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Gastone
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Posts posted by Gastone
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J A G: You said DRO Review 06/13, not a DRO Personal Hearing, right. Did either you or your VSO file a FOIA claim for a complete copy of your C-File? I requested my C-File 09/12 and finally received it via UPS mid 01/2014. Package was about 8+ inches thick. I think that's about 1500 or so pages. It wasn't the complete file, only had documents thru end of 2012. All 2013 was missing. If you or your VSO had filed for it, there would have been an FOIA Claim listed on your E-Ben site.
I wouldn't just send it back to VARO that sent it, you probably have 2+ yrs ahead before a BVA Court Hearing. Did you opt for a Traveling Judge? Are the 800 pages in any semblance of order? I'd consider Scanning rather than printing everything, trees are screaming all over the world.
What does your VSO that handled your DRO Review say?
Semper Fi
Gastone
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USMC2311: After 4yrs, multiple claims filed and 2 NOD DRO Hearings pending, I switched VSO's also. In those 4 years I had never heard from the VVFW VSO since the initial claim was filed 08/2008. He never answered his voice-mail and was never in his office at the VRO. Hooked up with Marine Corp League by accident in 2012, there was always someone in their VRO office. One of vso's offered me paper to slip a note under door of my VVFW office. After which I sat down with MCL VSO and discussed changing my VSO Rep. VSO's, as organizations, are very reluctant to do so after NOD's are filed. In the end, MCL completed all VA paper work needed to sever my representation by VVFW. Since then, always been a MCL VSO to discuss issues with, before but usually after I've decided on a course of action.
Semper Fi
Gastone
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ctbenja1015: No offense, but never "WAIT and SEE" with the VA. Prepair for the Denial, then celebrate if you are awarded on the first try.
I am assuming, usually not something you, I or We should ever do, that you have a SC Compensation Claim filed about a year or so ago. If you filed a SC FDC you probably had a C&P exam within a year of the filing date. Have you obtained a copy of the C&P Exam from the VAH Medical Center Records Dept? If not, please request all VA Clinicians notes as well as the VA DBQ that was completed and forwarded to the VARO rating Dept that has responsibility for your claim. That would be Chicago VARO. Be Proactive!
Semper Fi
Gastone
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USMC2311: It appears you filed your orig Comp Claim mid 2012? Did you ever get a copy of the C & P exam from your VA Medical Records? In 2012 I believe the C & P Examiners were required to complete whatever VA DBQ was being requested by the VA Raring Dept. The 1st time I requested my clinician notes pretaining to my PTSD C & P 2011, I got exactly that, the examiners notes. I went back and specifically asked for a copy of the completed PTSD DBQ that was submitted to the VRO Rating Dept. No idea why VA Med Records needed to be asked twice. I had asked for (all clinician notes and documents) from C&P exam.
Do you have "Proof of Receipt" for all "NEW and Material Evidence" that you have submitted to the VARO since your denial? If in doubt, send it again, US Mail Cert_Return Receipt.
Although your out of the US and it appears your handling this Solo ( Pro Se,) think about contacting a VSO to represent you. You will still be classified as "Pro Se" by the VA. I used a VSO for info only, filed all my own claims & Appeals. When it was time for my DRO Hearing, I requested the VSO provide a DRO Hearing Specialist. I struck Gold, my guy was Retired VA Employee from VRO Rating Dept. He had spent his last 10 or so years as a DRO. I would have liked to talk to him 4 yrs ago, a fountain of Knowledge and experience.
Semper Fi
Gastone
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USMC2311: Regarding your NOD Filing. I don't know if you can request a "personal Hearing" post NOD filing requesting only DRO Review. I do know that you can use the same "Informal Conference" request that is available to DRO's. I did and all of a sudden my original NOD Hearing was scheduled within (3) months.
Give consideration to using "Sworn Declaration" in place of VA "Statement in Support of Claim." My DRO seemed impressed when he reviewed my "S. Declarations." Just be sure that all of your "NEW EVIDENCE" is in your C-File for the DRO to REVIEW. This may mean making copies of all your "NEW" evidence and both mailing (1) large package to the VA Cert RTN Reciept US Mail as well as Scanning all to PDF and attaching to E-Ben Document. Remember, You have (1) shot at DRO Review, No "Request for "Reconsideration." If your not at an "Official DRO Hearing," with all your NEW evidence to be sure the DRO sees it before rendering a decision, you could get screwed again. The next stop is VBA Court 2-4yr wait. CYA BRO!
Semper Fi
Gastone
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NK: Do some research on Regs regarding "FOIA" claims. When I hand delivered a request to the Det RO to View and get a complete copy of my c-file 10 09/12, on a VA Statement in Support of Claim, I had no idea that I was filing an official "FOIA" claim. Later it showed up as a pending "FOIA" claim on my E-Ben site. I never followed up and it took about 15 months to finally receive via UPS 01/14. It only had records thru 12/2012. No notes from rating dept or DBQ's submitted in 2012 or 2013.
My late 2013 research indicates the when a "FOIA" claim for production of VA records is received, Courts hold the VA to a specific response time. I had missed all the opportunities to do anything about the VA's failure to produce the requested documents. Like everything else, "the squeaky wheel gets the grease." I didn't squeak and the VA took their time to produce an incomplete copy of my C-File. Note: there were (3) pages from VA Vocational Rehab that belonged to another Vet that had seen my same VRC in 2012.
Semper Fi
Gastone
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ctbenja 1015: A very interesting question, I'm not sure at this point, I will research the answer. However, at this point be sure your US mailing address is kept updated. If denied, I would send my NOD to the VARO holding your C-File. I think your looking at approx. 21/2 yrs for a DRO Personal Hearing. I've read where VA Appeals are brokered out to other VRO's for completion. If your using a VSO or not, it would be advisable to check with an experienced VSO regarding your questions on all aspects of your claim. Just remember, Trust but Verify. Quite often discussing your appeals and even basic claims questions with more than 1 VSO or VA Accredited Attorney, will provide different opinions. I have personally experienced this and it remains your responsibility to get as informed and knowledgeable as you can regarding your claims, appeals and VA Regulations.
Maybe all will be awarded and you won't have to appeal, YA.
Semper Fi
Gastone
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USMC2311: I agree with Berta.
It appears that you have the DXing covered, how do you compare to 38 CFR 4 rating schedual? You should be able to come fairly close to what your SC rating should be.
You filed a timely NOD, I procrastinated and did mine end of 11th month on my 1st claim. Did you ask for DRO with Personal Hearing? I just had my DRO Informal Hearing 6/27/14. 8 months of my 31/2 yr wait, due to my late NOD filing. The Face to Face with a Senior VA Rater worked out great for me. About 35 min of back and forth on my denied issues, all major issues from 2008 awarded. DRO said due to my decision to go with an "Informal Hearing" instead of the "Regular recorded and transcribed" hearing that I was scheduled for, we my as well take care of a 2nd NOD filed 09/2012. Walked out of hearing knowing what issues the DRO awarded from 08 claim nd TDIU award from 09/2012. Got a call from MCL VSO at 330 that same day, he already had an Official DRO Award on his desk addressing all issues, to include TDIU T&P.
Trust but Verify
Semper Fi
Gastone
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Notorious K: Your claim/claims denial had to be explicit in regards to what and why the VA rater decided against your claim. I've had approx. 6 claims submitted since 08/08 with multiple issues on all but 1. When awards or denials were issued, the rater, to best of my recollection gave a reason. My advice based on my own experience is to file your NOD stating the date of the VA Claims Denial letter. You don't have to list each claimed issue that was denied on your initial NOD. Your just "Officially" putting the VA on notice of your intent to appeal their decision/decisions regarding awards or denials list in your recent claims decision. This original NOD is the (1st) step and should be filed sooner rather than later. You can do it yourself or use a "Verified Competent" VSO that you trust. If your at the 11th month after the denial letter, FILE the NOD yourself before the "Denial" becomes final. Send it US Mail Cert-Return Receipt. Based on my VA Claims experience, 2 NODs, 1 "Informal Conference request" and recent DRO Personal Informal Hearing 06/27/14, I put "Requesting DRO Personal Hearing" on all NOD related correspondence.
You had to have had a C&P Exam, get a copy from your VAH medical records. The Dr had to fill out a VA DBQ regarding your claimed issues. Any outside medical DX's that you offered would be used in conjunction to rate your claim. Check your claimed issues in the 38 CFR 4 rating guide.
I waited over (3) years for my NOD Hearing due to waiting till the 11th month to file. The current time frame seems to be 21/2 years for DRO Hearing 3 to 4yrs for BVA Court.
Good Luck
Semper Fi
Gastone
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M090700: I feel you, but who is your "Visor?" Need more history and specifics brother, to help you. If you are the typical Vet, me included, you jerked around on the initial claim and denial. I waited till the 11th month, just before my appeal period closed, to file my own NOD requesting a DRO Review and personal hearing10/2011 or so. Never heard anything from my original Filing VSO. Finally got my DRO Hearing 06/27/2014. If I'm carrying my naughts right, that's 66 months since my original claim was filed 08/2008. Remember, my procrastination is responsible for at least 12 mos of the 66 mos. Quite possibly my lack of initial involvement probably directly contributed to the initial denial.
Semper Fi
Gastone
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Where is there any VA REG in 38 CFR 3 or anywhere else that addresses "Request for Reconsideration?" Is this just a "well intentioned VSO" theory?" I recently advised a VET that was at the end of the 11th month after his "Denial Letter," to immediately file his NOD requesting DRO personal hearing so as not to loose his appeal right and keep his claim alive. In response, they were worried about the NOD filing derailing their "Req for Recon" that had been pending for many months. My opinion based on that discussion, the VET's VSO is at fault. This uninformed Vet relied on a VSO's well intended but mistaken-misguided advice and risked his denial becoming final. If anyone has had success with the "Req for Recon," please advise. How can a Vet ora VSO track the Req's status?
My understanding of the "Req for Recon" is you send in a ?formal? request to the VA Rating Dept to take another look at your recently denied claim, due to some perceived error in their Denial Decision. You haven't Filed a NOD, so this isn't an official start of the appeal process. Your just asking , please take another look. Same rater=Different outcome, maybe, but I doubt it.
I hope that any vet that goes the "REQ for Recon" route includes something to the affect, " Regarding my recent denial of claim dated --/--/----, i request that the rating department give reconsideration to following issues and evidence. If after Reconsideration my claim is not Awarded, no later than (--/--/----(360 days from original Denial letter date) accept this as my "Official Notice of Disagreement with the VA Claim Denial dated --/--/----. I request a DRO Personal Hearing."
DON'T LET YOUR CLAIM DIE!!!!!!!
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Never gave SPN codes a thought, till today. Inlisted 02/68 on 2yr guarantee of Nam. Did 1 tour RVN. 2 mos on Okinawa, declined offer to ship-over and discharged 11/69. Just glad to be back in "Round EYE" Heaven. 24 month contract completed with early out after 20 months. Never gave option of active USMC Reserves a second or for that matter 1st thought. 2yr deal was 1 tour Nam and out, inactive reserves till final discharge. Stateside duty with lifers, definitely not for me. Lifers minded their manners in Nam. I know, not all lifers were bad but all it takes is 1 or 2 to make you dislike them all.
I think most mature American adults, of all political persuasions, know the US Congress and Senate is a potential highway to wealth. I don't have the stats but think most who serve (?), leave wealthier than when 1st elected. You can't say all, but I believe most start out well intentioned. Does the system corrupt or is it just the temptation to take advantage of their position and lobbyist $$. I think if we look at both sides of the HOUSE, we see a possible minority of good honorable public servants. The rest appear to be either Pigs or Hogs when it comes to self-enrichment. Some have spent most of their working life as Congressman or Senators. Wouldn't you or I for that matter, Like to be paid $160K (?) a year and become multimillionaires using our insider information and contacts to enrich our families and ourselves. Not to mention the Retirement and Pension package.
Why should I rag on them. Given the opportunity to serve as a Senator or Congressman, I can only hope I would have been an Honorable Public Servant. But, Like most men, you don't know till you know. Everyone says what they "Would or Could Do," it's not till your tested that your true character surfaces. It's the "life or death" moments or when nobody is looking that we find out what we're really made of.
Semper Fi
Gastone
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Marine10980: Is there anything in your VA Medical Record that supports an earlier effective date? I take from your post that you didn't appeal the 2009 reduction?
Here we are 2014 and you have had your PTSD rating increased from 50%(the rate reduction) to 100% SC. Great Job! As far as retro date, somewhere I read that the VA Rater can go back 12 Months prior to the file date. It all depends on the DX and medical evidence. If you don't agree with the award, I suggest you file a NOD requesting a personal hearing. The DRO Hearing worked great for me, IU awarded 6/27/14. You have probably already pulled all your VAH Medical records, Check your Mental Health Clinicians notes for discussion on DX and symptoms. I would specifically request a copy from Medical Records of your recent PTSD C&P. All the info used by the VA Rater should be on the DBQ.
Good Luck
Semper Fi Nam 69
Gastone
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2311: You will get all kinds of advice regarding doing just about anything after filing your NOD. I just had my DRO Hearing 6/27/14, from 1st NOD Filed 2010. My advice based strictly on my own experience is, DON'T Half STEP. Hopefully your NOD requested a DRO Review and a Personal Hearing. If you used a VSO, verify that a "Hearing" was requested, don't wait till you get a DRO Decision, to find out a "Hearing" wasn't specified in you NOD Filing.
My Time-line: 1st NOD 11th hour 09/2010, Multi additional SC Clms filed 2010, 2011 & 2012 NOD 09/2012. Finally got around to requesting C-File aprox 10/2012, recieved it 01/2014. Was getting edgy regarding 1st NOD, filed for "Informal Conference" hoping to get info from Horses Mouth at VRO DRO. Received VA Letter with DRO Hearing Date 05/26/14. No one at VSO I was going to use at Hearing, could get any info regarding what the 06/27 Hearing was going to cover. I decided to be prepared to address both of my pending NOD's. As it turned out, my 2010 NOD was on deck. However, because I opted to have an "Informal Hearing" after a preliminary discussion with the DRO, the DRO agreed to address both my NOD's. After approx 35 min, I was done, the DRO advised me what his decisions were. I was out of VRO by 915am and VSO called at 330pm, he already had the Officail DRO Decision granting all important issues, to include IU.
It appears that NOD Hearings are taking about 2+yrs and VBA Court 3-5yrs depending on remans.
Good Luck
Semper Fi
Gastone
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Kimmy; I was just awarded TDIU at DRO informal hearing 06/27/14. Been 90% SC since 70% PTSD award 2011. DRO said the Voc Rehab Denial Letter stating I was not currently eligible to continue the program due to the severity of my SC conditions, seal the deal. That Denial letter removes any questions regarding your current ability to obtain "Gainful Employment." Income above 1 person poverty level of approx $14,000.00 per year is the current VA income threshold for IU. This letter must be forwarded to the VRO handling your claim, fax it and mail it Cert Mail-Return Receipt.
As far as the place of his C&P, the examiner isn't going to be one of his treating clinicians. It will be a Psychiatrist or a PHD Psychologist either VA or Contract employee. They will complete a PTSD DBQ as requested by the VRO Rating Dept. You might want to review the 38 CFR 4 rating for what ever level of compensation you think your husband is entitled to. You can pull up the PTSD DBQ on-line. He needs to be fully prepared.
Good Luck
Semper Fi
Gastone
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Bsoldier244 If your at 80% SC, your still 20% effective. With VA math, you need something rated at 30%-50% to get you to 90%SC. Something rated at 75% would get you to 95=100%. A very tough hill to climb.
Even though you have an 80% SC rating, I don't think you qualify for a scheduler inferred IU claim, but there is always an extra-scheduler claim. Refer to TDIU claim requirements in the 38 CFR 4 Regs. Your complete SC disability picture may currently affect your ability to obtain or maintain "Gainful Employment," currently income at or above aprox $14,000 per year. This amount changes with the US Census poverty level income for (1) person each year. An IU claim would be greatly assisted if you had been through the VA Vocational Rehabilitation Program and been denied. The VA will accept a VA Voc Rehab Denial letter as proof you can't currently be retrained for "Gainful Employment." This is a very important piece of "GOLD" to your IU claim. Good Luck.
Semper Fi
Gastone
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Thadine: I just had a successful DRO Hearing 6/27/14 from an original NOD filed in 09/2010. I see you filed your NOD 11/2011, did you Request DRO review with a personal hearing or did you opt for BVA Court? I think DRO Reviews with personal Hearing are taking about 21/2 yr now. A Nam Vet friend of mine waited to the 11th month, to file his NOD. Then he allowed a VSO to file the NOD and request the DRO Review with a hearing. Problem came to light about 14 mos later, received a DRO Denial letter and a Statement Of Case. Never got the hearing only DRO Review and he never sent in the "Mandatory" New evidence. He says he planned to present it at his hearing, not a good plan. Turns out, there is no record of the personal hearing request, only the DRO Review. The DRO reviewed his C-File without benefit of new evidence and Denied his appeal. Next step is VBA Court, at least a 2-3 yr wait.
I guess the answer to your appeal timeline, really depends on what you asked for. DRO Review with hearing 21/2yr give or take or BVA Court 3-5yrs depending on any remans. Hope things work out for you.
Semper Fi
Gastone
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SSG O: 0% to 80% on your 1st claim, way to go. When you receive the Official VA award, it should be noted that an inferred claim for IU is pending, if you meet the VA Scheduler requirements. See the TDIU Requirements 38 CFR 4 etc. I was just awarded TDIU, at DRO Informal hearing 06/27/14. DRO said my Denial Letter from the VA Vocation Rehab Councilor was best "New" evidence I could have presented. As soon as you get your official VA SC Rating, I advise you look into the VA Voc Rehab. It really helps with the IU claim. Congrats & Good Luck
Semper Fi
Gastone
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It only took 5 yrs from the appeal filing, maybe the BVA hasn't got their act together. No idea, if Vet filed a DRO Hearing or opted for BVA.
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See Citation 1412612 Decision 03/25/2014 Detroit RO. Vet Awarded on DMII and PN and ED from DMII.
Original appeal 10/2008. Maybe the VBA is getting their act together.
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LY3: I forgot to mention the following. Get a copy of any and all PTSD C&P's from VAH Medical Record department. You will see exactly what the C&P Examiner stated on the PTSD DBQ. If you haven't already done so, review the 38 CFR 4 PTSD rating schedule, you'll be able to tell where you are. And keep in mind, "Depression" is a symptom of PTSD. If you received your PTSD rating since about 2010, You had to have had a Staff or Contract VA Psychiatrist or PHD Psychologist administer your initial and all subsequent PTSD C&P's. They may answer the DBQ differently, dependent on you medial records and your responses on the day of the exam, but their not going to reverse another VA Psch. MD diagnoses of PTSD, to just depression.
Before the recent adoption of DSM-5, an improved GAF score placed in your VA Medical Record, by a VA PTSD Social Worker or other mental health clinician, could be grounds for another PTSD C&P, if you filed a claim for anything. If the VA rater saw the improvement from say low 50's to mid or upper 60's, that could trigger another PTSD C&P. I think the Medical community and the VA realized that the same VET seen by 4 different clinicians, could get (4) different GAF scores, varying greatly in severity.
Gastone
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LY3: My research (2008-2014) regarding primarily "AO Presumptives & PTSD", indicates only a Physician, VA or Private, can DX a medical or mental condition. The VRO that has your C-File uses the Dr provided DX DBQ to rate you according to the 38 CFR 4 regs per your diagnosed condition. The raters can't change your Dr's DX, they can only use the original C&P DBQ to determine your SC %.
With that said, if for some reason, a new claim or appeal is filed, they can review and possibly order another C&P exam for your PTSD. I personally and the 8 Nam PTSD Vets I meet with, have not had a VA demand for new PTSD C&P since 2010. I've had 3 additional claims filed, including IU, which was recently awarded at a 6/27/14, DRO "Informal Hearing." One guy filed a NOD, at the last month for filing his appeal, requesting a DRO of his 50% award. He and his VSO who actually file the NOD, neglected to request a "Personal Hearing." The Vet never supplied the "Mandatory New Evidence," he planned on presenting the evidence at his DRO Hearing, that he never got. Instead he received a DRO Claim Denial Letter and a "Statement of Case." Between the Vet and his VSO, they screwed the pooch! His only recourse is BVA Court, another 2+yrs or so, good luck with that!
Regarding your current PTSD rating, even if you showed vast improvement (per new DSM-5, GAF Scores don't carry the weight they used to) my understanding of the VA regulations regarding reduction in rating, you could only be cut to the next lower PTSD SC %. In essence, if your at 70% and a new DBQ shows improvement to what is a 30% rating, Highly unlikely if not impossible, you can only be reduced to 50%. If that were to happen (Unlikely) you immediately file a NOD requesting a personal hearing. You do the NOD yourself, too important to intrust to a 3rd party.
Good Luck
Semper Fi
Gastone
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Coastie72: I've got the same rating in 2009, 10% Tinnitus SC hearing impairment 0%. Appealed the 0%, just recently withdrew that issue at 6/27/14 DRO Hearing. New along time ago, it wasn't going to fly. Get a copy of your Hearing C&P from your VAH medical records department. Compare the stated results to the 38 CFR 4 VA disability Ratings. I think you'll find, as I did, an appeal would be difficult if not impossible. With that said, you can appeal any VA Claims award or denial that you choose too. You have 365 days from the Claims Award or Denial letter to file your appeal, after that, the decision is final.
As for Sleep Apnea, if it wasn't DX'd in the military or within the 1st year after discharge, in and of itself SA isn't a ratable SC Condition. If you have a DX of a SC condition that is a medically know as a possible cause of SA, then a claim of SA secondary or aggravated is possible. Need to see a Sleep Neurologist, VA or Private, to determine most likely cause. I got my SA DX 2010 rated as Secondary to my DX'd CAD 2006.
Good Luck
Semper Fi
Gastone
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Veldrina: Your posts are most informative. I work with a few fellow Nam PTSD Vets. My point to them, pre DSM-5 implementation, was always remember "What you say can and will be used against you!" It wasn't unusual, when reviewing a Vets VA Clinician notes, to see his GAF score had improved 6-8 points. In some cases, enough of an improvement, to trigger a possible rate reduction exam.
If you could opine regarding the current PTSD regulations regarding the deference placed on private non VA Psychiatrist or Psychologist PHD or otherwise DBQ's, that are contradictory in diagnosis to the VA C&P Examiners DBQ.
Recently, I advised NAM PTSD Vet 50% SC, to file a Alcohol-substance abuse secondary and or aggravated by his SC PTSD. My position is the self medicating theory. He definitely has PTSD and now he has a diagnosis of Alcoholism and substance abuse. My concern is, he's was an alcoholic-substance abuser, well before receiving the official PTSD diagnosis from the VA. In most cases, that appears to be a deal breaker. I'm not sure if he has non VA medical records predating his PTSD DX indicating the alcoholism- substance abuse.
Thank you
Semper Fi
Gastone
Service Medical Records Request During Appeal
in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC
Posted
USMC2311: Regarding clinician's notes from your C&P. My 2010 C&P exam provided a Clinician note in my medical file which pretty much followed the VA DBQ. I believe the examiner completed the DBQ after I left his office and subsequently scanned the the DBQ into my VA med file as well as sending it to the VARO Rating Dept. I really can't be sure of the time-line back then. I don't think we could get clinician's notes from VAH med files until 01/2011.
Just recently 07/2014, I had a C&P from an FDC claim filed 05/2014. After discussing the Nexus of the medical issue with the Staff VA Dr, I realized I was wrong regarding the primary cause of the claimed secondary issue. The VA Dr pointed out my error and opined as to a Nexus of a different SC condition. I left his office having (2) DBQ's completed. My VA Med Records had the complete C&P discussion, including both DBQ's in it by Friday of the following week. The Dr noted that during the course of my exam, a different Nexus was discussed. After which I requested his aid in completing a "New" DBQ. He complied with VA policy regarding completing a DBQ at the time of request by the veteran. I left his office with my "New DBQ" indicating SC.
Semper Fi
Gastone