Gastone

Do you have your VA Comp Direct Deposit Account set up to Txt & E-mail you immediately, regarding all transactions? If not, might be a good idea. My experience has been, Retro Deposit has always hit, about 3 weeks before the actual Award Letter arrived. Most recently 01/03/16, E-Ben showed 12/15 Increase 90% IU to 100% SC with SMC S (1), due to Quality review of 07/15 Award. By mid 01/16 Retro Hit, actual Award Letter arrived in 04/16. The Award letter will catch up sooner or later, why concern yourself, right now. Relax, you won. You want to think about something? See how close you come to determining your Retro $$. That would be more productive and enjoyable than waiting by the mailbox. Get a copy of your PTSD C & P DBQ from your VMC Medical records. How does the DBQ comport with the 38 CFR 4. Do you agree with the 50%? Might be time to start putting your NOD together. Semper Fi

John, very few Vets, yours truly included, don't have our fingerprints all over our Claims Denials. We either relied foolishly on a VSO-Rep to be as concerned, as we eventually became, or just plane old ignorance of VA Claims and a good dose of procrastination. All 3 are a recipe for a Denial. You mention your waiting, I trust you have at least started your SA FDC on your E-Ben site, to establish the New Claim File Date, right. Refresh my memory, are you filing for SA as a Direct SC or a Secondary? What is your Medical Nexus Evidence? Posting redacted copies would be helpful. Semper Fi

Are you saying, that as of today 06/02/2016, you have not Filed a New Claim for SA based on the recent 04/16 Sleep Study? The reason would be? It appears that you missed the NOD Train on your previous Denials, or am I wrong? Did you ever file a NOD on anything? Forget about the Retro for right now, if you think you have compelling New & Material Medical Evidence that was or wasn't viewed by the prior Claims Raters, attach it all to your NEW FDC. Get the SA SC, just because you think or wish your SA will be SC'd, doesn't mean anything till you get the Award/Denial Letter. If you get the SA SC, then start researching for an EED Claim for the Large Retro $$. Semper Fi

More info please. What evidence and when did you supply it to the VA, regarding your SA Claim? Do you have copies of your SMRs indicating treatment for sleep issues? When did you get your official SA DX? Was your SA part of your original 2013 claim? Are you on Appeal now? We're all in a hurry, just human nature, VA is not in a Hurry for anything. Some discussion regarding a NOD for a DRO Review, why not a DRO Hearing? You absolutely have to provide the VA with New & Material Medical Evidence, that was not available for the original Rater's review. Without it, your sunk. How about posting redacted copies of your claims and Denials. Easier to get a grip on your situation. Have your filed a FOIA requesting your complete C-File? Will probably take a year to get, so get hot on it. Burn a day at your RO, request to view your C-File as a walk-in. It's the only way to verify what Evidence is already in the VA's possession. Semper Fi

How long did you have HBP, before it was DX'd, treated and brought under control? Your answer doesn't really matter. It's safe to say, it didn't just appear overnight. In most cases, if not all, HBP is working it's Dastardly Magic on your body for a significant period of time, before symptoms present and are DX'd. If you were getting yearly check-ups, at least a 12 month window, right. Just because you have controlled HBP, without a DX of CAD or other Circulatory Disease, filing a Secondary Claim will get Denied. Ask your VA PCP to refer you to the Cardiology Dept. If you were to get a Nuclear Stress Test or a Heart Echo that turned up a problem, a Heart Cath would be the defining test for CAD. Semper Fi

Pack a lunch. DRO Reviews anywhere 12 - 18 months, DRO Hearings 2+ yrs, mine took 4.25 yrs in 2014. Check your RO's, most recent, Monday Morning Report. Unless it's changed, the MMR will show the "Total Appeals" pending for your RO. It doesn't list the DRO's separately from the BVA's. Gives you some idea of what your into. Call any of the VSO's that have an office at your RO, try to get the MFIC or a Sr Service Rep on the line. Find out how many DRO's are on your RO's Staff. He should be able to find out exactly how many pending DRO Hearings have been handled in 2016. From there you can do the math. Keep in mind, you MUST submit the "New & Material Evidence," Mandated by the VA Reg for a DRO Review or Hearing. Early receipt of your N&M Evidence, could trigger the VA Automatic Review of your Denial by a Sr Rater or actual DRO. You "could?" get an award or a Continued Denial, much sooner than the actual DRO Hearing. FAILURE to submit the N & M Evidence, will guarantee you an Administrative Denial. At the 4 yr mark, I filed an Official Request for an "Informal DRO Evidence Conference." Never got the conference, but within 3 months I received the VA notification that my DRO Hearing was on deck for 6/28/14. I chose to go "Informal," no recording transcription. Hearing lasted 35 min, DRO told me he was awarding everything. I was out of the RO by 930am. VSO Rep had a copy of the DRO Award by 3:30 same day. Retro hit mid July, VA Award Letter, like Aug 1. It's not unusual for the DRO's Decision, to take up to a yr after a Regular (not informal) DRO Hearing. Semper Fi

Your Award has to pass the 1 year mark, without a NOD filing, to become final. I was in the same situation back in 07/14. Secondary 04/14 FDC Awarded @ 0%. At that time, I had just been Awarded IU at a 06/28/14 DRO Hearing, from a 2010 NOD. Sure didn't want to wait another 3 to 4 yrs for a DRO Decision. Filed a New Secondary FDC 01/15, exactly the same as the 04/14 FDC. C & P took place 04/15 (real Negative VA Dr), 07/15 Decision letter, same Secondary SC @ 0%. I was getting ready to get back on the NOD Train 12/15, just hadn't mailed it in yet. Went on E-Ben 01/03/16 to get a copy of my IU Award for MI Property Tax Exemption. Low and behold, the VA Quality Control Phantom Rater, had taken me from 90% IU to 100% Scheduler with SMC S (1), in mid December. I have no idea of how long the Quality Control Rater had my 07/15 Decision. Had I jumped back on the NOD Train right away, would that have stopped his review and subsequent Award, I don't know. Semper Fi

Sax, your NEW claim has no bearing or affect on the Issues being Appealed to the BVA. I don't recall you mentioning that you actually started a New claim on your E-Ben site. You know, right, just starting the Claim on E-Ben, establishes your Retro Date? Filing as an FDC, is the way to go. My experience has been very positive with filing FDCs, as soon as the New DX Condition is in my VMC Medical Record. Some would caution, that Filing New Claims would slow down your other older claims or appeals. I filed (2) Secondary FDCs 02 & 04/14, 4 yr old DRO Hearing request was held 06/29/14. Both FDCs (1 Denial, 1 Awarded) were done by 07/14. Semper Fi

What SA DX do you have, OSA, CSA or MSA? When exactly did you receive the Official DX? As to filing for SA as Secondary to a SC Condition, rather than a Direct SC itself, the existing SC must be in place and Awarded, prior to the SA DX. As for the Direct SC, very difficult without in service DX or Treatment of Sleep issues records backing up your claim. Snoring, in and of itself, won't seal the SA Deal. Look at the list (about 10 or 12 usual suspects) that most Drs consider to be the accepted primary causes of SA. How do you stack up? Semper Fi

When possible, posting redacted copies of your Award/Denial letter and discussion of evidence reviewed, would still be of great assistance. Semper Fi

JL, are you sure this was a MH C & P? Looking back at your 5/18 post, seems awful quick, for VA Rater to order MH C & P from the recommendation of a 5/1 (?) C & P. Have you obtained a copy of the MH DBQ from your VMC Medical records yet? Posting a redacted copy would be very informative. While your at it, get copies of all your C & P DBQs, let's see what the C & P Examiners had to say. Semper Fi

Buck, I hear ya. As I recall, My C-File copies weren't really in any chronological order, and ya, a pain to sit and go through. You can understand the VA wanting somebody sitting with you while you REVIEW your Paper C-File. The File is considered Evidence of Record and the VA has to maintain a Chain of Custody. I'm sure no Vet would try to remove or add anything in, right but you never know. I don't think that's a problem with viewing the Digital Copy and it should be a hell of a lot easier on the eyes. Printing copies should be faster also. I hope to give it a try in the next month or so, will keep you apprised. If a Vet knew there was 1 or 2 things in his C-File, that he absolutely needed a copy of, I think the RO Visit would be a must. Semper Fi

Took me 13 month to receive about 9 in of paper C-File back in 01/14. 1 document was from another Vet's file. The C-File copies were only complete up to the date I filed the FOIA Request, 13+ months prior. I recently spoke with a Retired DRO, now works for a VSO as a DRO Hearing Specialist, regarding VA Walk-in C-File viewing policy. According to him, all C-Files at the Det RO, including Nam Vet's old C-Files, are now digitized. A Vet can do a Walk-in, M - F 8 -4, 1st come , 1st served and view their File. Copies of selected pages are available. I plan on giving it a try in the near future, just to see if it works. As to the Vet that needs a copy of something right away, he needs to try it right away. The C-File is his only source for the supporting Document? I trust he's started the "Intent to File," on E-Ben? Semper Fi

What to do, What to do? So far, what you've tried to do certainly hasn't worked, right. Going it alone or using another VSO, is kinda like repeating your previous attempts and "HOPING" (not a good word for claims), for a different outcome. What's the chance of that? Slim & None. I have no idea of how strong your case or Medical Evidence is and maybe you don't either. Was your DRO a Review or Hearing? Posting a Redacted copy of your SSOC would provide a clearer picture. At this point, you should give consideration to contacting a VET Lawyer. It's time for 2 or 3 FREE Consults from Appeals PROs. Looks like you have a possible RETRO Award back to 05/11, BVA Hearings can take 2+ years, so the 20% of Retro Legal fee, will be substantial. If all 3 firms (include Chris Attig's Firm), jump all over the claim, you might have a good chance at the BVA. If they all beg off, you need to reevaluate your claim. Back in 01/14, I contacted 3 VA Lawyers regarding a DRO Hearing, requested in 2010. The 2 Online/Telephone Legal Firms wanted me to sign a POA that day and cancel my DRO Hearing request, opting for the BVA. 3rd Lawyer was local and I did the face to face consult. She said I had a good case and could probably handle it myself at the DRO, or she would Rep me for the 20% of Retro. Semper Fi

Who's pushing the change? Specifics please, VA, Congress, CBO? Semper Fi

That's what I would call an informative post. After you get the Official Award Letter, listing all the Evidence Reviewed, decide when the evidence supporting the increases was actually in your VMC records. As it stands now, looks like your Retro pay will be back to the 05/15 Effective Date. If your VMC Med Recds indicate an earlier date, get with a Seasoned VSO Rep at your RO and discuss an Immediate Official Review for CUE on the EED. May or may not work. You will still have till 02/01/2017 to file your NOD if needed but give the Review for CUE a couple months, can't really hurt. Using only the NOD, Filed Today, you'd be lucky to have a DRO Review Decision before early 2018, DRO Hearing 3+ yrs and BVA 4+. Use your above Award Letter to sign up for VMC Dental services at your 1st opportunity. If your State offers a 100% DAV Property Tax Exemption, file for it. There's another Letter on your E-Ben account that just says your 100%, without the breakdown of conditions. That letter will be sufficient for the State Property Tax Exemption. Last but not least, get your DOD ID Card from a nearby Military base. Apply for the FREE $10K VA Life Insurance policy and complete the application for your Wife's CHAMPVA. Wouldn't hurt to apply for the VA Independent Living Program, some great benefits are available, check it out. Semper Fi

Your Rating Reduction Clock started ticking down, the Date the VA Letter was generated, not the date you received it. It's not a matter of what you "CAN" do, it's what you "MUST" do, to stop the Reduction. File for the Hearing within the 30 days and supply the Medical Evidence within 60 days of the Letters Origination date. You received the VA Letter, 05/17/16, what was the DATE on the Proposed Reduction Letter? Have you filed an Official Request for a Proposed Reduction Hearing on a VA 21-4138, sent US Mail Certified Return Receipt Yet? If not, why? Filing the Official Hearing Request within the 30 day period, will put the Reduction Decision on hold until the Hearing & New Evidence are reviewed. Your failure to meet these deadlines, will result in the Rating Reduction Administrative Decision, NOT GOOD. Next stop, The NOD Train. Semper Fi

Do you have a SA DX? If so, linking it to a Future PTSD DX, won't work. The SC causative DX must be in place prior to the Secondary DX. Does your VMC MHV Medical Record indicate PTSD as one of your issues? Do you have a long history of MH treatment that could help in laying a Paper Trail back to your MSA? Is there anyone you confided in or who noticed and commented on a perceived personality or mood change about that time? A New PTSD claim, based on a both non-treated & non-reported MSA from the early 90's, is going to be very difficult. The PTSD Forensic C & P Psychiatrist/Psychologist PhD will be the final arbiter, as to your PTSD DX. Review the VA PTSD DBQ. Semper Fi

This might be one of those situations where you really do need to contact a VSO-Rep, preferably at the RO or at your VMC. You need to move on this, yesterday. No matter the reason for missing the C & P, it ends up on you. Do whatever is needed or possible to stop the Reduction, you can't file a NOD until you receive the actual reduction. Unless your in jail or the hospital, I'd recommend a personal trip to your RO, for a couple things. 1st see the MFIC of your VSO or any other VSO. You need a face to face to discuss your plight and they have greater computer access to you claims file, than do the VSO-Reps located at Satellite offices. While your at the RO, request to see your C-File. No appointment is necessary, it's 1st come, 1st serve. You could even ask to see the Rater handling your reduction, not much chance but I'd give that a try also. Semper Fi

If your currently 100% Scheduler SC, IU claim is moot. Sit back, relax and wait for the Award/Denial letter. Then you tell us. SMC S (1) may be waiting in the wings. If you can, post a redacted copy of your SSOC. Research the VA IL (Independent Living) Program, comes under the VA Vocational Rehabilitation Dept. Excellent additional benefits for either now or in the future. Semper Fi

Was the DX 07/13 & 13 Heart Surgery done by VA Surgeon and VA Cardio Drs? If possible, posting redacted Claims, DBQs and Award/Denial letters would be of great assistance to us. We need to see why the VA reached their Decisions and what evidence is listed. Are you currently using a VSO-Rep? What do they say and recommend as a course of action? Semper Fi

Oh, but it does matter if it's Awarded T & P, No future Exams. Then again, might be good to wait until you get the Actual Award Letter. If not T & P, NF Exams, it should state something about a Diary Dated Future Exam. Without the Award Letter, there's the possibility that you've been awarded IU. Doesn't affect the comp amount, just saying it might be the case. With IU, your earned income is limited and you are required to complete the VA 2140 form, each award anniversary date. Semper Fi

We need way more Medical Info. What is his current SC Rating, still 40%? I think maybe 80%? What is the exact date of his CAD DX? Retro Pay/Award Date, goes from the Date of Claim Filing or actual DX, whichever is LATER. Earlier symptoms and casual medical reference doesn't equal an actual DX. Every Lay person, MD/DO knows CAD is a disease that develops over a very long period of time, before it actually presents symptoms, MI, Angina, Shortness of breath on exertion. When exactly did you file the CAD Claim? Did you NOD the Award, requesting the 3 mos @ 100%, when? Semper Fi

Take a breath, step back, way to early to be talking about an Attorney @ 20% of Retro. Did you File an FDC or Reg Axx claim, big difference Decision Time-wise. Always be prepared for a NOD but take it easy right now. All your supporting DXs & Medical Records are in your C-File, let the Rater do his/her job. Be prepared to address the DBQ errors if needed. Try and relax, easy to say, tough to do, I know. Not much more you can or should do at this point. Start reviewing VA Lawyer Chris Attig's posts and web site linked here on Hadit. Good Claims procedure info. Check out the 38 CFR 4 for your conditions, what do you think your Rating should be? Semper Fi

The MH C & P Psychiatrists and Psychologists PhD are trained in Forensic MH interviews. The Rating Dept makes a specific request for a VA MH DBQ to be completed. You might want to review the DBQ listed for your condition. Having an idea of the questions to be covered, can take some of the edge off. As to your "worst day," if you don't discuss it, it won't be considered. Keep in mind, this a FORENSIC EXAM. The Dr will opine as to "over reporting" of symptoms. Your not trying to get over on the VA, so just be yourself, no better no worse. Depending on your issues, the exam could take 1+ hrs, be prepaired. Who really knows your Head, better than you? Review the 38 CFR 4, based on your answers to the respective DBQ, how do you Rate? Your "New Meat," "The FNG," forget about that "Hoping for a 0% SC." Semper Fi