Kelly Severance

Sorry for the long post. I am just trying to figure out what is going on..... Some of you may be familiar with our journey, but some may not, so I will try to fill in the gaps. My husband received his BVA decision packet in March, 2018. Migraines increased to 50% and TDIU remanded. The grant portion was settled in April 2019. Also in April 2019, we began receiving correspondence from the VA that they were working on the remand. Send any other medical records, employment info release form, medical records release form. We did all that. Then nothing until November 2019, when I emailed the BVA for an update. Their response : Thank you for your inquiry. On October 29, 2019, Atlanta Regional Office (RO) determined that you recently submitted a letter from your provider opining that migraines, PTSD, and Tinnitus makes you IU. Previous development was conducted in October 2017, but the evidence indicates your status may have changed. So, Atlanta RO needed additional development. Thank you for responding to their development letter. On December 12, 2019, your case was assigned to an administration team within Atlanta RO for appropriate action. Please contact our office if you need additional assistance. The "previous development" they referred to was for the original TDIU claim (which was denied in December because he was still listed as employed by the VA). The "Letter from your provider" was uploaded into this file by his VSO in August 2018. Also Nov. 2019, we received correspondence from VA requesting another 21-8940 form be completed and turned in. WE did that. December 2019, a claim opened in ebenefits for INCREASE (It listed TDIU, Migraines, PTSD, and Tinnitus) all of his SC disabilities. December 2019 he received 3 letters scheduling exams (Migraines, PtSD, and Tinnitus). Went to all of those. January 23, 2020, that claim closed. It was still listed in the 'gathering evidence" phase, but when I clicked on "details" in VA.Gov, it said that a decision had been made and a packet sent by US Mail. January 25, 2020 that claim completely disappeared from ebenefits and va.gov. It has not reappeared yet. All other historical claims are still there AND the Appeal/remand is still listed as open. January 30, 2020 a big white box arrived in the mail, which I believe is his C-file. It contained medical records, past decisions, VA correspondence, his VES exams from December (which we had not seen yet). We did NOT request his C-file. I still don't understand why it was sent because from my understanding, it is difficult and timely to get a copy. In the C-file I found an interesting document that I had not seen, nor had knowledge of: Form 21-6789 Deferred Rating decision dated Oct 29, 2019. Reason for deferral: 8940. In the notes it states: Please develop for a current VA form 21-8940. VAMC treatment records indicate the veteran has medically retired from his VA nursing job since we received his last VA for 21-8940 on 5/8/2017. Please develop for Social Security Disability records. RVSR notes to file: Veteran recently submitted a letter from his provider opining that migraines, PTSD and Tinnitus make him IU A 10/29/19 SHARE inquiry indicates SSA was denied. SSA development was conducted in Oct, 2017, but the evidence indicates the Veteran's status may have changed. Now on to the VES exams. Headaches DBQ: In the Functional impact section: The doctor answered "Yes" that his headache condition does impact his ability to work. In the "describe the impact" he states "3-4 times a week unable to report to work or complete assigned tasks". In the Remarks section there are 3 questions. # 2 Seems to be most important where they ask if the veteran's diagnosis has changed or worsened. The examiner stated "There is a worsening of the veteran's symptoms however no change to the service connected diagnosis and no additional diagnoses have been rendered. Question 3 asks how the veteran's impairment impact occupational and employment activities, including sedentary work. The examiner answered "3-4 times a week unable to report to work or complete assigned tasks". PTSD DBQ: Under the "Occupational and Social Impairment" section the examiner checked the box "Occupational and social impairment with reduced reliability and productivity". In the remarks section the doctor answered the same question listed above by stating "There is a worsening of the veteran's symptoms, however no change to the service connected diagnosis and no additional diagnoses have been rendered". Tinnitus DBQ: The doctor remarked to the same question listed above "There is no change to service connected diagnoses and no additional diagnoses have been rendered" Soooooooo.............Here we wait. We still have not received a decision packet (that closed on Jan 23) and there is no update in ebenefits. We have done an IRIS inquiry and emailed the BVA again, but no response yet. Any ideas of how this puzzle might come together and when?

Hello MandyP. This is exactly what happened to us. My husband's remand (TDIU) was being worked (finally) and we were getting requests for any further medical records, etc. That started in May 2019. I usually correspond with the BVA through email concerning the status of the appeal. In October, we were told it was "ready for decision", but by November, still no change. So I emailed them again. The correspondence said that the VARO had found a letter from our Primary care doctor stating that that my husband was unemployable due to his SC disabilities, so his case had been assigned to an administrative team in Atlanta for further development. Around that same time we received another letter stating that they were working on the remand and needed him to fill out an 21-8940 (which we had already done in May 2017, which was denied and then added to his appeal). So we did complete the form. I asked around and researched, but could not find any info as to whether or not we should do it, because my worry was that this would change his EED from May 2017 to November 2019. So we did fill it out and send it in. Once they received it, a new claim opened in VA.gov and ebenefits for increase (TDIU and his other 3 Service connected disabilities). After a few weeks that claim closed and said a decision packet had been sent by mail. THEN THE CLAIM DISAPPEARED FROM EBENEFITS AND VA.GOV......JUST GONE! We have not received the decision packet yet. However, the APPEAL still remains open in VA.gov. So we have no idea what is going on.

Thanks GBArmy. I just can't figure out who requested it...........But we are hanging on!

So get this........today we got a big white box in the mail from VA evidence intake center. In it was every medical record, va correspondence, claim, etc in it. It even had the results from the 3 VES exams he had in december. His only 3 SC disabilities are PTSD, Migraines, and Tinnitus......but it is the migraines that keep him from work (which we identified in the paperwork). The doctor stated that his migraines (which are already rated at the highest % (50) have worsened and with 3-4 each week, he would not be able to report to work and perform assigned duties. The one for PtSD also stated that his condition has worsened, but did not impact work. I also found in this big box where they had done an SSA inquiry and that he has been denied his SS disability :(. That's all I have for now! But as I searched through this document (maybe a C-file?) I did not find a decision letter......

Thanks for the response! Vetquest, the "Appeal" status is still listed as open. I am assuming that if the VARO denied the IU again, then the appeal will go back to the BVA. But the claim where they were working the remand for TDIU closed (and disappeared). So I am doing the only thing I can......Wait! .

And now that claim has completely disappeared from va.gov. It's not even listed in the historical claims. On wednesday, the status still said " review/evidence gathering" but when I clicked on details, it said it was closed and a decision packet had been sent. On Friday, the claim had completely disappeared.

So update, the claim that opened when the VA started working on the remand was closed yesterday in VA.gov. There was no change in Benefits letter, so we are assuming a denial of the TDIU claim/remand. However the appeal status still says "open" and has not updated since March 2018. I assume that now this will go back to the BVA?

I have this feeling that this may happen in our case as well. If the IU is granted, we will definitely fight for the correct EED. Question, why did you do a HLR instead of having it sent back to BVA for the correct EED?

Thank you Broncovet for your reply. To answer your question, Yes, we did file in May 2017, it was denied and then added to the appeal for the migraine increase at his hearing. In October, they did send us a new form and we did complete the form they sent and upload it into ebenefits. Hopefully the form they sent was the most recent! I would HATE to have more delay because of a dated form......

Vetquest, thank you for your reply. Yes, we were concerned about filling out a new 21-8940 form for the very reason you listed above. He filled out one in May 2017, and it was denied. When the BVA made the decision to increase the migraines (on appeal) the judge took jurisdiction over the denied IU (as he stated he would at the hearing in April 2017), but then remanded it for further development. So in October of this year, when we received correspondence (the letter said they were working on our appeal) from the VA requesting another 21-8940, we were confused and of course worried that, if granted, the EED would be from the newest form (Oct. 2019) instead of May 2017.......but for fear of being denied, we complied with all of their requests, including private medical records that we had already faxed in. We will, of course, have it sent back for an EED if they grant based on Oct form.

Just an update and some background to help anyone understand the attached correspondence from the AMO. My husband's appeal for IU was remanded by the Judge in March 2018 decision (migraine increased to 50%, IU remanded). He had previously applied for IU in May 2017 after his hearing for increased migraine rating. He was denied IU in December 2017. We began to receive correspondence from the VA in April of this year (2019) requesting the documents that the judge ordered in the remand. We faxed those in immediately. Then no other correspondence for awhile. Then in October, we received more requests (including medical records, 21-8940, 21-4142). We uploaded all of that in ebenefits, including a letter from his primary care provider (private doctor) explaining that in his opinion, my husband is unable to maintain employment due to his SC disabilities. I emailed the AMO a few days ago and received this reply:Thank you for your inquiry. On October 29, 2019, Atlanta Regional Office (RO) determined that you recently submitted a letter from your provider opining that migraines, PTSD, and Tinnitus makes you IU. Previous development was conducted in October 2017, but the evidence indicates your status may have changed. So, Atlanta RO needed additional development. Thank you for responding to their development letter. On December 12, 2019, your case was assigned to an administration team within Atlanta RO for appropriate action. Please contact our office if you need additional assistance. This reply seems hopeful. I just wanted to update!

The overall rating is 70%. 10% Tinnitus, 50% migraines and 30% PTSD.

Thanks Vetquest and Paul. We already have the maximum rating for migraines. That was granted at the BVA by the judge in March 2018. We have also already received the backpay on that partial award. The only part of the appeal left unworked is the remand on TDIU. The remand order was also in March 2018. The only remand order was to acquire a few private medical records that were not already in the evidentiary record. So a couple of weeks ago, we get a letter from the VA saying they need us to fill out the 21-8940 and 21-4192 (we had already previously completed these forms in May 2017). So I'm guessing they wanted a more updated 21-8940 to continue processing the remand. My question is this, when the VA is working the remand, will they open a new claim? That's what happened a couple of days ago in VA.gov. A new claim opened (it said Migraine increase and TDIU increase).

In VA.gov yesterday, there was a new claim that had been opened for TDIU (increase) and Migraine (Increase). I was wondering if this means that the VA is working on our remand? They sent us a letter requesting further evidence as they work our Appeal, and they requested that we fill out another 21-8940 and 4192 (? I think). We had previously filled those out in May 2017. But we filled them out again and faxed them in. Now it is showing up as a claim in Va.gov. So my question is this: Is this typical protocol when they are working on the remand portion of an appeal? The remand is also still "open" in VA.gov.

Thanks so much Buck!

Hello All. Quick question. Apparently a new claim opened on Nov. 14 that said "Authorization Review". And it closed yesterday. Any ideas what this might mean. The only thing we have still is a remand for TDIU, and that is still listed as remand with no other differences in ratings. It also says that a decision packet has been mailed. Any help would be greatly appreciated. Thanks!

No. When I went on the site and followed the directions, it said that evidence for an appeal could not be uploaded. I went back to the letter from VA and used the number provided to fax it in. So I HOPE they got it..........but really no way of knowing!

Sorry. It was Legacy.

Hello Wayne. My husbands hearing was in april 2017. At that time, my husband told judge that he had been put on notice at work. The judge, in duty to assist, brought up TDIU, and stated that if the migraine increase was granted, then TDIU would be possible. So we filed for TDIU that day. He was denied TDIU by the VA in December 2017. Then in March 2018, we received the BVA decision packet that granted the increased migraine rating to 50% and gave us the overall rating of 70%. ALSO in that decision was a remand for TDIU. The only order in the remand was for the VA to gather some additional medical records that were not included in our claim. A few days after we received our reward for the migraines, we got a letter from the VA and a form for release of medical records, which we have already faxed back in, as well as sent the records they requested that WE had. So I'm hoping they are working on that . My husband has not worked in 18 months. Hope this helps. Good luck!

Thanks so much Paul and Shrek for your responses. I'm about to give it a try!

Hello friends. I am trying to upload more evidence for our TDIU claim. Anyone know how to do this in ebenefits?

Update Everyone. We got our Retro this morning. Thank you Jesus! @treysnonnaI hope and pray you all get some relief soon. 11 months seems like a long time to wait on retro once your % has been updated from a grant! @25th Infantry for LifeI hope that you get your closure soon! We were told a variety of different things over the last 14 months. Have you tried emailing the BVA directly?

Thank you Hollie! I don't know if they are sending the retro now or not. Ebenefits updated to the new percentage on saturday, but no retro yet. I've read many times that once Ebenefits updates, it's only a couple of days before retro.....but nothing yet......

25th, so your remand is in Prep, but nothing on your grant? Usually the grant is worked first. I wonder if they worked them together and "Prep for decision" is for both the grant and remand? My husband's migraines are awful too. Do you get Botox?

Yes. It looks that way Vetquest. It says on the AB8 letter that the effective date of our last change to current award was Dec 1 2018. But we have been receiving the "OLD" amount for the last 5 months. So I'm not sure what that means.......... I do know that the judge granted the increase in migraines all the way back to 2005 AND under "Disabilities" on ebenefits, It says that the effective date for Migraines is 6/2005.