec. 2, 1992; 58 FR 16359, Mar. 26, 1993; 58 FR 59366, Nov. 9, 1993; 59 FR 6218, Feb. 10, 1994; 59 FR 6901, Feb. 14, 1994; 66 FR 56613, Nov. 9, 2001; 76 FR 52574, Aug. 23, 2011; 77FR 23129, Apr. 18, 2012] Supplement Highlights references: 7(2), 9(3), 10(2), 10(3), 48(1), 97(1), 101(1). 3.103 Procedural due process and appellate rights

Hello Bronco and Chuck, I discussed this with the Finance dept about a month ago and they said that they would pay me back to date of record which is over a decade for sure. But I have to get to that magic 100 %. Bronco ,,,,you got it ......they always hit you when you need it the most. Typical VA. However I am still happy that they Finance dept. is way faster than ROs. Still after a decade I am going to NEVER GIVE UP. God Bless. C.C.

Hello Deanbrt, I know that most of my financial questions and problems were taken care of much quicker than dealing with Regional Offices. Still most of the financial questions took about 3-4 weeks to be solved. Some thur Omaha and some thru Smyrna , Tennessee. Thanks again for bringing that info on copay reimbursements here. NEVER GIVE UP. God Bless, C.C.