USNDW

Wow, my first one took about 9 months, now we are talking two years???

I did not have an attorney or VSO. I don't have anything against either, but two different agencies I consulted with said No Way you can get that. I am 100% SMC S, and SSDI, which I never used any assistance for either. I know there are a lot of pitfalls in Compensation claims, but like I told the VLJ in the first hearing, this is not that complicated. I had a chronic disease that clearly manifested while in service, and had a confirmed diagnosis within 1 year of retirement. At the time I filed and began the fight I was 90% IU, so I knew that could be taken away by a bad decision. While fighting this claim I had worsening conditions, which I also filed without any assistance, and ended up with SMC S. Some people may ask why I am continuing? Because I asked for a 100% extra schedule due to the impact. Also in the BVA is SAH, and I have loss of use of s lower limb and have to wear a metal hinged knee brace on both knees, and use a cane. The Caregiver program had done assessments showing I need help with ADLs and cannot live alone, so I expect the VLJ to address that in out next hearing. Although the VARO has corrected the joint issues and service connected SNRA after 13 years, they still have not addressed the entire claim. God Bless all of you here, all Veterans everywhere!!!

Little late but better than never. September 9f 2009 I filed a compensation claim for Seronegative RA. The VARO failed to follow VCAA until 2019 when the VLJ ordered them to, or face consequences. I actually sent them the medical records from 2/2009 through September when my Rheumatologist and PCM did what seemed like hundreds of tests. Bottom line, for SNRA you do not have to have markers in your blood. If both sides of your body suffer from inflammation in all of the joints, it is some type of inflammatory RA. I don't blame the C&P examiner who lied, saying that SNRA required blood markers for a diagnosis, or said there was no evidence of synovitis even though I had multiple surgical reports showing synovitis, or even that he said pannus had to be present, which no serious doctor would ever say, I blame the VARO from the rater to the senior people who handled the NOD and CUE. They said in 2010 that Dr's KK, JB, and TM diagnosed and treated me for RA, it was not in the presumptive period or during service. They had my service dates on the SOC from 2002 to 2003 and they know I served from 1985 to 2008. Every one of 3,000 records before that SOC had my dates of service correct. I filed a NOD and they never answered. I sent a CUE and a copy to my Senator, they sent me for a C&P in 2012. That VA Dr lied, no two ways about it. I had copies of the medical records, medication I was taking, lab tests and imaging reports. The VA had 4 different licensed Dr's, two rheumatologist, and PCMs who diagnosed or agreed with the diagnosis, letters from me and my wife, my medical records contradicting what the C&P examiner stated. There was an overwhelming amount of evidence and the C&P examiner made faulty arguments, which they are not supposed to do, and had earlier admitted I had been diagnosed with SNRA. The BVA took 5 years and three remands, but back in July, magically 1 day, in ebenefits there were ratings for about 16 or 17 joints SNRA. I am still fighting and still at the BVA because I asked for a 100% because of the impact on me. SAH is still at the BVA. Hopefully not another 14 years

You have to decide if it is worth it to you. You can file for, and ask for an earlier effective date to the date your back rating. Ask for what you think is right. I know when they assigned my right leg at 60%, I argued that was the same as loss of use, received SMC K and eventually SMC S based on Housebound. Now I am waiting on BVA for SAH and still arguing for SMC L because my wife is my VA Caregiver Seems easy, but how many VA raters does it take to screw in a light bulb?? As many as they can fit in a room until a Veteran comes in and changes the bulb

I feel for you. I have been in a VA claim since Sep 2009. Actually been at the BVA for 5 years, 3 remands and a lot of VLJ instruction. I asked for A&A back in 2012 after my wife was approved for VA Caregiver. I thought the regulations stated if you need Daily Living Assistance you would qualify for SMC L. Maybe I did not read them right, but what I have read in asknod posts, if you need ADL assistance, regardless of your rating, you would qualify for A&A. I do have a 100% P&T, and SMC S since 2012, but S is not the same as L, and since the VHA corrobated my contention that I need assistance, it would seem to be less difficult than turning on the TV

I really don't know, but I would ask you this. Did you ask for SMC L? Do you need Aid and Attendance to perform Acrivities of Daily Living? Maybe look back and see if SMC L was implied and ask for it and an earlier effective date.

I wish. We were accepted into the program 12/2011, applied for A&A, the VA said no, you have to have a 100% single rating. Not combined, but 1. I do think the regulations have changed because last month as I was researching info I saw the R2, so I filed a new claim It does stand to reason that if you qualify for Caregiver you would also qualify for SMC R2

Actually it does. In fact, it says that a VA vendor stated I told them to dismiss my remand because I refused a C&P exam. In black and white, so I will see how the ALJ responds. I was never aware a VA vendor could communicate a BVA dismissal. I am pretty sure they are not in the decision process of claims. I have the letter, and so does my Senator

So yeah, the original question was, "can they dismiss a BVA remand" for not attending a 3rd C&P??? Mr CUE, I did get a letter from the VARO. What maybe was confusing was the original mailing was a repeat of a previous letter. If I had not called the 800# and asked if something else was supposed to have been sent. There was. The email the VA sent me contained a PDF of the VARO letter stating I had requested to dismiss my claim when I told them I would not attend a 3rd exam. I wrote a very awful letter to the BVA, VARO & Senators office. Within a week I received a call and the VA rep told me that when a Veteran does not attend an exam, they will cancel the remand. I asked the BVA to NOT take any action on my appeal until the hearing, which I am still waiting for a date, within 3,000 now , because my contention is the information they said was missing from the previous 2 exams is in my C file. I can give them the date and the Dr to prove my point. I have not yet got a call from LHI, so hopefully someone has shut down the VARO. My remark to them all was I am not a freaking yo yo and it is difficult for my wife to haul me to exams because they cannot get it right. Anyone who has read about this BVA before on hadit knows it started in 2009. I have won multiple issues, including SMC S, K, auto allowance and most recently the VA rated 12 different joints service connected. I am winning, but have a ways to go

Actually they did, or did not and then I had to request it. I got a notice that contained previous decisions and information from June. I pondered "why would they send me the exact same information" and it dawned on me that there might have been something else they were supposed to send. Sure enough, I called and asked if there was newly dated correspondence and yes, there was. The 800# rep sent me an email and the notice they were supposed to have sent me stated I had asked a VA examiner to cancel my remand. Obviously I was aggravated to say the least. Called them back and asked WTH and sent a letter to the BVA and VARO telling them not to do anything with my claim. On Fridaya VA rep called and said they received my letter(within 1 weeks time) and that in order to complete the remand I had to attend another exam because 3 sections were missed, and without them they could not complete the claim. I argued that the information from the three sections exists in my record, i.e. what type of brace was prescribed, who prescribed them and why The VA rep told me straight up that if I did not attend the exam they would cancel the remand I am waiting for a hearing date for review because they are idiots. They rated seronegative rheumatoid arthritis of the left knee. Not residuals, but of the knee. I have been in a claim since Sep 2009 for Seronegative RA as a chronic disease, requesting a 100% rating, BVA appeal started in 2018 and in January they got a new VLJ and they combined the left knee request for increase for meniscal removal and the claim for SNRA into one condition, SNRA of the left knee. I am so disgusted with these people, you have no idea

I have been dealing with a BVA for 3 issues since 2018,original claim 2009. A VARO rated left knee at 10% woth SNRA. I filed a NOD because Seronegative Rheumatoid Arthritis is a chronic disease, and they should have rated RESIDUALS. I have attended 3 C&P exams for this BVA, and they asked for an additional exam 5 days after I attended the last one. I called them and said "NO, this is ridiculous". They said they were dismissing the remand. Contacted Senators office and asked what the hell? I went to an exam, but apparently the examiner did not answer 3 of the 25 questions, so they told me if I do not attend another exam for the 3 additional questions, they will dismiss the remand. Can they do that? The information they are asking for already exists in my C file. Cannot express my disgust with VA claims processing right now

https://www.federalregister.gov/documents/2022/09/21/2022-20271/extension-of-program-of-comprehensive-assistance-for-family-caregivers-eligibility-for-legacy

Check your letters. When were you notified you are being dismissed from PCAFC?? They give specific time periods for clinical appeals, usually 1 year for Higher Review and same for BVA following a Higher Review decision VISN 19 also stated we can reapply. I use private health care and am going to get an IME from my PCM and get that into my VA records Remember that VHA and VA compensation sides are 2 different animals. VHA cannot see veterans C file records, only health records

Not a question, just wanted to inform those of you in the Caregiver PCAFC program, if you were recently dismissed and are still within the period of appeal or review a notice will be coming out to extend current PCAFC another 3 years. I contacted VISN 19 and verified this, but letters have not yet been sent. So many complaints have caused them to consider review and changing their guidance and explanations.

Just in the last 2 weeks the VA is extending benefits for PCAFC to those who are still eligible for review, meaning, if you still have the options of a Higher Level review or BVA after being dismissed, you have a 3 year extension. I have not yet received any letter from VHA but I read the instruction and verified with VISN 19 Administrator. I had wrote a letter of dissatisfaction with their clinical review and she returned my call. She verified that yes, the PCAFC is reviewing their decisions and guidance due to all the feedback from Veterans, Caregivers, and Senators and Congressmen/women. Don't know how long until notifications are being sent out, but if you were recently dismissed within the last year, you should be extended and they will be doing reassessment after they correct their guidance and criteria. In my case, they stated I did have a functional impairment that would exist for 6 months or more. I am rated 100% P&t with SMC K and S, so I asked how in the hell is that not a functional impairment? There is no answer, they were just kicking people out to reduce costs because ALL veterans are now eligible.

I did get loss of use for right leg. My rating is 60% following a failed replacement. 60% is the highest rating allowed per lower extremity and I had my treating physician respond to questions like "is there any left beyond what a prosthetic would provide"? I did not have any exams after stating 60% was the max rating, even for amputation. Maybe I got lucky and had a sane VA rating officer

You know, for several years I wondered where all the records were going that I was sending to the Seattle RO. I had signature required mailings and they were being signed for at the address they were sent to, but the VA continued to deny they received them. Three different mailings before they admitted receipt of. When I would say John Doe signed for the packages they would deny that person existed. Then I found out in 2010 that Seattle RO was one of those found shredding documents in the mail room. Disgusting, and the IG should have investigated further and criminal charges should have been filed against those who ordered this action

It depends on what level review you are in. The appeals information letter outlines each step and whether you can or cannot submit additional evidence. We thought we had used up all appeals other than BVA but the VISN network sent a letter with the denial stating we could request a review from VISN within 60 days, and new evidence could be submitted. That was not in the original denial with appeals, so I think Congress has had enough complaints that they are changing the way they determine eligibility. Up to 90% were being denied or removed from the program. In the VISN decision an extra step for review was offered, again, that is different than the appeals process was laid out, so be sure and read each letter you get because there might be slight differences. Also, remember, any records in your VA healthyvet or VA disability letter are not NEW evidence, they existed in your file when a decision was made. I printed out my disability letter with 32 ratings from 0% to 60% and sent it, noting it was not new evidence but that VISN needed to review it

Very late reply. Yes. We have been in the program since 2011. In April we had a clinical evaluation, three days later we got the letter stating we were being removed from the program. Mail moves fast with bad news. Took 2 weeks to get an answer as to why, the clinical report. I went back and looked at my healthy vet medical records and found the assessment. Went back and looked st PCAFC criteria, and we met the criteria for having at least 4 areas of daily living where I need help, and it was unsafe for me to live alone??? Sent in a request for review. Denied. Sent in the formal appeal. Denied. Even after we pointed out the page and paragraph where the assessment noted I met the criteria. Our only issue with the clinical report was the nurse wrote mobility or walking issues were short term. Even considering that we still qualified, but my mobility issues have existed since before I was medically retired, in fact that is why I was retired. We contacted our Senators office and they made an inquiry, and within 24 hours they called. When I asked how they could deny and remove when the clinician clearly noted I could not live alone and needed help with 5 of ADL listed in the PCAFC criteria. Crickets We got a letter stating we could request another review instead of the next step, the BVA, and followed with another letter stating the VA was reviewing the criteria, because they are kicking off 90% of legacy participants with their new criteria. My point, if you can roll over in a bed by yourself they will deny or remove, that is sick. I asked if they want to pay to put me in a nursing facility because that is what the clinicians report contained. Help bathing, grooming, walking, putting on orthopedic appliances, and dressing.

Hey Bronco, yes. There is additional benefits i am seeking. SAH and Aid & Attendance. My wife has been my VA Caregiver since 2011 and clinical assessment has verified I need help with 5 areas of ADL and need supervision for safety, medical care, and cues. Back then, when I filed the VA told me I had to have 1 100% rating. With active SNRA that has never been in remission and impacts basically every joint causing fatigue and is invapacitating. They did finally rate residuals last year, both shoulders, multiple fingers, wrists, and knees after imaging reports were finally obtained. At the time I was not rated 100% but TDIU, and they denied the Seronegative RA claim even though the evidence supported my claim. They got a VA examiner to, in the only way to describe it, lie. He was dishonest about elements of a diagnosis, the medical records i supplied, and findings. I know he was not as ignorant as his report was, so yeah, I got mad. Since then they never followed the VCAA or case law that I sent them regarding the evidence, equipose, benefit of doubt nor did they follow BVA remand orders 2x! VARO originally agreed my Rheumatologist and PCM diagnosed and treated SNRA but erred horribly on my dates of service, eventually leading to 3 more denials. The BVA Judge ordered specific actions, they ignored her. She then reordered actions, they ignored her again. In Feb I was notified she left the BVA, new judge. Another denial 1 month later which combined an increase for left knee following a meniscal removal and SNRA. Over 13 years there are 6 different SOC that describe the two conditions as separate, as is the SAH. Also denial of A&A. A new SOC was supposedly issued but I never received. The BVA accepted the SOC, so I filed a request for review from the BVA with a hearing, which has been granted, and a CUE with the VA, using all of the history of the two separate issues. The VA cannot combine a knee issue with a chronic disease issue. They could rate a residual, but cannot rate SNRA of the left knee, that is impossible. It would be the same as rating an eye for diabetes. An eye cannot have diabetes, it has to be rated as a residual and if a residual is rated then the disease would have to have been accepted. My biggest issue is the failings of multiple ROs and I want to have an impact that will help other Veterans in the future. This is not complicated stuff here. If a chronic disease is found compensable by 10% within 2 year of separation, presumptive. If there is a continuity of symptoms, service connection should be granted. My situation is bad, and the evidence supports my request for a 100% rating for a chronic disease. Maybe one day this claim will be used to set precident for future claims

I got that same message. QTC has scheduled you an exam. I contacted them and asked them WTH?? My wife is my VA Caregiver, so she has to be available. The first one they scheduled was almost 2 hours away. I called and they said it was the closest. After laughing for 20 minutes i asked if they needed me to research QTC examiners closer. I dont remeber ever being asked if they could release my private information to an examiner, good question to ask them, but it is probably in the 5 page of nonsens they send from Janesville

I feel you CUE. I was awarded Housebound in 2010 after they corrected a CUE for right knee residuals, and awarded loss of use. It is amazing that I can read the CFR and USC and see the regulations and laws and yet the RO will deny, deny, deny. I am working with my Senator and I want an impact from some authority to hold VA adjudicators accountable for their work. If there is evidence to support a claim, why do we have to fight for years? It is not supposed to be that way. Hang in there and keep fighting until they provide you your benefits

I would agree, just from my experience. Now I have had a couple of good VA examiners through QTC or LHI but also some bad ones. At the BVA the ALJ demanded they consider lay evidence in an arthritis claim, and they did not. They did pull the more persuasive argument, but I countered with overwhelming evidence and Benefit of the Doubt where we are supposed to have "tie goes to the runner" If you appeal you have to look for any process that was not done correctly, where in your service records evidence exists, possibly get an examiner to find a neus. In other words, look for every I and T and fight it

Thanks, I might give that a shot, but they may have me labeled as "hostile Veteran" because after my last letter describing the merger of two separate conditions I called them and told them their claims processing is garbage. I did actually call last week after I got a LHI letter asking for a third C&P on the left knee, and the rep I spoke with took the time to look at the claim, actually repeated what I explained and read me the message he was sending the RO. Kind of shocking but it appears that at least 1 person at the entire VA understood how bad they jacked this claim up Waiting for a second hearing date so I will likely have time to stop in and ask Thanks

Hey phury, thanks I guess the question is hiw do I see if the examiner checked those boxes? Cant get a copy of the exam until the case is resolved, which does not help me, but I have read Walker v Shinseki where they state the VARO must consider lay evidence for rating. Not once since I filed in 2009 have they even commented on lay evidence from me or my wife. Thank Goodness they accepted my request for review but I think it is pretty shady for the attorneys at the BVA to not have reviewed the 6 different SOC the three remands and the evidence over 13 years before accepting that decision. Causes a lot of extra work for me. And yeah, I know the bar is high but my SNRA has never been in remission. I dont have flares, I have daily widespread pain and fatigue that is disabling. I am rated housebound because of residuals and joint damage, so we will see