Claim Denied, Filing Appeal

[retiredat44]

I got my response for my new claim, it was denied. I had not yet sent in my IME/IMO with the claim because it hadn't been completed and sent by the IME doctor until a few days ago. My VSO helped me submit my claim in May 2009. I received the denial letter last week. I just saw my VSO and he had already took my IME and more forms, packaged them and is sending them for the appeal.

if I had the IME report earlier I would have sent it in sooner, before the claim had been fully processed. we were expecting claims to take many more months, mine shot through very fast! Many posts in these forums make it sound like claims are taking much, much longer to process.

The VSO told me my IME/IMO report is very good and he said it looks very good to him. Again, I found a specialist that does independent medical opinions and examinations and after getting that done, it took another two months for the report to be finished and sent to me. I don't care that it took me a few months of reseaqrch, the money spent, the time it took,l as the report was vewry professional and is very favorabale to My VSO told me that the letter with the report is better than a 'More Than Likely' letter, and better written than just that phrase, as the doctor wrote it did a very good job he said.

So we packaged the documents up for the appeal. he said I should be getting a new letter for the appeal in a couple weeks. I am just shocked they are moving claims very fast here in San Diego. So, those that say they are slow must be in another region that is overburdened by claims.

MY documents from the IME doctor are two reams of paper! All research is included!

Now that the VA's cards are on the table, we can work ont he appeal knowing what they know and think.

Also, the VA never sent me to any doctor for my new claim! WTH?? I am confused, if I remember correctly, when I filed my first claim 15 years ago, the VA sent me to doctors. So did Social Security for SSDI. At least that is what I remember. This time they never sent me to one doctor.

Oh well, I am stil happy as I think I have a solid case and so does my VSO.

Thanx all for listening, and good luck with yours,,

;)

[LarryJ]

Larry,

I know you can't go on the record and say for sure. But, I filed my claim in February 2008, I got a denial letter in Jan 09, I filed an N.O.D. in Jan 09, and it was handed to the DRO in Feb. 09, in Sep. 09 I received the VA form 9, I sent that to the Waco RO, and it was received Oct. 07, 2009. I assume it has been sent to D.C. to go before the Board. Does this claim have a chance of netting favorable results.

All records or service records, evidence of injuries, disorders, and disabilities that occured in service.

I have absolutely no idea. I would need to spend days going over your records and the relative VA rules, regs, decisions, records of appeals, medical history, doctors' files, etc.

And, then and only then could I give you an incorrect answer. ;)

[carlie]

Larry,

I know you can't go on the record and say for sure. But, I filed my claim in February 2008, I got a denial letter in Jan 09, I filed an N.O.D. in Jan 09, and it was handed to the DRO in Feb. 09, in Sep. 09 I received the VA form 9, I sent that to the Waco RO, and it was received Oct. 07, 2009. I assume it has been sent to D.C. to go before the Board. Does this claim have a chance of netting favorable results.

All records or service records, evidence of injuries, disorders, and disabilities that occured in service.

myround0,

I'm not Larry - but will provide my dollar's worth.

You posted,

"I received the VA form 9, I sent that to the Waco RO, and it was received Oct. 07, 2009. I assume it has been sent to D.C. to go before the Board."

In my opinion, it will be at least 5 - 6 months, and perhaps even a year before

the RO gets around to certifying and actually transferring your claim and file to the BVA.

I state this only from my experience with the situation of getting the file transferrd.

Question : have you gone over all the issues of your claim to ensure

each issue will actually be considered as under BVA jurisdiction ?

carlie

[john999]

Did you ever get a DRO Hearing?

[LarryJ]

myround0,

I'm not Larry - but will provide my dollar's worth.

You posted,

"I received the VA form 9, I sent that to the Waco RO, and it was received Oct. 07, 2009. I assume it has been sent to D.C. to go before the Board."

In my opinion, it will be at least 5 - 6 months, and perhaps even a year before

the RO gets around to certifying and actually transferring your claim and file to the BVA.

I state this only from my experience with the situation of getting the file transferrd.

Question : have you gone over all the issues of your claim to ensure

each issue will actually be considered as under BVA jurisdiction ?

carlie

carlie, they aren't asking when, they are asking if they are going to prevail.

hang on, I've put that ball somewhere..............................

oh, hi honey, have you seen that chrystal ball I had around here..................?

[carlie]

Larry,

Put on your reading glasses sweetie.

They also made the statement,

"I assume it has been sent to D.C. to go before the Board."

well of course - hell no it hasn't been sent from the RO to the board yet,

"I received the VA form 9, I sent that to the Waco RO, and it was received Oct. 07, 2009."

If Waco RO only received the Form 9 less than 25 days ago, this claimant still has

a long wait ahead of them before their claims file ever even gets certified

and transferred to the BVA.

Now something else I did not bother to point out as I didn't want to upset

this claimant more is that, even when this claim does finally make it to the actual BVA - he's still going to have one heck of a long wait as this appeal

stems from a N.O.D. that was only filed in Jan 09.

I would venture to speculate that even after this claim does make it to BVA,

he will have at least a three year wait - between remands and getting a decision

out of the BVA.

Now being that the claimant has a VSO - I would want to know why this VSO didn't bother to either:

1) request reconsideration with the new additional evidence ?

2) request a hearing with the DRO ?

Also, I fail to see mentioned in this thread any receipt of a SOC and/or SSOC's,

so how in the heck does he even know what issues contained in the claim

are actually under BVA jurisdiction ?

Another also is:

myround0 posted,

"I had not yet sent in my IME/IMO with the claim because it hadn't been completed and sent by the IME doctor until a few days ago. My VSO helped me submit my claim in May 2009. I received the denial letter last week. I just saw my VSO and he had already took my IME and more forms, packaged them and is sending them for the appeal."

Well if the DRO that prepares and certifies the claims file to BVA does, not

catch onto and adjudicate this additional new evidence and sends

it on to BVA - when BVA gets it - IF the claimant has not signed and submitted a Waiver of Regional Office Consideration - then BVA BY REGS, will automatically have to REMAND the evidence back to the Regional Office for adjudication.

Perhaps I've not kept up with this thread enough but this is the way I see it.

He is heading for the big cluster F - that many of us have been through,

are currently in - or headed for.

carlie

[retiredat44]

The VSO fills out so much paperwork and forms, and I sign them, I haven't looked at all the forms yet.. but he knows the procedures.. so, until I look over the forms, I cannot tell you which ones are being sent in..

too much paperwork.. and not feeling well, I need time to look at this stuff..

retired,

Sorry to hear of your denial.

You posted,"I just saw my VSO and he had already took my IME and more forms, packaged them and is sending them for the appeal."

It is important to study the Reasons and Bases Section of the Rating Decision

that you are filing the NOD on, (I am assuming here that you filed a NOD).

The Reasons and Bases Section, along with the Evidence Section are usually

very helpful in preparing your appeal, in the way that they will point

to what is needed inorder to get the claim granted.

By chance, did you and the VSO discuss filing a request for reconsideration

and submitting the additional medical evidence ?

carlie