doctorevil

bigoc, I was at 90, and now I am at 100%. As an added bonus, they also rated me P&T.

Claim closed out today, and I was rated for the maximum. No, thankfully vetquest, I didn't have to ply her with alcohol or get her flowers. I'm not sure why they told me anything. I was prepared to get the standard your claim is being worked lecture, but this was quite surprising. On the down side it looks like they jacked up my ED, so I will have to file a HLR for that. The put the ED as the date I filed my second supplemental and not the date that I filed the claim. All in all, I would say that I am happy with the process. I started on April 14, and after two appeals, I finally got a sane resolution after 7 months.

After calling Peggy on 23 SEP and letting them know they opened my appeal incorrectly, there was radio silence for several weeks. I checked Vets.gov last week and it showed they closed my HLR claim but reopened a new supplemental claim. However the date for the supplemental claim was 9 AUG, which was the date for my first supplemental. I found this to be odd and also I could not see any of the evidence I uploaded, so I called Peggy back today. I was told by Peggy that my claim was in the final review stages and it should be decided NLT 5 NOV. I also got Peggy to divulge that claim appears to be decided favorably for me and that there was a proposed rating in the system, but she would not tell me what percentage. So now, I sit and wait, but a little less anxious at this point.

I checked Vets.gov today and I noticed that they opened a HLR claim for me and not a Supplemental Claim. I find this odd since I faxed in new evidence and the form I submitted with the new evidence was on the supplemental claim form. I'm not sure if this is a good or bad thing, but I guess I'll have to call on Monday and see why they opened it the way they did.

So for those of you who are following, I submitted a second supplemental on 30 AUG. As of today, the claim still has not posted to Vets.gov. I called, last week to see if they received the fax, and Peggy stated they did not see it, so I resent it on 11 SEP. I called on 13 Sep to see if they had received any of my faxes and Peggy stated they had received them both and they were waiting to be scanned in. Thus far, this new supplemental claim has been in their possession for a little over two weeks and has not made any significant progress compared to my last supplemental which was "examined" and closed after only 12 days. The size of this fax was substantially smaller and the volume of information was much less to review, as this was only a new DBQ form. I'm not sure why it seems to be moving slower the second time around, but hopefully they will "examine" the evidence more carefully this time.

GBArmy, I did not have the DBQ in my initial claim or my first supplemental. I thought the evidence I submitted with my first supplemental was quite substantial and that Stevie Wonder would even be able to see the severity of my condition. Keep in mind that the rating criteria is simply a counting exercise, so I submitted 9 instances where I went to the doctor for a sinus infection and I only need to prove 6. Regardless of of the VBA calculates my visits, either incapacitating or non-incapacitating, I should meet the 30% threshold. I have also read every board appeal case related to sinusitis and all of them weight lay statements heavily due to the fact that most people don't go to the doctor for incapacitating matter. So, I thought the lay statement would help, which it still might if I have to go to the board. In any event, I was anticipating they would screw it up once I saw that Ebenefits did not update when they closed my appeal last week. Therefore, I got my ENT to summarize his last visit notes on the DBQ form. It literally contains the same information, it is just on the VA form for their convenience. He said they are simply not reading or translating his notes accurately. I am thinking that he is correct, that they are simply not reading the evidence. I really do not understand how they are coming up with their figures or how they do not understand medical diagnoses.

So I got the BBE today. Big fat denial. In their decision letter, they claim that they can only account for 2 instances of incapacitating sinusitis and 0 instances of non-incapacitating sinusitis. I find this to be odd because I sent them medical records from the past year where I went to the doctor for my sinusitis issues on 9 occasions. They make no mention as to what they classify the other 7 instances. Further, they completely discounted my personal statement and the statement I had my fiance write about my condition, which again is odd, as a non-incapacitating infection might be one that you do not go to the doctor for, and thus would not generate any medical evidence and could only be supported by lay evidence. They also ignored my ENT diagnosis of Acute Recurrent Sinusitis, which is defined as having 4 or more infections per year. On Wed, 28 AUG, I went back to my ENT for another sinus infection and had him complete a DBQ while I was there. We spend much longer than the QTC examiner did and he included by entire medical history unlike the VA examiner. I submitted a new supplemental claim today with the new DBQ once I got BBE just to ensure it did not contain any surprises. So my clock starts once again. We will see how long or short this takes.

Thanks GeekySquid. I'm a college professor, so this is what my students call me, though they do use it as a term of endearment. As far as VSOs go, this is the first time that I have ever used one for anything. I used to have DVA and when I asked them for assistance when I filed my first claim 5 years ago, I was less than satisfied. I now have the VFW and they are slightly better, as they were at least wiling to pull information from my C-file for me. However, they were a little discouraging when it came to file this claim. I believe the words the lady used were, "not very likely to succeed." Well, I have battled the BVA for 5 years and have gone from 30% to 90%, won 5 claims and 1 appeal without any VSO assistance. I have a decent command on the English language, case law, legalese, and I know my case. I think that is the lesson that every Veteran should learn is that no one knows your case better than you, and it is in your benefit to read the rating criteria and present the evidence that supports your claim. I know my evidence in incontrovertible; they just need to read it. In any event, I am anxious to see what they come back with in my BBE. It appears this last battle will be all uphill. I appreciate that the AMA appeals seem to be moving quickly, but it appears they may be in too much of a hurry to close cases. I will update this thread to keep folks aware of how the appeals process is working. This forum and others have helped me over the years, so hopefully someone will benefit from it.

I recently filed a claim to increase my service connected sinusitis, which is currently at 0%. My claim was filed 14 APR 2019, and was closed/denied 07 AUG 2019. Upon reviewing my files, the litany of evidence that I submitted to support my claim, which included records from my PCP and ENT showing were I had been to the doctor multiple occasions over the last two years, and where I was diagnosed with Chronic Sinusitis and Recurrent Acute Sinusitis just disappeared. I had also submitted a sworn statement from my fiance where she detailed my how many sinus infections per year I have experienced, along with describing my symptoms. Keep in mind that sinusits is rated based on the frequency of occurrences; either incapacitating or non-incapacitating. My evidence shows I have enough instances of both to be rated at the 30% level, not taking into consideration extra-scheduler ratings. For what ever reason, they did see one document, which was from my ENT, where the diagnosis is very clearly stated and the document contains the same information that would be articulated in a DBQ. Nevertheless, the BVA ignored my ENT's statement, and they went with the only other evidence they had, the C&P exam, which was conducted by a GP, not an ENT, and lasted a mere three minutes. I was able to have my VSO obtain a copy of their denial on 8 AUG, and I submitted a supplemental claim with the original evidence they lost/failed to review on 9 AUG. On 22 AUG, I checked VA.gov and saw that my claim was closed. It now states "The Veterans Benefits Administration made a decision" and under issues states, "Currently on Review - Compensation issue." To me this seems extraordinarily fast; only 10 working days. I think my case is strong, and at a very minimum I should be rated at least 10%. I would like to think they saw the evidence and adjudicated the case quickly. Neither eBenefits or VA.gov has any information. My AB8 has not updated and my rated conditions have not changed. I hoping that eBenefits is slow to catch up, but I'm not optimistic. If the VA weighed the evidence properly this would take me from 91%, with a bilateral factor of 2.7 to 100%, as I believe that I qualify for at least a 30% rating based on the frequency of my condition. Since its the weekend I'm now waiting for the BBE to appear, or not. Hopefully, the VSO can shed some light on what has happened.