XIbodybag

10 4, but if their are two opposing opinions aren't they required to give the benefit of the doubt to the veteran?

After filing an HLR I spoke with the senior rater during the informal conference and it updated and opened a supplemental claim stating a "difference of opinion has been asserted for sleep apnea". A records review was ordered and completed December 14th and now I'm still waiting. To my questions... does a difference of opinion mean the reviewer believes it is service connected? what leads to a difference of opinion getting sent for a records review as opposed to the reviewer just overturning the previous decision? I had already uploaded an IMO and completed dbq from a provider so why didn't the reviewer just use that?

Thanks! So the IMO i recieved was from a pulmonologist who works in a sleep clinic and the examiner in the C&P was a GP, geriatric doctor with 0 to 5 years experience as an examiner. The problem was that my pulmonologist did not cite the studies he reviewed in his IMO. So the HLR turned up a duty to assist error that said that the C&P examiner must take into account my IMO AND included studies as that my pulmonologist had reviewed it and opined on my sleep apnea being caused by my ptsd due to said studies. And it appears that this GP did not do that

sleep apnea secondary to ptsd Good afternoon all. I had a question about a higher level review that returned a duty to assist error. The VA determined that they did not take into account all the medical studies I uploaded as well as an IMO from a pulmonologist stating that my sleep apnea is more likely than not caused and aggravated by my service connected ptsd. The senior rater who determined that the VA must provide me C&P exam and the examiner must take into account the IMO from my pulmonologist as well as the studies I uploaded. Is fast forward to a couple weeks ago and VES Set me up for C&P exam but it was an Ace review. I received my results last week by calling The regional office and they stated that the examiner stated that there is no evidence that that sleep apnea and PTSD are connected And that my sleep apnea is less likely than not connected to my service connected PTSD. How can the examiner say there is no evidence when when I uploaded about 15 different studies connecting the two, some of which were from the VA themselves, as well as a board of veterans appeals ruling connecting the two? It seems that the examiner didn't even follow the senior raters instructions to take my evidence into account because he stated "no evidence" linking the two and did not refute the studies...so i filed a complaint with the white house hotline and the 1800 number and told them that due to the verbage in the examiners notes it seems he did not even address the duty to assist error and that i am requesting a new IN PERSON exam so i can make sure the examiner reviews all medical evidence/studies/imo from my specialist. Is it possible that they will set me up for a new c&p before closing out the HLR?

Okay so update. I recieved my "decision" on may 25 for my HLR. The VA determined their was a duty to assist error. The VA official I had my informal conference said that the VA did not take into account I was claiming that my sleep apnea was aggravated by my service connected PTSD and not caused by my service connected PTSD. She also stated that even though my IMO from a pulmonologist/sleep specialist did not specifically state the rationale in the letter that I had also uploaded the evidence/studies that PTSD aggravates sleep apnea and that the VA C&P examiner MUST take my IMO and uploaded studies into account in terms of PTSD being an aggravating factor for PTSD. My question is, does this sound like it will be beneficial for me? Also how much longer should this HLR take? It updated on the 25th and hasnt updated since, nor have i been contacted for a C&P. 1800 number says that its been assigned to a vsr but that they do not show that any more work has been done on it. I've been fighting this sleep apnea rating for 2 years now so i'm a little impatient.

Glad you're still here helping everyone out! Thanks for the info. If I did add more info though I'd probably get sent from prep for decision back to gathering of evidence right?

Last week I had my higher level review informal conference. The HLR and a seperate initial claim are both sitting in prep for decision now. How long does it take after HLR informal conference for decision? What about for an initial claim to get through "prep for decision" lately? Im under the san diego regional office if that helps. Thanks

So it finally was updated and I recieved my denial letter. Any advice on what I should do? It seems like they completely ignored my IMO. My contention, and the doctors contention, is that my secondary disability claim of sleep apnea is made WORSE by my PTSD and not caused by my PTSD. It seems they ignored the IMO completely. Attached are the decision and the IMO. decision letter edited.docx IMOedited.docx

No no change at all, i did more research and people on reddit have said it'll first say closed and then change to the vba has made a decision with supplemental claims. So hopefully that's whats going on.

Hey fellow vets. I filed a supplemental claim with an IMO tying my sleep apnea to my ptsd on sept 21st. In mid october it went to prep for decision and today the claim is reading "closed" but not "the va has made a decision". I looked up the meaning for it saying "closed" and the va website states that if it says closed it may mean this Your Supplemental Claim was closed We closed your Supplemental Claim. This may be because you didn’t take an action VA requested. I dont get it. I've been in constant contact with the VA 1800 number (as in calling weekly) and they kept saying prep for decision and nothing further was needed...so why would it be closed with no decision? Of course I cant call the VA today because they are closed in observance of the holiday.

Hey all. Back again. I recently filed a supplemental claim for mental health diagnosis less than a month after my initial decision. My initial decision for the mental health claim was other stressor related disorder even though I have had multiple diagnosis of PTSD from personal psychiatrists. I was also rated way lower than I should have been due to the C&P examiner. I was recently approved for a change in the condition from other stressor related disorder to PTSD and increased from 30 to 70%. They changed the effective date of my mental health diagnosis to january 5th of 2021 (when I had my supplemental claims C&P) under the basis that it was the "earliest ascertainable date of diagnosis of PTSD" effectively screwing me out of over 15000 in back pay from the initial effective date of march of 2019. My argument is that the C&P examiner told me that my mental health should have been rated at 70% from the get go. He also said that I should have been awarded PTSD from the get go as it was "clear as day" I have PTSD. To me it makes no sense that they change my effective date of an already rated mental disorder when all they did was change the diagnosis. But they initially DID acknowledge a mental health condition and rate it as of march of 2019 (albeit a different diagnosis). I also filed the supplemental claim way under the time limit to be actively pursuing my claim. Attached is the excerpt of their reasoning. What can I do? I already filed an HLR via fax yesterday. Is there a good chance I can get my effective date restored?

Okay so I found out that they are not going to have my effective date remain the date of the initial claim. Their contention is that my condition got worse and so they are changing my effective date from march of 2019 to january of 2021 to avoid paying me that backpay....is that even allowed? What is the point of appealing with a supplemental claim if they can just do that?

Hey thanks for the response. My claim just closed and ebenefits has updated under the disabilities section with an increase from 60 to 80%. Under the contention that was increased and changed (other stressor related disorder rated at 30% changed to PTSD with TBI at 70%) there is a new effective date that was previously dated march of 2019. It has an effective date of january of 2021...I was under the impression that if you filed a supplemental within a year of decision notice that you are supposed to retain your initial effective date correct? Does this mean that I wont recieve my backpay to march of 2019? Also my letters havent yet updated from 60 to 80% on ebenefits either.

Anyone have an idea why supplemental claims dont show status updates on VA.gov? It continually will just say "We dont know your status" until the claim is closed.

Yeah so the benefits side of the VA did diagnose me with a service connected mental condition but not ptsd (even though I have a CIB on my dd214 as well as the initial award letter from my CIB, and an arcom with v). But the contracted dr diagnosed me with "other stressor related disorder" and low balled me. In contrast the health side of the VA DID diagnose me with chronic ptsd w/ panic attacks. They also denied my claim for my right knee even though I uploaded evidence of me complaining about pain in my knee in service and provided evidence of a tumor removal from that same knee after I got out. It now causes me chronic nerve pain in that portion of my leg, which i also have medicine prescribed for and a diagnosis of nerve pain from my VA primary doc. Here are my contentions and what was denied and what was approved on the initial claim. Disability Rating Decision Related To Effective Date tinnitus 10% Service Connected 03/04/2019 right knee Not Service Connected traumatic brain injury 10% Service Connected 03/04/2019 migraine headaches 30% Service Connected 03/04/2019 back injury Not Service Connected other trauma and stressor related disorder 30% Service Connected 03/04/2019 post traumatic stress disorder (PTSD) Not Service Connected PTSD - Combat