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Marineleo

Seaman
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About Marineleo

  • Rank
    E-3 Seaman

Previous Fields

  • Service Connected Disability
    70%
  • Branch of Service
    USMC

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  1. I just wanted to give everyone an update; We just got our phone call from the higher level reviewer- (HLR request filed May 10). He was out of the Seattle Office and we FINALLY got someone who knows how to read!!! I was getting ready to start quoting law to him and he told us immediately he's a veteran himself and wanted to apologize profusely for the clear errors on this claim. He stated that he is documenting that the VA failed in their duty to assist and that the medical opinion listed in the file is "complete and total crap". Apparently the Dr who wrote the medical opinion contacted the VA and offered her apologies stating that she realized she was mistaken in stating that his STRs had no documentation of intestinal issues or resection. (It might have had something to do with a certified letter we sent to her advising her we were considering legal action for medical malpractice due to her completing medical documentation in gross deviation from the facts of record available to her which she inaccurately cited.) He said that the VA already ordered a NEW opinion which is completed and favorable but since it was done AFTER the HLR was filed, he technically is not allowed to use that for consideration. So, Long story short is he is filing the notice of error and basically "remanding" it back to the decision board because he said once that happens, they will officially have access to the new opinion and can issue the service connection. He is also documenting that our claim has been continuously executed for the last 2 1/2 + years and that the service connection date should go back to the original filing date. Nothing "official" yet, but he estimated we should have service connection within 60 days. I will post an update when we get it confirmed!
  2. Berta (and all the others who have responded with lots of good comments and suggestions!) Thank you for all your helpful insight and time! I have spent so many hours researching and writing and submitting things to the VA I feel like it's a second full time job! (It took us 2 1/2 years to get his PTSD service connected- 70%) and I've reached the conclusion that they just deny things for the sake of denial in the hopes that people will either give up or die while they're waiting. The VA is an absolute joke of a system and it's appalling that they treat veterans the way that they do. (On a side note- any Seal team fans out there besides us wondering if CBS having the courage to call out the VA on a national TV show will light a fire under anyone in D.C. to do anything?) I told my husband that when I retire I'm going to spend my days camped out at the closest VARO so I can help other Vets who are just getting started on their claims and have no clue what they're walking into. I was kind of confused on the 38 USC 5109(a) because of the language referring to appealing to the Secretary so I thought that was only for CAVC decisions and yes this is just a VARO decision. On the attachments with the CUE (the 18 pages of Service Treatment Records I shared at the beginning of this post) I wrote the name and file # at the top of each page and labeled them as attachments p. # of # at the bottom of each page. I was going to fax it to Janesville using fax by email because this generates an immediate auto receipt with the number of pages submitted and verification that they received it (and also gives me a verifiable paper trail so they can't say, Well yes we got an envelope from you but No we didn't see that document inside.) I wasn't sure about the first person vs using "the Veteran" (I guess I've spent too many hours reading the BVA and CAVC decisions and had the third person language stuck in my head!) Any thoughts on getting another IMO from a Gastroenterologist to add to this in the form of "reopening with new and material evidence"? I feel like if we already have the CUE and the Higher level Review going it might be "too much" or too confusing if we do that. I also wasn't sure if that would even make a difference since their "argument" isn't that there's not a connection between symptoms and surgery but rather that they can't "find" any record in his STRs that the surgery even took place? Thank you again everyone for all your help!
  3. Attached is the CUE (with the annotated/ highlighted service records as the attachments) and a copy of the decision letter. I've read it over multiple times and don't see anything that stands out to me other than it seems kind of odd that 90% of the "evidence" listed is documents that were previously filed for his (already granted/ service connected) PTSD. Would this normally just stay in the evidence list even though it has nothing to do with this claim? CUE 4-27-19 , REDACTED.pdf Decision 4-27-19.pdf
  4. Should we wait and see if we get any response to the "higher level review" under the new appeals program first or just tell them to disregard that and skip straight to the BVA? Do you have to have an attorney for the BVA appeal or do you think we could win since this is a pretty straight forward case and we have all the records?
  5. That's all he filed for was the actual surgery/ resection and the question is HOW/ WHY can they deny it when we've literally even given them copies of the service records and they say there are no records showing this?!! Yes, he was 17 at enlistment, turned 18 in boot camp. The VSO (FDVA) said hire an attorney. We talked to several and everyone wants to try and make it a TDIU case because he already has 70% for another condition but he is still working. I get that 80% is better than nothing but it seems like such B.S when it's literally right there in black and white. Wish there was a way to get even 5 minutes with a rating officer to hand them those records and ask them to explain how they feel there is no documentation that this happened!
  6. I am absolutely dumbfounded by the VA's inability to read ! My husband filed a disability claim for the removal of 1/3 of his Intestine (and the large painful residual scar) that was done WHILE ACTIVE DUTY. (The resection was specifically filed as 38 CFR § 4.114 - Schedule of ratings -digestive system. 7329 - Intestine, large, resection of: With symptoms, objectively supported by examination findings). They denied it, so we added supplemental information which included copies of his Service Treatment Records (Attached) that clearly show they did a Hemicolectomy, AKA Resection of Large Intestine. We later submitted an Independent Medical Opinion from his primary care Dr that stated that he has ongoing symptoms and that these symptoms were "more likely than not" a result of the resection of his large intestine which occurred in service and also submitted color photographs of the very large abdominal scar with and without scale. They denied it again so we filed a CUE. They finally after 2 years sent him for a C & P exam at which he handed the examiner his service treatment records. She wrote that she thought he "may have had a resection of his SMALL intestine" (which is a totally different procedure name than the Hemicolectomy cited in his operative report). They also requested a medical opinion from another one of their own Dr's who wrote "It appears the Veteran had surgery in 1982 prior to enlistment". Wait, What??!! Nope, He never had any kind of surgery before enlisting in 1984- as evidenced on his enlistment physical records. She also stated that "There is no evidence in the Veteran's Service treatment records consistent with any intestinal issues or a partial colectomy". And now they've denied it AGAIN ! The denial letter reads; Service Connection for Intestinal Bleed & Colon removal, claimed as Resection of Large intestine is denied since this condition neither occurred in nor was caused by service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. We did not find any link between your medical condition and military service. Your VA Medical Opinion stated the claimed condition was likely than not (less than 50 % probability) incurred in or caused by the claimed in service injury, event, or illness. All of your medical records were reviewed. There is no evidence of any intestinal issue that would lead to surgery during active service. The VA exam conducted on April 12, 2019 diagnosed you with resection of the small intestine, GI bleeding with Polyps. Service Connection for Scarring, residuals of Resection of Large intestine is denied since this condition neither occurred in nor was caused by service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. We did not find any link between your medical condition and military service. The VA exam conducted on April 12, 2019 for scars and disfigurement diagnosed a linear scar on midline abdomen, residual of partial colectomy. ------------- In the evidence listed that they considered is his service treatment records, the DBQ, THEIR Dr's medical opinion, but conveniently did not consider the CUE letter (with attachments) we filed, the IMO from his primary care Dr, or the photographs we submitted of the scar. So we filed another CUE and a request for a higher level review. My question is what else can we possibly do? The VSO straight up told us to hire an attorney but it seems ridiculous to give them the $ when the information is right there in black & white IN HIS SERVICE TREATMENT RECORDS!!! Anyone have any suggestions at all? I was thinking about going to the VARO (Bay Pines) and submitting information on nearby literacy classes for them since they clearly can't read?? *See attached service records- (Identifying info redacted- the copies we gave the VA weren't) Service Records Redacted and Highlighted .pdf
  7. The most recent decision where they state there was no new and material evidence was December 30, 2018. I asked the VSO about filing a CUE and I don't think he has any clue what's required to do that from all of the information I'm reading on here and everywhere else. He literally typed about two sentences on a 4138 that said something to the effect of,- Would this not be considered a CUE because we submitted these documents on this date and how is it not new and material evidence. ..... That was it. We've gotten pretty much no help from the VSO at all other than a point of contact to send in documents and someone to go to so we can look at the file regularly to see if there's anything new in it. Every time we ask him what to do, how to do it, or why things are denied he either has no answer at all or tells us something that makes no sense based on everything I can verify on my own looking on line.
  8. Thank you everyone for all the helpful information! I am typing up a CUE letter today using some of the other examples on here. Can I hand submit this at the VARO at Bay Pines? (It's a little over an hour drive but I would much rather put it in their hand directly and get the stamp on it showing that they received it). Can it just be in letter format on standard paper or is there a specific VA form that it needs to be submitted on/ with? Berta in answer to your question- Every time we've submitted something we've had the FDVA VSO submit it via FAX and have saved all the confirmation pages showing that it was sent/ received. The VSO also pulled it up in the file to confirm that all the documentation we've submitted is in there. We did not get a 5103 Waiver. They had issued the initial decision, we responded back with the highlighted copies of the surgical records (in case they somehow missed it in the other medical records), the Nexus statement from the primary care physician, and the photographs of the large midline scar. They responded back that it remains denied because the evidence submitted is not new and relevant. It includes a 4107 and 21-0958 to fill out but I'm not seeing a date for appeal?
  9. VSO is FDVA. We did contact them and he said it makes no sense to him either but he wasn't very helpful in offering suggestions. He said it looks to him like they just plain didn't read the information we sent them. When we previously submitted all the documentations, we highlighted and circled all the dozens of places where it shows DIAGNOSIS: Gastrointestinal Bleed, PROCEDURE PERFORMED: hemicolectomy (removal of the descending colon). He submitted a 21-4138 asking them how the information we submitted was not new and material evidence but that doesn't seem like something that's likely to get anything accomplished. I just can't comprehend how service records showing the surgery while on active duty don't clearly create the service connection??
  10. I need help with a CUE, (and deciding if it's worth filing or if we should just contact an attorney to file a NOD). My husband filed disability for 1. Large Intestine Resection with moderate symptoms (7329) & 2. Residual painful scarring; status post left hemicolectomy. (7804). We provided to them his IN SERVICE active duty surgical records showing the emergency surgery was performed due to an intestinal bleed. They issued their decision stating that "Service connection is denied since this condition neither occurred in nor was caused by service. There is no objective evidence to support the claimed condition of intestinal bleeding or ulceration; There are no medical records to support the veteran's claimed colon removal. Therefore it is less likely than not that the veteran's claimed colon removal was incurred in or caused by surgery while on active duty." We responded with "new and material evidence" sending ADDITIONAL medical service records which included the emergency admit records at Bethesda, the subsequent clinical medical notes and follow up treatment records and the lab records showing their examination of the 7 1/2" of removed colon. We also sent color photographs with and without scale of the large abdominal scar and a Nexus statement from his current primary care physician stating that his current and ongoing symptoms are more likely than not a result of the prior surgical procedure. They responded back that the claim "remains denied because the evidence submitted is not new and relevant".???!! Will a CUE help? If so, is there a "form" we file it on or does it just get submitted on a 21-4138? What do we need to put in the CUE to explain that they're idiots and clearly did NOT look at any of the medical records if they think he did not have a GI bleed and surgery? I don't understand how/ why this can be denied when we have all the medical records showing it happened while he was on active duty?
  11. I need help with a CUE, (and deciding if it's worth filing or if we should just contact an attorney to file a NOD).  My husband filed disability for  1. Large Intestine Resection with moderate symptoms (7329)  &   2. Residual painful scarring; status post left hemicolectomy.  (7804).  We provided to them his IN SERVICE active duty surgical records showing the emergency surgery was performed due to an intestinal bleed. 

    They issued their decision stating that "Service connection is denied since this condition neither occurred in nor was caused by service.  There is no objective evidence to support the claimed condition of intestinal bleeding or ulceration; There are no medical records to support the veteran's claimed colon removal.  Therefore it is less likely than not that the veteran's claimed colon removal was incurred in or caused by surgery while on active duty."  

    We responded with "new and material evidence" sending ADDITIONAL medical service records which included the emergency admit records at Bethesda, the subsequent clinical medical notes and follow up treatment records and the lab records showing their examination of the 7 1/2" of removed colon.  We also sent color photographs with and without scale of the large abdominal scar and a Nexus statement from his current primary care physician stating that his current and ongoing symptoms are more likely than not a result of the prior surgical procedure.  

    They responded back that the claim "remains denied because the evidence submitted is not new and relevant".???!!

    Will a CUE help?  If so, is there a "form" we file it on or does it just get submitted on a 21-4138?  What do we need to put in the CUE to explain that they're idiots and clearly did NOT look at any of the medical records if they think he did not have a GI bleed and surgery?  I don't understand how/ why this can be denied when we have all the medical records showing it happened while he was on active duty?

    1. Tbird

      Tbird

      please post this on the Veterans Affairs Claims forum

    2. Marineleo

      Marineleo

      Sorry, I'm new- Do I have to create a new post or how do I do that?

       

    3. Marineleo

      Marineleo

      I think I got it

       

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