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winger
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Question

Hi folks,

this is mt first post please bare with me.

I Was awarded PT&IU on 4/18/02 after I applied for an increase on a bilateral shoulder condition , which I was medically discharged from USMC on2/76 TDRL first then VA picked it up an gave me 50% and have held that since 30yrs+.

The increase I applied for in 2002came back rated 60/40 PT/IU I Have also held that since that date. Well back in 4/08 I received a letter reducing my rate back to 60% because of 2140 employment questionnaire they said they did not receive. I did mail it like I always do but, I Guess it didn't reach them. Immediately hand carried a new one the day after I got their letter

and got a stamped and received copy of the 2140. Now this was all supposed to go away as soon as the paperwork caught up. The told me at the Varo This should not be a problem and I asked for a letter of proof of 100% for my life insurance so they would continue paying my premiums. They gave it to me with no problems. I know this is wordy but please read on.

The problem started when the exam scheduled for me because of questionnaire was still on. It should have been stopped along with the other proceedings. When I called the VARO I Asked why it was still on and the rep said because the 2140 was not in , again I told him it was and have a stamped copy. I Asked him again and was told the exam would continue because someone on the rating team wanted it to and no reason was given. So I went to DAV and let them represent me. I also went to C&P which was for IU. By the way the day after my phone call to VARO about exam I received a letter that said periodically the VA reviews claims to verify the cond. and to see if its properly rated. I am rated for bilateral shoulder Postoperative status code 5202 Left at 30% ,right at 20% since 2/16 /76 . when I applied for an increase in 02 because my cond. had worsened-and it came back ; service connection for DJD rt shoulder 10% and SC for DJD left shoulder at 10%

They added the 10 and 10% for 10% which brought me to 60% and awarded me 40% IU P&T. I never applied for IU It Was give to me without the 8940 application for IU. I believe this is an inferred claim? Well after my C&P was done I got a call from the RO asking me to fill out the IU application because it was not done in 02 and they needed it for their records this didn't sound right so I asked what if I don't turn it in, He said it would go bad for me. then I asked him are you folks trying to take my IU away? The rep said No not at all we just need it for an up date This conversation is almost word for word, I also have his Name and what office he works in. So I receive the VA proposed reduction in rating for me. and under the evidence section there was my IU application form that was supposed to be for the 2002 records. also the c&pwhich was done poorly and by a GP doc. I logged a complaint with the pat adv. at Hosp. What the Va is saying is that because they added the djd to my postoperative status it is pyramiding therefore it is considered a CU&E based on the 2002 records. I have held my 100% for over6 yrs. I am currently waiting for a date for the predetermination hearing at my VARO. The DAV submitted my disagreement letter on 7/20/08. The bottom line is my cond. has worsened to the point of only surgery to correct the problems . This was recommended by the VA orthro DEP and My Private MD. Two years ago I went to the VA for a orthro check up on shoulders at that meeting They said it could only be fixed by surgery and exercise but only come back if you want surgery. I have this report which the VA missed when the reviewed me for this reduction. Ok Sorry it was so long thanks for reading. I'm looking for advice, resources, any input would be most appreciated

Thanks WINGER 72

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Winger:

Welcome to Hadit. At least you have a 100% check coming in every month so the hard lifting has been done. You probably should ask for a DRO Hearing and than talk it out with the DRO and perhaps clear up the problem when you can talk them into it. This method works but be sure and watch your deadlines and file a NOD and a From 9 before one year from award is up.

Good Luck

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The VA needs the TDIU form 21-8940 to justify any TDIU decision they make.

It sounds like you are one of probably thousands of vets caught up in the recent VA OIG findings.

"I have this report which the VA missed when the reviewed me for this reduction."

Of course they missed it-this has become SOP for the VA.

Is it listed on your SOC as evidence and then referred to in the Narrative at all ?

"The DAV submitted my disagreement letter on 7/20/08"

did the DAV make an argument specific to their denial and why you are disagreeing with it -based on the evidence they ignored?

"I am currently waiting for a date for the predetermination hearing at my VARO."

What is that- do you mean a Decision Review Officer hearing?

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The VA needs the TDIU form 21-8940 to justify any TDIU decision they make.

It sounds like you are one of probably thousands of vets caught up in the recent VA OIG findings.

"I have this report which the VA missed when the reviewed me for this reduction."

Of course they missed it-this has become SOP for the VA.

Is it listed on your SOC as evidence and then referred to in the Narrative at all ?

"The DAV submitted my disagreement letter on 7/20/08"

did the DAV make an argument specific to their denial and why you are disagreeing with it -based on the evidence they ignored?

"I am currently waiting for a date for the predetermination hearing at my VARO."

What is that- do you mean a Decision Review Officer hearing?

Berta , thank you for answering my post.

I,m not sure I was TDIU I was receiving ch 35 Health benefit for spouse ID card and letters from varo stating I am P&T /IU.

I have not submitted SOC yet there has been no request Just the VA proposal to reduce my award.

The DAV is just waiting for the VA reply. They told me to get a doc to say I could not do work because of my condition and have them say its permanent. and they will do the rest.

I have been reading about this claim i have since March 08.

I know this hearing is coming soon so Im getting a little worried.

Could the decision they made in 4/02 be a Inferred claim because I never asked for P&T /IU they just gave to me on a request for an increase?

again thanks for your intrest I hope I answered your questions

Winger

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Berta , thank you for answering my post.

I,m not sure I was TDIU I was receiving ch 35 Health benefit for spouse ID card and letters from varo stating I am P&T /IU.

I have not submitted SOC yet there has been no request Just the VA proposal to reduce my award.

Winger - the claimant does not submit a SOC. A SOC is a Statement of the Case that VARO sends to the claimant.

The DAV is just waiting for the VA reply. They told me to get a doc to say I could not do work because of my condition and have them say its permanent. and they will do the rest.

I'm glad you get a VSO in on this one.

I have been reading about this claim i have since March 08.

I know this hearing is coming soon so Im getting a little worried.

Seems to me that this is going to be a DRO Hearing. I hope you attend and not

just your VSO. Go see your VSO often.

Even tho the VA proposed your reduction are you still receiving your comp at the

100% rate ?

It looks like either you or the VSO must have already put in a Notice of Disagreement on the reduction and that's why your having a hearing.

Does this sound correct?

Could the decision they made in 4/02 be a Inferred claim because I never asked for P&T /IU they just gave to me on a request for an increase?

again thanks for your intrest I hope I answered your questions

Yes, since you never requested IU it looks like a decision maker inferred the TDIU

during your request for increase.

Winger

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Thanks Carlie,

What do you think about my claim? I have Have had a private doc review my cond. and he recommends surgery because the staple has begun to migrate in my shoulder and my right is very unstable and also needs surgery. The VA exam in 2003 was a surgery recommendation also . Problem is I am a poor candidate for surgery because of a heart cond. blood pressure, among others. Because they are saying the decision in 2002 was pyramiding with djd on a postoperative status that I should not have received the 10% for each shoulder for DJD. That may be so but because of their percent change my cond. did not get better it got worse and more complex. I May be wrong but because the VA made the mistake I am allowed to add evidence after the cue in 2002. Iknow these cases are hard to win but after reviewing the progression of this cue some thing is not right. Like why did someone on the rating team specifically want my c&p to continue when almost all cases regarding the missing 21-4140 go away when the form is received. I don't know maybe I'm reaching but this is really taking a toll on my family and myself .

I have research case logs and found cases like mine that have been rated higher. which I've copied. But I'm hoping I can pick up some more information here to help me with this proposal. Thanks again for your input. the wording I received was my hearing was called predetermination. and I will most certainly be there.

thanks Winger

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Have you sent them the 4140?

Have you asked for a hearing?

Have you responded to any deadlines they gave you?

Yes recently VA Sec Peake had to make a formal statement as to 4140s.

Still-in your case-if they did receive it, it appears your TDIU is still being threatened.

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