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Am I Legally Entitled To A Dro Review/conference

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cannoncocker

Question

this is what I entered into the IRIS system attempting to obtain the following:

Before I obtain an IMO and complete VA Form 9 selecting BVA hearing I request:

1. Statement of Case (were the two mailings referenced above the Statement of Case?)

2. I never received a DRO review that Is documented as requested.

3. I never recevied the DRO personal conference.

So far all I recevied was another written denial. Am I not legally entitled to a DRO personal review and conference if requested, which I did? If not I will accept that and move on in the appeals process, but I would still need clarification on the Statement of Case (SOC) or (SSOC).

This was my entry into iris

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

I have received 2 packages from the Winston Salem VARO.

Mailing 1

1. Dated June 22 2009

Rating Decision

Introduction

Decision

2. June 23 2009

318/YRO/VAB

CSS XXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXXX

Dated 30 June 2009

1. I replied to the above decision in consultation with my DAV VSO Representative on form VA Form 21-4138 Seeking Reconsideration for my lumbar spine injury.

a. W-S VARO Acknowledgement of receipt of my written disagreement with Department of Veterans Affairs Decision of June 23, 2009.

318/213/PAD

CSS XXXXXXXXXXXXXx

XXXXXXXXXXXXXXXXXX

Additional evidence regarding Lumbar Injury Denial

b. W-S VARO Acknowledgement of receipt of my election of the Decision review Officer (DRO) to handle the appeal.

c. IRIS [inquiry: 090702-001052]

7008 2810 0001 1824 0040 date 03 July 2009 evidence

7008 2810 0001 1824 0033 dated 06 July 2009 evidence

Mailed USPS Certified Mail with Receipt copied in previous post in this inquiry for Request for Reconsideration Denial (Medical Description: Lumbar spine injury with radiating through buttocks and down legs). Response directly to 318/YRO/VAB

CSS XXXXXXXXXXXX

XXXXXXXXXXXXXXX

DECISION Dated June 22, 2009

enclosed Durham Neurology Dept. Notes

d. IRIS [inquiry: 090727-000693]

I select in consultation with my DAV Representative Mr.XXXXXXXXXXXXXXX

Asheville VAMC DAV Service Officer (828) 298-7911 EXT.15349 option 1,

the Decision Review Officer (DRO).

e. [inquiry: 090802-000091]

Currently your appeal is still pending review with the DRO. During this process, the DRO will review all evidence, arguments, statements from your representative, and any other pertinent information as it relates to your claim. At times, this can lead to a request for additional evidence. In addition, the DRO may request you participate in an informal conference with the DRO to clarify questions regarding your disagreement.

f. [inquiry: 090807-000262]

Dear Mr. XXXXXXXXXXXXX

This is in response to your inquiry of August 7, 2009, regarding your VA benefits.

We are able to assist you with both of your requests. We have forwarded your inquiry to the appeals department at the regional office to request a hearing with the Decision Review Officer (DRO) be scheduled. It may be some time before you receive a response to your request, as appeals issues are processed as they are received, oldest to newest.

XXXXXXXXXXXXx

National IRIS Response Center Manager

jmb

The appeal process, is when you disagree with a decision the VA made on your claim. At this time you may elect a Decision Review Officer (DRO) reviews your file and issue a Statement of the Case

g. submitted Charles George VAMC ATTN: FEE BASIS Approval of epidural injections, which I declined, but corroborates the hand written notes explaining my therapy options and pain orgin from S1 pinched nerve/degenerative diseases/L5S1 herniated disc.....

Mailing 2

1. Dated august 19, 2009

318/AUTH/LLS

CSS XXXXXXXXXXXXXXX

XXXXXXXXXXXX

Stated in reference to my request for reconsideration for lumbar injury:

The previous Rating Decision denied service connection for a lumbar spine injury.......

you submitted a statement requesting reconsideration of this issue.

It acknowledged receipt of VAMC Durham reports, this was not a report , it was hand written notes on the Neurologists stationary stating orgin of pain/treatment options/ he verbally stated and pointed out the age of the injury on the 2008 MRI by distinguishishing the dark and light disc fluid leakage which would be apparent to any Neurologist.

Review does not show that your current lumbar injury was incurred in or caused by your military service.

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

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

Before I obtain an IMO and complete VA Form 9 selecting BVA hearing I request:

1. Statement of Case (were the two mailings referenced above the Statement of Case?)

2. I never received a DRO review that Is documented as requested.

3. I never recevied the DRO personal conference.

All I recevied was another written denial which included decisions on 2 deferred items. Am I not legally entitled to a DRO personal review and conference if requested, which I did? If not I will accept that and move on in the appeals process, but I would still need clarification on the Statement of Case (SOC) or (SSOC).

I accept denial of my psychiatric claim as I have no in service documentation but that is absolutely not the case for the lumbar injury.

Sincerely,

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First, thank you guys for posting our rights!

Also I hate to disillusion anyone reading this, but I sent that request in for a DRO Hearing, well I forgot, I didn't use Urdu, but by all means available: IRIS, certified ltr. and this is the result:

This message is in response to your inquiry dated August 28, 2009. We do show your request for a DRO hearing. We are currently working on getting that hearing scheduled. The Appeals Team at our Winston-Salem Regional Office will contact you regarding this hearing. No SOC will be issued until after the DRO hearing.

Thank you for contacting us. If you have questions or need additional help with the information in our reply, please respond to this message or see our other contact information below.

Sincerely yours,

So they were sitting on it hoping I would drop dead or whatever or were just backlogged but zero correspondence till I Inquired. Up to that point is was simply no, move along, nothing to see here. It would have been nice had they told me their intentions/next action in this maze. but oh no.

You guys were right though, spot on. The VA just didn't confirm that they were going to adhere to the rules. I don't just assume they will do the right thing/adhere to their own rules.

I do have 1 further question regarding a "SOC". What exactly does that entail? Revealuation of my entire claim or only the denied claim item for which I requested the DRO hearing for. Still paranoid regarding retaliation and reducing claim items they just increased. Or to do that would they have to reschedule another C&P or just arbitrarily assign any value they want to get the desired total they are looking for. Simply, I may be right, but that doesn't alone make it end up right. Another way of stating it is: I don't want to jump into the frying pan into the fire.

I am pefectly perpared to debate this any time, anywhere, so that is not an issue.

I'd be a goner without this forum and the members.

Edited by cannoncocker
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  • HadIt.com Elder

The Statement of the Case is pretty much a reiteration of your rating decision. It is supposed to explain why you got the rating you got and why you didn't get a higher rating. It is useful because it contains the clues that help you win your appeal. It lists the reasons why a complete grant of all benefits was not awarded and why. The "why" is what you attack in your appeal. I found the best why to attack an SOC is to get a doctor to refute the SOC point by point.

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The Statement of the Case is pretty much a reiteration of your rating decision. It is supposed to explain why you got the rating you got and why you didn't get a higher rating. It is useful because it contains the clues that help you win your appeal. It lists the reasons why a complete grant of all benefits was not awarded and why. The "why" is what you attack in your appeal. I found the best why to attack an SOC is to get a doctor to refute the SOC point by point.

Thank you john, the was exactly what I needed, the in context. I already had a definition:

http://www1.va.gov/opa/is1/12.asp

Which gives zero information on how it is relevant to me.

Very useful and hope so for others.

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And a SSOC,

Supplemental Statement of the Case =

Prepared by the agency of original jurisdiction, when additional pertinent evidence

has been introduced, an amended decision has been made, or a material defect

in the Statement of the Case has been discovered (38 CFR19.31 (2008)).

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