VetsLady

Re: You SSA award letter, was it a letter stating "why" you were given an award or, was it a letter stating you were entitled and will begin receiving SSD? I ask, because our local SSD office told us that it would take up to 6-8 months for them to research it AND, that it would cost us up to $200 for the research to be done. At that time, if we couldn't get it that day, it wasn't going to help anyway. VA, in a SSOC told us what SSD determined as the "primary" dx was....which had nothing to do with the current claim. There were 3 medical issues that would constitute permanent disability for my husband. SSA picked the one (and it wasn't the 1st 1 we listed on the app) that was closest to the date of the "couldn't work one more day" date and disabled him. I'd really like to get a copy of the determination from SSA. Just to have it on in our records....one never knows when they may need it. I'm going to check the SSA web-site and see how to obtain a copy. FOI should apply.

Thanks Carlie. I'm one of those who needs it. Much appreciated, VetsLady

That is GREAT and Encouraging news! Congratulations on your WIN!

Thanks Carlie....I'm wiped out from brain fry today. Thanks for the clarification. Basically then, we can send on the additional evidence to AMC and the BVA, add a NOD to the AMC decision and request the new evidence be reviewed and the claim reconsidered. I tried to find a "Waiver" on the VA web-site to no avail. The NOD is contained within the body of language of the cover letter we will submit. Berta.....I hopy you are feeling better. I've had major bronchitis the past 2 weeks, on antibiotics, codeine for the cough at night and taking care of my husband's needs. It's alot for one person. Thank you to everyone who offered advice, I really do appreciate it.

Carlie and Berta.... Thank you for your input. We did receive 1 VCAA Notice on the appeal, but that was around Feb/March of this year. I have all of the evidence the VA has not reviewed. I want to be certain I understand this correctly, you say that I should send the evidence directly to the BVA with a signed waiver of RO review. Actually, since the claim file is in DC, it would make sense to send it there, especially since Seattle RO did not forward it. I imagine the form for a waiver is located on their web-site or I could just type it up with verbage that: "I, Mr. Veteran, waive my right for RO review of the evidence listed below and that is enclosed for the review of the BVA. Respectfully yours, Mr. Veteran." BVA remanded the claim specifically to the AMC in DC.....why not just send AMC and BVA the evidence? By way of, attaching a letter to the BVA and AMC packets indicating they are both receiving the same exact documentation requesting the the AMC to reconsider the claim after review of the additional evidence? AMC would be put on alert that BVA has the same evidence at hand and BVA would know that AMC has the exact same evidence and that since the Remand was to the AMC in DC, they might be on their toes and get to it pronto like. In a nutshell: 1. Can the waiver can be found on the VA web-site? 2.) Should I send the evidence, along with a catagory of the evidence to both AMC and the BVA? 3.) AMC currently has the file, and they have stated we have 30 days to respond. Would this be considered a NOD of their decision, just as a new claim? I know the Form 9 is on the VA web-site but, would the letter I have drafted and plan to send explaining why we disagree suffice? There was also a SSOC the Seattle RO sent Sept.08 denying the 2 issues that were on the table then. We have just 1 issue on the table currently and in the SSOC Seattle RO sent, there were numerous errors that our former SO didn't respond to - I know now we should have. I would request in our NOD they review the SSOC from Sept., review what the doctor in the SSOC reported and that within the evidence submitted, Dr. Private Sector stated the same thing. The 1 issue on appeal was denied by Seattle RO - the Rater stated the QTC (VA C&P doc) was incorrect in his report, that the layperson statement could not be reliable as it was "too long ago" - I call bs on that, the VA sc my husband on another issue with the evidence in the file (they only had thru mid 04) and the layperson (buddy) statement and that Buddy Statement was written 3 1/2 months later than the Buddy statement included in the issue still on appeal. Seems odd to me that VA can say they believe a statement that was written 3 1/2 mos after the Buddy statement in the current file at AMC.....hmmmmmmmmm? Both statements "tip the scale towards the Veteran's side", they didn't have all of the evidence in the file for the DM2 claim (that was sc in 4/08) and they don't have all of the evidence now. There are strong Nexus statements from both the QTC doctor and my husband's private physician and the IMO Nexus we obtained on our own and paid for out of our pocket in Oct. 08. I would be sending evidence supporting the current condition from mid 04 through the present. And, he was dx with a complication of his current condition by his Primary Care Provider at the VA earlier this year. His condition will never get any better, it could stay the same or get worse, but it will never get any better than it is right now. Seems like an ez process to me...... Send the docs, they read the docs, they read the NOD, they see the error RO made in the SSOC from 9/08, and they sc based on the new evidence and rate. Case closed. Vets Lady My apology if this post is wordy....I really need to make this right, this time around. I don't want to have the file passed around for another 2 years from BVA to AMC to RO to the Moon and back.

Allan and Shag and all who have replied, I hear what you are saying....and know for certain it's not meant to be steered toward any one person who has posted on this topic. Most people, and I am an optimist, would not consider "doctoring up" records or submitting false evidence. What would be the reason? It all comes out later. It will always, always come around and bite the butt off that individual. It's Karma. And, I want to receive as much good karma as I can. It always comes back. Always. I have to believe that they care. If I don't, and this is just my feelings, then what is this world coming to? We should all care about each other but in the real world that isn't the way it is. It may be a numbers game with VA, or whatever their agenda is to knock claims out faster than the speed of light. The bottom line is the Veteran who incurred an injury or illness while in-service is entitled to medical care, compensation and fairness in applying the law. Why is it that so many Vets have to fight for their benefits? It's a crying shame and should not be. "Should" and "Are" couldn't be farther away from each other than Planet Earth is to the Milky Way. On submitting anything to the VA, yes, I always keep a complete set of anything I send, and I don't send the originals. I always send them either FedEx or USMail, Return Receipt Requested. Never, ever any other way. How would I possibly know that having filed the TDIU claim with the RO that all of the evidence submitted would not be automatically sent to BVA since the Remand mentioned the TDIU claim? We did what the SO told us to do and submitted the evidence as we were told to do. If I'd thought to send a copy to the BVA, wow.....this could have been completely avoided. Bad advice from them, and ultimately it still falls on the Vets lap to make sure the evidence gets into the right hands. That's where the crack in the vase begun. Never again will I rely on advice without checking it out myself. Maybe this will help someone else down the road and they won't make that same mistake. VARO review of the additional evidence was waived at the BVA hearing and that being said, wouldn't anything else that is submitted to AMC/BVA be considered under the same waiver? I would think so, but then I'm not a lawyer. What's done is done and what matters now is that it's not too late for evidence to be submitted to AMC. BroncoVet: Thanks for starting this post, I learned alot today that I hope may help someone else who happens along this topic. I do appreciate all of the feedback. Thank you. VetsLady

§ 3.156 New and material evidence. (a) General. A claimant may reopen a finally adjudicated claim by submitting new and material evidence. New evidence means existing evidence not previously submitted to agency decisionmakers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. (Authority: 38 U.S.C. 501, 5103A(f), 5108) ( :) Pending claim. New and material evidence received prior to the expiration of the appeal period, or prior to the appellate decision if a timely appeal has been filed (including evidence received prior to an appellate decision and referred to the agency of original jurisdiction by the Board of Veterans Appeals without consideration in that decision in accordance with the provisions of §20.1304( B) (1) of this chapter), will be considered as having been filed in connection with the claim which was pending at the beginning of the appeal period. Bingo. I knew I'd come across this CFR before. They have to include the evidence in the appeal decision. I've got the draft done and will copy the records they need to make a correct decision. The appeal period has not officially expired since we still have the 30 days to respond before it goes to the Board for final determination. However, I do believe if AMC reviews the missing evidence they will reverse their decision and rate him right then and there. The claim(s) that were pending at the beginning of the appeal period were 3 issues. 1 was resolved. 1 was dropped and 1 is the current issue at hand. If, anyone can point me toward a direction that this CFR would not apply in our case, please let me know..... Thanks! VetsLady

BroncoVet... I re-read your original post and see you have included what I'm looking for. Any other suggestions....feel free to post. Thanks, VetsLady

We dropped them like a hot potatoe when it became apparent they were useless and I could do a better job....afterall, we have the vested interest in a positive outcome. Not to say all SO's are useless, this particular SO was. We waited until after we received the Remand to drop them. Seriously, the former SO suggested we file the TDIU claim - wrong move during a pending appeal. It clogged the appeal action like grease in a drain. How would a Veteran know? We trusted them to know. The woman who went into the hearing with us had never met, spoken to or read my husband's file, let alone, she didn't even have it during the hearing and was going on the evidence WE brought to the hearing that I sent to the SO more than 1 month prior. Sent via CM/RRR. And, to top it all off - she was late, arriving 5 minutes before the hearing was called to order by the VLJ! I heard through the grapevine that she is now working as a SO for homeless Vets. I hope and pray she has her act together now as they definetly need a voice and does take a "special someone" to work the streets on behalf of way too many homeless Veterans, just as it takes a "special someone" to do the Veteran that walks into a SO office or, that offers assistance to Veterans online. I applaud those who do right by the Veteran. Perhaps one day I would do the same as I would be very interested in doing so but, with my husband's current health conditions, it's enough for me to care for him and work his claim. Oh yeah, and take care of me too! VetsLady

You hit that one spot on John999. I wonder about the Veterans who have no one to help them. I can only hope that my experiences will help someone else on their own claim. The Vets who don't have someone need a voice too. BTW, I have a fairly large shovel I'm digging with. I think our former VSO was using a child sized beach sand sifter, not even a shovel. I await advice and input..... VetsLady

akwidow.... I appreciate your response. I'm not disappointed as there is a 30 day period of time to submit the evidence that the RO obviously didn't forward to AMC. If they had, it would have been listed in the evidence portion of the SSOC we just received. There were errors in the SSOC denial for sc we received in August 2008 and they should have been addressed at that point by our SO as requested and they were not. Regardless, it's up to the Veteran to provide the supporting evidence to the VA or how would they know it even exists? The assumption that the claim would naturally progress through the appeals process and the errors would be corrected was a reasonable expectation on our part. Wrong. If anything, I should have sent a NOD of the Sept. 08 SSOC, and had I known now what I know now, I would have done just this. I was also advised that if you have a SO going into an appeal that you can't drop the SO until the appeal is past the Board's videoconference. In caring for a chronically ill husband, it's very easy to believe your SO will handle the situation and not realize the fact that it's really up to the Veteran. My primary focus was the care of my husband and if I erred at all in the process of his claiml, it was my assumption the SO would handle it. In the meantime I have drafted a rather specific NOD to the current SSOC from AMC as we have those 30 days to respond and why. This is a very clear claim that should be sc and it has fallen into the cracks of the unknown, very specific errors were made in the Sept. 08 SSOC, and the AMC were not afforded the entire file to include all of the evidence we submitted in Jan. 09 for review. Lay person statements were admitted into the portion of my husband's claim that has already been sc, however the lay person statement written 3 1/2 months earlier for the appealed portion of his original claim were not allowed. How could they accept the layperson statement writtten in Dec. 04 that actually ended up being the slice of pie that sc him for a portion of his original claim and the layperson statement written in Sept. 04 not be allowed into the evidence as it was "too long ago to be accurate". There were originally 2 issues on appeal, we dropped 1 because we received a more probable diagnosis than PTSD and how in our heart of hearts could we claim PTSD when in fact it's not the correct diagnosis. If anyone has any input regarding a CFR or additional thoughts to be sure that I include in this NOD, please let me know. I believe that once they receive and review the NOD and the reason's why we disagree, they will sc my husband on the appealed portion of the claim. The original claim was filed in 2/03.....almost 7 years later. I know there are many, many Vets whose claims are older and I feel for them/you as I know you feel for us. I appreciated whole heartedly any advice. VetsLady

How would the BOD rule apply IF the evidence was submitted in support of a TDIU claim at the RO when the main file was in DC with the Board. The TDIU claim was denied, the development of the Appeal was begun after the TDIU claim was denied as per instructions from the VLJ. RO had two separate claims folders set up for the Veteran, 1 temp for the TDIU and 1 main file that was in DC. If the Veteran submits all of the evidence to the RO and RO doesn't forward the evidence to DC to be included with the main file, who would really be responsible and wouldn't this be considered "evidence of record"? RO has the evidence, appeal went to AMC who denied the claim based on the "evidence of record" - however, "all of the evidence of record" was not available to the rater at AMC who denied the appealed claim. Would it not be a reasonable expectation that RO would forward the temp file and it's contents to DC to be included in the main file? Seems a little bassackwards for RO to wait until the main file returns to include the evidence in the temp file. Seems logical that if evidence is submitted by the Veteran then it's evidence submitted to the Secretary and should be considered. The Veteran is of course my husband, and we have 30 days to respond. The white envelope came last week and none of the evidence that was submitted to RO was included in the evidence considered section. Needless to say, we were stunned. We had every reason to believe that RO would have sent this file and, had we not, I would have definetly forwarded to the Board immediately, which would have been several months ago. If evidence is submitted to the RO wouldn't it be considered to have been submitted to the VA, including the Board? What to do......need advice..... We had BOD rule apply in a former claim as we could prove my husband set foot in Vietnam (he was stationed as a Marine onboard a ship along the DMZ that pulled into DaNang several times for top secret meetings and this is where he had to disembark the ship. The evidence of record on the VA side didn't show the ship ever pulling into DaNang however.......with layperson statements, a map that came from the ships official "scrapbook", photographs of the ship in the Harbor and my husband on land with the CO, it was considered equipose and they could not deny the claim. I get the equipose in this situation but how can it be applied in the RO/Board situation? Update: *** I am now drafting our response to the AMC and it suddenly occured to me that the Remand specifically mentioned the Veteran had filed a TDIU claim and referred the TDIU to the RO for adjudication. So, would it not be a reasonable expectation for the Veteran to take for granted that the Board and AMC are aware of the pending TDIU action and would associate the temporary claims folder for the TDIU action with the main claims folder that is with the AMC?

Thanks John....I can see where an impact could be made from one to the other. Husband will never be able to do the occupation he did - you need strength in the shoulders to do it. You need a clear mind. Cognitive thinking process. Energy. Yes, the disability claimed with SSA was to last more than one year and will actually last the remainder of his lifetime. He is already receiving Medicare as the 2 year mark has come and gone. In the denial from AMC they mentioned the SSA records were reviewed and considered. Since they are two separate entities and two separate injuries/illnesses, the SSA in this case would have no bearing. I think the AMC didn't receive the updated medrecs otherwise they would have granted his claim. I'm not a Rater, I don't work for the VA and I don't read minds. I do know everything about this claim as it stands and it's rock solid. They are just being butts about it and probably hoping we don't push it further. I will definetly take it to the ends of the earth, I might have to with the VA...but I'm ready to rock and roll. Any thoughts are much appreciated. VetsLady

Can someone tell me what the relationship is between SSD and VA Comp? Why would the granted disability for SS have something to do with VA Compensation? Seems to me these are two completely separate things. SSD=Disabled / VA Compensation=compensation for an injury/illness while in the service. This thought came to mind today as I wondered what a granted SSD claim had to do with a denial of a Compensation claim with the VA for my husband. He files a Comp claim with VA 2/03. He has an independant VA exam in 2/08 (QTC). The claim is finally granted at 70% in 4/08. 12/31/05 he stops working due to needing shoulder surgery and because he could not care for his patients anylonger due to the remainder of his disability. He has surgery.....Dr. said he will not recover within a year and will need the other shoulder done eventually (it's been done). The shoulder issue that SSA disabled him for has nothing to do with his military service. We file a SSD claim 1/06. It's granted 4/06 and bennies start in 6/08. He has a 2nd VA comp exam in 8/08 for the remainder of the appealed claim. Dr. said in his report the illness he has on a more probable than not basis is due to his in-service exposure. His private doctor gave a 2nd strong Nexus. There is another post about what happened next on this claim.... My main question is......what would a SSD claim for disability have to do with a VA claim for compensation due to an illness/injury - even though it may cause a disability, it's still compensation for the in-service injury/illness. I look forward to hearing members thoughts.... P.S. This is one of the reasons the AMC said they denied his claim...due to SSD disabling him for the shoulder(s). Which is hogwash in handbasket. We never claimed a shoulder injury to the VA because there never was one. The other two issues on the SSD claim are the two issues we did claim with the VA.

Thanks for the support everyone. Berta....I can't say for 100% sure, but they do not have any of the additional evidence listed in the denial we received from AMC. I was thinking about delivering it myself....but, DC is a little too far to travel right now from WA. I'm thinking that Seattle didn't forward the evidence that was submitted for the TDIU claim that was denied. The just filed the file away instead of extracting the evidence, closing the file and sending the evidence to be placed into the main file. Had they done that, this would not have happened. If we still get a denial after the do review the evidence, I'm prepared to go all the way. I appreciate the support.

Thanks for the comment Pete. I just re-read all of my posts from yesterday on this subject and WO was I spitting fire or what? I should clarify. The TDIU claim was filed in Oct. The BVA videocon was in Nov. Why former SO suggested we file for TDIU concurrently is a mystery to me now (I would have never filed another claim so close to a BVA videocon). The updated medrecs, from mid 04 to Jan 09 were sent up on Jan. 30 to Seattle where they were placed into the TDIU file. The TDIU was denied and I just looked, they have them all listed in the TDIU evidence list, with the from to dates for each provider. In the Remand, the VLJ only mentioned obtaining the SSD records to be made part of the file and that a PTSD exam should be done and stressor verified (we dropped this part of the claim as it was determined he really doesn't have PTSD afterall). His depression was related to the issue on appeal. VLJ also mentioned the Veteran filed the TDIU claim and referred that matter to our local VARO. In the denial we received yesterday, none of the evidence we submitted on behalf of the TDIU claim was listed (2 separate claims)....you would think that the information would be in the same claims folder. I was told that they set up 2 different claims folders so the claims could be worked concurrently......but, it doesn't really work that way. That close to a VA videocon we waited 5 years for, well....TDIU could have waited. The appeal should have been completed before moving on to the TDIU claim. The former SO we used, didn't have any of the evidence in the file we'd sent up (this was before Jan 09) - luckily I brought a copy which she copied, the VLJ asked her to send it to him. I did confirm BVA received it. The SO who sat there with us in the videocon had never spoken to or even met my husband. We started his claim closer to our home. I'm hoping that all of the evidence submitted didn't get put into the same file once the TDIU claim was denied. If that is the case, I was told yesterday by the higher up that it's VA's fault and they will have to correct it immediately and reconsider the claim. It's a strong claim, it happened, we have the evidence, the odds weigh on my husbands side....the QTC doc gave a strong Nexus and so did my husband's private doctor. It was the rater of who did the rating in aug 08 who didn't know right from left, the SSOC was a complete mess and suppose I should have filed to have it corrected but with the BVA hearing coming up, well..... I thought we were well represented by the former SO and that if should have been done, they certainly would have told us about it. I'm going to try and have a better day today. I'm going to spend the morning watching tv with our two little doggies on my lap. Then, it's a doctor appt for the hubby this afternoon and maybe a stop for an early dinner. VetsLady

I sent the new (updated medrecs) evidence PRIOR TO the Remand. It was sent to Seattle as we'd filed a TDIU claim that was dumped on. However, the TDIU claims folder and the contents were what they were waiting for to make the appeal decision. His appeal file began in Seattle, then took a trip to DC and waiting in line for almost 3 years for a hearing date and in the meantime he has a VA exam, yup.....5 years after he originally filed the claim. BVA hearing was last Nov. Former SO suggested we file for TDIU while awaiting BVA hearing decision. TDIU is denied. Claims folder is then sent to AMC who sends it to Nashville for further development who then send it back to AMC in DC. It's a big merry-go-round if you ask me. I'm an optimist. A pissed off cautious keep my mouth shut ears open catch flies with honey pissed off optimist. Hopeful the higher up can deterimine whether or not the necessary, and all of the necessary evidence was in the file when they slapped a big denial on the appeal as not one shred (ooooo, don't like that word) of evidence we submitted was on their "evidence considered" list. Things that make ya go hmmmmmmmmmmm.......... Anyone have any ideas, I'm listening.

Send all you've got. Received the mail just after I posted my last and in it was big white envelope from AMC. They denied his SC and guess what? They denied it without having all of the medical evidence that Seattle VARO was sent in January from us. You bet your cookies and milk we sent it overnight UPS Priority. Had the signature of the person who received it in. His claim folder has been all over the country and was in Nashville for further development pursuant to the Remand. When that was completed, they sent it on to AMC in DC for decision which is like reading a 100 page book with only 6 pages in it. I was so mad after reading it, and was all over it like honey on a hot bisquit. The higher ups are now involved and assure me that if that evidence was not in the file when it was reviewed, his claim will go to the top of the pile, yeah right. Is this what they call a CUE? Trying to calm down, had to really take that chill pill the anxiety was horrible. VetsLady

Thanks Carlie. I needed that. Mine was getting empty. Maybe my politeness rubbed off on her. I hope so. Thanks again for the vent....... VetsLady

Argh..... I need to vent. VA appeal is sending me bonkers. And, why on earth do they need to be rude? At that point, I just politely say, "Thank you for your time" and hang up. The information they have, if they have it is not correct. This Rep told me to contact our SO....we don't have one and for many good reasons. I know most of you have received the run-around from time to time with VA.....but why, why, why did this woman have to be rude? My Mom always told me you catch more flies with honey than with vinegar. I'm always polite and courteous. Arghhhhh.........just needed to vent. It's very frustrating this appeal process. Oh, and she told me "Look, these appeals take years" emphasis added on the word years. Deliberately she placed great emphasis on one particular word. I'm thinking, ah yeah, they take years off your life. Send me a chill please............ VetsLady

At his BVA videocon hearing, my husband signed one of these waivers. Last November. His case may have gone for review faster had we not filed for TDIU at the mis-guided suggestion of his former SO. Supposedly, his claim went to AMC early Sept., It's pretty clear cut claim, old (filed in 2003) and have received notice via AMC that his claim is now upstairs waiting for a rating.....rating there means a review also. I called and asked. They use terms interchangeably and for the same thing often. I was also advised they are reviewing remands from 2006 now, but who really knows. I feel he did the right thing signing the waiver.....our RO bucked his being in RVN for years, finally agreeing he was there and he received SC for that part of his appeal. Now, we await this 2nd part.

We had the same experience at the local VAMC. They can bill for NSC treatment but, then my husand is 70% not 100%....it's a disgrace if the VA doesn't pay for 100%. Did anyone see the 60 minutes segment on the Medicare billing scandal that aired last night? Unbelieveable. Medicare Madeoff's.

Hubby received this VERY informative phamplet enclosed with his BVA appeal decision, that was remanded. If it were only that simple.

The IRIS we received also said the VA made my the inquiries made through IRIS a permanent part of the file for the regional office's review and information while processing his claim. We do the same