Jump to content
  • Searches Community Forums, Blog and more

Search the Community

Showing results for tags 'higher level review'.



More search options

  • Search By Tags

    Type tags separated by commas.
  • Search By Author

Content Type


Forums

  • Coronavirus - COVID-19
    • Coronavirus - Covid-19
  • General VA Disability Compensation Benefits Claims Forums
    • VA Disability Compensation Benefits Claims Research Forum
    • Appeals Modernization Act AMA
    • RAMP Rapid Appeals Modernization Program
    • Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC
    • Veterans Compensation & Pension Exams
    • E-Benefits Questions
    • PTSD Post Traumatic Stress Disorder Claims
    • Entitlement - Veterans Compensation Benefits Claims
    • Eligibility - Veterans Compensation Benefit Claims
    • CHAMPVA
    • TDIU Unemployability Claims
    • CUE Clear and Unmistakable Error
    • Success Stories
    • OEF/OIF Veterans
    • VA Caregiver Benefits for Post 9/11 Veterans
    • SMC Special Monthly Compensation
    • IMO Independent Medical Opinion
    • Veterans Benefits State & Federal
    • VA Medical Centers Navigating through it
    • Medication – Prescription Drugs-Health Issues
    • VA Training & Fast letters, Directives, Regulations, Other Guidance Documents
    • MEB/PEB Physical OR Medical Evaluation Forum
    • VA Regional Offices
    • VA Disability Claims Articles and VA News
    • VA Law
  • VA Claims References
  • Specialized Claims
    • TBI Traumatic Brain Injury
    • Mefloquine / Lariam
    • Gulf War Illness
    • Agent Orange
    • ALS - Amyotrophic Lateral Sclerosis
    • MST - Military Sexual Trauma
    • Radiation Exposure from Operation Tomodachi (Japan Earthquake Fukushima Nuclear Assistant)
    • Project SHAD/Project 112
    • Vocational Rehabilitation
    • VA Pensions
    • DIC
    • FTCA Federal Tort Claims Action
    • 1151 Claims
  • Veterans Helping Veterans Podcast
    • Veterans Helping Veterans VA Claims Podcast
  • Welcome Aboard
    • Help Files - How To Use The Forum
    • Introduce Yourself
    • Test Posting Messages Here
    • Roll Call
    • Technical Support For Forum
  • Extras
    • Hiring an Attorney Discussions on S. 3421
    • Social Security Disability Questions
    • VA Scandals
    • Discounts for Veterans
    • Title 38 / 38 CFR
    • 38 CFR 3 Adjudication
    • 38 CFR 4 Schedule for Rating Disabilities
    • Federal Register Announcements
    • Active Duty MEB/PEB Physical OR Medical Evaluation Forum
  • Social Chat
  • Veterans Social Chat's Social
  • Veterans Social Chat's Topics

Find results in...

Find results that contain...


Date Created

  • Start

    End


Last Updated

  • Start

    End


Filter by number of...

Joined

  • Start

    End


Group


AIM


MSN


Website URL


ICQ


Yahoo


Jabber


Skype


GooglePlus


Military Rank


Location


Interests


Service Connected Disability


Branch of Service


Residence


Hobby

Found 6 results

  1. Hello hadit Community. I submitted an initial claim for Claustrophobia in 2011 and my claim was denied in March 2015. I submitted my NOD and appealed the decision. I recently (March 19, 2020) received another rating decision on my claim for Claustrophobia and was denied again for service connection. The issue in 2015 was that I had no evidence of my account of being mistakenly locked in the Arms Room. My period of service in the US Army was from 1985 to 1994, where I was a Supply Sergeant/Unit Armorer and stationed primarily overseas. I submitted buddy statements and a description of my Unit Armorer duties which required me to work in a vault like setting for long periods of time. In September 2019, I submitted an affidavit from Allstate Insurance Company, (on their company letterhead) along with the date and time of the accident to include the Allstate claim number (the accident took place in January 1988) to the Evidence Intake Center. I called the VA Call Center (1-800-827-1000) numerous times afterwards and they confirmed receipt of the document and stated it was in my C- file. I also hand delivered a copy of the Allstate Insurance Company affidavit to my Regional Office in October 2019 and have a stamped copy of the documentation as evidence of my submission. In March 2020, I finally was scheduled for a C&P exam for Claustrophobia. My C&P exam took place on March 13, 2020 and I showed the C&P examiner the Allstate affidavit and discussed my automobile accident and my duties as a Unit Armorer as my stressor events for Claustrophobia. My case was decided on March 19, 2020. When I reviewed the March 19, 2020 Rating Decision, the Allstate affidavit was not listed in the evidence section. The author of the rating decision spoke vaguely about the evidence and on Page 3 of the three (3) page decision, made the following statement; “ There is simply no evidence to confirm that the reported incident(s) occurred, or that you sought treatment documented during service as a result.” In the March 19, 2020 Rating Decision, the rater stated: “that the March 13, 2020 C&P examination reported a diagnosis of situational phobia (claustrophobia) and the examiner opined that the present diagnosis was at least as likely as not due to the event you subjectively reported.” The March 13, 2020 C&P examination is also listed as a Favorable Finding in the March 19, 2020 decision. What is troubling about the rater’s language is they reference the “event” but does not refer to what the “event” specifically is. In addition to the Allstate affidavit, I submitted a lay statement from my sister also confirming the accident. I also included in the evidence: a copy of a February 2015, C&P exam, which was held at the Baltimore Maryland VA Hospital and conducted by VA Psychologists and they opined that my conditions of Claustrophobia and Agoraphobia is directly connected to my military service, a copy of a August 2019, Mental Health DBQ which was conducted at the Washington DC VA Hospital and conducted by a VA Psychologist. The DBQ states my Claustrophobia is linked to my military service; a September 2019 medical opinion letter from my VA Contracted Psychologist, where the doctor states that the automobile accident and my Unit Armorer duties are directly responsible for my Claustrophobia and Agoraphobia. a very detailed Statement in Support of Claim chronologically listing the events in service along with the previous diagnosis that I received. My question for my fellow Veterans is this Rating Decision a Clear Unmistakable Error or just clear incompetence? I have been examined four (4) times and currently by Psychologists and all of them have diagnosed me with Claustrophobia. I also have evidence of the automobile accident that I was involved in (thanks to Allstate keeping records over 30 years). I requested a Higher Level Review on April 13, 2020 and articulated all of the above on the VA form. I also requested that a different office conduct the HLR in addition to requesting the informal telephone conference. Thanks!
  2. 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.
  3. 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.
  4. I filed for tdiu and ptsd claim in Oct of 18, I didn't have all my medical files lined up and was given service connection for unspecified anxiety at 30% in March 19, and denied tdiu for failed scheduled rating needed and they mentioned that I had work experince and helped for a year with my niece , weird mention in the paperwork for why tdiu was denied but whatever. So I filed supplemental claim in april and had a highly regarded univeristy brain department and psychiatrist department diagnosis me for ptsd as a referral from the VA. So boom got another c&p in June and was given 70 % rating for ptsd but didn't file anything for the tdiu, at this time hired a va lawyer before I got my 70% rating thinking id have to appeal if they denied my ptsd again but they didn't so then I kept the lawyers on as they looked at my files for more things to be done and then they had me file tdiu paper work again but then on OCT 31st they filed a higher level review for my TDIU decision going back to march when it was denied. My two questions are how does HLR handle tdiu claims and cause I was denied originally for it for lack of rating and lack of medical evidence does my new c&p in June and my medical diagnosis with recommendation that got me to 70% now, will that evidence be included in the review of the tdiu or is the Review just of the evidence that was available at the time of the original denial back in march? I've been out of work for over a year as well but haven't kept a job down for a decade though I've tried for sure. OIF 08-09 1-22 INF, 1 BCT, 4th I.D. Also do granted my tdiu effective date should be Oct 2018 right as my intent to file date? Thanks
  5. I wanted to share my experience with this new "fast track appeal" option called Higher Level Review (HLR) and see if anyone else has had this experience. My original claim for IVDS of Cervical Spine and Knee Conditions, Bilateral ( Arthritis in both and have had 2 surgeries on left and 1 on right for meniscus tears) was approved at 10% neck, 10% left knee arthritis and 10% right knee arthritis. My contention is that all three conditions should be rated at least at 20% each. First, my neck has "straightened/revers lordosis" which is a qualifying condition for 20%. On both of my knees, the meniscus are frequently popping out, causing swelling, pain and locking which should qualify each knee for 20%. I filed the HLR on March 12, 2019. The form to file the HLR didn't have a place that I could find to submit any supporting information. It only had a section to list the specific conditions to which you wanted them to take another look at. The HLR form did have an option on the form to request an "INFORMAL CONFERENCE CALL" which I checked off so I could explain my disagreement with the rating given. About 32 days after submitting my claim, and ironically while I was at VA appointment stuffed into an MRI machine, the decision officer Marcus called and left a message. I called him back within 45 minutes of his call and the number the give you is out on the west coast and only has a voicemail option. You can't speak to a live person. I left a message and told them day/times that I had available. I waited 2 days and hadn't heard back so I called again and left a message. I went onto my e-benefits to check something else and noticed that my claims appeal had been closed as of April 15, 2019 and a decision sent ... WTF. I called the main VA number and let them know the situation and they sent an internal message to the decision office Marcus. Well Marcus called me back later that day ... and when I picked up the phone he sounded surprised that I picked up. He then went on to say he was calling to schedule an informal conference call with the decision officer .... UGH WHAT? I told him my availability and he said he'd forward right over to the decision officer and I'd likely get a call in a few minutes. Guess what .... that call NEVER CAME! I called back to the main VA number several times and they sent messages and finally one of the people who picked up the phone said just wait for the decision letter. Well I waited (and am still waiting for the original decision letter), when the required 7-10 days passed I called and had them do a verbal FOIA and fax me the decision letter while I was on the phone with them. Yup, you guessed it, the appeal was denied and the reasoning was a cut and past from the original claim decision. Fortunately, at least I hope so, I have the option of a Supplemental claim, which I put all of the supporting information together in a nice package and faxed it to them, called 3 days later to confirm receipt and hopefully that will address the issue. Bottom line, it looks like the HLR process is really BS at this point and they are all about making it look like they are processing these HLRs at about 30 days, at least it was in my experience. Anyone else have HLR experience?
  6. This is not a question but a post on my RAMP journey since not much data is out there. On the 1st of February I received in the mail the option to opt into RAMP for my legacy appeal. Based on the goal of 120 days, this should be done if the goal is met by June, 1st, 2018. If average was counted from the average time for completion starting at when the VA processed RAMP, the estimation of completion was on/around April 6-16th. On February 8th I opted in to the Higher Level Review with the informal conference option selected through my attorney. I made that decision based on My appeal had already been pending for over 4 years with not a single status update after my NOD was accepted. Even though I do have a lawyer. The Higher Level Review appeal option (OPT-in only) is allowing the evidence submitted since the original appeal. (NOTE: Future Higher Level Reviews will only be a second look and will not allow new evidence. Only evidence submitted during the legacy appeal is accepted.) RAMP has a low participation rate, with presumably dedicated assets. First Milestone: On February 28th of 2018 my RAMP Opt in was finally processed and my legacy appeal was closed out. *The RAMP appeal did not show up on ebenefits but did show up on vets.gov along with a warning about my appeal being denied for RAMP because it was already slotted for the BVA. On follow-up with the VA I was told this was an error caused by RAMP not really fitting into the software/application of the online portals and that the only way to get information about the RAMP appeal was through an agent. The BVA error has since stopped appearing and now vets.gov simple says "Your legacy appeal has been closed because you opted into RAMP, at this time it is unknown when this will be completed" Second Milestone: On May 2nd of 2018 my informal conference was scheduled for the 15th of May. Roughly 45 days after the VA processed my RAMP opt in. On May 15th we had the informal call.My lawyer brought up many of the issues being contended. IE: Upper and Lower Back Injury cant be by VA law a single rating.IE: Documented Hearing LossIE: Migraines (Personal Doc did a DBQ and a VA Neurologist offered a Nexus statement)IE: Acquired Psychiatric Conditions. & That the VA had committed some duty to assist errors for a few other conditions.The Higher Level Reviewer agreed with much of what the lawyer said and said he could work with that and thought he could separate out the rating for the back and grant a higher rating for the upper back then the current rating before separation . He said he saw all over my file that the VA was treating me for PTSD and MDD and their was a nexus opinion from the VA to service connect. He said he could do the hearing loss too since i kept my service records that showed the in-service hearing loss. The migraines he thought he could work with too. The call went well and the lawyer was cautiously optimistic but still completely mistrustful. On 5/21/2018 I was told on a call with the VA that he had sent his decision for authorization. As of 6/7/2018 no further news and whenever I contact the VA i'm given the generic "Your VA Ramp Appeal has been assigned to a Higher Level Reviewer" and i'm not getting anymore answers.
×
×
  • Create New...

Important Information

{terms] and Guidelines