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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
- 0 replies
Picked By
Tbird, -
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Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
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Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
Lemuel, -
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Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
Welcome to hadit!
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait! Is this money from disability compensation, or did you earn it working at a regular job?" Not once. Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.
However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
Picked By
Lemuel, -
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Post in What is the DIC timeline?
broncovet posted an answer to a question,
Good question.
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.Picked By
Lemuel, -
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Question
Berta
(Email from COl. Dan Cedusky)
Just when you think you have heard and seen it all.. delay...deny..appeal..deny..delay.. die waiting
where is the outrage from the major VSO's? and our congress
The article at this web site refers to info below
http://www.opednews.com/articles/opedne_rl...new_way_to_.htm
http://www.vawatchdog.org/07/nf07/nfOCT07/nf101307-1.htm
NEW VA POLICY COULD CHANGE LARGE, RETROACTIVE
AWARDS -- "...New procedures...to follow in cases involving awards with an effective date retroactive eight or more years
or that result in a lump-sum payment of $250,000 or more..."
The VA has a new policy..."...New procedures...to follow in cases involving awards with an effective date retroactive eight or more years or that result in a lump-sum payment of $250,000 or more..."
I was sent a VA Fast Letter explaining this change and asked a veterans' benefits attorney to comment. Attorneys thoughts are in italics.
"In essence now the VA Central Office C&P service in Washington will make the decision with regard to the effective date and the amount of the award. While I'm not sure there is a legal problem with this procedure (this procedure is similar to that by which an extraschedular rating is granted or denied), the new procedure will obviously result in a delay of payment to a veteran or surviving spouse or children. It also appears somewhat smelly."
I asked the attorney: Does this mean that VACO could actually change the date/amount awarded to a veteran? If so...explain, please?
"In short, yes. The Fast Letter states '[w]henever a rating decision grants service connection with an effective date retroactive eight or more years, the claims folder must be flashed to alert the authorization activity of the extraordinary award. This instruction also applies whenever an earlier effective date of eight or more years is granted for a previously service-connected disability.' Thus, the provisions of the Fast Letter apply to both claims for service connection (S/C) and claims for an earlier effective date (EED) where S/C was previously granted. As usual, the wording of the Fast Letter leaves much to be desired. For example, the Fast Letter does not discuss from what date the 'eight or more years' is to be calculated. Without going into all the possible scenarios, suffice it to say there are several different ways an ED for a grant of S/C or an EED for a previously granted claim can be assigned, and each of these ways present different possibilities for the determination of a starting date from which to calculate the 'eight or more years.'
The Fast Letter actually proscribes three levels of review for these EEDs and awards over $250,000. First, the rating officer makes a decision. If the decision involves a grant of an effective date 'retroactive eight or more years"'or results in a lump-sum payment of $250,000 or more, then it will be reviewed by the 'Post-Determination team' at the RO. Then it will be reviewed by the RO's Veterans Service Center Manager and finally by the C&P Service in Washington. At any stage of the review process the original decision could be changed.
In case you are wondering, the ultimate decision issued by the RO after the three reviews can still be appealed to the Board and the CAVC. A Fast Letter cannot change this procedure.
Fast letter at: http://www.vawatchdog.org/07/nf07/nfOCT07/...sFastLetter.pdf
Fast Letter printed below:
-------------------------
DEPARTMENT OF VETERANS AFFAIRS
Veterans Benefits Administration
Washington, D.C. 20420
August 27, 2007
Director (00/21) In Reply Refer To: 211B
All VA Regional Offices Fast Letter 07-19
SUBJ: Procedures for Handling Extraordinary Awards
Background
The Compensation and Pension (C&P) Service Bulletin dated June 2007 discussed new
procedures for regional offices (ROs) to follow in cases involving awards with an
effective date retroactive eight or more years or that result in a lump-sum payment of
$250,000 or more. These awards require a review by the C&P Service prior to award
authorization. This fast letter (FL) provides more detailed guidance for handling these
types of cases.
Responsibility for Identifying These Cases
The Rating, Appeals, and Post-Determination Teams are responsible for identifying cases
that meet these criteria.
Procedures for Appeals and Rating Teams
Whenever a rating decision grants service connection with an effective date retroactive
eight or more years, the claims folder must be flashed to alert the authorization activity of
the extraordinary award. This instruction also applies whenever an earlier effective date
of eight or more years is granted for a previously service-connected disability. After
flashing the folder, forward the case to the Post-Determination Team. Do not offer these
rating decisions to any veteran’s representative for review until the C&P Service makes a
final determination regarding the propriety of the decision.
Procedures for Post-Determination Teams
Rating Veterans Service Representatives (RVSRs) and Decision Review Officers (DROs)
should be the first to identify a case involving an effective date retroactive eight or more
years. However, Veterans Service Representatives (VSRs) and Senior Veterans Service
Representatives (SVSRs) on the Post-Determination team are ultimately responsible for
Page 2.
Director (00/21)
identifying these cases, as well as any awards involving a lump-sum payment of
$250,000 or more. If using VETSNET Awards, the application will automatically
calculate the retroactive amount.
The VSR or SVSR who identifies a rating decision meeting the established criteria will
prepare the referral memorandum for the Veterans Service Center Manager (VSCM) to
request an administrative review by the C&P Service (see enclosed). The VSCM will
then review the decision and sign the memorandum if he or she agrees with the decision.
Signature responsibility may only be delegated to an individual serving as VSCM in an
acting capacity. For additional information on requesting an administrative review,
please refer to M21-1MR, Part III, Subpart vi, Chapter 1, Section A, Topic 3.
Please note: Do not leave any of these awards in GAP’d status or authorize them until
the C&P Service concurs with the Veterans Service Center (VSC) decision.
Procedures for Transferring the Claims Folder to C&P Service
After completing the memorandum and attaching it to the file, the VSC will send the
claims folder via Federal Express to:
C&P Service (211B, Advisory Review)
810 Vermont Ave, NW
Washington, DC 20420
Reflect a temporary transfer of the claims folder in COVERS and update the suspense
accordingly. In addition, before the claims folder leaves the RO, add the claimant flash
“250K Retro Review” via the VETSNET Participant Profile application. The C&P
Service will review these cases and return them to the VSC by Federal Express within
five days of receipt.
Procedures Upon Return of the Claims Folder From C&P Service
If the C&P Service concurs with the VSC decision, the veteran’s representative (if
applicable) will then be allowed to review the decision prior to its promulgation.
These new procedures do not replace the three-signature requirement for awards
exceeding $25,000 (whether processed through BDN or VETSNET). The VSC must still
follow the three-signature award procedures as outlined in M21-1, Part V, 9.01(.
If the C&P Service determines the decision is improper, it will provide specific corrective
action.
Page 3.
Director (00/21)
Cases Involving BVA or CAVC Decisions
Ratings based on decisions by the Board of Veterans’ Appeals (BVA) or the U.S. Court
of Appeals for Veterans Claims (CAVC) will be excluded from the C&P Service review
only when BVA or CAVC assigns the effective date and/or the retroactive increased
evaluation. Otherwise, when processing decisions by BVA or CAVC, follow the
procedures outlined in this FL whenever the rating decision involves an effective date
retroactive eight or more years or the award results in a lump-sum payment of $250,000
or more.
Cases Processed Under the Nehmer Court Order
Cases processed under the Nehmer v. U.S. Veterans’ Administration court order are
exempt from the provisions of this FL because these cases are already being reviewed by
the C&P Service.
Questions
Questions concerning this fast letter should be submitted to VAVBAWAS/CO/21Q&A.
/s/
Bradley G. Mayes
Director
Compensation and Pension Service
Enclosure: Sample Memorandum
Department of
Veterans Affairs
Memorandum
Date:
From: Veterans Service Center Manager, _________ Regional Office
Subj: Administrative Review-Retroactive Effective Date/Lump-Sum Payment
File number: _________________
To: Director, Compensation and Pension Service
Issue(s)
At issue in this case is whether the effective date and/or amount of payment are
appropriate.
Background
Please see rating decision in claims folder dated ________.
Conclusion
We propose to .... (Propose a recommendation for each issue cited in the
first paragraph. Example: “We propose to pay $275,000.00 retroactive
benefits for the period 07/01/97 to 08/01/07.”) Your concurrence is
requested.
___________________________
Signature
( ) CONCUR
( ) DO NOT CONCUR: See attached.
________________________________________ ___________
Director, Compensation and Pension Service Date
__._,_.___
Messages in this topic (1) Reply (via web post) | Start a new topic
Messages
"Keep on, Keepin' on"
Dan Cedusky, Champaign IL "Colonel Dan"
See my web site at:
http://www.angelfire.com/il2/VeteranIssues/
Change your email address when needed by signing in at
http://groups.yahoo.com/group/VeteranIssues/
Forward to other veterans, tell them to Sign up at:
http://groups.yahoo.com/group/VeteranIssues/join
Edited by BertaGRADUATE ! Nov 2nd 2007 American Military University !
When thousands of Americans faced annihilation in the 1800s Chief
Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
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