[Supplemental Claim Question]

On 5/25/2023 at 4:17 AM, Rattler said:

Tinnitus is getting more and more hard to get ratted. If I remember right the VA changed how they rate it. I know other Vets who are having issues getting ratted for it even though the VA issued them hearing aids. broken my know more on this issue. 

The question I have is what was your MOS. For example if you were a heavy equipment mechanic you would be exposed to a lot of noise. The same if you were in combat and around gun fire, alterlary etc. I would point out this error in an HLR. 

Reading your decision I think the ratter errored in that they did not properly give weight to your IMO. VA must provide an adequate statement of reasons or bases for its decision. In your case it did not. 

Now without reading the IMO I am assuming this.  Read the below info. I am going through this in one of  my claims that dates back to 1982 - 1983.

"Federal statute requires VA to weigh private DBQs equally with C&Ps (38 USC 5101 as amended by Pub. L 116 315, title II, 2006(d), Jan. 5, 2021, 134 Stat. 4976). This equal status is now expressed most explicitly by the policy regarding increased rating claims: "Do not routinely request an examination if a disability benefits questionnaire, completed by a private or VA physician, was submitted" (M21-1 IV.i.1.B.1.g). However, this same principle applies to all types of claims."

" VA cannot "develop to deny" a claim. Since I have already submitted a complete package of private evidence, any further development with C&Ps would violate VA policy: "Decision makers may not arbitrarily or capriciously refuse to assign weight to a claimant's evidence or develop with the purpose of obtaining evidence to justify a denial of the claim" (M21-1 Vii..3.B.1.a). This prohibition was emphasized in a law review article published by the BVA: "additional evidence should not be procured for the sole purpose of denying the veteran's claim" (1 Veterans L Rev. 94 (2009)). Even CAVC has strongly affirmed this policy: "Because it would not be permissible for VA to undertake such additional development if a purpose was to obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for
its decision to pursue further development where such development reasonably could be construed as obtaining additional evidence for that purpose" (Mariano v Frincipi, 17 Vet. App. 312 (2003))."

 

 

I unloaded and loaded cargo plans on the flight line (Air Transportation 2T231). The audiologist that wrote my nexus letter came to the same conclusion you did; the rater didn't properly consider the IMO letter.  The IMO documented the review of my STR, which the rater implies below was absent. The IMO is willing to do a rebuttal letter if the HLR is denied, which seems like the next logical step.  Thank you, everyone!

 

The medical opinion we received from the VA Medical Center was more persuasive than your private physician's opinion because it was based on a thorough review" of your military and /or personal history and contained a more convincing rationale.

[Supplemental Claim Question]

14 minutes ago, brokensoldier244th said:

Depends on the reason for denial. Without that there's not much anyone can advise you on. 

I attached a copy of the VA letter - is not viewable on your end? If not, let me know and I'll see what I did wrong. Tks

[Supplemental Claim Question]

It only took five weeks for the VA to respond to my nexus letter and supplemental claim - denied again. Thoughts on the next steps; file HLR, go straight to NOD, obtain another IMO letter, and file a supplemental claim (this option seems like tossing good money after bad).  see the attached VA letter. I appreciate any advice. 

Thanks!Redacted VA Supplemental Claim Denial_Redacted.pdf

[Supplemental Claim Question]

12 hours ago, Rattler said:

They May surprise you. When you get a good IMO from a doc that has done more than one and has a good back ground that they can't challenge it may turn around. I did for me on five SC issues in the last 6 mo.

brokensoldier244th I was told about the auto C & P Exams by 800-Betty so take it for what it's worth.

From your lips to God's ear!

[Supplemental Claim Question]

I appreciate the input from all. I submitted my supplemental claim with my IMO nexus opinion from Dr. Erickson. While she worked for the VA doing hundreds of hearing/tinnitus C&P exams,  I expect the VA to deny my claim. 

Thank you!

[Supplemental Claim Question]

I don't have any ratings yet. 

[Supplemental Claim Question]

1 hour ago, Stayfocus said:

You are 100%, what are you trying to do?

Sir,

My goal is to get SC for tinnitus. Unfortunately, I didn't get an IMO nexus letter within a year of being denied. However, I got a nexus letter this week from an audiologist and want to try and get a new C&P exam. I am not sure of the best path moving forward. 

[Supplemental Claim Question]

I appreciate your response. Is the next step to submit a nexus letter with VA forms 20-0095 (decision review request - supplemental claim) and 21-4138 (statement in support of the claim)?

Lastly, in addition to the nexus letter, is there anything I can do or submit to increase the odds of the VA re-opening my case?

[Supplemental Claim Question]

Hello,

My claim for Tinnitus was denied. I submitted a HLR and it was also denied. It has been over a year since the HLR was denied. I had given up the fight against the VA but recently decided to try again. If I obtain a nexus letter from an audiologist, is that considered "new and relevant evidence" to warrant the VA re-opening my case?

Thanks!

[High Level Review Timeline]

Hello,

I submitted a HLR. On the VA.Gov site, there is a green bubble which says, "A senior reviewer is taking a new look at your case."  Does that mean my HLR has been assigned? I am not sure how many stages there are for a HLR.

Thanks!