[DRO Review Timeline]

Wow.  What VARO are you with?  I just heard from someone else that his DRO Review request has been sitting at St. Pete for over 600 days.

 

[Might be doing first NOD - advice appreciated]

Hi broncovet,

All this transpired while I was still in my original "Intent to File" date which I did on eBenefits.  So the second time around, I submitted the claim myself in eBenefits and have the very same "Intent to File" date.  Hopefully the "Intent to File" date won't even matter.  If I win the CUE, the pay will be back-dated to my retirement date in 2009, not my "Intent to File" of Oct 2016.  

However, I started this thread mainly because I am faced with doing my first NOD for another matter.  Please read the orignal post and look at the attachments.  I hate doing a NOD with a request for DRO Review, because another veteran with same condition has had a NOD request at the same VARO for over 600 days.  I don't know if I would be better off doing the "non-existent" request for reconsideration first, and file the NOD before my year is up if nothing happens with the reconsideration.

[Might be doing first NOD - advice appreciated]

Broncovet -  since the CUE dates back to the date of my original claim, the effective date won't change and I also re-filed within my original "Intent to File" date.  The VSO produced a cover letter that says he sent the CUE to the Data Inprocessing Center, but that proves only that he did a cover letter, not that he actually sent the documents in.  

 

[Might be doing first NOD - advice appreciated]

Thanks Broncovet.

 

[Might be doing first NOD - advice appreciated]

Thanks Gastone.

The date of the letter on the secondary PN is 10 Feb 2017, so I have some time to file a NOD.  

I was lucky getting the C&P exam info when I did.  I requested a copy of my C-File last July so I could review my disabilities from when I retired in 2009 and I just received it yesterday.  The C&P exam from my October claim for secondary PN was in there.  I have looked for my C&P exams in Bluebutton, but they only show up when done at a VA Center and not a contract clinic (huge foul I think).

I have a DAV VSO that is 7 hours away in St Petersburg.  He is the second one I have had and I am not impressed.  The first one said he submitted a CUE back in October and whenever I would ask for a status he would tell me I wouldn't hear anything until it was closed.  I was nervous because I thought it would show up in eBenefits at least that it had been submitted, but there was nothing.  I finally called the VA myself and they said they had never received a CUE from my VSO.  The VSO claimed the VA ignored it.  I don't know who to believe.  Then I was assigned another VA VSO without asking, and he doesn't seem any more responsive.  I may have to try my county VSO but I live in a small county and he is part time with limited hours.

The medical documentation isn't really missing - the VA has the DBQ with the "moderates to severes" on it.  Do I need to just point out what was under their noses or provide new evidence?

I have continued treatments.  I used Tricare to see a neurologist and had injections in my neck after the C&P exam.  That provided some relief, but it is temporary.  The pain is gradually coming back and it is known that the injections only last up to 6 months normally.  I also continue to see a chiropractor and massage therapist under Choice at my neurologist's urging (she even wrote a script which I sent to VA to get renewed under Choice).

[Might be doing first NOD - advice appreciated]

Vync,

Thanks, but how do I go about just writing the VARO and requesting they change the decision?  Is this the same as requesting reconsideration which according to some info I've seen doesn't really exist?  Do I do it through eBenefits or postal service?

Thanks for your support.

[Might be doing first NOD - advice appreciated]

I am considering doing my first NOD. I received 20% for peripheral neuropathy (pain and tingling in my arms and hands) secondary to Cervical Spondylosis (narrowing of the spinal openings in my neck) for both my left and right sides in February 2017. I just received a copy of my C-File that I requested back in July 2016, and it has the C&P exam that was done on me for the peripheral neuropathy. In the C&P exam, I was clearly rated for SEVERE pain on my non-dominant side and moderate numbness and tingling on my dominant side.  

I was given a 20% rating for mild conditions on both left and right side, but from the DBQ the doctor submitted it looks like I should have been given severe to moderate ratings, which would be 40% for my dominant side and 30% for my non-dominant side.

Do I file a NOD and request a DRO review?  

Am I missing a reason why the VA only gave me 20% on each side?  I have attached screen shots from the DBQ.  

Code 8710: Neuralgia of the upper radicular group. Neuralgia cannot be rated higher than moderate, even if it is severe. If the condition is moderate, it is rated 40% for the dominant and 30% for the non-dominant. If it is mild, it is rated 20% for either arm.

This is the quote from my decision package:

"Service connection for left upper extremity radiculopathy (peripheral neuropathy) has been
established as related to the service-connected disability of cervical spondylosis.
● We have assigned a 20 percent evaluation for your left upper extremity radiculopathy
(peripheral neuropathy) based on: • Mild incomplete paralysis of the minor extremity
● Although the lower radicular group and middle radicular group nerves were shown to be
affected, only one evaluation is allowable in this case. This rating is based on the highest
rated nerve.
● A higher evaluation of 30 percent is not warranted for paralysis of the middle radicular
nerve group unless the evidence shows nerve damage is moderate.
● Service connection for left upper extremity radiculopathy (peripheral neuropathy) is granted
with an evaluation of 20 percent effective May 11, 2016, the day we received your intent
to file, with your completed application received on October 29, 2016. VA examination
conducted in support of your claim notes that your noted radiculopathy is related to your
service connected cervical spondylosis."

[How My Cue Succeeded]

Hi Berta,

I just learned about Special Monthly Compensation for Loss of Creative Organ.  I decided to see if it was possible to do a CUE to receive back SMC pay, and ran across your article.  Thanks so much for posting this; it gives me hope and is very educational.  

I was service connected at 0% when I retired in 2009 for a procedure that caused sterility.  I believe I should have been given SMC under "When loss or loss of use of a creative organ ... resulted from operations in service for the relief of other conditions, the creative organ becoming incidentally involved, the benefit may be granted."  

Your post has taught me two things vital to my situation.  1.  I can do a CUE for Special Monthly Compensation.  2.  I did not have to claim the SMC to be entitled to it.

Thanks for all you do to help veterans get their benefits.

JustGettingStarted

[VA Tallahassee and Gainesville refuse to mail glasses or provide travel pay]

On 7/25/2016 at 7:45 PM, Inarticulate&Distorted said:

You wont be paid for ANY travel to and from a VA Hospital unless it is demanded of you by the VA(i.e. C&P Exams)

The reason I get travel pay for scheduled VA appointments is I live over 40 miles from the nearest VA location that can provide the needed services.  This includes eye exams, annual physicals, and even scheduled lab work I believe (although the lab is very good about taking me early if I am fasting).  

[NEXUS letter or Presumptive for colon polyps]

15 hours ago, Buck52 said:

Its hard to get colon polyps S.C. B/C There is not a diagnostic code.

Because colon polyps are not assigned a specific Diagnostic Code the RO rated them under 38 C.F.R. § 4.20 by analogy to irritable colon syndrome, 38 C.F.R. § 4.114, Diagnostic Code 7319. The evidence currently available, however, is insufficient for rating purposes. As such, a new examination is in order. 38 C.F.R. § 3.159.

It should be rated under 7344 Benign neoplasms, exclusive of skin growths, in the Digestive Systems section.   

I would not expect any additional rating for it as long as they are benign, and I already have 10% for GERD.  I just figure it would be better to start working on service connection now, rather than wait to see if something happens years down the road and then try to get S/C for it. My question is still, should I ask my doctor for a NEXUS letter, or will it be presumed I acquired the polyps in service since my first colonoscopy was 1 month after my retirement date?  

If I knew back then what I know now, I would have added it to the claim I initiated before I retired.   

I have had three colonoscopies since I retired, and have had polyps (i.e. benign neoplasms) removed at each visit.  What good would a re-exam do if the polyps have been removed?  I would hope the medical records from my civilian doctor would be sufficient to prove I had the polyps and that they do re-occur.  

 

[NEXUS letter or Presumptive for colon polyps]

I have been retired for 7 years now and was rated at 60% for various disabilities after I retired.  

One month after I retired, I had a colonoscopy; benign polyps (i.e. benign neoplasms), a type that could turn to cancer, were found and removed.  I have had polyps removed twice since then.  Now I would like to get my polyps service connected at 0% in case something more serious were to develop in the future.  

My question:  Since my polyps diagnosis was only a month after I retired, do I need a NEXUS letter to say the polyps were "more than likely" to have developed while on active duty, or would it be presumed the polyps developed while I was still on active duty?

I looked at the presumptives in Title 38, and I don't think this fell under any of the automatics.

Thanks for any help.

[New and need help updating my profile]

Hi all.  This website is a great resource.  I am learning a lot from it.

I need help updating my profile.  I clicked on my name, Profile, and "Edit Profile" and it lets me put in my rating etc..., but I can not see anywhere to update my rank.  I am showing up as a Seaman E-3 next to my name on posts and I didn't input that; I figure it must have defaulted to that somehow.  I have tried three different web browsers - chrome, internet explorer, and edge, and the Rank block does not show up.  

Any help is much appreciated.

[VA Tallahassee and Gainesville refuse to mail glasses or provide travel pay]

I've decided to try another tactic.  Since Tallahassee and Gainesville say they will not mail glasses because of Florida statute, I have sent an inquiry to the Florida Board of Opticiary responsible for the statute.  I've explained that some VA clinics mail eyeglasses in Florida and some don't and explained this is a hardship on veterans that live a long distance from VA clinics.  I have received acknowledgement of my inquiry and now my fingers are crossed they can provide some good clarification that will help with this issue.  

 believe there are many optical companies that mail eyeglasses to Florida residents.  

[VA Tallahassee and Gainesville refuse to mail glasses or provide travel pay]

"38 CFR 70.4 - Criteria for approval

(c) When a claimant requests payment for beneficiary travel for care or services that were not scheduled with VHA prior to arrival at the facility and were not emergency treatment and the travel did not include a special mode of transportation, VA will not approve round-trip payment under this part but will approve payment for the return trip if VHA actually provided care or services."

According to this statement, VA is supposed to pay 1-way travel for medical services that do not require an appointment.  I have been searching Title 38 and have found no exceptions for picking up eyeglasses or prosthetic equipment.  

[VA Tallahassee and Gainesville refuse to mail glasses or provide travel pay]

13 hours ago, seminoles said:

They will not pay you if you are just going to pick up glasses, they have it posted.  I personally, don't care.  I am picking up what would cost me easily over $500 worth of glasses yearly.  I am rated at 100% so it has nothing to do with rating it is policy for eyeglass pick up, they do pay travel for your exam of course. 

 

I wouldn't have an issue with the travel pay if my clinic would mail the glasses like most other VA clinics do.  That's what I am really asking for.    

That still doesn't explain how an institution can refuse to follow their own laws by writing memorandums and/or posting a sign.  

[VA Tallahassee and Gainesville refuse to mail glasses or provide travel pay]

1 hour ago, Inarticulate&Distorted said:

You wont be paid for ANY travel to and from a VA Hospital unless it is demanded of you by the VA(i.e. C&P Exams)

I don't understand where you are coming from on this.  I already get paid mileage for my scheduled appointments at the VA in Tallahassee, such as eye exams and physicals.  This is per Title 38 because I am rated at over 30% disability.  Title 38 also says that for medical services not part of a scheduled appointment should be paid one way travel [70.4 (c)].

[VA Tallahassee and Gainesville refuse to mail glasses or provide travel pay]

31 minutes ago, broncovet said:

 

My VAMC wont mail eyeglasses either.  There is a reason for that.When you order glasses, they measure you and your glasses are custom "fitted" to your face.  When the glasses arrive, the optomitrist "tweaks" them so they fit properly on your face.  If the glasses do not fit properly, it can make you somewhat crosseyed or cause vision and other problems.    I got headaches once...and adjusting my glasses fixed the problem.  They get bent out of shape somewhat easily.  If the new glasses can not be adjusted properly, then they will have to be sent back for a remake.  This is what happened to my wife once.  

If this contractor mails you your eyeglasses, and they dont fit you correctly, and in adjustment, there is some liability for them if you tried to sue them.  

They are not trying to do you wrong..they want to make sure the glasses fit.  I dont like it when they mail them out, on more than one occassion my "brand new" eyeglasses did not fit right and had to be adjusted.   It is not particularly easy to "measure" someone's face...try it some time.  

Optomitrists and technicians go through training to fit your glasses, and it is unlikely you attended this training, and may not even be aware whether your glasses fit you correctly or not.    I was not.  

Do they pay you any travel pay when you pick them up?

I heard from many vets that do get their glasses mailed to them.  A couple have said they get them adjusted for free at Walmart.  The eye clinic at Pensacola mails glasses and tells vets they can get them adjusted at Walmart--I talked to them last week.  I chose to live near a military base where I can get my glasses adjusted.

[VA Tallahassee and Gainesville refuse to mail glasses or provide travel pay]

I live 108 miles from the VA clinic at Tallahassee.  It is the nearest clinic to me, that I know of, that provides eyeglasses.  My husband and I have been going there every year for exams and eyeglasses.  From the beginning, they told us we would not get travel pay to pick up our eyeglasses because it was not a scheduled appointment.  This year, instead of making the round trip of 216 miles, we requested the eyeglasses be mailed to us, but we were told they don't do that because of Florida state law.  I asked to see a copy of the law, and they sent me "APPENDIX A to MEMORANDUM NO 136-4" dated March 6 2009.  The memorandum does say they do not provide travel pay for picking up prescriptions, glasses, and prosthetic equipment.  It does not reference a statute for this decision.  

I checked with two other clinics in Florida, Pensacola and Viera, and they both mail out eyeglasses.  I contacted Gainesville, and they do not.  It just so happens that their optical shop is run by the same contractor as Tallahassee - Superior Optical Labs.  The Gaineville optical shop faxed me their policy that says they will not mail eyeglasses unless the vet is incapacitated, in assisted living, or live out of state.  Once again, there was no legal reference for the policy.  I asked the Tallahassee clinic about the "out of state" policy, and they told me they will mail glasses to a vet that lives 50 miles or more away in Georgia, but will not mail the same glasses to vets that live in Florida (keep in mind I live 108 miles away).  Besides saying it was state law, I was told it was also so the veteran could get the eyeglasses adjusted - I explained that I could get the glasses adjusted at the base 20 miles from my home, and that the Pensacola clinic told me they let their patients know that Walmart would adjust the glasses they mailed out for free.  At this point, the clinic offered to mail my eyeglasses to me, but I explained that I had already picked them up because of the policies that had been quoted.

All of this appears to violate Title 38 which says that unscheduled medical care should be reimbursed "return" travel, i.e. one-way.  Also, the Tallahassee memorandum said they will only pay travel from city limit to city limit, whereas Title 38 says travel is reimbursed from "the beneficiary's residence to the nearest VA facility where the care or services could be provided".  How can they choose to ignore Title 38?

I have put in a formal complaint to the VA on the practices at Tallahassee and Gainesville through the IRIS website.  I also submitted a claim for travel to the Tallahassee clinic.  Per 70.30 to Title 38, if the clinic refuses to reimburse me, they have to do so in writing and advise me of my rights to request consideration or appeal. 

I have posted some of this on a Veteran's Facebook page, and veterans all over the country tell me their VA will mail their eyeglasses to them, or they receive travel pay to pick them up.  The only issue I have found is where the optical shop is contracted to Superior Optical Labs.  

This isn't just about me and $40 in travel pay.  I hope to get the unfair practice by Superior Optic Lab and the Tallahassee and Gainesville clinics changed because it is affecting many veterans.  If there is any other action I should take, I am open to suggestion.  Thanks.