Dro Process

[donews]

I apolagize in advance if I have asked or if this has been answered previously.

My mind being what it is does not always function well. lol

I used the DRO process for a claim and they never contacted me, but they did decide in my favor. My disagreement is the rating percent I received and the evidence they used.

I found out during my most recent hospital stay for CHF that all the evidence to support a 100% rating was and always has been in my private and va medical records that they have.

The va cardiologist was even suprised that I wasn't 100% (although he is reluctant to actually put his signature on anything good or bad, he said he preffers to stay out of the boss mans crosshairs).

The questions being :

Can I appeal or nod and request that it be kept in the DRO process?

Can I request to meet with the DRO ? (they never contacted me during the original DRO process)

Can the DRO change the decision based on the outcome of the meeting ? (I will have all the records in hand as to preclude them from not having the records thay need).

[donews]

jbasser,

1. Ejection Fraction is 22% Now Was 25% in Sept 2007 and 31% in Nov 2005

2. By MI you mean Myocardial Infarction or Heart Attack? If so I have had at least 2

3. I have had a cath done atleast once a year since 2003 also had many before that due to all my heart conditions. As for Pulmonary hypertention, I do not ever recall being told I have that.

Thanks to everyone for all the good information.

[jbasser]

Don, according to the regs, an ejection fraction based on a heart cath of less than 30 percent meets the requirements for 100 percent. Dont let them mislead you.

That is the bottom line and you can quote the regs to the DRO.

The reason I mentioned pulmonary hypertension is that it is rated at 100 percent for the Pulmonary criteria. It is based on Right side heart failure.

[john999]

If the VA has had evidence of your being unbable to work or meeting the criteria for 100% for a long time you might at some point after the smoke clears consider a clear and unmistakable error claim. For instance, if you are on SSDI for your SC condition and the VA knew it then they had an obligation to consider you for TDIU. One area where vets have the most friction with the VA is over effective dates. You may have an inferred claim but the VA does not pick that up and run with it unless you put it in front of their noses. By all means meet with the DRO and get the maximum rating you can. You can also bring up evidence regarding the effective date.

[donews]

Thank you to everyone for the great advice.

I am going to ask for a meeting with the DRO.

I should have a DAV rep by then, it shouldn't hurt to go ahead and request a meeting before I get the rep.

I found out after talking to my VA Cardiologist that the VA Medical Records and Private Records clearly show that I have:

Chronic Congestive Heart Failure

Ejection Fraction under 30%

AICD Implant Device

Each one of those individualy qualifies me for 100% for any of my SIX Service Connected heart conditions, let alone the fact that I have all three.

I am hoping that once I actually put the records in front of the DRO and he gets a chance to see me in person, he will realize I should be at 100%.

Yes john999 from what I can find the VA has had some form of evidence about my job loss due to my service connected conditions.

It is on several of my medical records where the doctors have stated that I was unemployed due to my disabilities.

Actually on my original claim for benefits I listed that I was unemployed due to several conditions, and each of the conditions that I listed have eventually been Service Connected.

I also noted on my origianl application for benefits that I was receiving SSDI.

So I will be checking on that at some time as well.

I just want to concentrate on getting the ball rolling on the Heart Conditions as I believe they will be resolved the fastest.

I will be asking a few more questions in some other posts as to not veer off topic here to much.

[donews]

Jbasser,

I was browsing through some of my medical records and found this:

"Mild-to-moderate pulmonary hypertension with pulmonary artery pressures of 45 noted. "

It is on a 2D Echocardiogram Report from Aug 2006.

Is this what you were talking about?

[Berta]

Did you formally apply for TDIU on the 8940?

If so the day they received that form could be the EED retro date they give you-

BUT- if it is their EED you might well be able to get a prior year retro too-

If a vet gets SSA disability for SC conditions-the VA should give them an EED that replects one year prior to recipt of TDIU claim- in some cases-

each case is unique-

what I mean- and I always use the many experiences my husband had as they help others here-

He was 100% SSA date Nov 1991.For SC PTSD.

He was awarded 100% P & T by VA for SC PTSD in 1997.

The VA used his claim date of 1992 for the higher rating (from 30%) but also properly awarded on one year prior-

the date SSA awarded his 100% due to SC PTSD.

Since he was already dead for three years his award was an accrued benefit to me-

I hope I havent misled anyone here on that-

I only got 2 years as accrued because that was the accrued limit for widows/widowers at that time.

If Rod had not died due to VA care he himself would have received a VA 100% P & T back to 1991 (or I sure would have made sure he did)

The regs are not clearly stated on this point-

they say the EED is the date of evidence of unemployability- but I have never seen them go back prior to one year before the receipt of the TDIU or higher increase claim or the SSA award date-

I HAVE see them fail to proper award the EED however-and just got a vet a year additional comp due to his SSA award date.