Nod/dro Va Obligations

[cannoncocker]

I have submitted a request for reconsideration to the VARO. They responded by requiring me to choose between the "normal appeal process" or the DRO Process. I selected the DRO process. They acknowledged this choice in writting. I then requested a personal conference with the DRO and submitted new evidence. I started the NOD request on 29 june 09. On 24 August I received a decision on 2 claim items that had been deferred and a rubber stamp denial of my lumbar injury denial. Completely in contradiction to submitted evidence, in writing from their Neurologist, on his stationary, and the approval of a fee basis epidural injection, which the VARO has denied ever happened.

So, the question is, Does the VA have any obligation regarding the DRO process, since they asked me to chose. Their decision came in the same form as the rest of the claim did. They did not accept my request for the DRO conference nor did they deny it. They did nothing but deny the lumbar claim with the same form as the other deferred claims (1 they approved, the other denied) using erroneous information regarding the lumbar injury.

I basically would like to know if they have any obligations regarding this or can they simply ignor it and in which case does anyone have a recommendation moving forward?

[jbasser]

The clock is ticking for you.

I would request a complete copy fo the claims folder.

I would also NOD the other denial. This will preserve your time.

The C file may tell you what happened or that they are the unorganized mess that you are led to believe.

If you have VSO, use them. They have inside folks.

Dorry for your frustration but Most everyone goes through it.

J

[john999]

You have to request a personal hearing with the DRO. The DRO Review often results in a rubber stamp denial.

[Philip Rogers]

If you're waiting for a DRO hearing, I believe they've been taking 18-24 months before you'll get one. This appears the average nationwide.

pr

I have submitted a request for reconsideration to the VARO. They responded by requiring me to choose between the "normal appeal process" or the DRO Process. I selected the DRO process. They acknowledged this choice in writting. I then requested a personal conference with the DRO and submitted new evidence. I started the NOD request on 29 june 09. On 24 August I received a decision on 2 claim items that had been deferred and a rubber stamp denial of my lumbar injury denial. Completely in contradiction to submitted evidence, in writing from their Neurologist, on his stationary, and the approval of a fee basis epidural injection, which the VARO has denied ever happened.

So, the question is, Does the VA have any obligation regarding the DRO process, since they asked me to chose. Their decision came in the same form as the rest of the claim did. They did not accept my request for the DRO conference nor did they deny it. They did nothing but deny the lumbar claim with the same form as the other deferred claims (1 they approved, the other denied) using erroneous information regarding the lumbar injury.

I basically would like to know if they have any obligations regarding this or can they simply ignor it and in which case does anyone have a recommendation moving forward?

[cannoncocker]

jbasser

The clock is ticking for you.

I would request a complete copy fo the claims folder.

I would also NOD the other denial. This will preserve your time.

The C file may tell you what happened or that they are the unorganized mess that you are led to believe.

If you have VSO, use them. They have inside folks.

Reply: Actually after my DAV reps eyes stopped rolling in his head when I said I wanted a complete copy of my C-file, which he said he had never done before, we called the 800 number and requested the medical records for the lumbar time frame. I see a trip yo the VARO in my near future to physically request the entire file which i believe they said would be 10 bucks or something. I agree and will do that very soon.

Another NOD. I do not currently ave any new documentation to open a new nod. They have:

1. Active duty ER notes

2. Unit Follow up notes which changed medication.

3. ETS

4. MRI 2006 which documents a plethora of protruded/extruded/degenerative/pinched S1

5. MRI 2008 same as above.

6. 2008 Neurology consult stating degenerative discs/pinchedS1/herniated discs

Options:

a. pain medication

b. PT

c. epidural injection L5-S1

d. Surgery (Discretionary)

I selected meds and PT with use of TENS and Brace

7. Letter approving fee basis epidural injections from the Asheville VAMC.

The VA Neurologist pointed out on the MRI the new fluid which indicates new injury and dark fluid which indicates old injury. both present. So maybe an IME?

Thank you for your input!

john999

You have to request a personal hearing with the DRO. The DRO Review often results in a rubber stamp denial

Reply: that is rich, the rubber stamp part. I did indeed request a personal hearing with the DRO. The VARO acknowledged my reqest for the DRO then the next thing I received is a reworded denial as if they never received any new evidence or were cutting and pasting to fit their needs. Which was to refuse me a 100% disability. That is the issue. at 60% and the condition of my back, that has 100% written all over it. They evidently refuse to do that.

Any Ideas on how to fight back? I do worry about retaliation if I push too hard.

philip rogers

If you're waiting for a DRO hearing, I believe they've been taking 18-24 months before you'll get one. This appears the average nationwide.

Reply: I am not really concerned about the time so much as winning what I know to be right and fair. My brothers have my back like I had theirs when we were younger so not worried about that. I requested the hearing then they sent a denial so I can interpret that as a hearing is not part of their agenda.

So the question becomes, what do I do now? hire a lawyer/IME/file another sort of appeal? I don't have any new evidence. I shouldn't need any new evidence. My ER notes from Ft.Polk has pt.states pain at waste level. Now who would walk into an ER and say their waste level hurts. doctor's have actually laughed at that. They just saw VA claim written all over me. That is funny because as dumb as it sounds, I had never even heard of the VA at that point. I didn't even ask for an ets physical since tey had told me at the er to leave the same way I got in whaen I told them I could barely move. My medical condition was clearly of no interest to them.

But what now? C-file yes for sure. But what to keep the ball rolling without irritating them to the point they retaliate againsty me since I am satisfied with my claim minus the lumbar denial.

I spent 6.5 years humping projos in excess of my own weight that far exceeds the NIOSH Standards. The VA Neurologist pointed out old and new injury on my MRI, which I had both, distinguished by light and dark fluid. They did zero diagnostic work at the Ft. Polk ER, just motrin for my pain at the waste level. Now what exactly could a buck Sarg do about that? Nothing. Later at the unit they changed it to pt complained of low back pain and tey changed meds, but still no diagnostic work. Does the military medical prof. have no conduct requirements?

Edited August 25, 2009 by cannoncocker

[sharon]

I have submitted a request for reconsideration to the VARO. They responded by requiring me to choose between the "normal appeal process" or the DRO Process. I selected the DRO process. They acknowledged this choice in writting. I then requested a personal conference with the DRO and submitted new evidence. I started the NOD request on 29 june 09. On 24 August I received a decision on 2 claim items that had been deferred and a rubber stamp denial of my lumbar injury denial. Completely in contradiction to submitted evidence, in writing from their Neurologist, on his stationary, and the approval of a fee basis epidural injection, which the VARO has denied ever happened.

So, the question is, Does the VA have any obligation regarding the DRO process, since they asked me to chose. Their decision came in the same form as the rest of the claim did. They did not accept my request for the DRO conference nor did they deny it. They did nothing but deny the lumbar claim with the same form as the other deferred claims (1 they approved, the other denied) using erroneous information regarding the lumbar injury.

I basically would like to know if they have any obligations regarding this or can they simply ignor it and in which case does anyone have a recommendation moving forward?

Did you receive a decision or a Supplemental Statement of the Case (SOC). The SOC looks like a decision but is only a review of the past decision.

[john999]

I would go to the VARO and give them another request in writing for a Personal DRO Hearing. Get a copy. As Pete has said you are entitled to a personal hearing at any time with someone at the VA regarding your claim. At my VARO it is taking about a year to get a hearing with a DRO. Your other path is to go to the BVA. That takes two years and if you want a hearing at the BVA that probably takes another year. The thing I believe is that talking to a human being that can rate you is your best bet unless your evidence is just so good that it is bullet proof. I don't believe that kind of evidence exists because you can't make the VA read it. Ask Berta! I know in at least one of my claims the VA did not read or understand the evidence if they did read it.