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I Don't Know Whether To Be P*ssed Or Confused!

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Shark

Question

I just received an IRIS response to my request to find out the status of my appeal and new claim, here it is:

Response (Department of Veterans Affairs) 11/09/2009 12:20 PM Dear Mr. xxxxxxx:

This is in response to your inquiry dated November 6, 2009, regarding the status of your appeal and your claim for increase.

Mr. xxxxxxxxx, we thank you for your service to our country and the sacrifices you have made for our freedom.

Our records indicate that we received your Notice of Disagreement on October 28, 2008, for your appeal seeking entitlement to Individual Unemployability (IU). You originally selected a Decision Review Officer to make a decision on your appeal but switched to the Traditional Process appeal on December 11, 2008. We show that your file has been sent for an examination for your appeal. You will be notified by U.S. mail of the date, time, and location of the examination.

The appeals process can be a very lengthy and time consuming process. Appeals are worked in the order in which they are received. We suggest that you stay in touch with your Power of Attorney, Disabled American Veterans. They are very knowledgeable and helpful with the appeals process.

We show that your claim for increase was opened on July 9, 2009, for hypertension secondary to Diabetes Mellitus Type II with foot ulcers and Gastroesphageal Reflux Disease. It is currently being reviewed to make sure all of the necessary development is completed. Once that is done, your claim will be forwarded to the rating team where a rating specialist will review all of the evidence and make a decision. From there, your claim will go to the post-determination team where they will make sure everything is in order before sending you a letter by U.S. mail, notifying you whether benefits were granted or denied.

We appreciate your patience during these processing procedures. Be assured that we are working as quickly as possible to make a fair determination on your appeal and your claim for increase.

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,

E.J. Kruse

National IRIS Response Center Manager

Now the strange part...I asked to be changed back to the DRO process in January of this year. In July I submitted a new claim for hypertension and GERD. In August I received a letter from the DRO that the application for IU was considered a request for an increase in all disabilities. C&P's were scheduled for September. The PTSD follow-up exam stated for an increase and unemployability. The Psychiatrist stated:

"Claimant is unemployable due especially to irritability and poor concentration." She then went into her rationale for that statement. She also provided evidence that should have me at the 70-100% rating for PTSD.

Then I also had a medical C&P in September where the doc stated that "at least as likely as not" that I was service connected for hypertension and GERD.

Now I get the second part where they are in development of the new claim, but why would they want to do another examination for the PTSD? Could it be that they did not like the results of the first exam and are going out for another opinion?

I know...I should be out fishing and not worrying about this!

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  • HadIt.com Elder

Be damn sure that your DRO is going to happen. When you start to change things the VA gets confused. They may be actually waiting to certify your claim to the BVA. I would double check this. It happened to me. I asked for a DRO Hearing and the VA was in the process of certifying my claim to the BVA when I stopped them.

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Shark,

I thought I read here that if your C&P is more than 1 year old the request a new one. It looks like your ordeal has been going on for a little more than a year. I am sure one of the experts can shed more light on it my DRO process is approching 1 year and I expect to have a new exam.

Good luck

Edited by kw34
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  • HadIt.com Elder

Waiting one year for a DRO is not a long time. What you want to be sure of it that you are indeed in line for a DRO Review or Hearing. You cannot just trust them. I would verify it if I had to go down to the VARO on foot. They should have sent you a letter saying they acknowledge that you are going the DRO route in lieu of a BVA appeal. If you change your mind in the middle of the process watch out!

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Can you contact your VSO to find out what is going on with your claim..They can sign out your claim and read what's going on with it/where it is in the process...(The VSO at the VARO that is). You have to keep on top of them all the time!

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I would suspect that they did not see the C&P exams had already occured. Apparently you file is processing to go to the appeals section for determination. Once that determination is made then it goes to thr review board. The 1-800 number people can usually at least tell you where the claim is i.e. what stage of the process. Workup - Determination, or Review. Sounds like your is still in workup for some reason. The C&P may be for some other issue as well, not related to the appeal directly. Who knows really, the 1-800 people can tell you if you have any C&P's pending normally as well but you have to make sure and tell them this is an appeal, and not a new claim - different screens.

Bob

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