Willy P

2016- Initial Compensation Claim (denied) Dec 2019- Supplemental Claim adding IMO- Approved February 2020- Higher Level Review for effective date- Approved. I received the letter on Friday. The senior rater claimed that the VA made a CUE in the 2016 decision. This is exactly what I was hoping for.

Update 7/8. Money in the bank! Success! Looks like the back pay is all the way back to the time I left active duty.

Update 7/8. Money is in the bank! Success!

Update 7/3. It's official- the HLR on VA.gov shows up as closed and my ebenefits effective date on the disability tab goes back to the day after discharge. Success! Now my only question- it looks like when I try to generate a letter, it keeps showing an effective date of December 1, 2019. Is this just because that is when the 50% monthly compensation rate was last updated, or is there a mistake?

Update 7/3. It's official- the HLR on VA.gov shows up as closed and my ebenefits effective date on the disability tab goes back to the day after discharge. Success! Now my only question- it looks like when I try to generate a letter, it keeps showing an effective date of December 1, 2019. Is this just because that is when the 50% monthly compensation rate was last updated, or is there a mistake?

Right, my original intent was to use CUE as a last resort and simply file a HLR to get them to look at the effective date. Basically I only wrote a sentence or two on the HLR form talking about my situation. In my case it worked out favorably, but I think I got lucky with my reviewer to be honest. I thought that benefit of doubt should definitely apply, but since you can't argue that in CUE maybe the VA could CUE itself, if that makes sense...

Well I have an interesting update now... Yesterday 6/27 I received my informal phone conference that I requested for the HLR. The senior rater Agreed with my statement in the HLR that the 2016 denial was in fact a mistake. He made two points: 1) The denial letter I received stated that there was no evidence in service. This is incorrect because I did in fact complain of sleep problems and snoring during active duty. 2) The rater should not have overruled the VA examiner. This is exactly what I was hoping for- the senior reviewer went back and looked at all the details in the 2016 claim and found the error. I honestly thought I had little to no chance of getting this decision, but I'm glad I went this route. Great day yesterday!

Well I have an interesting update now... Yesterday 6/27 I received my informal phone conference that I requested for the HLR. The senior rater Agreed with my statement in the HLR that the 2016 denial was in fact a mistake. He made two points: 1) The denial letter I received stated that there was no evidence in service. This is incorrect because I did in fact complain of sleep problems and snoring during active duty. 2) The rater should not have overruled the VA examiner. This is exactly what I was hoping for- the senior reviewer went back and looked at all the details in the 2016 claim and found the error. I honestly thought I had little to no chance of getting this decision, but I'm glad I went this route. Great day yesterday!

This was at a VA facility, not even a contractor. I was amazed that I was still denied after that. But others pointed out that maybe the rationale wasn't quite right.

Thanks for the feedback Bronco. Just to be clear- I submitted the Supplemental after the 1 year appeal period (2016 denial and 2019 Supplemental claim). The HLR is basically just a hope that they recognize that the VA got it wrong in 2016- maybe by CUE'ing themselves? Do you think BVA would be effective still? I was thinking if HLR is denied, maybe I should jump to CUE...

Hey brother, HLR is still pending as of now, been going on 5 months. I'm not entirely confident, but I wanted to try HLR before submitting a CUE. I try to post all updates in my original thread so it may help someone out some day:

6/4 Update The HLR has sat with no updates since it first showed up in March. I figured this is pretty normal timeline (within 120 days) so no reason for alarm. Today, the va.gov site says that there is a new claim received. I have no idea what this means and of course details are lacking. Hopefully I'll get a letter in a few days or something. When I select the claim files tab, it shows what appears to be all of my claim documents previously submitted. Ebenefits has no updates.

Another Update. VA.gov site updated to show my HLR claim on Friday. I faxed it in February 19, so that's a little over 2 weeks to populate on the website. I requested a phone conference- I get a ton of robocalls, so it looks like I'll be answering a lot of junk until it's finally the VA that's reaching out. I'm keeping this going just to keep an accurate track of my claim progress, in case any one needs it someday...

I used Dr. Anaise. He reviewed my claim file and medical docs via email and agreed that he could help. After I paid him, I had the IMO in about a week. The IMO is what won my supplemental claim for sleep apnea, so I recommend contacting his office.

Another update. Based on some light reading I decided to use my HLR option instead of going after the CUE. I faxed the HLR request over a couple of days ago, and now it's just time to wait.

Yes they were. Overall I'm pretty impressed with the supplemental claim route, but I guess I'm biased now. From the date I mailed in the form, it was right at 30 days before ebenefits was updated. I just faxed a HLR yesterday trying to chase down some backpay.

@paulstrgn, Maybe I missed it, but did you elect to have the same office process your HLR? I just had a supplemental SA claim approved and am trying to use HLR first for EED. I'm not sure if it will work, but I wanted to use that before trying a CUE.

Mine took about 3 weeks to show up on va.gov. Then a week or two after that, the decision was made and ebenefits updated.

Thank you for the link! I have to admit, I got a little optimistic while reading about HLR. I would look forward to having a phone call with a reviewer to state my side of the situation. It sounds like HLR is the next logical step, since I won't have any new evidence and it is much quicker than VBA.

Good Afternoon Team, Short back story/timeline: Left Active Duty: August 2015 Diagnosed with Sleep Apnea February 2016 (6 months later) Submitted claim in May 2016 with my evidence: Sleep study DBQ In service complaint of snoring exerpt from my medical record Favorable C&P Exam opinion (at least as likely as not...) VA Denied my claim in August 2016 I did nothing because I didn't think I could come up with any other evidence Fast forward to last year..... I scratched some pennies together and paid for an IMO, then submitted the letter via a supplemental claim. I was awarded SC for sleep apnea at 50% within a month of the VA receiving my claim. Success! Here is the link to that process in the research forum: So here is my line of thought... Can I use HLR to fight for an earlier effective date, or do I have to use CUE? I mean, the VA had everything it needed to make the proper rating the first time (In-service event, nexus from the C&P doc, current diagnosis...). I have a hard time with the fact that I had to pay an outside doctor just to agree with the C&P exam doctor. Why would the rater place his/her opinion over the VA's own doctor? Shouldn't the benefit of the doubt have gone to me? From what I understand, I can't CUE the benefit of the doubt anyway. Since I am within the appeals period of the supplemental claim, I'm thinking the easiest path may be to request HLR in order to ask them to CUE themselves on the 2016 decision. Is that possible? I'm just trying to avoid CUE if I can, since it's mainly a "last resort" type of measure.

Bumping the thread, hoping there is another way besides CUE.

Update Again. Today I received the decision letter. 50% granted for sleep apnea, effective 1/04/2020 for a payment effective date of 2/01/2020. Now the only thing left to answer is "how" I can request earlier effective date. To summarize: I missed the appeals window of the 2016 denial. The IMO was the only new evidence submitted with the supplemental claim. The IMO used the same evidence to concur with the C&P examiner's opinion. Is there another avenue besides CUE to request the earlier effective date?

Very curious to see what your VSO puts together. I've even thought about contacting the law firms, because 80% of 50K is still very much worth it. To your point about the C&P, in my case it didn't even matter. I had the diagnosis 6 months out, positive C&P opinion, and complaint of snoring in service, and the VA still denied it. The IMO used the exact same information to agree with the C&P doc, so in my mind the VA messed this up.

Blah, We are in the same situation. I was diagnosed with sleep apnea within 1 year of discharge. Like you, I was denied. That was 2016, and I gave up. I scraped some pennies together and paid for an IMO, then submitted a supplemental claim a month ago. I was approved (still waiting on the letter in the mail, but ebennies is showing 50%). Even though the C&P Doc said "at least as likely as not" service connected the first time around, the IMO is what was needed I guess. Like you, I've been told that this should have been a CUE. I just don't see in writing where it would apply as a presumptive condition. If I win a CUE, I would win about $50K in back pay, so I'm debating on whether to write one or not.

By the way- has your ebenefits disabilities screen changed? Mine was updated with the new decision either the same day or day after. I went from no service-connected to 50%.