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bigoc

First Class Petty Officer
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About bigoc

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    E-5 Petty Officer 2nd Class

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  • Service Connected Disability
    100%
  • Branch of Service
    Army

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  1. Yes, once the retro comes in I will make a donation.
  2. I didn't get the letter yet. I forgot about the cola increase. Thanks that make sense now.
  3. I finally made it to the magic number. One question though. Why would the effective date of change to current award be December 01, 2019 and the effective date of P&T be October 10, 2019? My recent claims that put me over to the 100 P&T are dated effective October 10, 2019. I'm not understanding where December comes into the equation.
  4. So I agree with some of the advise of not checking ebenefits to often or trusting the information. However I will share my experience that seems very similar to others descriptions. My claim went to "preparing for notification" in the morning. By evening the pending claims and letters had updated. Hope this is helpful. Again not absolute so there might still be different experiences out there.
  5. broncovet, I am not the best at understanding(work in progress) effective dates. I thought it was when you put the application in or if there was a mistake. I put an request for SC or increase for April of this year and one of the supporting documents such as x-rays shows that the condition was present 1 year earlier than this date. Using the date of the x-ray for this example. Is this earlier date the possible effective date?
  6. Congrats! By maximum do you mean you are over the top to 100?
  7. I have a claim in for an increase to 4 already SC psoriatic arthritis conditions that was supposedly(still waiting for the letter) decided. Status changed on one of my pending new claims. 1. The claims were decided and I am waiting for a decision letter and can not get a strait answer when I call. I moved on for the moment on this problem. 2. I next put in for several new service connections for other joints. I submitted x-ray evidence for these. 3. My question here: Why would one of my new pending claims change from new to inc? This condition(left hand) is not currently SC. Is it possible that his joint was SC from my decided claim? I did not put left hand in until 10/29 for my newly claimed joints. Again still waiting on the letter for this decision. The joint in question is my left hand(not SC). I am however SC 10% for my left wrist. The submitted x-rays with my new claims do show evidence of psoriatic arthritis involvement and change in the left hand and I made complaint of pain in the left hand at my last C&P in September. I have some kind of weird fusion of claims going on here to complicate this issue. A pending claim went to decision sent and no decision has arrived after 10 days. Now it looks like some new(submitted 10/29) pending claims are changing to increases and I am not SC for these so I am wondering how you can get an increase for something that is not SC?
  8. So after looking around still nothing on this guy. I have his name and google returned the court case which appears to be outside the VA court system. I think it was some sort of lawsuit that was dismissed. His name is listed in my C&P and the VA confirms he is a doctor over the phone but could not provide his specialty. It seems the VA will let you look up a doctor that provides treatment which I have found actually works. I forget the exact site but is a VA website and even tells you where they went to school. It seems C&P examiners are off limits to background research as to the specialty. Further a lot of or possibly most VA examiners are not required to have a state medical license. Eliminating another avenue of research. Where am I going with this? I am prepping for some IMO's and I am thinking ahead to if the VA denies my claim. I have specialist(rheumatologist) treating me. This mysterious doctor the VA has been using could be a pediatrician for all I have been able to find. I feel like I am going to have to file a request that involves a long fight. At my last C&P which included my feet this VA doctor asked if I had seen a podiatrist for my condition and wondering how I could know what was wrong with my feet if I had not seen one. While foot specialist, podiatrist are not typically the doctors you would see for a psoriatic arthritis condition.
  9. I would actually be ok with them combining these claims. The reason being is that it seems they went back to the earlier date. I just can not believe they did this as it seems it would have taken a human to take some extra steps and I did not ask them to do this. I always thought the VA is just a bunch of drones going through a process. Kind of like the answers I have been getting when I call. They just keep telling me a decision has been made and a letter has been sent yet it has not arrived.
  10. I understand the feeling about ebenifits and to not trust what it says. This is a new issue I think bizarrely effected my claim. 1. 4/19/2019 I filed for an increase in current SC conditions. 2. 8/3/2019 I go to a C&P for this claim. I had to go back again 3 weeks later if forget the exact date because something was not done correctly at the first C&P. 3. 10/10/2019 I filled out an intent to file on ebenifits. I did not do anything with the application other than start the app with no other information filled out. It showed up in ebenifits. 4. 10/15/2019 my claim from 4/19/2019 shows as complete and pending notification which was updated on 10/17/2019 as notification sent. Here is where it gets weird and confusing. I checked ebenifits yesterday to complete my intent to file application. It somehow is not listed as a new claim but combined with the 4/19/2019 claim that was completed and notification sent which I confirmed with a few calls over the past few days to the VA. I have not received the letter yet but they keep telling me over the phone that the letter was sent. I'm trying to figure out how after the 4/19/2019 claim supposedly closed the new intent to file claim now has the start date of 4/19/2019? I tried asking this question over the phone and the VA seems as confused as if they are only looking at the same thing I am on my ebenifits. The fact that today I am hitting the 10 business days from notification sent and my letter still has not arrived tells me something strange happened. I'll wait till todays mail but suspect it was never sent. I understand why people are so hesitant about doing anything while they have a pending claim. I understood an intent to file as not having any effect on current claims. I think this incident has broken that barrier. Its not supposed to but it seems like something happened to combine the start dates of the 2 claims.
  11. Going on 9 days now. I am wondering if there is a RO in the Pacific(my letter must be on a sailing ship)? I'm on the east coast. Unless the letter is stuck int he mail room somewhere a letter does not take more than a week to transit the US. Postal Service while a Government sponsored private company is sometimes not the best, they get letters to where they need to go in a timely fashion. There is no way a letter supposedly mailed on the 17th of October has not arrived anywhere on the country by now. There has to be a few days of delay before a decision letter leaves a VA RO.
  12. I hope you get compensated for what you have found. Perhaps breaking this down into the specific case law history would help. This seems like an "inferred" issue that I am currently researching. Inferred(additional finding) vs informal(you asking by means other than the appropriate form). Informal claims have seen a change and basic elimination. My take, and like I said I am still researching case law. An inferred issues which still exists and further has been explained(feb 2019) in more detail by the VA, also raise the situation of the VA developing the claim in a sympathetic way as apposed adversarial way. My interpretation of these issues is that when the VA finds something new in the evaluation of a condition they are supposed to develop new or ancillary benefits found. You usually need to to help them along in doing what they are supposed to be doing for veterans in various states of mental capacity. Change Date February 28, 2019 III.iv.6.B.1.a. Recognizing Issues and Claims When Preparing a Rating Decision When preparing a rating decision, the decision maker must recognize, develop, clarify, and/or decide all issues and claims, whether they are expressly claimed within scope of an expressly claimed issue, such as complications of the claimed condition, or unclaimed subordinate issues and ancillary benefits, or compensation entitlement issues that arise based on the Department of Veterans Affairs’ (VA’s) review of evidence, such as reductions of service-connected (SC) disability evaluation clear and unmistakable errors (CUEs) entitlement under the Nehmer stipulation, or competency reviews. Note: Within-scope issues encompass additional benefits for complications of the claimed condition, including those identified by the rating criteria for that condition in 38 CFR Part 4, VA Schedule for Rating Disabilities, and any ancillary benefit(s) or other unclaimed subordinate issues not expressly raised by the claimant that are related and arise as a result of the adjudication of a claimed issue. References: For more information on the definition of a substantially complete application, see M21-1, Part I, 1.A.4.f considering subordinate issues and ancillary benefits, see M21-1, Part III, Subpart iv, 6.B.2 issues to consider when deciding claims for disability compensation, see M21-1, Part IV, Subpart ii, 2.A.1 issues within scope of a claim, see M21-1, Part III, Subpart iv, 6.B.1.c, and 38 CFR 3.155(d)(2) ancillary benefits, see 38 CFR 3.155(d)(2), and M21-1, Part IX, Subpart i, and compensation entitlement issues that arise based on VA’s review of evidence, see M21-1, Part III, Subpart iv, 6.B.1.f. III.iv.6.B.1.b. Definition and Example: Expressly Claimed Issue An expressly claimed issue is defined as when a disability and the benefit sought are both explicitly identified on a standardized VA form. Example: Epilepsy is listed as a claimed disability on VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits. References: For more information on how to file a claim, see 38 CFR 3.155 standardized VA forms, see M21-1, Part III, Subpart ii, 2.B.1.b, and status of claims, see 38 CFR 3.160. III.iv.6.B.1.c. Definition and Example: Issues Within Scope An issue within scope is one that is not explicitly identified by the claimant on a one of the forms listed in M21-1, Part III, Subpart ii, 2.B.1.b, but is identified upon review of the claims folder during the decision-making process for an expressly claimed issue. An issue within scope arises based on a sympathetic reading of the claimant’s statements and/or evidence of record. It encompasses such things as entitlement to any ancillary benefits that arise as a result of the adjudication decision, and additional benefits for complications of an expressly claimed condition. Note: VA does not expect, nor does the law require, claimants to articulate with medical precision the disabilities for which compensation is sought. Veterans regularly claim disability compensation for a specific clinical entity and ultimately establish service connection (SC) for a similar, but clinically distinct, condition. Example 1: VA may, in developing a Veteran’s claim for SC for sinusitis, provide the Veteran with an examination that renders a diagnosis of a similar condition, such as allergic rhinitis, rather than sinusitis. Result: In the event that the examination is otherwise sufficient for rating purposes and the condition is associated with service, the decision maker awards SC for allergic rhinitis as within the scope of the claim for sinusitis. Example 2: The Veteran’s VA examination shows that his SC) posttraumatic stress disorder (PTSD) warrants an increase to a 70-percent evaluation at the examination. In addition, the Veteran reported that he has been fired from several jobs due to his inability to deal with stress, and the VA examiner identified the Veteran’s stress management problem as a symptom of his PTSD. Result: The decision maker addresses the issue of individual unemployability (IU) in the rating decision. Example 3: The Veteran submits a claim for SC for right knee strain. The evidence of record, including the resulting examination, shows that SC for the knee strain is warranted. The examination also reveals a knee scar that resulted from a post-service arthroscopy procedure. The examination indicates the arthroscopy was associated with the SC right knee strain. The examination also shows that the scar is not painful or unstable and is less than 6 square inches. Result: In the event that the examination is otherwise sufficient for rating purposes, the decision maker awards SC for the knee condition and separate SC for the noncompensable knee scar as within the scope of the claim for SC for right knee strain. References: For more information on sympathetic reading of a claim, see Robinson v. Shinseki, 557 F.3d 1355 (Fed.Cir. 2009) scope of claim, see 38 CFR 3.155(d)(2), and M21-1, Part III, Subpart iv, 6.B.2 identifying reasonably raised IU claims, see M21-1, Part IV, Subpart ii, 2.F.2.k, and tinnitus associated with claims for SC for hearing loss, see M21-1, Part III, Subpart iv, 4.D.3. III.iv.6.B.1.d. Definition and Example: Unclaimed Subordinate Issues Unclaimed subordinate issues are issues derived from the consideration or outcome of related issues. Often, the primary and subordinate issues share the same fact pattern. Example: SC for treatment purposes under 38 U.S.C. 1702 based on a denial of SC for compensation purposes is considered a subordinate issue for a psychosis based on wartime service, or for any mental disorder based on Gulf War service, and when entitlement is shown under 38 U.S.C. 1702. References: For more information on subordinate issues, see M21-1, Part III, Subpart iv, 6.B.2, and when to address entitlement to SC for treatment purposes under 38 U.S.C. 1702 by rating, see M21-1, Part IX, Subpart ii, 2.5.f. III.iv.6.B.1.e. Definition and Example: Ancillary Benefits Ancillary benefits are secondary benefits that are considered when evaluating claims for compensation pension, or Dependency and Indemnity Compensation (DIC). Note: Eligibility for ancillary benefits is derived from a Veteran’s entitlement to disability benefits or the circumstances of the Veteran’s death. Example: The Veteran is granted a 100-percent evaluation for amyotrophic lateral sclerosis (ALS) and complications, and the VA examination shows that he requires the daily assistance of his wife to attend to his activities of daily living. Result: The rating activity addresses the issues of aid and attendance (A&A), Dependents' Educational Assistance (DEA), specially adapted housing (SAH), and automobile allowance and adaptive equipment in the rating decision. Reference: For more information on subordinate issues and ancillary benefits, see M21-1, Part III, Subpart iv, 6.B.2.
  13. Thanks for the tips. Its weird how I can staff from the treatment side of the VA but the C&P is like looking up a secret agent. I have the name of the doctor but I was trying to find their specialty and training which you can get from the VA site on treatment doctors. It tells their schooling. C&P staff is a blackhole. Probably go to have to try the request.
  14. I have had no success in looking up a C&P examiner. I used the VA site and nothing. I just had an exam a few weeks ago so I'm pretty sure he still works there. He has been there for at least 10 years that I know of. I'm not sure if he's a full-time employee. I have seen him in 2 different VA hospitals for C&P exams. Does anyone have any suggestions on how to look up this guy? To see his credentials or anything for that matter. He's a ghost. The only mention I have found of this guy is a court case outside of the VA system. Needless to say something seems not right about this guy. More than just the usual bedside manor issue.
  15. Would it not be assumed the veteran is seeking benefits and not treatment if the exam is for a C&P? I had something like this happen and I'm still working on it. The exam in question for me was a VA requested future exam. Kinda like the "don't poke the bear" if you got something theory of which I don't believe in. Only this time for me it was the VA that poked themselves with identifying a new joint from an already SC arthritis condition. I'm not well versed in this area but I hope others are able to help you understand if there are open issues with this. I think some VA examiners go to such lengths to disprove something, they open the door to others.
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