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Question About Re-opened Claims.

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Rockhound

Question

Am I right to assume that any re-opened claim with new and material evidence, whether the claim is specified or not, that any Service connected condition must be looked at as if it were an implied claim for increase?

I'll try to explain this another way. If I re-open a claim for say a foot condition, but I have other Service conneceted condition of record. must the VA consider the other claims as an implied claim for increase as well?

Rockhound Rider :rolleyes:

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  • HadIt.com Elder

What is suppose to happen and what actually happens varies. Yes, the VA is supposed to look for all potential SC conditions (or increases) claimed or not. Examples often seen would be 0% ratings for hearing loss and scars from in-service surgeries.

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  • HadIt.com Elder
If I re-open a claim for say a foot condition, but I have other Service conneceted condition of record. must the VA consider the other claims as an implied claim for increase as well?

Rockhound Rider :rolleyes:

The answer to this is pure legality. The ultimate responsibility for the claim rest upon the veteran. It is nice should the VA notice the unclaimed "claim" but at the end of the day the burden rest with the veteran to make the claim.

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  • HadIt.com Elder

You have to consider that the C&P doctor is paid piece rate so he/she wants to get to the next case. Don't expect them to waste time looking for other SC conditions. That you need to do on your own.

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  • HadIt.com Elder
Am I right to assume that any re-opened claim with new and material evidence, whether the claim is specified or not, that any Service connected condition must be looked at as if it were an implied claim for increase?...

Rockhound Rider ;)

That has not been my experience...

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Rock - the only responsibility of the VA is to fully explore your claimed issue and any secondary issues that may arise from it ie a claim for DMII.

If you have a rating for a foot injury (prior rating) and you ask for a relook at a head claim (or request a new rating for a head injury) then they are not required to relook the foot injury claim.

With that said in many cases they will - as evidenced by reduced ratings on previous claims. They can legally look at any rating you have anytime they touch your file. But they are not required to - that is your responsibility.

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  • HadIt.com Elder
Am I right to assume that any re-opened claim with new and material evidence, whether the claim is specified or not, that any Service connected condition must be looked at as if it were an implied claim for increase?

I'll try to explain this another way. If I re-open a claim for say a foot condition, but I have other Service conneceted condition of record. must the VA consider the other claims as an implied claim for increase as well?

Rockhound Rider ;)

I think you might want to search online under M-21 AND inferred condition AND veteran. I also suggest you search online under M-21 AND implied condition AND veteran. I don't remember ever having read anything on an implied condition but since you have heard of this then do this search. I suggest you do these searches because the M-21 is the manual V.A. uses for adjudicating claims. I've been told before by a rep of Paralyzed Veterans of America that the M-21 contains statutory requirements that V.A. must follow. In terms of some regulations on increases and reopened claim one regulation you might want to look at is 38 CFR 3.157 (:). I also suggest you read 38 CFR 3.156 and 38 USC 5108. I'm thinking that if there is evidence of an increase shown in an exam under 38 CFR 3.157 (B) then a claim for increase must be filed within one year to get the date of that exam as the effective date. I also suggest you read V.A. Office of General Counsel Precedent Opinion 12-98 which discusses asssignment of an earlier effective date on claims. There is a case I remember reading about inferred condition. I think it was EF v. Derwinski but maybe I'm wrong about this.

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