[THIRD exam, same issue]

Hi all. 
 

I had an exam last June - left knee, left shin. It came back not in my favor due to nexus. Opened another claim, nexus proven, but VA unable to approve because I didn’t “appeal” through the right channels. 
 

Back in February, I finally got a VSO. They submitted December’s exam (done by a VA doctor), with an MRI from my private care doctor, alone with my supplemental appeal. Today, I found out they want ANOTHER exam, and that’s the holdup. 
 

What’s the deal here? Anyone know? Three exams for one thing - even for the VA - seems to be overkill. I asked my VSO, but have not yet heard back. I feel like this should be something that can be ‘squashed’ so to speak. 
 

Thanks!

[Supplemental Awaiting Internal Action?]

27 minutes ago, broncovet said:

Short answer:  We dont know.  

What we do know is that ebenefits is unreliable and usually not up to date.  Some Vets advocates recommend not checking ebenefits for this reason.  

Now, I have a question for you.  You posted:

I appreciate you telling us this, but I have to ask how do you know that?  

Hey Bronco,

I asked them directly when I called.

[Supplemental Awaiting Internal Action?]

Good day all, I hope you are all staying well during these *interesting* times.

I filed a supplemental claim in early February, and VA.gov still says, "we don't know your status" - they have my signed 5103 and all evidence. I called Peggy, and she says they're waiting on "an internal document."

Does anyone have any idea what that might be?

Thanks!

 

Update: For what it's worth, the VA is still up & running claims, just with most regionals on telework.

[Doc Upload for Supplemental Claim]

1 hour ago, awgv001 said:

There's a link to upload evidence on the VA.gov front page? Are you saying once you log in that it won't let you upload the forms because there's no link for a pending claim?

https://www.va.gov/disability/upload-supporting-evidence/

Hi! Thanks for you reply, you steered me toward the answer I needed. You can't upload evidence to support an appeal, which is what I'm doing. I have to have my VSO do it.

Thanks again.

[Doc Upload for Supplemental Claim]

Hi all,

I have my signed 5103 and the evidence I want to upload with it, but I do not see an area to upload because I do not have a pending disabilities - since it's a supplemental claim. Is there a workaround or do I have to go through my VSO?

Thanks!

[Supplemental w/ 5103]

4 hours ago, Berta said:

"1) They said they sent out a 5103, which is apparently a request for info not in my file. However, I know that was provided to them already, so is the 5103 necessary?"

 

I assure you that vetquest is right- send them again anything they might have already such as the 5103 and the DBQ.

I receive one 5103 for 2 separate claims.The VARO VSO verified to me by phone that they had all of the evidence for both claims because I made him read back to me what he had received that I also listed ( and advice all to do this- I had listed all of the enclosures on the 5103.)

( so he could not just agree by phone  with what I said I had sent.I think he then shit canned my evidence-and made that point in a cmplaint I filed with the Inspector General.

It was the second serious VCAA error this RO committed , and 5103 or VCAA errors will screw up a claim for years.

"I'm still trying to figure out who Betty is LOL. Whoops."

Maybe you mean what we call the 1-800-827-1000 VA number- 

Peggy-

because of this:

 

https://community.hadit.com/topic/69514-peggy-for-newbees/

 

 

 

Hi Berta,

Thanks for your response. I will definitely resubmit the DBQ and my MRI results from private care as soon as the 5103 arrives (hopefully this week).

As for the "Betty" comment - I was making fun of myself, I called her Betty instead of Peggy in the original post. Too little sleep.

[Supplemental w/ 5103]

1 hour ago, vetquest said:

I would send the positive DBQ with your 5103, they might have it already but if they do not it could hurt your claim.  The VA for some reason generated a 5103 on my last fully developed claim and I had to call and tell them I had no more evidence. 

The VA does not always get the claims right.  When I filed my NOD they added conditions to my appeal that I did not have on the original DBQ.  If you are concerned that they have not handled your claim correctly I would note this on the 5103 also.

Excellent, thank you. I will do that then, better safe than sorry.

I'm still trying to figure out who Betty is LOL. Whoops.

[Supplemental w/ 5103]

Hello all,

I spoke with Betty this morning, and found out my supplemental claim has auto-generated a 5103 request - which means they're asking me for additional evidence, even though I already supplied everything. Below are some questions I sent my VSO, but thought I might get an answer faster here:

Good morning!

 

My supplemental claim now appears on VA.gov, with a receive date of 2/10.

 

I called the VA this morning, to see if they needed anything from me, and now I (of course) have questions.

 

1) They said they sent out a 5103, which is apparently a request for info not in my file. However, I know that was provided to them already, so is the 5103 necessary?

2) I notice now we're appealing the decision for my left knee & shin, nexus my right knee. That is concerning to me because when I reopened the claim, it was against my lower back and left ankle sprain - which are both SCD. The latter claim received a positive DBQ, while the former did not.

3) Do I need to submit the positive DBQ when I receive the 5103?

4) The Rep at the VA informed me that in December there was a DBQ addendum, which apparently is because there was a disagreement between the two DBQs. This concerns me because if they use the "right knee" nexus, that DBQ is less likely than not while the lower back and left ankle DBQ is at least as likely.

 

Thanks!

[Supplemental w/ all evidence]

5 hours ago, Willy P said:

Mine took about 3 weeks to show up on va.gov.

Then a week or two after that, the decision was made and ebenefits updated.

Were your results positive (in your favor)?

[Supplemental w/ all evidence]

Hi all,

My VSO submitted my supplemental claim form on Feb 7, 2020. I called Peggy, she says form received February 10, in the upload cue.

While it's awaiting upload, are they also reviewing it? Or does review begin AFTER the upload is complete? I submitted it with all appropriate evidence (new and relevant, of course) which should be cut and dry - a positive DBQ from a VA facility, and an MRI reading from my private care doc. 

I know Google says 125 days (as does VA, obviously) but I've seen some people say as little as 10 working days. I don't even see the appeal on eBennies or VA.gov yet - is that normal?

Thank you!

[Supplemental Claim Form Submission]

On 2/13/2020 at 8:28 AM, paulstrgn said:

When I fax in claims I find it takes between 3 - 4 weeks to show up in the system. I will usually call the 800 number and they tell me my claim is in the cue to be uploaded into the system.

Hi!

Thanks for the reply. I called the 800 number, and they told me it's in the cue - as you suggested.

When it's awaiting upload, does that mean they're also reviewing it for completion? Or does it get uploaded, THEN get reviewed for decision?

Thanks again!

[Supplemental Claim Form Submission]

48 minutes ago, brokensoldier244th said:

Honestly, it’s been 5 days. You’re on his clock now. Once you knew the proper form you could have filled it out yourself and submitted it. Now you’ll have to wait for him to do it.

Wow, an internet tough guy. So much for “one team, one fight” huh?

I clearly asked how I could go about checking the status. I also clearly said she (the VSO) already submitted it. 
 

honestly, if you had no help to provide me, you could’ve just move along. 

[Supplemental Claim Form Submission]

Afternoon, fellow vets and those who have "had it."

I filed a secondary claim in May of last year for my left knee, nexus was denied due to a bad C&P. After receiving my decision, I opened another claim, adding shin splints (also left leg) and a phantom groin condition - that was in November. I waited a few weeks, and was called to another C&P - which was favorable for all three conditions (groin / left knee / shin splints), and after a few months I got my BBE. The BBE denied the groin (no diagnosis, that's fine). But denied left knee and left shin because I didn't use the appropriate form (20-0995). I enlisted the help of a VSO, and they got to me quickly, and submitted my 20-0995 supplemental claim, citing the updated DBQ as evidence, as well as an MRI I got of my left knee that proves I have some serious issues (sprained ACL, severely bruised MCL, missing cartilage below my kneecap).

The VSO submitted it on February 7th, and 827-1000 says they have it, but it has "not been uploaded to the system." What does this mean for me? How do I go about checking the status if I can't see it on VA.com or eBennies?

Thanks!

[At Least As Likely As Not - Denied SCD]

1 hour ago, broncovet said:

Mr. Anxiety:

    Many, if not most of us have been denied "even when" there is favorable evidence.  This happens for several reasons:

1.  OFTEN, the VA decision maker does not read our entire file.  Berta noticed that,  I have noticed it also.  Its faster for rating specialists to just mark "denied" than to read through sometimes thousands of pages of evidence.  (My cfile is about 1400 pages..and no doubt longer now, and many are bigger than that.  I think Alex said his was 3 times that size)  

2.  Even if they do read our file, there are "built in incentives" for VA to delay or deny us.  Frankly they have a financial incentive to delay or deny us.  

3.  Its just faster and easier to deny, and there is no accountability.  However, if a rating specilist signs 60 Veterans with 100 grand Retro's, watch him get called into the oval office and be sent packing.  

    My advice is to appeal.  If you KNOW what is in your cfile, and you are certain of the evidence, then appeal using HLR.  If you need more evidence, the use SCL.  Get ready for a long fight..its what VA does..

    Persistence on your part should eventually win your benefits, but giving up almost never will.  

Thanks Bronco. That all makes a lot of sense - also never thought about the "inverse accountability" (as I'll call it). A part of me definitely understands that, since I'm 91% (compensable 90, obviously), that a bilateral 20% pushes me to 100. Therefore, I kind of assumed the fight would be long and arduous although I will admit today felt like a big defeat when I saw the rating. 

Once I get my letter in a couple days, I'll redact the PII and post here. I have reached out to a VSO, although I cannot meet with him until January 8th. I'll admit I'm not the most patient person, but I do want to do this right. I'm not "looking for 100" like I know some are, I just want them to rate me appropriately for a knee caused by a service connected disability.

[At Least As Likely As Not - Denied SCD]

Hi all,

New to submitting, but have been a passer by for quite some time.

I got out of the Navy in 2010, with SCD disabilities for many things. What I'd like to talk about here is my lower back (surgically repaired and rated 20%), and my right knee (rated 10% and 10%).

Back in January of this year, I submitted a claim for my left knee, which was made worse by my RIGHT knee. The VA Doc gave me a "less than likely" for nexus, so claim was denied.

I then opened a new secondary claim in October of this year, saying my left knee condition was caused by my lower back. In either case, right knee or lower back, it's an accurate statement. My gait has been altered and it has dramatically and significantly affected my right knee. 

At the second C&P, the results were positive. "At least as likely as not" which if I understand correctly is the terminology necessary for rating, as like in baseball, the tie goes to the runner (vet). Along with this left knee claim, I claimed my left groin and shin splits in my left leg. By the way, my left leg IS service connected for sciatica due to my back trauma.

They denied the groin & shin splints, which isn't a huge surprise to me (even though "at least as likely as not" was used there, also). The big, irritating, frustrating surprise to me is they denied service connection on my knee. 

I do NOT understand what I am doing incorrectly. I have the used the correct forms. I have a positive DBQ from a VA doctor. I have private health records proving my knee is an issue, I have x-rays, I have shown nexus on two different occasions, and I even have buddy lay statements. Yet, the VA still says no.

I need help.

Thanks,

Frustrated Veteran