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Found 6 results

  1. So on my threads about my first claim under AMA I stated I put this here to track time and the AMA process. My claim for Voiding Dysfunction was filed on May 8 2019 and closed June 16th 2019 (according to VA.GOV) so basically 36 days. I was denied, and will start writing my NOD. What is new besides the speed, is that on Ebenefits yesterday I noticed a new entry under my listed Disabilities. It will be good for others to start tracking this to see if this remains the standard. It was marked Pending Claims. Today after visiting VA.Gov and seeing my claim closed I went to Ebennies and looked under Disabilities and the DENIED claims are already showing. This is a change in process. It used to take some time to get Ebennies updated. usually at least 10 days. today however, the day after VA.gov says the claim closed, I see the following It will be good for others to start tracking this to see if this remains the standard I am tagging in a few people who I know are active here and may have recent claims under AMA. @paulstrgn @vetquest @shrekthetank1 @Buck52 @jamesriley1990 @richard1234 @Oceanbound @Richard1954 @Amazing Becky hopefully you all will help track this change. It can alleviate some of the "wait time" stress as we look for the BBE in the mail. If you all see someone asking about processing time for a claim please ask them to track for this notification under Ebenefits Disability link. Rated Disabilities Disability Rating Decision Related To Effective Date bilateral hearing loss 0% Service Connected 08/20/2018 tinnitus 10% Service Connected 11/30/2012 post traumatic stress disorder with bipolar II disorder (previously rated with major depressive disorder, psychotic features ) 100% Service Connected PTSD 08/16/2018 benign prostate hypertrophy Not Service Connected urinary incontinence Not Service Connected erectile dysfunction 0% Service Connected 08/20/2018 benign paroxysmal positional vertigo 30% Service Connected 08/20/2018
  2. Hi all, This will be the first NOD I have to file, and I fall into the odd gap between Legacy, RAMP, and AMA processes. As I understand it Since the claim I am NODding was started Aug 2018, with a partial decision dated Oct 2108 and the deferred claim decision dated April 2019, I am supposed to still use the VAB Form 21-0958-ARE, which is the fillable form. The first question I have is about the actual form itself and I have filled out a sample to make sure this is acceptable to the VA. I am trying to make sure that I clearly indicate that attached records support my claim and that I give the reviewer an explicit road map as this is a complex claim. Please look at the attached sample and tell me if this is okay. --------------------------------------------- The second question is a bit more complicated and involves 3 distinct award/decision letters with different dates. The question is, which decisions do I NOD? Letter 2 and Letter 3 are both 2018. Letter 3 gives me the award but not the dates on Hearing Loss, on Vertigo it gives me an award but the wrong effective date and should be rated as Meniures instead of Vertigo based on all the evidence. Both should be back dated to 2013. here are the details. I have 2 of them in my possession and am waiting for the BBE for the 3rd one issued in April 2019. Letter 1 -Oct 2013 Letter 2 - Oct 2018 Letter 3- April 2019 In each of these letters the same issue is addressed, SC for hearing loss Letter 1 denied SC because C&P Doctor only looked at 1 enlistment to gather hearing loss and in-service Treatment for hearing loss w/ OSHA evaluation. Award states I have rateable hearing loss, but SC cannot be established. Had I known better I would have NODded or CUE'd this back then. Letter 2 denied reopening Hearing Loss denial from Letter 1 claiming evidence provided (proof the doc overlooked evidence in my record) and subsequent hearing tests. Acknowledges Hearing Loss rateable, denies SC claiming the evidence is not N&M despite showing that doctor did not look at all the evidence in my service record. I am sure I can also CUE this and would jump on that except for Letter 3 below. Letter 3 oddly grants SC from 2018 Hearing Loss C&P but gives effective date of 2018 instead of 2013 Important factors here: The 2018 rating percent would be 0% because I can still hear a little in that ear. Having the EED back to 2013 (Letter 1) is significant as that decision failed to Notify me of a possible claim for Documented Vertigo, failed to Assist me in developing that claim, failed to infer from the evidence, failed to acknowledge inferred request by me. The VAMC now claims they lost the evidence yet my medical records are replete with requests for help with Vertigo, ENT exams, OTO exams, Fragments saying I had OTO exam, MRI, and VNG tests and that I have Nystagmus. The sequence here is: Letter 1-ignored all evidence of Vertigo, failed to assist in developing claim, failed to infer, failed to notify, failed to even mention Vertigo Letter 2-Deferred my direct claim for Vertigo. Note: VA order C&P's and in fact I had 4 related to vertigo and hearing (which is a fustercluck unto itself). Letter 3- Have not received BBE but Ebenefits states I am now rated 30% for Vertigo and 0% for Hearing loss, both SC. In a fair world (I put that in for chuckles) the VA would have performed properly in 2013. They didn't. They would have corrected themselves in Letter 2. They didn't. I don't have Letter 3 yet but they in effect CUE'd themselves but gave wrong effective date on hearing which is integral to eventually getting Vertigo back dated to 2013. What they rated in the latest round actually fits Menuiers disease more than Vertigo. The 2018 OTO C&P doctor was incompetent and did not fill out a DBQ during the exam. He did not know why I was there. Did not deal with my gait issues or ask about them. Did not ask about frequency of events. He had his wife type up the form at home (those are his words) as he does not allow computers in his office. He and the rater ignored records in my med files concerning gate, MRI, VNG, etc being performed. He did not ask for MRI records or VNG records. There are a couple more issues like this but the above shows the complexity of my process. You can all see why I need to make sure I use the right forms and can create a roadmap for VA to follow. Any input would be appreciated. sample for hadit question.pdf
  3. Interesting little blip I discovered today and am wondering if anyone else has seen these same things under the AMA process. ----------------------- The situation: I just applied for a rating for Voiding Dysfunction as the VA said I had a possible claim when they granted my ED claim. The whole C&P was a joke and I suspect I will have to appeal based on the fact the Dr was not qualified among other reasons. However, the blip is that today I went to VA.gov to check the status. I do this to track how many days it takes to get to each stage. In the file today I noticed it had two closed requests so I went looking around. Both requests are marked closed Documents filed Request 2 Exam Request - Request for Clarification ---Now who they sent this too and if it means the VA has the C&P is up in the air. I will call peggy on monday to find out. No longer needed Request 1 Exam Request - Processing No longer needed -------------------- One the files tab under additional evidence was this line Additional evidence File: Type: VA 21-4192 Request for Employment Information in Connection with Claim for Disability Now the blip is that I own my own company, and nowhere in the claim application, C&P, or my VA files is the name and address of my company. Nowhere is there a reference to the fact that I own a company. This is intentional on my part. The Dr who did this C&P did not ask who I worked for or what type of work I did. He only asked how my BPH was service connected and how having to pee a lot impacted my work. I have not received that request form and of course the VA does not show dates sent. But VA.gov does show that 2 requests were made and both were closed on May 15th and 17th respectively. I am 100% P&T and generally work at my office or home. In none of my claims has there ever been a letter from the VA asking about my employment and I don't remember ever seeing that Form Name or Number on any of my previous claims in Ebenefits. I searched my existing C-File copy and that form is not in there at all. I am wondering if this is a new thing under AMA and who they sent that form too. It is aimed at an Employer not at the SSA. I am also wondering if I will be able to get the form and who they sent it too from the VARO office when I go get the C&P once I know it has been brought into the VA system. ----------------------------------------- There is also this under additional evidence Additional evidence File: Type: VA 21-8940 Veterans Application for Increased Compensation Based on Unemployability I did not file an IU request. I am 100% already. IU would be moot. I searched my C-File for this one too and that form has never been recorded into the C-file. ---------------------------- I don't know if the presence of these files is some automatic thing under AMA. I will have to look and see if they are just new form names and numbers under AMA, but either way they were never sent to me or filled out by me in any of my claims.
  4. I made the first post under the AMA forum about my 1st Claim under the AMA process. I put it up to track the dates and times things took I filed that post May 8 2019 the same day I filed the claim On May 17 I was emailed that VES was looking for a Doctor. on May 20th I found out my C&P was on May 24th On May 29th VA.GOV said estimated completion date was Oct 22, two days later it went to Oct 23rd. The next week VA posted they had sent a Request for Clarification. No change until this morning at 4 a.m. PST. The status went to Preparing for notification with a completion date of 17 June. Since I am OCD and have taken the good advice not to obsess over what Ebennies and now VA.GOV says about estimated completion dates. I limit myself to checking it once in the morning, usually around 4 a.m. and once around 8 p.m. So that is what makes this a little funny. Last night at 8 p.m. the status was still Oct 23rd, but by 4 a.m. PST it changed to June 17th. It appears someone was working overtime or literally waited to Saturday morning to flip that date switch. I don't know for sure. So now the wait begins. What I know for sure is the Dr. was a idiot and not qualified in Urology or anything else I am rated for. He is only licensed as a General Practioneer I posted his weak credentials elsewhere. basically he has never practiced medicine, He just does C&P's and probably insurance evals. I suspect I will be filing a NOD. I do know that since the change on VA.GOV I am sure the RO has the DBQ, so I will go down and see if I can get that one and the other three I need. That alone is logistical chore but I will figure that out. The wheel chair and all the hills near the VARO make getting there a bit much. I will post again when the date changes and see if I start my wait for the BBE or if they bounce it back again.
  5. Hey All, This is posted just as information and to put a clock on the claim since the AMA process that started Feb 19, 2019. I don't believe AMA will affect this claim. I am also posting this so when I do get a decision I can come back here and review my thinking and rationalizations that I will list below. sorry it is so long. As a note anyone with an ED award secondary to PTSD, and who has any type of leaking, might consider a claim for Voiding Dysfunction or other related Genitourinary problem. I filed this claim today, May 8, 2019. This claim is a Secondary Claim suggested by an existing SC award for PTSD. In a 2018 Award for SMC (K), ED secondary to ptsd, I was notified of another potential claim for Voiding Dysfunction. I filed an Intent to File in 2018. This was all under the Legacy system, not RAMP. Things I don't know about Claims processing since AMA went into effect: 1) I don't know how this claim will process since AMA seems to deal mainly with Appeals instead of a new claim filing or secondary claim filing. 2) I don't know if this will go into the national queue or be done directly by my local RO, which is Seattle. 3) I don't know for sure how the VA will view this claim, meaning will I need a C&P, since they suggested the claim and I submitted a very detailed Statement in Support of Claim form vba-21-4138-are. I know that some consider this the most useless form in the VA library, but since I want to test the process in their suggested way I will use this form. I used the DBQ criteria and Rating criteria to write the factual information for the claim. I was truthful and exact as possible. 4) To upload that vba-21-4138-are, I had to select Buddy/Lay statement as the type of document. 5) I uploaded the Award letter that contained the recommendation to file for Voiding Dysfunction. 6) Voiding Dysfunction did not exist in the category of Secondary claim I had to select from so I chose genitourinary as that is the broadest related category they showed me related to this condition and the ratings table for genitourinary contains Voiding dysfunction ratings. ------ I am going to guess, and this is probably really just wishful thinking, that this will be a rocket docket process for this claim. I think that because I am already SC for a known related condition that this is claimed secondary too. The VA has lots of medical literature connecting the two. I think since they suggested it as part of their Duty to Assist/Notify, that will ease the processing/decision time I think giving a detailed State. in Sup. of Claim (vba-21-4138-are) using the information from the Rating Table and DBQ, they may not even need a C&P. This is because in my case, my Primary Care Doc has ordered appropriate pads for me. I have a diagnosis of BPH. I am awarded SMC (K) for ED as a secondary, and I am 100% SC for PTSD. I explicitly stated pad usage, urinary frequency for day and night times and the effect it has on my life. All of which are part of the Rating Table and DBQ. I think I will get rated at the max, 60% but there is a path that puts it as SMC (K) and I think (but am not sure) that we can get multiple SMC (K) awards but I don't know if they will just 0% it and award SMC (K) or rate it at 20, 40 or 60 and award SMC (K) or bump me to SMC (S) which I have found is met with a single 100% coupled to a 60% rating (even combined I believe). Either way, if an award is granted I end up with more money each month. The third rating outcome would be 0% SC without SMC (K) or (s) and that would be depressing. ------------ I am also wondering if @Tbird will consider creating a user-contributed database of Secondary Conditions Connections. It could be a very helpful resource and would be a unique resource for Veterans trying to figure out what their conditions might extend too if the medical facts concur. The SEO value would be huge if done right. Veterans are searching the internet for SC conditions every single day by the thousands. I don't now who hosts Hadit, but they should have a free SQL database engine and interface available and the design is literally the most basic. For example the user Selects from a list, I am Rated X%, then selects for Y condition from another list, and Secondary to that I am rated Z. This last could be a combo of user input and list. The ability to input could easily be condition on membership, free or paid or allow both. Indexing the Y condition would allow displaying the listed secondaries reported by the users and even could say when they were input into the datebase to give a time reference. Indexing the Secondaries would display possible primary conditions to associate to. The search could be that the user selects " I am primary for Y what are possible secondaries." The other search is "I have Z what is it secondary too." Only two public searches (queries) needed. 3 basic public tables (4 of date included in database is shown). Output would be a simple HTML list. If anyone else thinks that DB would be helpful please chime in. I will update this as I find things out. That advent of the AMA and cancellation of RAMP changes things in ways we just don't know yet.
  6. I will ask the first question in this new forum. I have just been granted a 30% rating for Vertigo from a 2018 claim. If this were a "normal" first claim I would fall under the AMA and have to NOD using one of these three lanes. My confusion comes from the following. In my original award fro 2013, the VA knew about the vertigo. They had sent me for a VNG (waterboarding through the ear) and an MRI for vertigo. I had two C&P's, one for PTSD and one for Hearing Loss. Both knew about the vertigo and tests. The award letter from 2013 did not mention vertigo or the tests even though they were in my file (or at least the ordering of the tests and notes that said the results were being uploaded). Since it did not mention them, and I did not know they were compensable, I did not NOD the decision at that time. I also did not know what a NOD was so that makes things worse. I was denied SC for Hearing Loss in 2013. I did not know that they reason they denied was that they only looked at 1 enlistment instead of both which covered 10 years and were consecutive. I only found out the reason they denied in Aug 2018 and filed to reopen based on New and Material evidence even though I did use that exact term. They denied reopening the hearing claim for SC based on the old C&P form 2013 and did not offer a specific C&P for SC connection. In that same Aug 2018 claim I filed for "dizziness" which is what I have always called my episodes of vertigo. They sent me for a C&P. The doctor was incompetent and did not even have a DBQ in front of him and no computer in the office. He stated his wife does all his computer work at home. He stated he did not know why I was there or what the VA was expecting. I told him about the vertigo (I had learned that was the correct term). Further he looked up my nose, in my ears, then said the problem was between my ears meaning a problem he could not see. He did not ask about my gait, frequency of events or if I had nystagmus (I do and it is documented). The C&P for Vertigo did include a hearing test. I pointed out to Audiologis, and showed the records, that the 2013 C&P was wrong on SC. She stated she was not doing a C&P just an hearing test but would include a note on the SC and dates. The VA bounced this around for months, even reaching pending final verification with a Due date of 1/8/2019. They then bounced back to gathering evidence and ordered a C&P on Hearing Loss, ostensibly for the Vertigo claim. The results were finalized about 20 days ago and Ebenefits disabilities were updated to show Vertigo at 30% and Hearing Loss as SC. The BBE has not yet arrived so I don't yet know their reasoning. So my questions are: Do I NOD the 2018 Vertigo decision using the AMA and which lane? Do I NOD the 2013 award or CUE it? They VA failed to even mention the tests in that award. The did not notify me that a claim was possible and they did not offer me an assist in getting the C&P. They now claim they have lost the records Do I Nod the 2013 hearing denial for SC and request EDD? or Do I NOD the 2018 hearing decision asking for EED to 2013? Do I CUE this to get my EED? The doctor clearly did not look at my full record and even states it so. The VA did not notify me of that fact in the Award letter, which significantly changes any NOD choice I could have made back then. As I am still waiting on the 2018 Vertigo claim and Hearing SC connection I cannot post them. I will gather all the award letters and redact them once that shows up. Any help? suggestions?
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