tdiu I Visit The Ro And The Plot Thickens

[dav_marine72]

So I need to go to the health center for an appointment and to try and get some nexus letters. If anyone remembers I received a TDIU letter without any reference to DEA or P&T yet my SO says he has one. I called the 800 number and they tell me I am 100% P&T. So I show up at the RO and state I need a copy of my latest rating decision because mine does not say P&T. They say we may not have your file here because of your appeals. I'm like you made the decision it should be here. The receptionist gets an RO helper person and I explain I need a copy of the rating for my SS case that says P&T. He brings out a decision letter with a different date that although it looks close to the one I recieved it states I was awarded DEA. It's like I'm in the twilght zone. A different decision copy for them and me. Almost like they didn't want me to know I was P&T. Then I read why they gave me DEA. It states when a Veteran has a disability that permanent and total he or she is entitled to DEA. So I say okay but why doesn't it say I am P&T. Then the receptionist says you aren't P&T you have an exam in 2011. So I say but you can't get DEA unless you are P&T. I said you can be P&T but still have a future exam. She says no you can't. I'm thinking this lady works at the front desk why the hell is she telling me crap that isn't even true. So I ask the rep again why can't they just put P&T in the letter because there is no way I am not. He says I'm not saying anything. I didn't have anything to do with this decision so I'm not saying a word. He then says I don't want to say anything that might not be true because then you will be mad at me. I can sort of understand that logic. However, then in front of everyone in the room (about 5 vets and 3 VA employees) he says I also don't want you coming back and beating me with your cane hahahaha. Then a woman from the VA says oh I want to see that one. I am so pissed by now I tell him (he is a large African American by the way) I'll drop the cane and go outside right now. The woman VA employee then says you must be on too many drugs and laughs. Finally the rep says why don't you go see your SO. I said okay.

I go down and verify yes I am P&T and sure enough in the letter I didn't get it says my back (which is chronic in nature, 13 years in the making, 2 failed surgery including L3-S1 fusion, I am scheduled for a spinal stimulator because I am in 5 times the pain after this last surgery) has a good probably of getting better down the road. My SO does verify I am P&T. I also have 10 service connections together with many on appeal and have a good chance of getting 100% on the schedule because I was 80% prior to TDIU.

I really don't care about the future exam. I am used to fighting these clowns and will win again. It's BS yes but what are you going to do. What troubles me is if I never inquired I would not have known I had DEA and CHAMPVA benefits. Why did I get a different letter than the RO and SO had on file. Then on top of all my troubles here I just go to the RO to get a copy of the decision letter they didn't send me and I have to have a receptionist tell me I'm not P&T when 1 thats not her job and 2 she doesn't have the knowledge to talk to me about my case. I have a VA rep come out and basically say I know nothing and won't say anything. Then he embarrasses me by saying he doesn't want me to come back and beat him with my cane. I thought for once the VA had some integrity by giving me TDIU and P&T which I rate and then I have to find out they hid a letter from me and the VA workers think it's funny I need to use a cane. These people disgust me.

[deltaj]

So I need to go to the health center for an appointment and to try and get some nexus letters. If anyone remembers I received a TDIU letter without any reference to DEA or P&T yet my SO says he has one. I called the 800 number and they tell me I am 100% P&T. So I show up at the RO and state I need a copy of my latest rating decision because mine does not say P&T. They say we may not have your file here because of your appeals. I'm like you made the decision it should be here. The receptionist gets an RO helper person and I explain I need a copy of the rating for my SS case that says P&T. He brings out a decision letter with a different date that although it looks close to the one I recieved it states I was awarded DEA. It's like I'm in the twilght zone. A different decision copy for them and me. Almost like they didn't want me to know I was P&T. Then I read why they gave me DEA. It states when a Veteran has a disability that permanent and total he or she is entitled to DEA. So I say okay but why doesn't it say I am P&T. Then the receptionist says you aren't P&T you have an exam in 2011. So I say but you can't get DEA unless you are P&T. I said you can be P&T but still have a future exam. She says no you can't. I'm thinking this lady works at the front desk why the hell is she telling me crap that isn't even true. So I ask the rep again why can't they just put P&T in the letter because there is no way I am not. He says I'm not saying anything. I didn't have anything to do with this decision so I'm not saying a word. He then says I don't want to say anything that might not be true because then you will be mad at me. I can sort of understand that logic. However, then in front of everyone in the room (about 5 vets and 3 VA employees) he says I also don't want you coming back and beating me with your cane hahahaha. Then a woman from the VA says oh I want to see that one. I am so pissed by now I tell him (he is a large African American by the way) I'll drop the cane and go outside right now. The woman VA employee then says you must be on too many drugs and laughs. Finally the rep says why don't you go see your SO. I said okay.

I go down and verify yes I am P&T and sure enough in the letter I didn't get it says my back (which is chronic in nature, 13 years in the making, 2 failed surgery including L3-S1 fusion, I am scheduled for a spinal stimulator because I am in 5 times the pain after this last surgery) has a good probably of getting better down the road. My SO does verify I am P&T. I also have 10 service connections together with many on appeal and have a good chance of getting 100% on the schedule because I was 80% prior to TDIU.

I really don't care about the future exam. I am used to fighting these clowns and will win again. It's BS yes but what are you going to do. What troubles me is if I never inquired I would not have known I had DEA and CHAMPVA benefits. Why did I get a different letter than the RO and SO had on file. Then on top of all my troubles here I just go to the RO to get a copy of the decision letter they didn't send me and I have to have a receptionist tell me I'm not P&T when 1 thats not her job and 2 she doesn't have the knowledge to talk to me about my case. I have a VA rep come out and basically say I know nothing and won't say anything. Then he embarrasses me by saying he doesn't want me to come back and beat him with my cane. I thought for once the VA had some integrity by giving me TDIU and P&T which I rate and then I have to find out they hid a letter from me and the VA workers think it's funny I need to use a cane. These people disgust me.

The events you are describining are extraordinary but it is believable that some people in V.A. are insensitive and uncaring. You tried to obtain this information from the health center. What you need to do is find out where the V.A. adjudication division is at the VAMC (VA Medical Center). You want to go into that office and ask the same questions. The most recent rating examination will have a box on it for the date of future exams. Whether you have a future exam scheduled is what determines if your dependents have entitlement to DEA (Dependents Educational Assistance) and CHAMPVA. If you have dependents, I suggest you obtain and complete a declaration of the status of dependents form. Send the completed form and the attached certified copies of the documentation needed for it to V.A., via certified mail return receipt requested, so that it will be received within one year of the rating decision because of 38 USC 5110 (f). The most recent rating decision should be dated just before the notification letter you received. Get some advice from your representative with a service organization who is representing you on whether you should send a cover letter with it because V.A. may later try to claim that cover letter from you was your notice of disagreement with the most recent decision. Also you need to make a written request for complete copies of your C file. You want that for 2 reasons: (1) You want to have your SS attorney review those records send copies of the medical records to Social Security in support of your pending claim. (2) You want copies of those records so you can decide if you are going to appeal V.A.'s latest rating decision. What comes to mind is an appeal on percentage of rating, whether you are permanent and total, whether you have entitlement to an earlier effective date under 38 CFR 3.400 (q) and 38 CFR 3.400 (o) (2). Don't tell V.A. that is why you are seeking copies of your C file. Instead, I recommend you tell them you are seeking the material for personal use. Anyway, if you get copies of your C file keep the original photocopies for your use and get copies made for your Social Security attorney who is appealing Social Security's denial and get copies for your visit with the representative with a service organization who is representing you and is your appointed power of attorney.

Edited October 1, 2009 by deltaj

[dav_marine72]

Hey Delta,

Thanks for the advice. One thing though I was at the regional office. It's in the same building as the health center. I do have a copy of my C file already. I just need to refresh it from this summer when my RO made it for my U.S. court attorney. Thank you for your time.

[jbasser]

Shouldn't the Adjudication division be located inside the Regional Office. The only claims issues the VAMC deals with are the Claims and Pension section and are the only VBA employees inside the hospital. Unless the RO is located inside of the VAMC.

http://www.wbdg.org/ccb/VA/VASPACE/7610-821.pdf

J

Edited October 1, 2009 by jbasser

[dav_marine72]

Some questions:

"V.A. adjudication division" you are talking about the regional office correct?

"The most recent rating examination will have a box on it for the date of future exams. Whether you have a future exam scheduled is what determines if your dependents have entitlement to DEA (Dependents Educational Assistance) and CHAMPVA."

I definitely have DEA and CHAMPVA benefits. The exam she was talking about is for the 40% they gave my back rating which actually is heading back to the BVA from the U.S. court for an intial higher rating than 20% ortho and 10% neuro from 2000 and 2002 respectively. Granted my TDIU is based on back 50%, mental 50%, asthma 30% and seven other 10s and or 0s. It did not say under my TDIU rating that I would have a future exam. Under my temp 100% for convalescence it said after that my back was bumped from 20 to 40%. Then it said however since there is likelihood of improvement this rating is not permanent. Funny thing is once it gets back to the BVA my lawyer believes I will get at least 40% ortho, 40% right lower extermity and 40% left lower extremity. That would put my back at a combined rating of 80%.

Maybe I should just post my decision on here with private info blocked out for people to look at?

[dav_marine72]

I just want to make sure everyone understands my RO used to be in a federal building. They moved the entire RO office into a couple of floors in the hospital. So I was at the full RO office when this took place.

[jbasser]

I think the reason it says future exams is the fact that you have a rating for Mental. Even though it is P and T they still feel there could be an improvement in the future.