Retro Date Issue

[mountain tyme]

Hello

I have a question regarding retro date of a claim based on a reconsideration of a rating decision. If the reconsideration was filed within one month of the VA decision and the reconsideration was for a higher percentage and the VA outcome was favorable for a higher % would the VA go back to the original claim date or would they only go back to the date the reconsideration was filed for retro pay?

Thank You in advance

mountain tyme

[mountain tyme]

Good Morning Berta,

Yes, I too was surprised for the amount of information I received by the VA guy...

("When I called the VARO office on Friday I was told that a decision was made and I should hear something within 30 days..and I was also told that if I received a favorable outcome and was rated higher that the retro pay would not go back to the date of the original claim of 05 but by the date of the reconsideration which would be march of 07 because the decision would be based on new and material evidence (doctor statement) that was not present during the inital determination. "

That is a lot of info to get out of an 800# vet rep at the VARO-")

Normally all I hear is that my claim is pending or that it is with the rater...ect..ect..ect..

But there have been that rare occassion that I would talk to someone that would take the time and tell me what they can...

only to call a few days later and be told a whole new set of information...I don't put much stock in the information I receive from the 800 folks...because I do understand that they are limited in what they can tell you or what they can see on the screen and there primary function is not claims pending but for general information on VA benifits...and knowing this I still call...mainly due to aniexty is why I call. but, having said that.

I am going to have to wait to see how the VA will handle the reconsideration...as far as retro date...all the information that my doctor responded to was based on evidence already filed with the VA prior to there determination...my doctor more or less brought out the facts or highlighted the evidence they had and how it met the critera for a higher rating based on there rating scale.

I will post an update once I receive the VA decision...and go from there...thank you all for your time...

MT

[Pete53]

Well if they want more time to answer phones giving complete and truthful informations would probably cut out a lot of duplicate calls?

[john999]

That does sound like a VA tactic to say that they are basing your increase on a new piece of evidence and to date your increse from the time they got the new evidence. Technically they may be right, but morally they are wrong since many have claims on appeal for years and then they send in one more piece of evidence and bingo the VA grants the increase and makes the ED the date of reception of supposed new evidence. This is just a way to save money at the vet's expense.

[vaf]

You have an IMO doc who would possibly "persuade" the VA to correctly interpret the existing evidence already in the record. It's not new evidence, it's a correct interpretation of the evidence the VA already had. I agree with Berta, you should push for the EED based on the objective evidence that the VA should have interpreted correctly, according to its own rating criteria, in the first place.

We're in a similar situation. When the evidence has been in the records all along, and you need to get an outside professional opinion to steer the VA along the course of interpretation that the VA itself has established, and should have correctly followed in the first place, then the EED should be the date the rating takes effect.

[JSM754]

"When I called the VARO office on Friday I was told that a decision was made and I should hear something within 30 days..and I was also told that if I received a favorable outcome and was rated higher that the retro pay would not go back to the date of the original claim of 05 but by the date of the reconsideration which would be march of 07 because the decision would be based on new and material evidence (doctor statement) that was not present during the inital determination. "

That is a lot of info to get out of an 800# vet rep at the VARO-

If VA did have sufficient medical evidence of higher rating-then I feel the retro should go back to the filing date-if the rating should hacve been higher when the claim was filed.

The 800# rep could be right- then again they could be wrong-

it all depends on what I call the Watergate question-

WHat did the VA know and when did they know it-

If VA could have awarded higher rating due to evidence they had-which you have a doctor's opinion on-I feel the retro should be when the VA had this evidence that supported the higher rating.

I hope you hear something soon-

"after my doctor reviewed the C/P and the VA criteria on how they rate my disability she stronly felt I rated higher and wrote a statement of fact in support as to why I medically met the criteria set forth by the VA"

In my opinion she supported medical evidence VA already had- thus- the EED shoud be the date of the claim-

that is only my opinion and best to see what VA does and what rationale they would use as I dont see this as "new and material" as to the date of disability-

The VA usually never gives a retro date as the same date as receipt of an IMO.

The retro is based on when the clinical record showed the disability/and/or an increase in its affect to the veteran.

The 800# person might have been talking out of their

hat

Hi Berta,

As I was reading the Information that you/or whoever received from the mentally challenged Consumer Repreps at the 1-800 number is exactly one of the reasons I am where I am today. Read Carefully and check the Reg's:

**A veteran files for an Increased Evaluation dated 01 January 2004. (DATE OF CLAIM) The Veteran disagrees with every Rating Increase Denial, which at some point more likely than not puts the Issue into BVA status. As the Veteran waits for their BVA Review, they continue to request a Reconsideration at the RO Level.**

For arguement sake the Veteran is granted an Increased Evaluation Rating Decision dated 28 August 2007. It does not matter that the Veteran coninued to request a Reconsideration by the RO while waiting for a BVA Review.

**THE BOTTOM LINE IS THAT IF AN ISSUE IN PENDING APPEAL STATUS IS RESOLVED BEFORE BVA REVIEW IS TO BE GIVEN THE ORIGINAL DOC (I.E. 01 JUNE 2000)

Please get back to me

JSM754

[Berta]

JSM- I agree that a claim which is continuously prosecuted and finally awarded- regardless of how the award is prompted (NOD and/or Reconsideration request)- that the date of the initial claim is the date of the retro.

(AO claims under Nehmer and other types of claims could render a EED further back than the actual claim date. The retro would be based on the rating at time of initial claim (once that rating is determined)

"continuously prosecuted" a good point----not only is this the claimant's responsibility but also that of their vet reps:

See: Title 38 USC, Chapter 1. Part 14, Sec 14.633

"(d) Accreditation shall be canceled when the General Counsel finds

an agent's, attorney's, or representative's performance before the

Department of Veterans Affairs demonstrates a lack of the degree of

competence necessary to adequately prepare, present, and prosecute

claims for veteran's benefits."