Jump to content
  • 0

I Just Appealed My Denail Of Benifits...


Mr.Tann

Question

The VA here in San Fran., Ca denied all my claims.. I have appealed the denail about one month ago and they responded with a letter. In the letter they described the three ways I could go about the Post-Decision Review Process: 1) Choose a Decision Review Officer 2)Traditional Appeal Process 3)Hire an Agent or an Attorney. I am woundering which decision would be the highest probability of getting compinsation.. Can anyone help?

Link to comment
Share on other sites

  • Answers 4
  • Created
  • Last Reply

Top Posters For This Question

Popular Days

Top Posters For This Question

4 answers to this question

Recommended Posts

  • HadIt.com Elder

I would opt for the decision review officer but that is a matter of opinion.

Link to comment
Share on other sites

There are 2 ways that work in the appeals process.

A DRO is a Review at the RO level. A different person looks at your claim and has the authority to overturn decisions. This may be quicker.

I would however ask for a Formal Appeal to the BVA. This process is lengthy and can last a couple of years.

I would also suggest go to www.va.gov and search under BVA decisions pertaining your situation. Compare these to your case.

Link to comment
Share on other sites

" I am woundering which decision would be the highest probability of getting compinsation.."

Mr. Tann- regardless of which way you go- it is medical evidence that gets compensation-

I am assuming that you received a Statement of the Case- an initial denial that listed the Reasons and Bases for the denial. Or was this a response to your Notice of Disagreement?

Others might disagree but I see NODs as the veteran's first avenue of attack-and any SOCs that come as additional opportunities to expand your evidence. I feel a veteran should read the SOC carefully- take a few days to go over it-

they have given reasons and bases for their decision that they are stuck with and this is what you have to deal with. It is all you have to deal with- what they said to deny the claim-

Check the evidence list carefully and see how they used the evidence in the narrative.

I would file a Response to Supplemental Statement of The Case of _____(date)

I type this heading and underline it on these responses.

Then argue with each and every point of the SOC that is incorrect.

Make sure you have copies of any actual C & P exams to do this as the VA will parse and manipulate C & P

results to highlight anything negative and forget anything positive.

Refer to in the response, and attach to it copies of anything else you feel is pertinent to your claim and tell them why.Pretend they are 10 years old-dont assume they know anything---or can use common sense- spell it all out-

If they listed evidence but did not use it- tell them- if they have evidence but did not list it- tell them-

State focused on the Reasons and bases-

For example -VA told me "the veteran was not diagnosed with diabetes" and "the death certificate did not list diabetes"- this was an initial denial I got in 2004.

OK- I provided a diagnosis of diabetes from a real doctor, an IMO -Independent Medical Opinion- and also a statement from a former treating VA doctor-and a wealth of evidence from VA med recs indicating diabetes and the autopsy-consistent with end organ disease due to DMII.

On the death certificate part-of that 2004 denial- I more or less made the point that since VA had misdiagnosed the veteran (Sec 1151 1997 many times) and had never diagnosed or treated DMII which caused his conditions at death- that I did not have a crystal ball when the coroner asked me what VA was treating him for. My logical statement ,supported with the 1151 award, stopped that part of the denial cold. My point is stay focused only on the reasons they gave you for denial.If they make an illogicaL statement-jump on it.

For example they told one of my local vets that his vision problems were unrelated to his service connected ones-and had unknown etiology- this was illogical based on his medical evidence.

we sent them a copy of his actual C & P, that connected them both, a medical treatise to support the connection,his opticians reports, and a CAVC decision that helped his claim as it was very similiar.And his SSA award letter which they had continuously overlooked.He won the secondary disability claim for vision problems.

If you tell us a little more- what disability you are claiming and why they denied- maybe we could help more-

I too agree to ask for the DRO review-

Do you have a vet rep or service officer?

If so do they have an office within the VARO complex that you got this decision from?

Do you have any private medical opinions to support your claim?

Does VA have all of your VA and private medical records?

Do you?

If this is a question of denial due to lack of nexus (link) to your service, do you have your SMRs? Service Medical Records?

Do you SSDI benefits- and if so are they for they same condition you claim is due to your service?

Welcome aboard here and thank you for your service. Berta

PS:

(You mentioned they denied ALL -how many claims did you file?)

If many are contingent on service connection of a main claim- that is the one you need to focus on-

What I mean- if you are claiming for example-diabetes evidenced in service with claims for secondary conditions like heart disease, visual problems, HBP etc----due to the diabetes----and

it is the diabetes as the main cause of these other conditions-

the VA has to understand the linkage to service of the main disability and then can consider the secondary ones.

Edited by Berta (see edit history)
Link to comment
Share on other sites

Mr. Tann - Berta is correct. "Medical evidence gets compensation." Also I believe her method is very effective if you are trying to obtain C&P rating. She also mentioned a "Statement of the Case" you need to review this, point by point. Then post additional questions with regard to the "Statement of the Case" outline.

-good luck

" I am woundering which decision would be the highest probability of getting compinsation.."

Mr. Tann- regardless of which way you go- it is medical evidence that gets compensation-

I am assuming that you received a Statement of the Case- an initial denial that listed the Reasons and Bases for the denial. Or was this a response to your Notice of Disagreement?

Others might disagree but I see NODs as the veteran's first avenue of attack-and any SOCs that come as additional opportunities to expand your evidence. I feel a veteran should read the SOC carefully- take a few days to go over it-

they have given reasons and bases for their decision that they are stuck with and this is what you have to deal with. It is all you have to deal with- what they said to deny the claim-

Check the evidence list carefully and see how they used the evidence in the narrative.

I would file a Response to Supplemental Statement of The Case of _____(date)

I type this heading and underline it on these responses.

Then argue with each and every point of the SOC that is incorrect.

Make sure you have copies of any actual C & P exams to do this as the VA will parse and manipulate C & P

results to highlight anything negative and forget anything positive.

Refer to in the response, and attach to it copies of anything else you feel is pertinent to your claim and tell them why.Pretend they are 10 years old-dont assume they know anything---or can use common sense- spell it all out-

If they listed evidence but did not use it- tell them- if they have evidence but did not list it- tell them-

State focused on the Reasons and bases-

For example -VA told me "the veteran was not diagnosed with diabetes" and "the death certificate did not list diabetes"- this was an initial denial I got in 2004.

OK- I provided a diagnosis of diabetes from a real doctor, an IMO -Independent Medical Opinion- and also a statement from a former treating VA doctor-and a wealth of evidence from VA med recs indicating diabetes and the autopsy-consistent with end organ disease due to DMII.

On the death certificate part-of that 2004 denial- I more or less made the point that since VA had misdiagnosed the veteran (Sec 1151 1997 many times) and had never diagnosed or treated DMII which caused his conditions at death- that I did not have a crystal ball when the coroner asked me what VA was treating him for. My logical statement ,supported with the 1151 award, stopped that part of the denial cold. My point is stay focused only on the reasons they gave you for denial.If they make an illogicaL statement-jump on it.

For example they told one of my local vets that his vision problems were unrelated to his service connected ones-and had unknown etiology- this was illogical based on his medical evidence.

we sent them a copy of his actual C & P, that connected them both, a medical treatise to support the connection,his opticians reports, and a CAVC decision that helped his claim as it was very similiar.And his SSA award letter which they had continuously overlooked.He won the secondary disability claim for vision problems.

If you tell us a little more- what disability you are claiming and why they denied- maybe we could help more-

I too agree to ask for the DRO review-

Do you have a vet rep or service officer?

If so do they have an office within the VARO complex that you got this decision from?

Do you have any private medical opinions to support your claim?

Does VA have all of your VA and private medical records?

Do you?

If this is a question of denial due to lack of nexus (link) to your service, do you have your SMRs? Service Medical Records?

Do you SSDI benefits- and if so are they for they same condition you claim is due to your service?

Welcome aboard here and thank you for your service. Berta

PS:

(You mentioned they denied ALL -how many claims did you file?)

If many are contingent on service connection of a main claim- that is the one you need to focus on-

What I mean- if you are claiming for example-diabetes evidenced in service with claims for secondary conditions like heart disease, visual problems, HBP etc----due to the diabetes----and

it is the diabetes as the main cause of these other conditions-

the VA has to understand the linkage to service of the main disability and then can consider the secondary ones.

Link to comment
Share on other sites

Guest
This topic is now closed to further replies.


×
×
  • Create New...

Important Information

{terms] and Guidelines