Reconsideration Vs Dro Review

[Guest jangrin]

Can someone explain the difference between a DRO review and a reconsideration?

It seems like you get the same result with either one.

We think we have decided to file for reconsideration on the recent rating my husband received. There are multiple issues that we feel were rated incorrectly. We think this happened possibly because of an inexperienced rated or just too many issues on one claim.I

How should the reconsideration papers/letter be organized. Most important to least important? Is it best to ask for the reconsideration on everything together or to ask for each issue to be look at seperately?

Thanks

[Vike17]

Jangrin,

A request for reconsideration is when you ask the decision maker that "reconsider" their previuos decision. This, however, can only be done if you submit "new" evidence, which is evidence that the decision maker did not have before them during the previuos evaluation. You have one year from the date of the decision to request a "reconsideration" based on "new" evidence, and if the decision is then subsequently decided in the claimants favor, they retain the original effective date. See M21-1MR, Part III, subpart II, section E, §20© and §3.400(q).

An appeal with a DRO review should be initiated if you disagree with the decision based on the evidence before the decision maker and how they were perhaps weighed. Granted, a claimant can submit "new" evidence also during a DRO review, but one would probably be better served time wise to ask for a reconsideration instead of initiating the appeals process in this instance.

Request for reconsiderations generally go quicker because they are processed by the date of the claim and if you submit evidence within the one year time fram, the initial date of the claim is preserved. Appeals are generally worked according to the date of the appeal.

One thing to note is that "request for reconsiderations" are reqeusts to "re-open" a claim, it's just a matter of when the evidence is submitted that determines the effective date. If you submit evidence after one year of the rating decision then the effective date, if the claim is granted, becomes the date the evidence was submitted. Also, since you're technically "re-opening" a claim within the appeals period, you shouldn't have to worry about submitting an NOD if a decision isn't made before the one year time period is up. There has been many discussions about this in the pass, but I'm willing to bet since it's a "re-opening" of a claim, then that claim is an open issue until a decison has ben made on the "new" evidence. It all boils down to the effective date which in this case is governed by §3.400(q).

Vike 17

[john999]

Jangrin

Just remember if you ask for a reconsideration the "one year" rule for filing a NOD still stands. Even if you get close to the one year time limit for the NOD and you have not gotten the reconsideration then you still need to file the NOD to keep the appeal going. I asked for a reconsideration on my recent claim and I am waiting now to hear something.

[john999]

Can you ask for reconsideration of a CUE claim? How can you submit new evidence in a CUE claim?

[Guest jangrin]

I have another question on this topic. How is one to differentiate between "new" evidence and evidence the rater has already weighed in detemining the rating. Is new evidence anything that was not listed in the award? Or is new evidense anything that is not in the c-file once the award is made (evidence that is "dated" after the award date)?

If you file a notice of disagreement, is that considered an appeal? I guess I am having difficulty figuring out the difference between an appeal, DRO review, and NOD. Can someone lead me to water here.

thanks-

Jangrin

Edited May 10, 2007 by jangrin

[hurryupnwait]

I have another question on this topic. How is one to differentiate between "new" evidence and evidence the rater has already weighed in detemining the rating. Is new evidence anything that was not listed in the award? Or is new evidense anything that is not in the c-file once the award is made (evidence that is "dated" after the award date)?

If you file a notice of disagreement, is that considered an appeal? I guess I am having difficulty figuring out the difference between an appeal, DRO review, and NOD. Can someone lead me to water here.

thanks-

Jangrin

I have the same question?

Paul

[Rockhound]

Can you ask for reconsideration of a CUE claim? How can you submit new evidence in a CUE claim?

john999: You cannot present new evidence in a CUE claim, unless it was evidence extent at the time of the alleged CUE. Even the statutes, regualtions and USC's must reflect what they were at the time of the CUE occurred. It must also be evidence that was before the adjudicator and/or examiner at the time of CUE. You cannot bring in or point out evidence that might have been available but not seen or used in the claims process. Only if it was a procedural error or a some stutute, regulation or USC that wasn't applied when they made there decision.

I'm not sure a CUE claim can be reconsidered, I think it can only be appealed to the next higher level.

Another thing about CUE. Once the court has decided on they matter and if it is denied, then you can not go back and fix your mistakes in your CUE claim and precent it again based on the same factual basis of the old CUE. One shot in the courts on one subject. But if you have a different claim for something different that happened at the time of CUE and you think that too was CUE then it would be under different factual cercumstances and you could file on that.

get what I am trying to say?

If not maybe someone else can explain it better.

Rockhound