Foxhound6

This is the interesting part. Now, this could just be my memory slipping but I do not recall putting in for a MH claim until 2016 personally (which was a different DX altogether so 2016 claim would be moot, I believe). Which is why when I found the C&P for MH in 2013 I was very surprised. I could not recall putting in for it then but the C&P exam report states that I did in the beginning (like all do at the beginning of the document). I wonder if they were looking at it because they were trying to see if it was ratable and maybe presumptive after service along with my knee? I also did not have the DX listed in my Ebenefits for any MH claims until I tried in 2016 and shows as NSC. So this 2013 C&P, to me, is a bit of a mystery. But I have that C&P stating depression and anxiety, showing I was having psychiatric issues toward the end of my active time. I also have my reserves profiles that begin in 2012 and continue thru 2014, which was also available back in 2013. I remember talking to mental health around same time as my Knee C&P, which I thought was a screening. My Left Knee C&P exam shows that a psychiatric disability existed and check boxed "Mental Disorder (other than PTSD)". So I wonder if the MH C&P exam was based upon a referral or that my Mental Disorder was noted in the knee C&P (I had the injury in 2009 so I had already been dealing with symptomology for about 4 years at that point). So it would also appear the VA had the same evidence as I used this time around for my current MH rating. I had stated that I had insomnia early on and was sort of the first symptom to develop (aside form pain) and led to the depression and was all related to my SC knee. They sent me to VES for new C&P for my 2019 claim, examiner was thorough and apparently opined favorably (have not seen that VES exam report as I am waiting on the VA to send me my C-File that I requested back in January of this year...). From start to finish the claim was done in 3 months....so it makes me wonder if they should have came to this same conclusion in 2013 or back to the presumptive date of my knee 2011? Thanks for taking the time to help!

@BertaUnfortunately, I do not have that 2016 denial, however, it was for a different diagnosis than that of 2013 so I believe I would need to focus in on 2013? In addition, I believe the terminology of denial was same as usual, "Did not occur or worsen during active duty, etc etc" I never had anything show up in EBenefits under disabilities (such as Depression/Anxiety Not Service Connected) for the 2013 MH CP exam either, even though it diagnosed me with Depression at that time. With that 2016 denial they did add the other diagnosis to my disabilities list as "not service connected". However, they never did this during 2013 when they did DX me. So 2013 I would have had at least a 10% rating for Depression/Anxiety with Insomnia, chronic pain? Currently, I was awarded secondary SC for my MH. It currently lists as "adjustment disorder with Depression/anxiety, chronic pain, and insomnia. I feel this should have been the DX back in 2013 had the doctor not rambled on about the issues that were exacerbating the issues I had. So to me, it seems like they had a DX but wanted to pin it on personal things. My marriage issues, as examiner stated, started before I was out. Which was WHY I was having marital issues...its like they just quickly shoved me DX and issue under the rug. Here is a look at my C&P from then. Perhaps it can help shed some light for you as well??

@BertaI was recently informed you cannot or do not do messages. I apologize if this was something I should have known. However, there was something within this topic thread (as old as it is) that I could use an opinion on. Here is what I sent via mesage: Berta, thank you for all you do here. I was hoping to run something by you. I was browsing the forums and came across an old topic regarding old cases and CUE. In it, you stated the following regarding this topic: In my case, I was actually being seen for a CP exam for my Left knee in 2013 (was for a presumptive as I was out of service in 2011 and the claim took 2 years to process). I recall talking to someone at the VA regarding my mental health not long later (I may have tried to seek some help at my C&P exam? I don't recall fully how I wound up there for that). This seemed like an intake or screening of sorts. They asked me about how things were going, current life events, all that. I never requested a C&P exam for that then, nor did I ever receive any decision in the mail regarding that visit aside from my knee exam previously which was what I had claimed. Meanwhile, I had profiles from my unit (reserves after active duty)from 2012 thru 2014. I then went to the VA from 2015- 2018 for my MH issues. Fast forward, I tried to apply for a MH claim around 2016 but had no idea what I was doing and it was denied, I did not appeal this. I finally made another claim for my MH in NOV 2019 and was granted SC for depression and anxiety secondary to my knee issue. Upon searching thru my VA records while researching my MH for 2019 claim, I discovered a CP exam for MH in 2013, the same time I did my knee exam that was granted. In it, it has favorable findings but the examiner did not provide an opinion but noted my divorce at the time and other silly comments related to finances. He did mention before this that I was suffering from insomnia in service and taking meds. I was talking about what he had asked about. I assumed it was a screening, not a CP exam. I am unsure if this could be construed as a CUE (inadequate C&P exam??) and my current secondary SC for depression and anxiety could change my effective date to the presumptive date of my SC Knee?? Thanks for any insight!

I believe it will come down to the complexity of your claim. HLR is just a higher level reviewer taking a look at your current claim as it is, without any NEW evidence. My claim is under HLR now as well. From everything I have read they try to get them done within 125 days, I think. However, I have heard others say it took about a month or a month and a half. It all depends. Assuming the new CP exam was for the claim and requested by the HLR, it may not take too long but then again with current events happening it could take a few months? In my experience, they tend to move much faster with mental health claims. I was able to win mine in about 3 months on the first go as a secondary to my SC condition. Not sure if this will help you or not but a ball park might be the best you'll get in terms of a timeline? You can also search around the forums here for HLR timelines, see how others fared? Good luck with your claim! You got this!

Yes! 100% to both you and Broncovet. My mentor, and previous boss, always says: "Never burn a bridge until you're ready to BURN THAT BRIDGE". In other words, don't let the emotions of the moment cause you to lose your cool. I keep telling my wife this as well. When things go wrong, she always tends to want to blow up on the person informing us or what have you. I cannot count how many times I have gotten an initially grumpy, rude sounding rep to completely turn 180 with attitude all because I was being polite and using respectful terms like thank you, please, and Sir/Ma'am. It doesn't work 100% of the time, but you may be surprised how often it does work. Sometimes being the "good" in someones day is enough to turn them around and, in turn, help you.

@Buck52 Agreed. This would be something that @brokensoldier244th might be able to chime in on. I agree with both views and the logic behind both. I would be very interested to see someone with more inside knowledge weigh in.

@broncovet This is great info. Ive been denied twice now for my current claim and during the time I was representing myself, I had "The Rep for Vets" under Harry Binder, on the back burner feeding them what I was doing. Once the second denial hit I went ahead and gave POA to RFV. So far, they've helped me in getting a solid nexus letter from a doctor by providing a letter addressed to the doctor, fully explaining what they need for my case in a way I could have not done myself. The doctor I found reviewed my records and stated he had enough information to verify what I was asked for in the letter. He is also assisting me with completing a Psych questionnaire. So far, they have been top notch. The only issue I have had is their aid messed up my social a few times on my initial paperwork. They overnighted the form back to me to make up for it. Not huge but its a nice thing to see them try.

Indeed. I had told my friend long ago that it was going to be a long drawn out process lol. Hopefully, once done, it will have what is needed.

Update for April 8, 2020. Received a letter back stating our request was now being forwarded along again. This time to Awards and Decorations? It stated once the Awards side finishes their research, they will correct any findings and send a copy. Sam.award update_Redacted.pdf

Shrek, I believe, is correct. VA.gov handles the uploads. Head to VA.gov, Log in. Then look for "Claim or Appeal Status". You should find your list of claims or appeals, select the one needed and there will be a section or tab for you to upload documents.

@vetquest Point taken. I just find it infuriating for them to miss so many things, so often. No worries then. For now, I will point out the error in their decision as it is and add more continuity of claim based on STR's. Paint more of the picture, as it were.

@JKWilliamsSr Would you happen to know where I might find this in writing? Id like to use this nice factoid in my rebuttal. If not, no problem, I am browsing forums and online.

Thanks JKWilliams. I assumed I may eventually have to do this specifically this way, however, I felt I had ALL of that on this claim to be honest. Had multiple lay statements, both service members and family and myself. I may take a swing at another supplemental, explaining their decisions shortcomings. Perhaps they will agree but doubtful. But by doing that, I would at least have my argument in the file for BVA review later if needed. I am still formulating my argument so all input is appreciated!

Noticed this just now..in the denial it sates "The first note from the Phoenix VA from May 26, 2016 also DOES NOT mention any back pain." In fact, it does. Even the VA examiner NOTED that in his opinion. He states "Initial visit to the Thunderbird Clinic on October 23, 2013 under review of systems notes for musculoskeletal pain some complaints of left knee pain, chronic. No complaints of back pain were noted. The initial note from the Phoenix VA May 26, 2016, notes back pain." Immediately after this, the examiner also confirms MY story of when I was told it was probably my knee causing the back pain in 2013. "In the history, it notes that he was told several years ago that because he has been limping on his left knee he would have back problems and now it is catching up to him." Perhaps they need to reevaluate the claim as secondary to my knee instead? (I have attached the DQB for reference) 1706204915_DBQRedacted.pdf

Ok everyone. Here is where I can really use some advice. Most of this denial seems based on lack of notes. Theres a few points I can make to these: During the time I was examined by VA first time, I was trying to go there for mental health help. I did complain of back and neck pain at the time but they didn't note it apparently and I was also told it was most likely due to my knee issue during same visit (2013). I eventually went to a different clinic, one I liked much better, and then was seen for my back and further mental health (2016). (I avoided the VA like the plague when the Phoenix VA appointment books fiasco around 2014 happened). My NP at that new clinic felt, it seemed, my pain i said was in my back, shoulder and neck was all related to my back. She called it "referred pain". I'm no doctor, I just went along. She did xrays of my back and found the DDD then.. Some time a little later, after the pain had just become unbearable at times, I went back and she scanned my shoulder and upper back, but not the neck. Few more years later, my neck is REALLY bothering me. At this point, with the PT and other alternatives I tried for pain I stopped going to VA for the treatment. I then went to my PCP and she referred me to the Core institute and when I get my MRI's that is mentioned in the denial. I have NO idea how they put down 5 years in the history as I explained my story to them just as I did with the VA by giving DATES. I did not specify number of years affected. I told them about my incident I felt caused it and the DATE it occurred. I don't feel my claim should have been denied based on someone else's poor arithmetic skills.. As far as in service, I ETS'ed from active approximately 3-4 months later. The pain then was NO WHERE near where it is today. I'm not fully sure how to attack this honestly. As I said, my initial visit with that VA clinic in 2013 was for MH issues primarily. I wasn't thinking about the back or neck at THAT time, even though I did mention it to them.. Back denial_Redacted.pdf

Congrats @Phild523!! I know the feeling! I was recently awarded the same (combined rating) for one of my claims. Enjoy the win!!

I agree...I have not received the letter yet but based on the doctors opinion and the DBQ I can already come up with 2 possible ways to appeal which tells me they probably rushed it once they saw the doctor opinion. But will have to wait and see. I have done all this myself, no VSO so far. Thanks!

Excellent. Thanks for that. I assumed that but I never like to assume things. Should give me multiple avenues to appeal this claim. Still waiting on the letter to arrive so I can see what the hiccup is. But this is helpful to know. thanks!

Curiosity question: If denied for a direct service connection issue, can you appeal it to be reviewed as a secondary to a current condition instead (based on evidence/CP opinion) or does this require a whole new claim?

@Vync Superb logic with that, Sir! These are the parts of the claim process that tend to give me the most satisfaction; being able to adjudicate your claim better than the VARO HA!

Yeah it is understandable. Lol I had filed it on the 1st so I had just figured I wouldn't have to worry about that since it wasn't a "partial month" but this makes sense as well from an accounting stand point.

Ahhh roger that. That makes sense then. Thanks for the fast answer lol

So, little premature as I am still awaiting letter..however, I am seeing a pending payment in the amount I was expecting in retro. The problem is it is only one months worth when I should have 2. I looked on Ebenefits to look and see what I could see ( I know, blasphemous!). I found two items. My effective date listed under disabilities (November 1, 2019) and then on my compensation summary letter it states that the "effective date of the last change to your current award was: December 1, 2019". It appears, at least SO FAR, that there is an error with my effective date and the retro payment? Or am I just completely jumping the gun here?

I would second this. I generally do the math and calculation manually which....takes time lol. Would be interesting to see if there is one, however, I feel there may be a lot of variables involved in such a calculator. Perhaps too many to create an accurate calculator based on individual circumstances? I may do a little googling later when I am more free.

Thanks everyone! I probably should have included background lol: Submitted as Secondary claim to L. Knee SC on 11/01/19 with all evidence I had and pointed to a specific symptom in my STR (Insomnia). Had CP Exam with VES on 11/19/19. The examiner stated afterwards that she felt she would be able to tie the issues to my L. Knee SC. VA received the CP exam results in December. I assume then the holiday slowed some progress down at that point. For the longest time it had a estimated completion date of March 22, 2020. Then, yesterday (1/21/2020), It was updated to show that it was in the "review and decision" phase with a new estimated completion date of 1/28/2020. Today, it was updated again to "awaiting decision review" with an estimated completion date of 1/25/2020. A few hours later, it showed the new rating of 70% secondary SC to L. Knee, combined at 80% So from 11/01/19 to 1/22/2020 was the entire time line. NOT too shabby it would seem??