JKWilliamsSr

While I feel my C-File is missing a lot of rater attention I will have to say that there is one piece of really good info in there. I am currently rated 10% for Bronchitis but originally filed my claim for Asthma. Now the reason I am not service connected for Asthma is 100% my fault. I did not submit the necessary information to support that claim but there is information in my record that would have made it a slam dunk if I had. I have been diagnosed with Asthma since around 2004. My claim for asthma as deferred and the VA did state that I needed to send proof of an asthma diagnosis. I just did not. A the time I was going through a pretty bad divorce and just did not focus on it. Like I said my fault for not sending in the records. The VA in their deferral decision states "Examination dated 4/1/2010 diagnoses Asthma/Bronchitis related to symptoms in service." There is also a statement that states " Va examination dated 4/1/2010 diagnoses Asthma/Bronchitis at least as likely as not [50/50] probability that the veterans current sinus condition, bronchitis, asthma symptoms are similar to the sinus/bronchitis symptoms that he had while in military." If I would have just sent in my medical records I would have been rated for asthma. Something I plan on correcting. It is great news because this information is already listed in my C-file I will not have to jump through hoops to service connect my asthma.

Asknod., I agree with you 100%. After receiving my C-File over the weekend I have come to a clear understand of how the VA works or more accurately does not work. Now I have to accept some of the blame myself for now educating myself properly. That is on me. However, the VA should be ashamed of themselves for the way they adjudicate claims. Looking at my file I can see where they gave me blanket denials and provided no iinformation. It wasn't until I filed my NOD did I get a direct statement as to why there was a denial. They will not do any real legit work unless they are forced to do so. I understand that now. My claims are not designed to make the job easy for the rater. It is to provide all the necessary legal information necessary to win on appeal.

I agree they have gotten better but the major issue is that they have to be forced to look at things. One of my older denials was based on "Not Well Grounded Claim". In other words if the rater did not think it was a good enough they could just deny it. That time frame ties ties into when they initially denied you. The law was changed in 2000 and "Not Well Grounded Procedures" ceased to exist. In that original denial the based it off of records from 1986-1989. My service years are from 1986 to 1996 so the did not look at 7 years of records. Then instead of looking at the full record they deny me based on my not submitting new and material evidence. In other words they pretty much said.....they are not going to look at anything. I need to point out their specific failures. The VA uses the law to their advantage as well. They know a large number of veterans do not know how to argue legal precedence and how to point out their legal errors.

Of this I am in complete agreement. I did not know how important until I started posting here and on a couple facebook pages. The consensus about the importance of the C-File is the same across the board. It is funny that some of my claims were denied because new and material evidence was not presented when the very evidence needed is actually IN my C-file. They just never looked at it. Bottom line is that if I do not specifically point it out they will not bother to look at it.

I swear I could be a case study for the VA's process of straight blanket denials. My C-File is devoid of really anything useful. There are no rater notes anywhere the tells me how they came up with their decisions. The documents that have the most information is the statement of case I received when I filed my appeal back in 2010. Other than that it took me a while to find anything a VARO actually did. In fact the only reason there is any detailed information is because I filed a notice of disagreement. Otherwise there would be very little information in my file. It appears my denials are based of the initial review for benefits after I separated in 1996. The reason is stands out is because in the statement of case for my 2009 denial for back benefits a statement is included from my 1996 denial with the exception of a major key point.... the dates. My most recent statement of case states. SMRs showed episodes of discomfort sprain, and spasms from without a diagnosis of a chronic condition. Here is where a big problem exists..... the entire statement actually reads SMRs showed episodes of discomfort sprain, and spasms from 02 86 to 08-29 89 without a diagnosis of a chronic condition. The dates were omitted in my 2009 denial and the sad thing is that there is at least 6 visits to the doctor after 1989 for back issues. It is like they did not review any of medical records after 1989. All in all getting my C-File helps me because I see that the VA has no real intention of giving me benefits. My files shows that if I am going to actual beat them I need to hand feed them every single disability step by step.

I recently heard that if during a C&P exam if the examiner lists something that was not claimed by the veteran it becomes a pending claim and the VA is required to adjudicate it. In this video the person stated that because of this they won a claim for backdating. I was not certain if I am allowed to link the video but will if one of the mods say it is ok but I will give a synopsis of what was said. His claim was for knee issues but during the examination the examiner noted in the the "HEENT are significant for frequent headaches which are felt related to eye strain as well as frequent upper respiratory infections"...... (HEENT is a medical abbreviation for head, eye, ear, nose throat) The veteran did not make a claim for headaches at all. He stated in this video that because the examiner made a note of this in the record it automatically became a pending claim and the VA was required to adjudicate this and if the did not do so it would remain in as a pending claim. He stated that when he did file for headaches he won the appeal and got back pay all they way to the date the original examiner made a note and the rater did not make a decision. Now my question is if this is true? I am going to assume it is because the guy won the appeal but I cannot find the regulation, law or any information that discusses this. Google who is normally a wonderful friend has not been so in this case ..... Anyone know where I can find info on this?

I am still preparing my claim as we speak. I filed my intent to file back in December. I have a full copy of my SMR's as well as a copy of the VA medical records. I would prefer not to submit before I get a look at my C-File but will not let it stop me. I am working on setting an appointment with the Ellis Clinic and once I get that done I will submit my file with or without looking at my C-File.

I think $18k upfront is too much to ask someone. There are some companies that can help you and you only pay based on what your increase is. I have been in touch with two companies that seem legit and they are expensive as well but you only have to pay if you get an increase. I would look into them before sending such a large amount of money with no increase. I will not mention names because I don't know if it violates any rules. I personally did not use them but know a few people that have. I felt I am able to do myself what they offered. Not everyone can put together a claim the right way. I know I screwed it up myself with my first claim but I have learned a lot over the last year or so. If you want information just send me a private message. I can't guarantee their effectiveness because like I said I have not used them but if you need assistance maybe they can help or even an attorney as well. If you think you can do this on your own it is like Vetquest said. Maybe we can help you out to get you started and then go from there.

Probably not a bad idea...... Do you have the email address? I am also contemplating calling the white house hotline. I am annoyed because while I know it may take some time I think 7 months is unreasonable. In March I submitted an IRIS inquiry on the status of receiving my C-File and got the standard bureaucratic answer. At the time my request had an estimated date of late April. After I got my response from IRIS it jumped to a July date. My claim was received Jan 14th. It went into initial review on February 4th and from there it will take until July to copy my C-File and send it? Unbelievable.

I sent for my C-File in January and still have not received it. I do know they have the request because it is in Ebenefits. I checked recently and it stated it will not be completed until July. Makes no sense to me to be honest. Anyone have a suggestion on what I can do to maybe get my file faster. It is holding me up on filing the rest of my claims.

My question is this. Is it a good idea to list case law in your statements in support of claim? Or even adding separate statement that lists all the case laws that support a claim? I personally think it would be a good idea to do so even at the risk of upsetting rater. I personally do not have confidence of any rater properly deciding my claim or anyone else's for that matter. I am not saying that all raters are bad but there is a large number of bad decisions and we as veterans are probably just as likely to receive a bad decision as often as we receive a good decision. I base this from what I have read here as well as on a couple facebook pages. Two immediately come to mind. 1. Someone posted an excerpt from a BVA decision overturning his denial where the decision stated (I am paraphrasing) - A veteran was denied service connection for diabetic neuropathy and rater stated they could not find a connection for the current claim of diabetic neuropathy and their SERVICE CONNECTED Diabetes. 2. A veteran was denied service connection for a disability because they could not find any mention in their SMR. This was discussed in a facebook forum. The veteran stated that the disability was secondary to a current service connected disability. His assumption was that the VA would connect the dots for him. This led to a long debate about this because there were some that said the VA does not do that and others stated that the VA is required to connect the dots. I was on the side where the VA was required to connect the dots because of their duty to assist. While I disagreed with the side that said the VA is not required to do this I did see the logic where they were saying you have to connect the dots for them yourself. Don't assume they will make for you. I do recall in the past (IIRC) the form did not give you the option to file a claim secondary to something. I do know you can do that now on ebenefits but I don't remember getting that option when I last filed in 2009 But I digress. The main reason I make the request is because I see a lot of claims denied because raters are completely ignoring Buddy/Spouse/Lay statements and I feel if you have the law sitting there right in front of them it may not be so easy for them to just deny the claim.

Because of that you will win on appeal. An easy slam dunk to be honest. It is sad that it will actually have to come to an appeal though. I have been reading a lot where raters are completely ignoring one exam over another. The assumption I guess is that they have to choose. Federal does not allow that. They by law have to side with you UNLESS they can justify it with a legit medical opinion.

Ahhhh ok. Did not know that. I am working on gathering my information to send him the paperwork. My hopes is to get an appointment with him sometime within the next couple months. I am probably looking at July....just will not have the funds for the payment until around then. Did your examiner say why your claim was not favorable?

When you submitted your claim and the information from Dr. Ellis did you also upload his Curriculum Vitae?

VA math is not linear. They use a formula to determine percentage. I normally use this calculator to help me calculate. https://www.hillandponton.com/va-disability-calculator/

My thoughts are this. If you have the evidence necessary to support your claim submit it. Include all the disabilities you feel your qualify for. It makes no sense to submit them in batches. I just don't think that is smart. He made it seem like raters were going through small stacks first and working their way up. Well to be hones that is called working smarter not harder. In my job I would do the simplest jobs first to get them out of the way and then progress to harder tasks.

I had a discussion with someone about the number of claims that should be filed at once. Someone told me that VA Raters have a quota for the number of claims that must be completed per day. Because of this he suggested keeping the number of claims initially filed to a minimum. He said that if you had a claim that was fairly large with a lot of disability claims it could be bumped to the bottom. Now to a point I can see the logic behind that but at the same time I don't think that is efficient. He actually said your claim should only have 3 or 4 claims and when that is completed you file 3-4 more until completed. He said this is the fastest way to get your claims finished. To be honest that made absolutely no sense to me. So that leaves me with a couple questions. What do you think about that? and if you think amount of claims should be minimal what number do you suggest initially?

I am not familiar with the PTSD rules but does the VA require veterans are treated by VA docs for PTSD or only require a diagnosis?

Awesome. Thanks....this helps a lot.

Buck did you put specific dates or date ranges? My wife made the comment while starting a letter for me. She asked me about dates and said she could not pinpoint dates because she sees my symptoms pretty much ever day and they have been ongoing for years.

As a layperson, the appellant is competent to provide information regarding visible, or otherwise observable, symptoms of disability. VA has a duty to inform a claimant that lay evidence may be submitted to associate symptoms of disability to military service. Case law on this is Washington v. Nicholson, 21 Vet.App. 191 (2007) SwiftSig regardless of what the examiner said make sure you upload every lay statement you have in support of your claim. I will not speak to the credibility to what is in them as I am not privy to what was written but at a minimum they are required to be considered. That is a matter of law.

This right here is why no one believes the VA cares about the Veterans it is supposed to support. Not only was this person wrong. she is also pretty ignorant and does not know how to do her job. There is case law that requires the VA to consider Lay statements. Not only are they required to consider them if they deem them "worthless" like this person has done they have to specifically say why. Now I could be wrong on this so I am going to research it further. I remember reading somewhere and there is case law to support it but the VA is required to tell you that Lay Statements can support your claim as part of it's duty to assist. If I am wrong on that someone can correct me and I will continue to try and back this up with some facts.

I think Bronco hit it dead on. I think people may overthink lay statements and try to do more that what is necessary by adding information that may not necessarily be relevant but used against you. I think lay statements fall into two categories, physical and mental and how that information should be presented is different. Mental (PTSD, Depression, etc..) - Letters from a spouse here can be tricky and it is here where I feel Bronco's comments really hit the mark. Mental disabilities are so subjective it is not even funny. It is probably very difficulty to be on the same page with someone that views things differently than the veteran. If the letter has some discrepancy in it as far as not being on the same page the rater probably often uses that to question the validity of the spouses statement. One person's interpretation can be different than someone else's and that often can come back to bite someone in the but. Physical issues are probably easier to document in lay statements. I think where people tend to get into trouble is they will say things like I noticed my spouse was limping and he stated his knee was hurting and it was because of his arthritis. Once a statement like that is made the rater will assume that the spouse is making a diagnosis that the knee pain was caused by arthritis and then ignore the lay statement. The only think that needed to be said was I noticed my spouse was limping and he appeared to be in pain and he complained that his knee was hurting. That is all that needs to be said. Nothing more. It is a statement that shows you observed an issue.

I personally believe that a letter from your spouse or significant other is one of the most important pieces of evidence you can have inside your claim. I believe that many examiners and raters do not consider them important and tend to dismiss them and give them no credibility. However, on appeal it is something that seems to be a deciding factor in overturning a poor rating decisions by the BVA. There are two important pieces to this letter that I believe is critical. 1. Your spouse should only list symptoms they see. They should never state in the letter a diagnosis. If your letter has a diagnosis in it and your spouse is not qualified to render a diagnosis the rater will immediately ignore it. 2. Your spouse should state how your disabilities impact your day to day living. What things you could do in the past but cannot do now because of your disabilities. No one is more qualified to stated how your daily life is impacted than your spouse. I think anything else in the letter would be overkill but that is just one man's opinion.

I have decided that I am going to go this route an contact Dr. Ellis and set up an appointment. It is probably the smart thing to do for those of us that are claiming secondary conditions. After discussing things with all of my civilian doctors the seem clueless as to what is needed in order to get service connection. One doctor even said to me it should be obvious. They seem to be willing to fill out the DBQ but tend to not have an understanding on what is actually needed. The diagnosis part seems to be easy. The VA required terminology......not so much. So I think it is best get an examination from a doctor that can look at all my medical records, give me an exam and help dot all the "i's" and cross all the "t's" After reading a lot of the posts here and from a couple veteran facebook groups I belong to, I have zero faith in the VA's "desire" to help me. There is wealth of information here and I truly am thankful for everything you guys do here. If I have learned one thing it is this. When dealing with the VA I am in way over my head. While I may be intelligent enough to understand what is going on and to see the fallacy in the system it does not mean that fighting it will be a walk in the park. To me it feels as though I am completing my claim for submission to the BVA instead of to the local office for a rating.