I've Never Gone Thru The Nod/appeal Process

[Rockhound]

I know I need to file a Notice of Disagreement, but have never done this before, since like a dummy in the past, I never went any further with my claims. But now is different and I plan to appeal as long as it takes, even to the Court if I have too.

I have three issues I wish to appeal, (1) two small painful scars at 10%, (2) Chronic Sinusitis, (3) Chronic Non-Allergic Rhinitis, all secondary to a SC Nasal Fracture and Deviated Septum due to Trauma.

I do plan to seek an IME and IMO for these conditions from a private ENT specialist, in the hopes they will be able to provide the evidence I need to rebut the VA's opinion.

Must I make my intentions to NOD the decision within a time frame other than the year in which I can appeal their decision? When should I, If I decide to ask for a DRO, make my desire known to the VARO?

They gave me written notice on what I can do if I disagree with their decision, but since I have never gone this far with my claim, it's a bit of unknown territory for me and a bit daunting/scary for me as well. I don't take disappointments very well and I am a day and a half without my meds, since I stayed in town to make it to a next day appointment to see my PCP on an un-related issue that I thought I would have to wait a month or so to get. Getting the next day was a god send from from the great spirit that looks over me, so I jumped at the chance to see my PCP so soon.

It does nothing for how I feel like a heal to my cat Tom and kitten Tammi that I had to leave them to fend for themselves for this long, even though I make sure that when I do into town they have plenty of food and water for a few days, just in case of things like this coming up. This will be Tammi's first time this long without my super vision, but Tom being an indoor/outdoor cat has had this forced upon him a couple of times in the past.

Well it's time for me to check in at the VAHC for my morning appointment, so I am off probably till I get home tonight, so please make your suggestions and experiences known so I can make my plans for the next step in the Claims process.

Oh yea, should I wait until this NOD or appeal is done before submitting another claim I have been working for some time to get the evidence I needed and it appears I have it now, but I am pretty sure this claim will take some time due to the issues at hand?

Rockhound Rider

[WHOLESALE]

requesting a DRO review might speed things up.

Frank

If your going to do your own NOD, you can write it like this:

I wish to file a notice of disagreement with the rating decision dated (MM/DD/YYYY).

I wish to appeal the following issues:

(List the issues by the number they were listed by the DVA and what percentage they rated your for or if denied, list that)

Ex:

1. Sleep Apnea, currently rated at 30% disabling,

5. Bilateral Hearing Loss, currently rated at 10% disabiling,

10. Headaches, currently denied.

I wish to have a Decision Review Officer (DRO) adjudicate my appeal.

In support of my claim, I am providing several 21-4142's. These records will describe the nature and severity of my issues. When not going to the doctor, I have been using conservative measures (to include over-the-counter medications, heat, exercise and when necessary - ice).

I wish to elect to have (either no hearing, a hearing - in person, or a telephonic hearing).

If necessary, I am available for an examination for rating purposes. Your attention to this matter is appreciated.

******************************************************

Having done several hundred of these claims, this is a generic appeal. Though the fax number I'm providing is for the regional Office in Roanoke Virginia, once the appeal has been sent in (keep the fax receipt to prove you faxed it in on a timely basis), you will have perfected your appeal. You can fax it to (540) 597-1792. I hope this helps.

[Rockhound]

My mind doesn't work in a logical way, going step by step to a logical conclusion, rather It seems to jump around alot, sometimes forgeting something important, but if I keep the subject forefront in my mind long enough, everything or at least enough gets processed to finally make the logical sence that is needed when putting it down on paper.

One thing that came to me, is that when I was confronted with making a diagnosis when I was the junior medical officer aboard a U.S. Navy Ship at sea, I reference what I could from the current volume of the MERK manual and if that was not sufficient then I took it to my Chief medical officer or relayed my information to the tending Dr of our group and discussed what I had found and what I thought may be the problem and/or correct diagnosis and if he concurred, I would then discuss the proper treatment, if it was available aboard my vessel, if not, then that person was either transfered to the tender where the Dr was or they where transported to the nearest shore hospital for further evaluation and treatment.

The short of it is that I haven't yet looked to see what the Merk manuel has to say on the subject, so that is what I plan to do as a layperson with a medical background.

Also, I am in the process of getting my medical referral arranged, it won't be with I had first chosen to seek an opinion with, but with someone else, since I have found out that their are limited spaces or number of patients that civilain Dr's will see who wish to do so using Medical as their insured payor. Bummer. But I did find someone who will take my appointment, just as soon as my PCP send then a directed Fax to this ENT specialist requesting them by name, then an appoint will be made for the enitial visit. I only hope after explaining what I need and what hoops they will have to jump thru for their opinion to have any baring on my claim, that they will consent for a more complete and thorough IME/IMO. that is complete and up to the task of rebutting what the VA C&P Examiner has opinioned on the subject.

I hope the MERK manual proves probative on this subject, it will make my own personal findings that much more probative in my own mind.

Rockhound Rider