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Showing results for tags 'clear and unmistakeable error'.
so............... I WON MY CLAIM! sorry i had to get that out one more time. i am now 100% p&t. but my eed is december 2019 instead of the original claim date. i am trying to figure out what i need to do. should i file cue? should i just file a supplemental and ask for correction without cue? should i do something i am not even thinking of that you guys know better? reason i think cue is because in my letter, the judge specially says my original claim was 2013 and dx was 2008. it seems the vro clearly ignored this. also, they didnt even use the latest appeal date. i reopened the original 2008 claim back in 2013, but was denied and appealed multiple times and the last appeal was in 2019. Ill have to go through my c-file to get exact dates but this seems a big miss to me but maybe they are getting me on loop hole here because I didn’t reopen the original claim from 2008 until 2013, after the appeal window had closed. Any help or advice of course. Thanks guys for everything. I couldn’t have gotten here without your wisdom and encouragement! **EDIT TO INCLUDE PREVIOUS DENIALS FOR CONVENIENCE** here is the original denial: here is the the reopened claim denial: Denial for HLR: Denial for first CUE: Law Jude Decision.pdf decision-letter_osa_4-20-21.pdf
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 everyone! I'm new to the page and was hoping someone here might be able to give me advice on possible next steps. I've already taken action on getting earlier effective dates for two conditions but because you never how claims are going to go I want to prepare myself should my claim not go in my favor. My story begins in 2007 when I filed my initial claim with the help of AMVETS. The entire VA claim process was very intimidating and I depended heavily on my VSO to tell me what I could/couldn't claim. He went through my STR and told me what I could claim. Ultimately, I was awarded 60% and felt extremely lucky given all the negative things that I had heard about dealing with the VA. Once I received my award I didn't revisit my VA claim until 2016. My conditions had gotten worse and after doing research online and finding the CFR I realized that I was not being compensated fairly and that I was also not being compensated for conditions that I had in service/currently had and were never claimed. I filed my intent to file and then scoured my STR for evidence of current conditions that I wanted to get SC. This post only concerns two conditions that I believe I should have an earlier effective date for so I will only mention those two below. I figure the easiest way to digest my story is by listing everything chronologically so here I go: Sep. 4, 2007: Separate from the Navy Oct. 24, 2007: File claim for chronic lower back and radiculopathy down right buttocks, also filed claim for SUI, Cystocele and Rectocele Jan. 24, 2008: Awarded service connection for lumbosacral strain 10% (claimed as lower back condition w. radiculopathy down right buttocks) Awarded SC for Urinary Stress Incontinence with Cystocele and Rectocele 20% Effective Date: Sep. 5, 2007 May.9, 2016: File Intent to file Jun. 16, 2016: File claim for increase for chronic lower back condition, file new claim for uterovaginal prolapse Sep. 6, 2016: Awarded increase for lumbosacral strain 20% (claimed as spine condition), awarded SC for radiculopathy right lower extremity (20% even though I did not claim this but it was noted during my C&P exam for increase for chronic back pain), awarded SC for uterovaginal prolapse (30%) Effective Date: May. 9, 2016 Apr-May 2017: Look through old rating decision and claims file and realize that I had claimed radiculopathy on my right side in 2007 claim. Realized that the VA mentioned my uterovaginal prolapse in their decision about my SUI and cystocele/rectocele. Aug. 30, 2017: Visit Baltimore RO with NOD in hand to request earlier effective dates for my uterovaginal prolapse and radiculopathy, they stamp it and then tell me that I need to file a new claim not a NOD. They told me that I can't appeal a decision that they haven't issued yet. They rip up my NOD (which I still have) and provide me a form 21-526ez where I request earlier effective dates. Sep.6, 2017: I receive a letter from the RO stating that I filed my NOD on the wrong form. This was confusing because I didn't file a NOD because the RO told me that I had to file a new claim for the EED. Sep. 16, 2017: They add the new claim for earlier effective dates and I can see it in E-benefits. They combine it with a current claim that I still had pending for something else. Sep. 26, 2017: (decision on uterovaginal prolapse and radiculopathy become final) Oct. 6, 2017: My claim on something else is completed and they completely ignore the claim that I filed for earlier effective dates Mar. 6, 2018: VSO fills out another claim requesting EED for uterovaginal prolapse, and radiculopathy. Claim is currently at preparation for decision I believe that I'm entitled to earlier effective dates because 1) I claimed radiculopathy on my right side in 2007 and they combined it with my back pain in 2007 and issued me one rating. My symptoms are exactly the same now as they were in 2007 so why were they able to issue me a seperate rating in 2016? I was diagnosed with sciatica/piriformis syndrome in service and I have radiculopathy that originates in my buttocks and goes down my right leg. 2) I didn't claim uterovaginal prolapse because I didn't know that I could but the VA knew about it and mentioned it in their Rating Decision narrative for SC for my SUI and cystocele/rectocele. Everything that I read says this amounts to CUE because they did not "sympathetically read my claim and determine all potential claims raised by the evidence". I was told by my VSO that they were supposed to invite me to claim that condition which they never did. What do you guys think? Had the VA issued me ratings for those two conditions I would have been awarded 80% instead of 60%.