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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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    • So, my lawyer sent an IME w/ IMO and filed a supplemental claim solely for IU on March 20.

      It was closed on March 25, and va.gov just states claim closed and nothing more.

      Hopefully, I get good news.
    • Thanks for the responses. I am filing a new claim but will continue pushing the NOD. My new question is it stated in law or statute that if during the claims process the VA finds conditions that could possibly rate service connection that was not originally filed for, the VA will “invite” the veteran to file the claim on the claims form. Reason I ask is that my private DBQs, NEXUS letter, and even the VA nurse examiner's DBQs lists bilateral upper radiculopathy as present. If it is written in statute or official guidance it might qualify as a CUE. Just looking at all angles. 
    • Everyone needs to read our stories so they can try to avoid these screws by the va...
      Thank you, everyone contributes, good or bad, all of our stories will help others, and yes, they have been stated by others for ages, over and over, but we just get depressed, and the time turns into years as they screw us..

      Welcome to the department of Veterans Affairs!  I can honestly say, "been there, done that".  

      Even after winning my tdiu in 2017, it was back to the drawing board as VA hornswaggeld my effective date.  (but of course).  

      I finally won my tdiu effective date in Feb. 2020, 18 years after I first applied!!!  

      Here is how they managed to drag mine out 18 years:

      1.  They never adjuticated my decison until 2009, where they called it "moot".  

      2.  I appealed, said it was not moot because it could result in an earlier effective date and SMC S under Bradley vs Peake.  The judge agreed with me, and ordered VARO consider me for extra schedular TDIU, under 4.16 b.  

      3.  The VARO piddles with  the remand for 3 years, and hoped I wouldnt notice.  I noticed and raised cane until they adjuticated it.  (denied of course).  

      4.  Finally, after the baord denied again, I hired a lawyer, in 2014, and appealed to CAVC.   

      5.  The lawyer won a remand, got an IMO and I won tdiu in 2017.  But at the wrong effective date, even after 15 years.  

      6.  I hired another lawyer, Chris Attig, and appealed the effective date, and he won a remand for effective date.  Trip 2 to CAVC.  

      7.  Mr. Attig won a remand, and advised me to get another IMO.  

      8.  The board awarded my earlier effective date in Feb. 2020.  

           So, I do have advice fighting VA for TDIU, they fought and fought and I hung in there and won it all.  

      ADVICE:  Dont count on VA, they could easily throw your fax in the trash.  Follow up!  
    • "Keep in mind that due to the nature of the digestive system, VA would most likely combined your conditions and pay you at the higher rate to avoid pyramiding".    That is one of my main gripes.  They are only listing the GERD with hiatal hernia and ignoring the rest of my gastric issues such as the gastritis which I also had in service.  I included it in my 2007 request for increase and again in 2019.  The info from the civilian dr that stated I had the gastritis with H pylori was not even provided to the examiner in 2007, nor did he have my VA health records. The 2019 request was based on an EGD I had AT THE VA in Jan 2019.   I filed for an increase 6 Mar and they did an ACE on 27 Mar and downgraded to noncompensable on that date.  The only reason I was thinking CUE:  38 CFR § 3.326 - Under Examinations  it states (c) Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination".  
    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
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Wings

Use Of Telephone, E-mail And Fax For Claims Development

Question

WARMS - What's New? http://www.warms.vba.va.gov/whatsnew.html

Veterans Benefits Administration M21-1, Part III

Department of Veterans Affairs Change 135

Washington, DC 20420 November 10, 2005

Veterans Benefits Manual M21-1, Part III, “Authorization and Clerical Procedures,” is changed as follows:

Pages 11-III-1 and 11-III-2: Remove these pages and substitute pages 11-III-1 and 11-III-2 attached.

Paragraph 11.17c is amended to clarify that the telephone call must be properly documented, even if the information is advantageous to the beneficiary.

Paragraph 11.18a is revised to show that award action may not be taken on oral information or statements, unless all the requirements cited in this paragraph are met.

Paragraph 11.18a(3)6 is added to show that before ending the call, the VSR should explain to the beneficiary that a notification letter of our decision will be sent, based on the information obtained during the call.

Paragraph 11.18b is revised to show that regardless of whether the information obtained during the call will favorably or adversely affect the award, it should be documented.

Minor editorial corrections were made to the subchapter.

By Direction of the Under Secretary for Benefits

Renée L. Szybala, Director

Compensation and Pension Service

Distribution: RPC: 2068

FD: EX: ASO and AR (included in RPC 2068)

November 10, 2005 M21-1, Part III

Change 135

SUBCHAPTER III. USE OF TELEPHONE, E-MAIL AND FAX FOR CLAIMS DEVELOPMENT

11.17 GENERAL

a. Regional offices should make full use of telephones, e-mail and fax machines as an integral part of claims development procedures for compensation, pension, and burial claims.

b. Issues Suitable for Telephone, E-Mail and Fax Development:

(1) Social Security numbers of dependents, including the Social Security Number Verification Match;

(2) Correct mailing address(es);

(3) Date(s) of birth;

(4) Reserve or National Guard unit information (e.g., address);

(5) Information concerning retired, severance or readjustment pay;

(6) Names and addresses of physicians or medical record numbers;

(7) Employment information (current or past);

(8) Change in dependency status, name and address of person having custody of children, etc.;

(9) Income information (e.g., change in income or date of receipt of first Social Security payment);

(10) Clarification of medical expenses;

(11) Verification of Medicaid-covered nursing home status;

(12) Burial claim clarification information (e.g., status of unpaid bills);

(13) Whether the veteran has service medical or other records.

c. Beneficiaries are not required to advise VA in writing of changes in income, net worth, dependency or marital status. VA may increase or decrease benefit payments based on information submitted orally, or by e-mail, fax or other electronic means. If the change results in adverse action, a predetermination notice is not required but contemporaneous notice must be sent. However, do not take adverse action with contemporaneous notice or favorable action based on oral information unless you follow the specific telephone contact procedures shown in paragraph 11.18a.

11.18 TELEPHONE, E-MAIL AND FAX CONTACT PROCEDURES

a. Sound discretion must be exercised when requesting information by telephone or e-mail to ensure that the source of the information is reliable. Verification of the source is necessary. If the person is unable to furnish the information requested or if the VA employee remains uncertain of the person’s identity, complete development by letter. VA may not take action based on oral information or statements unless the VA employee receiving the information meets the following conditions:

(1) during the conversation identify yourself as a VA employee who is authorized to receive the information or statement (these are VA employees authorized to take actions under 38 CFR 3.100); and

(2) during the conversation verify the identity of the provider as either the beneficiary or his or her fiduciary by obtaining specific information about the beneficiary that can be verified from the VA records, such as Social Security number, date of birth, branch of military service, dates of military service, or other information; and

(3) during or following the conversation document the following information for the beneficiary’s VA records:

1. the specific information or statement provided; and

2. the date such information or statement was provided; and

3. the identity of the provider; and

4. the steps taken to verify the identity of the provider as being either the beneficiary or his or her fiduciary; and

5. that you informed the provider that the information would be used for the purpose of calculating benefit amounts. (38 CFR 3.217(b))

6. before ending the conversation, inform the beneficiary that even though the information was obtained telephonically, a notification letter will be issued.

b. All information received by telephone from the claimant must be completely documented on VA Form 119, “Report of Contact”, or equivalent, regardless of whether the information will favorably or adversely affect the beneficiary’s award. If the veteran has a power of attorney, send the representative a copy of the VA Form 119.

c. All information received by e-mail from the claimant or beneficiary must be printed out on paper and placed in the claims folder.

d. When information received by telephone, e-mail or fax results in an award or denial action, the notification letter must include a statement of this information as well as the date of the telephone call, e-mail or fax.

e. If benefits are reduced, terminated or otherwise adversely affected based on oral information or statements, they will be retroactively restored if, within 30 days of the date that the notification of adverse action is issued, the beneficiary or his or her fiduciary asserts that the adverse action was based upon information or statements that were inaccurate or upon information that was not provided by the beneficiary or his or her fiduciary. (38 CFR 3.103(b)(4))

11.19 DOCUMENTS SUITABLE FOR RECEIPT BY FAX OR E-MAIL

All documents except original applications and separation documents intended for proof of service to establish entitlement to benefits may be accepted via fax or e-mail. However, if there is any question about the validity of any documents received by fax or e-mail, the original should be requested.

11-III-2

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  • Our picks

    • So, my lawyer sent an IME w/ IMO and filed a supplemental claim solely for IU on March 20.

      It was closed on March 25, and va.gov just states claim closed and nothing more.

      Hopefully, I get good news.
    • Thanks for the responses. I am filing a new claim but will continue pushing the NOD. My new question is it stated in law or statute that if during the claims process the VA finds conditions that could possibly rate service connection that was not originally filed for, the VA will “invite” the veteran to file the claim on the claims form. Reason I ask is that my private DBQs, NEXUS letter, and even the VA nurse examiner's DBQs lists bilateral upper radiculopathy as present. If it is written in statute or official guidance it might qualify as a CUE. Just looking at all angles. 
    • Everyone needs to read our stories so they can try to avoid these screws by the va...
      Thank you, everyone contributes, good or bad, all of our stories will help others, and yes, they have been stated by others for ages, over and over, but we just get depressed, and the time turns into years as they screw us..

      Welcome to the department of Veterans Affairs!  I can honestly say, "been there, done that".  

      Even after winning my tdiu in 2017, it was back to the drawing board as VA hornswaggeld my effective date.  (but of course).  

      I finally won my tdiu effective date in Feb. 2020, 18 years after I first applied!!!  

      Here is how they managed to drag mine out 18 years:

      1.  They never adjuticated my decison until 2009, where they called it "moot".  

      2.  I appealed, said it was not moot because it could result in an earlier effective date and SMC S under Bradley vs Peake.  The judge agreed with me, and ordered VARO consider me for extra schedular TDIU, under 4.16 b.  

      3.  The VARO piddles with  the remand for 3 years, and hoped I wouldnt notice.  I noticed and raised cane until they adjuticated it.  (denied of course).  

      4.  Finally, after the baord denied again, I hired a lawyer, in 2014, and appealed to CAVC.   

      5.  The lawyer won a remand, got an IMO and I won tdiu in 2017.  But at the wrong effective date, even after 15 years.  

      6.  I hired another lawyer, Chris Attig, and appealed the effective date, and he won a remand for effective date.  Trip 2 to CAVC.  

      7.  Mr. Attig won a remand, and advised me to get another IMO.  

      8.  The board awarded my earlier effective date in Feb. 2020.  

           So, I do have advice fighting VA for TDIU, they fought and fought and I hung in there and won it all.  

      ADVICE:  Dont count on VA, they could easily throw your fax in the trash.  Follow up!  
    • "Keep in mind that due to the nature of the digestive system, VA would most likely combined your conditions and pay you at the higher rate to avoid pyramiding".    That is one of my main gripes.  They are only listing the GERD with hiatal hernia and ignoring the rest of my gastric issues such as the gastritis which I also had in service.  I included it in my 2007 request for increase and again in 2019.  The info from the civilian dr that stated I had the gastritis with H pylori was not even provided to the examiner in 2007, nor did he have my VA health records. The 2019 request was based on an EGD I had AT THE VA in Jan 2019.   I filed for an increase 6 Mar and they did an ACE on 27 Mar and downgraded to noncompensable on that date.  The only reason I was thinking CUE:  38 CFR § 3.326 - Under Examinations  it states (c) Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination".  
    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
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