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Morning All, My Questions in this post are somewhat tied to my post of Feb 8th. I really appreciate all the input I received on that post. I've been really struggling on how I should proceed with two of my secondary claims (OSA and Hypertension) that were denied by the VA. Especially the OSA claim. And here's why... For my C&P exams for my Hypertension, Back Issues, Bilateral Radiculopathy, Abdominal Hernia, and OSA, the VA sent me to a Physicians Assistant (PA). The PA checked all of these claims in one appointment and hardly asked me anything about my OSA and Hypertension. My claim for Radiculopathy ended up being granted and I received an increased rating for my already service-connected (SC) back. However, the other claims were denied. Just to be clear, as I believe I noted in my Feb 8th post, I submitted the denied claims as secondary claims to my SC lower back using my obesity (caused by my SC back issues) as the "intermediate step" to these secondary claims. On a side note - I was given a C&P exam by a different PA, on a different day, on my knee. This was also a weight-related secondary claim that was denied. So, so far, the VA has denied all of my secondary weight-related claims. In any case, I have been seeing a Sleep Specialist for my OSA, who wrote a Nexus for me that I submitted with my claim. In fact, every claim I submitted I had a Nexus for (from Doctors - not a PA), as well as sufficient medical records. And yet, the VA chose to take the word of a PA over a Specialist. On a good note (at least I think) the VA did acknowledge in their decision letter that I did in fact have OSA and Hypertension. Is that a good thing for me? Even though I have four claims that have not been rated as of yet, that I sent in at the same time as the ones mentioned above, the VA sent me a decision letter for the ones that have been decided. The claims I'm still waiting on three claims that fall under the mental health category, and my TDIU claim. So I'm not sure if the VA already knows they will deny them, or if they realize it will take a long time to decide, so they went ahead and sent a decision letter. Doesn't make sense to me that they would send a decision letter when I still have undecided claims out. Thoughts on this?? Anyway, my main questions are: 1. For my OSA claim: should I get a DBQ from my Sleep Specialist and file for a Supplemental Claim, or no DBQ and just do a Higher Level Review (HLR)? This is the question that's had me tossing and turning the most. 2. Should I wait for all my claims to be decided before I file for a Supplemental or a HLR on my denied claims? 3. Should I file all denied claims at the same time, or stagger them? I'm mostly concerned about my OSA and Hypertension claims getting approved. If any of my conditions kill me, it will likely be one of those two - and I want to make sure my wife has a good chance at DIC if it does. Thanks again for any inputs and advice. It's much appreciated!

Hey fellow vets. I filed a supplemental claim with an IMO tying my sleep apnea to my ptsd on sept 21st. In mid october it went to prep for decision and today the claim is reading "closed" but not "the va has made a decision". I looked up the meaning for it saying "closed" and the va website states that if it says closed it may mean this Your Supplemental Claim was closed We closed your Supplemental Claim. This may be because you didn’t take an action VA requested. I dont get it. I've been in constant contact with the VA 1800 number (as in calling weekly) and they kept saying prep for decision and nothing further was needed...so why would it be closed with no decision? Of course I cant call the VA today because they are closed in observance of the holiday.

As of 9/25 my Supplemental claim was placed in for ready decision phase. It’s being processed ar Houston RO. What’s was experience and wait time in this process?

I know the VA has the 125 day timeline to make a decision. My question is what was your timeline like? How long after your supplemental claim did you have an answer? I did a claim and was given 100% per my doctors c&p and nexus and it was then taken away by QTC c&p exam which was done after my private doctors. Obviously, I did an appeal and went to QTC last week and the VA just received my c&p results yesterday. Also, ebenefits says " We don't know your status." Is that normal? My supplemental was sent to Houston's regional office.

I had submitted a claim for a back injury in 2000 when I originally got out of the Army. It was denied because I was a turd and the claim was less than solid. In 2008, I reinjured my back during my deployment. I tried to do a claim for a new injury in 2008 but it was rejected saying I needed to appeal my original back claim in 2000. Of course, none of my new evidence supported my claim 8 years prior so it was sure to be denied which it was. Im completely stuck on how to submit a claim for the new injury in 2008. VSO’s in my area are worthless. Any ideas/suggestions? Thanks!

Berta replied that I may have a cue because the VA didn't list my SSDI information in the evidence section of my denial for TDIU. I filed a supplemental claim with a vocational expert opinion as new evidence. I just received a letter requesting another 21-8940 and 21-4192 that I included them in my first claim. I want to know should I comment that I received SSDI after leaving my last employment, because of my service connected injury in the remarks section of the 21-8940. I would appreciate any input as to what they are looking for. Thanks

I appealed my lower back condition (DDD, strain) and am still waiting on a virtual hearing since July 2020. I called and they said they are still on 2019 claims but would not give me any other information. From what I've read on here I'm better off withdrawing my hearing and submitting a supplemental claim with IMOs. I know I would lose the back pay though. Are there any other negatives to withdrawing my hearing? Does anyone have an idea how much longer I'd wait for a hearing? Thanks

I have a C&P Exam coming up. I put in a supplementary claim for Agent Orange hypothyroidism. Does anybody know if it has been added to the presumptive list. I heard it has, which is why I filed the claim. But my VSO, who filed the claim, says it's still waiting for Congress to pass it . Otherwise why would she submit the claim?? Please help, my email is richarddharrison@juno.com

I think I already know the answer to this question. I have a supplemental claim in for PTSD. Is it important for me to continue to see my mental health counselor?

Hey all. Back again. I recently filed a supplemental claim for mental health diagnosis less than a month after my initial decision. My initial decision for the mental health claim was other stressor related disorder even though I have had multiple diagnosis of PTSD from personal psychiatrists. I was also rated way lower than I should have been due to the C&P examiner. I was recently approved for a change in the condition from other stressor related disorder to PTSD and increased from 30 to 70%. They changed the effective date of my mental health diagnosis to january 5th of 2021 (when I had my supplemental claims C&P) under the basis that it was the "earliest ascertainable date of diagnosis of PTSD" effectively screwing me out of over 15000 in back pay from the initial effective date of march of 2019. My argument is that the C&P examiner told me that my mental health should have been rated at 70% from the get go. He also said that I should have been awarded PTSD from the get go as it was "clear as day" I have PTSD. To me it makes no sense that they change my effective date of an already rated mental disorder when all they did was change the diagnosis. But they initially DID acknowledge a mental health condition and rate it as of march of 2019 (albeit a different diagnosis). I also filed the supplemental claim way under the time limit to be actively pursuing my claim. Attached is the excerpt of their reasoning. What can I do? I already filed an HLR via fax yesterday. Is there a good chance I can get my effective date restored?

Anyone have an idea why supplemental claims dont show status updates on VA.gov? It continually will just say "We dont know your status" until the claim is closed.

Filed a supplemental claim 12 days ago. Sent a current diagnosis from VHA of combat related PTSD (they diagnosed me with other stressor related disorder at 30%) and evidence of symptoms and interactions with police that should put me at 50 or 70% in like 50 pages of evidence via . Called 1800 number today to check on status and they said that it had already been decided for 10/20/2020 (tomorrow???) and no new C&P was given. Does this seem a bit fast to you? Does that mean its unfavorable or have you seen favorable decisions made that quickly?

I will apologize in advance for the lengthy message but I am looking for insight on what may be happening here. Dec 2019 I filed claim for CCCA - which is a progressive alopecia typically found in certain group of women and very specific symptoms. I combed STR and found first instance of it in 2003 while active duty. I was treated over the years but it progressed (nothing you can do to stop it only slow it down). Based on disfigurement criteria I believe that my records, statements, etc. met at least four of the requirements. Last 3 years I had been treated by dermatologist and this was her specialty. She wrote medical opinion and completed DBQ (although not correctly) as she had done this before. I submitted STR, civilian treatment records (over last 10 years), statements(my own, a battle buddy while active duty, hairstylist when active duty, and current hairstylists), and color photos on Dec 2019. I had CP Exam with VA contracted NP in January 2020. We talked she measured and “agreed” or confirmed that she saw what I saw. Within 30 days of my initial submission, I received rating indicating 3 of 4 had been met additional they described the wrong location (back area of head not middle/front). I filed HLR with conference. I had conference on day 123 and he asked what did they miss? I asked should I give you page numbers of submitted docs to support criteria #4? He said no that’s my job. He also said if criteria not identified in CP Exam then not given weight. Result on Day 125 continue current rating. I then filed a supplemental claim, submitted additional doctors records (last visit had not been submitted), the DBQ that my private doctor completed in Nov 2019 (with color photos)and two additional statements(mine and spouse). I have now received request for another CP Exam. Is this typical? Anything I should consider? I tried to lay out all of the pieces. Is this CP Exam another opportunity? I am prepared to go to BVA - as I have done my homework. Seems like the CP Exam was given significantly more weight instead of total picture presented. I requested January 2020 CP exam and opinions in February 2020 ebenefits shows available 5/2021. @Berta @Buck52 @broncovet @Tbird

Hi Everyone I want to file a supplemental claim but I was told that I have to fill out form 20-0995 and fax it to the office that sent me my denial letter. But I also wanted to know when I fax in the form do I also fax in the IMO the lay statement and the case law that I have as new evidence in support of my claim.

Hi, new member here, longterm lurker. I'm seeking advice on moving forward with my claim regarding loss of peripheral vision (code 6080), TDIU as a result. Specifically, I'm wondering if I should file the supplemental reopen to include EED, SC, and the TDIU? Here's the timeline: Initial VA claim in 2015 for numerous things including field of vision loss, back pain, lower leg numbness, etc. This resulted in only 30% service connected lower back arthritis, but denial on the vision issue. By 2018, the back worsened and a few other issues arose, so I submitted another claim resulting in the back increasing to 40% SC, hemorrhoids 20% SC, lower limb radiculopathy 20% for 70% total. I did not appeal the vision due to lack of education on the VA claims process. However, I've done my research and found that my initial vision C&P exam was insufficient. Per 38 CFR § 4.77 - Visual fields., the exam must be conducted using Goldman kinetic perimetry or Humphrey/Octopus automated. Neither of those occurred during my test. My vision test was outsourced via LSI (?) to a local optometry store. After meeting the doctor, he was informed that the "machine" was broken, so my test was performed manually using a tangent screen skipping Goldman. This is the basis for the insufficient exam. After receiving my initial 30% in 2015 I entered into the VA for my medical care, as a part of that I indicated I had vision issues and thus began annual visits at the VA to get an exam and meet the ophthalmologist. My initial Humphrey scans did show significant loss of peripheral vision and I was transferred to the head of the department for follow on analysis. She did a full eye exam, could not find anything physical in the eye that might be causing the loss and recommended annual visits to track the progress. Fine. 3 years passed and each year the Humphrey test showed continued loss of peripheral vision. In 2019 I started seeing the neuro-ophthalmologist who decided it was time to do more investigating and ordered a MRI and then later a CT Angiogram. The results of those tests was that once again no physical cause could be seen for the vision loss. I'm a Gulf War vet with 42 combat missions in the aircraft in 1991 and then a 2nd tour in the Gulf during Southern Watch during 1992. Additionally, our airwing was based and I lived at NAF Atsugi which has been highlighted for issues regarding a dioxin incinerator just south of base. I was going to name these issues to garner a SC but recognize that may be weak sauce. My left eye concentric contraction is around 15% and the right eye is around 20%. Based on the better eye this translates to 50% rating. The TDIU is something I've only recently thought about. I have issues with driving and going into busy stores is extremely stressful as I cannot see people coming from the sides so I avoid them. Previously, I owned my own business but prior to Covid I had already shut one location and sold another as I was reducing my workload due to my back and vision. In March I closed my last location and do not anticipate reopening because I don't think I can handle it. Physical labor is out of the question and the back/hemorrhoid precludes extending sitting and the vision is making driving near impossible and headaches are an issue. Thanks for any advice on how best to further the vision claim and perhaps include some of those issues I've talked about. Any problems with reopening a claim based on an insufficient initial exam?

Good morning all. Hoping someone could shed some light on a couple things. I’m on second go around with Supplemental claim on the same issues, but this time, actually got to see a doctor through QTC that listened, and looked at everything with me. Tried for a higher level review, but missed the second phone call to schedule appointment, was in VA appt. I called Peggy last week and they explained the DRO is requesting a records review from the doctor? Last night I received a package from QTC explaining that a different nurse practitioner will be reviewing my records ? I’m a little confused and wondering if this will bode well for my claim as this person did not see or speak with me.

May-1. Filed for increase on mental health condition (Depression 2nd to Tinnitus)2. VES exam, didnt go well, got reduced. Examiner said I had another condition, it wasn't service related, etc, etc. July-3. Filed a supplemental with a DBQ from a private psychologist (looked like 50-70 percent)August-4. New exam from QTC, went well, probably around 70 percent 5. VSO told me a few weeks ago they sent it back to examiner for medical opinion. I know the QTC examiner had mentioned that they did not ask for one in which he thought was odd during my exam in August. September- 6. VSO told me today that they sent it back to the VES examiner from May, and the examiner basically regurgitated the same thing he already said. He already provided a medical opinion previously in May. Examiner said I had OCD (never been diagnosed by anyone in 5 years). I am confused to why they sent it back to the VES examiner and not my most recent examiner? Could this be a mistake? Thanks. Not sure how this will pan out.

Which came first, the chicken or the egg? Or the claim request or the right form? Or when is a claim considered officially open? This is a case of my VSO helping me submit a new claim in April 2019 right after the AMA changes went into effect. At the time, neither of us knew we needed to submit it as a supplemental claim instead of a new claim. Years earlier, I had filed a heart claim for Afib, but I forgot about it. I have medical treatment records and a "more likely than not" IMO from a neurologist that I would like to provide to the VA. Just need to get an idea of the actual status of my claim and how I should submit the records. I never received a formal decision letter granting or denying my claim for heart condition. Instead, on July 29, 2019, the VA sends me a decision letter denying Cushing's (separate claim), but it says this about my heart claim: The VA claims "no action on this issue was taken", despite taking action on this issue (i.e. C&P exam). The rating narrative pages for the Cushing's claim make zero mention of heart issues. The VA's stance on supplemental claims appears to be that if you previously filed for any claim regarding an organ, then all future claims regarding the same organ would be supplemental, regardless of the actual diagnosis. I checked on va.gov and found the claim they received on May 3, 2019, for Cushing's and heart condition was closed. I called Peggy and they are as baffled as I am that the VA can claim to take no action, despite having taken action. Is my heart claim legally considered open? How can they take action on a claim request and not consider it open? Should I submit the IMO with a supplemental statement of claim or as a supplemental claim? Thanks!

Hello, My claim is being denied over and over again since 2009 and the VA states it is due to my OTH Discharge . Here is a rundown of the claim, Bars to benefits per the VA: 1. AWOL more than 180 days 2. Acceptance of OTH discharge in-lieu of General Court Martial. VA states no records indicate insanity at time of offense, nor compelling circumstances. I recently was made aware my mental health records from Fort Bragg do exist but for 12 years I was told they don't. Someone eventually informed me after countless calls that they do exist and cannot be released to me because of the sensitive information within and might me attempt suicide? I filled the supplemental claim October 28, 2019 with 4 "buddy statements", gave specific locations of these "clinical inpatient records from Fort Bragg", listed my current mental health treatment records from 2012 to 2019 and I am now seeing a VA psychiatrist at the mental health clinic in Tampa, FL 2019 to 2020. VA closed the supplemental claim Novemeber 20, 2019 after 23 days. Called and requested a informal hearing via telephone with ST. Petersburg Florida RO, called 800-827-1000 and a represenative filled out VA Form 27-0820 on my behalf. Mysteriously the same supplemental claim "reopened" on VA.GOV Website and after speaking with a "Assistant Coach" as the man claimed he literally said my claim had no hope and to just give up cause your service is dishonorable. VA closed supplemental claim again December 13, 2019. Fast forward to February 2020 and behold my long awaited clinical inpatient records from Fort Bragg arrive, My period of treatment was from August 1998 to February 1999, the records I got covered only November 1998 to February 1999. I was excited because I finally had the silver bullet and my records proved I had 9 different diagnoses, 52 days in the WOMAC Psych ward at Fort Bragg. Plus I was awaiting for a bed at medical holdover for a Physical Evaluation Board to wrap up my medical discharge. Filed Supplemental claim March 10, 2020 with a clear and concise case that I was insane at the time of offense and 13 days later on March 23, 2020 claim closed again but here is the kicker they once again reopened the October 28, 2019 claim and as of yesterday March 31, 2020 they closed it again. After speaking with a VSO who called on my behalf to inquire the reason, and no surprise it was the character of my service and once again they denied me even though I provided a legal brief that I learned how to write so they could understand every statue and regulation that applies to my claim. Lastly, here is one more point I applied for a VA home Loan certificate and was denied which I knew I would be but wanted the character of service determination and I got the letter stating my character of service is sufficient for VA purposes, so go figure? If anyone can please help me here I would greatly appreciate it, I am exhausted from staying up every night reading statues and VA regulations, I am about at the end of my rope. Sincerely, yours Frankie I.

Hi, I received me letter today, and I was denied. This time the error is clear. The Doctor who preformed my ACE examine said my initial diagnoses was Epilepsy then proven to be pseudo seizures. Initially at the ER (and my week long hospitalization after) and for about one month after I was diagnosed with PNES and not epilepsy. However since I kept experience both petite mal and grand mal episodes and then Epileptic medication treatment began to WORK, I was diagnosed with Epilepsy. My doctor in my civilian record's back dated the diagnoses to the May when the first event occurred. I've attached my letter; you'll see that they received my Neurologists note about my treatment since may and then confirmed my Diagnoses on 04DEC2019. Pseudo seizures are only mentioned in my records between May2019-June2019. I think this VES contracted doctor saw the diagnoses labeled in may but didn't review(or care) to look at the LETTER AND NOTE DATED BY MY DOCTOR ON 05DEC2019 WITH MY CONFIMRED DIGNOSES AND THEN UPLOADED TO THE VA ON 24DEC2019. Opinions? HLR or do I wait 3 months to see my VA Neurologist, as I no longer have Tricare to see my UCHealth DR., and have him confirm the diagnoses... I'm only 5 months away from all this stuff lasting a year and getting really fed up with the VA. My first denial was also because of the phraseology used by my ER and Hospital doctors after the first event in may. Hint that's why I had my specialty neurologist who had been seeing my since June confirm my Epilepsy diagnosis... uuuhhhggg.

Hi there, Recently actually yesterday the 21st of February the VA gave me notice that my supplemental claim had been decided and that they had sent out the letter that morning as well (meaning the decision was actually made on the 20th). This of course prompted me to check Ebenefits, where I saw no change in my rating. I'm currently rated at 40% for other issues. And in the past Ebenefits updated almost instantly leading me to believe that this supplemental claim was denied. I originally submitted my Epilepsy claim back in august, it was denied about 4 months later due to conflicting phraseology given by one of my doctors (mind you i still have a diagnoses of Epilepsy with 15 witnessed Grand Mal seizures at this point). Once i got the original decision letter I contacted my County VSO's office and set up an appointment. After they reviewed everything they we surprised that my claim was denied as it has a clear nexus and on top of that falls under the conditions; that if they manifest within a year its considered service connected (I separated 02/01/2019, first seizure onset was 05/25/2019). They did review the 112 pages of evidence from my civilian doctors and did see the conflicting phraseology. They told me that if I could get my Neurologist to just confirm my diagnoses and say i was and have been under treatment since 05/25/2019 that we could submit a supplemental claim since that's the fastest route. So that's what we did. That brings us to now. Under the standards for Epilepsy I was looking at a single rating of anything between 80%-100%. An 80% from 40% would have resulted in something Close to 90%. While i'm holding out, since in either case the retro pay (if my claim was awarded) would be greater then 20K that the additional signatures required are slowing down Ebenefits from updating, but as in most cases if the letter has sent and Ebenfits doesn't updated, 90% of the time you Claim/Supplemental/Appeal is denied. ( I mean correct me if I'm wrong). Whats the moral of the story? No matter how much evidence you have to support you the VA will be the VA. I'm lucky that I'm rated for other conditions so that I can at least have the VA help me cut down on the costs of treatment for Epilepsy, but it would have been nice to have it service connected so that I wouldn't have to wait months on months for Neurology appointments since I don't have priority. If any one has any information for me that might help moving forward, I'm all ears as once my letter is received and upon reading of the denial ill be filling an appeal.

I filed a claim in october of 2018 for ptsd and TDIU, long story short I tried to do everything myself and didn't have the proper diagnosis so I was service connected for anxiety based on having a medical marijuana card diagnosis for anxiety but the rating was 30% and I much worse off then that. So I obtained a referral from the va to a fancy psychiatrist from the university of north florida's behavior health department and was diagnosed with ptsd, bi polar 1 and panic disorder. I used this new medical evidence as my supplemental claim evidence and filed it April 16, 2019 after receiving my letter March 20, 2019. My claim is now at Pending Decision Approval with an estimated completion date of july 2, 2019 which is super fast from all I have read. My question is, Am I going to be awarded tdiu with the evidence I submitted if they adjust me up to 70% which I think it will . Or if they award 70% for ptsd on this new supplemental claim will i have to re-apply for tdiu again? Or would that all be considered in the final review of the entire claim? Thanks for any help. 1-22 1BCT 4th I.D. "Regulars by God"

Howdy all. I'm finalizing my NOD to submit. I should have it ready to submit early next month. I have been told that I need to submit in the Supplemental Lane because I have additional support document to rebut the C&P Nurse examiner's exam. But I also plan to submit supplemental claims for the pain, numbness, and tingling in my arms and legs due to my neck and lower back problems. They will be secondary to those two issues. But the arms and legs issues were both listed as problematic in my original claim and even identified in my NEXUS letter and the DBQs I submitted. I did not specifically claim those issues independently though. Would those also be part of the NOD since they did not acknowledge them or actual supplemental claims?

Long story coming. In 1991, my husband was in a Light Armored Vehicle accident which killed his best friend. My husband did not adjust well after this, and started having gruesome and violent hallucinations. Sixteen years later in 2009, my husabdn's PTSD was becoming horrifying again. He stopped talking for a month. I panicked and called the VA hospital where he went for his regular spinal cord injury treatment ( he was considered a catastrophic non service connected veteran). I filed a NEW claim for PTSD, with all of the evidence from his LAV accident in 1991, notarized affidavits from his girlfriend at the time stating he was suicidal, evidence of the LAV accident,etc. He was given a 30% service connected rating in 2009. He was then able to receive proper treatment at the lake City VA Hospital. In 2011, my husband died at the age of 39 from complications due to his quadriplegia. I receive no widows benefits. I would like to re-open his claim from 1992 so that he could get a 100% service connected rating. It is what he deserved, and I feel he was stomped on and spit out by the Marine Corps and the VA. I am not concerned about back pay or accrued benefits, although I won't turn them down. What is the best way for me to get the rating he deserved? Reopen his claim using the 30% service connection as evidence for his PTSD/quadriplegia? Or do I claim his quadriplegia is secondary to his PTSD? Or should I just try to get his successful 30% increased to 100%? Thank you so much for this site. I have avoided this for 4 years, and it may be too late. But I really want to give him the rating he truly deserved while he was alive.