Help! Need Answer Fast

[jessie0054]

Help!!

Son just got off the phone with the folks on the 1-800 line.

They are telling him that because he summited new material with his letter of reconsideration it is now a re-opened claim.

When we sent the Letter of Reconsideration on the rating decision i sent copies of material that was already in the file and highlighted the areas i wanted them to pay attention too along with a article of the Blood Journal that gives the guidelines for the treatment of his diease to get them to understand that when his Blood HCT levels are above 45 he is to have a phlebotomy. [ he had been denied a phlebotomies by the VA because they said his HCT wasn't high at 52 and was within their norm.]

They now want to schedule another C&P exam!!! What's the point!! All the evidence is in the file and just needs to be given the correct rate for the condition!!!

His SO is out of his office and will be out for a long period of time due to his own health.

So what do we do to get this thing moving again???

Anyone!!

Thanks

Jessie

[jessie0054]

I've read the same regarding the abandonment of a claim (i.e., not showing up for a c&p exam).

Thank you for your replies:

I agree that he should not miss another C&P if one is ordered. I had read that somewhere too!

So if he does nothing and lets the claim go forward as a RE-Opened claim. does that mean that he will lose any retro back to the opening of the claim back to Feb. 06??

Jessie

[entropent]

the "reopened claim" that he was told about on the 800 line is what is known as an "020." it is merely a tracking method. when the rater gets the claim, he will assign an effective date in accordance with applicable law. meaning that, if an increase is warranted, it can go back to the date he submitted his original claim for increase. provided that his condition met the criteria for increased evaluation on that date.

the "abandonded claims" provision does not apply here. if your vet is concerned about this, he can call the 800 number and explain that he cannot make the exam, and to please send his claim to the rating board on the evidence of record in the file. they will gladly do so. again, this is only if he is quite confident that he has submitted evidence sufficient to warrant increased evaluation. chances are pretty good that if he has had a va examination within the last year, the rater will not schedule him for another one, anyway.

[carlie]

M-21-1MR http://www.warms.vba.va.gov/M21_1MR.html

Chapter 5

<H3 style="MARGIN: 0in 0in 12pt">Section E. Reopened Claims

hope this helps a vet.

carlie</H3>

[jessie0054]

the "reopened claim" that he was told about on the 800 line is what is known as an "020." it is merely a tracking method. when the rater gets the claim, he will assign an effective date in accordance with applicable law. meaning that, if an increase is warranted, it can go back to the date he submitted his original claim for increase. provided that his condition met the criteria for increased evaluation on that date.

the "abandonded claims" provision does not apply here. if your vet is concerned about this, he can call the 800 number and explain that he cannot make the exam, and to please send his claim to the rating board on the evidence of record in the file. they will gladly do so. again, this is only if he is quite confident that he has submitted evidence sufficient to warrant increased evaluation. chances are pretty good that if he has had a va examination within the last year, the rater will not schedule him for another one, anyway.

entropent:

Thanks, I think i get it now!! Sorry so slow, My mind is working in overtime trying to work with My son, My husband, My brother and Brother in law's Claims.

We are very confident that there is enough evidence submitted already to rate the claim that warrants the increased rating.

It that's not enought evidence i still have 6 months of recent phlebotomy report. I just haven't sent them as i didn't want to slow down the decision.

Jessie

[jessie0054]

M-21-1MR http://www.warms.vba.va.gov/M21_1MR.html

Chapter 5

<H3 style="MARGIN: 0in 0in 12pt">Section E. Reopened Claims

hope this helps a vet.

carlie</H3>

Carlie:

Thanks, I go read and see what this is about.

Thanks again jessie

[jbasser]

Jesse, have him write a 21-4138 and put these words on it.

Previous information submitted. ( Attach a Copy) was an official request for reconsideration, Not an appeal or a request to reopen the claim.

Explain that you are well within your NOD period of April 07.

You can also ask for a DRO review of this decison (0) percent.

They are missing the point on this one. Maybe just a delay tatic being used.