hypertension The Va Goofed?

[AimHigh1986]

I filed a reopen claim in Jul 09 for heart disease/heart bypass secondary to my SC hypertension. The VA rec'd the claim 4 Aug 09. In Sep/Oct/Nov 09, I was scheduled for several C&P exams (stress test, EKG, ECG, x-rays, etc) with QTC. Concurrently with my heart disease exams, the VA decided to reevaluate my migraines, so they scheduled me for a C&P exam with QTC specifically for migraines. On 14 Dec 09 I rec'd a call from QTC saying they were finished with my heart disease C&Ps and was going to transmit their findings to the VA that day. On 15 Dec 09, the VA sent me a decision letter on my migraines, stating that there would be no change to my 30% rating. Somehow, the VA thought that the migraine decision letter finalized my heart disease claim as well. I spoke to numerous counselors and they swore up and down that the 15 Dec 09 migraine decision letter covered my heart disease claim as well. I finally convinced one counselor to listen to me and actually READ the decision letter to see what I was talking about. This counselor told me that he would initiate an inquiry to my local VA center. 2 weeks passed but I still hadn't heard from the VA. Not even an obligatory "we are still working your claim" letter. I called the 800 number again today and the counselor told me that the system still showed that my heart disease claim was completed on 15 Dec. Another inquiry was initiated. This time, I was provided a case number. Again, I wait...

[deltaj]

I filed a reopen claim in Jul 09 for heart disease/heart bypass secondary to my SC hypertension. The VA rec'd the claim 4 Aug 09. In Sep/Oct/Nov 09, I was scheduled for several C&P exams (stress test, EKG, ECG, x-rays, etc) with QTC. Concurrently with my heart disease exams, the VA decided to reevaluate my migraines, so they scheduled me for a C&P exam with QTC specifically for migraines. On 14 Dec 09 I rec'd a call from QTC saying they were finished with my heart disease C&Ps and was going to transmit their findings to the VA that day. On 15 Dec 09, the VA sent me a decision letter on my migraines, stating that there would be no change to my 30% rating. Somehow, the VA thought that the migraine decision letter finalized my heart disease claim as well. I spoke to numerous counselors and they swore up and down that the 15 Dec 09 migraine decision letter covered my heart disease claim as well. I finally convinced one counselor to listen to me and actually READ the decision letter to see what I was talking about. This counselor told me that he would initiate an inquiry to my local VA center. 2 weeks passed but I still hadn't heard from the VA. Not even an obligatory "we are still working your claim" letter. I called the 800 number again today and the counselor told me that the system still showed that my heart disease claim was completed on 15 Dec. Another inquiry was initiated. This time, I was provided a case number. Again, I wait...

I think V.A. has something called a deemed valid denial. I'm hoping I'm recalled the term correctly. This is where an issue is ignored. I suggest you read up on this term and consider you options carefully before filing a notice of disagrement and submitting evidence of service connection during the appeal period of the decision. You only get one Notice of Disagreement with each decision and it must cover all issues including the conditions you were seeking service connection for, the percentage of disability, effective date, evidence considered, informal claims [under 38 CFR 3.157 ( and 38 CFR 3.155], etc.

[Berta]

"This time, I was provided a case number" do you mean a number they gave the inquiry?

They might be reading the PC screen wrong- I suggest you use the IRIS system and ask for the exact status of the heart claim.

Ask them for email reply or snail mail to the IRIS inquiry and not a phone call in reply so that you have hard copy of what they say.

We have to really stay on them sometimes- in the award letter I got last week they never mentioned my CUE claim- a separate issue from my award - but this AM I started thinking that I better contact them as to the status on that claim as maybe they think -since they-for the first time in 7 years- actually sent me

an award that is half right-maybe they think I will forget about the CUE claim. No way.

Aimhigh-with 70% are you still able to work?

[broncovet]

I agree with Delta. IMHO "deemed denials" are one of the VA's many "dirty tricks" right down there with shredding evidence. To be safe, a Veteran needs to file a NOD within one year of a decision the Veterans did not receive. For some links on cases and discussions of "deemed denials" see the link at the bottom of this post. PR seemed to think that the issue of "deemed denials" has been settled in favor of the Veteran, but I am not quite that certain about that.

http://www.hadit.com/forums/index.php?showtopic=34528

I do not think it is a "goof" and I will explain why I say so. Some time ago, there was a big complaint about companies overcharging consumers. The price would be on the shelf, but when it was scanned, the customer would be charged the scanned price. Statistically, you would have a 50/50 chance of being charged more or less than the price quoted, in the event of an "error". However, since about 90% of the errors were in the companies favor, you begin to wonder how many of these were really "errors", and how many were to generate additional revenue for those customers who do not check their receipts.

In the same way, if it was a legimate error, the VA would inadvertandly award benefits to Veterans that the Veteran never sought, as well as just plain forgetting about the ones he was seeking. With the VA, it makes errors/delays in its favor, and those errors in the Veterans favor are so rare that it could easily lead one to beleive they never happen at all.

Have you ever heard of the Va making a mistake and awarding benefits in one week? I didnt think so.

Edited February 13, 2010 by broncovet

[AimHigh1986]

I find it very hard to believe that the VA would purposely ignore my heart disease/heart bypass claim after subjecting me to 5 C&P exams to check out my heart. Especially the treadmill stress test -- that was quite risky for someone who just had heart surgery. I'm hoping that it was either an oversight or that the VA counselor incorrectly read the screen.

Berta: yes, the case number refers to my latest inquiry. I will take your advice and do an IRIS inquiry. Thanks!

I'm still able to work, but now I'm confined to light desk duty and have lost a step or two (which makes me less competetive for promotions/bonuses, etc).

[Berta]

"I find it very hard to believe that the VA would purposely ignore my heart disease/heart bypass claim after subjecting me to 5 C&P exams to check out my heart."

After dealing with VA for 2 decades I think it might have been on purpose.

I received some decisions the other day-

In one decisions (key to my CUE claim of SMC accrued) the VA acknowledged my husbands SSA award but re characterized what it was for.

Rod had a SSA award for catastrophic CVA from DMII (AO) and then ,after we filed reconsideration request-the SSA awarded him totally for PTSD.

The CVA (stroke) cannot be characterized by some non medical rater as anything else but a major totally disabling stroke. The CVA and the PTSD alone warrants SMC-=this is what they are trying to get out of paying me for.

When VA awarded 100% for PTSD 3 years after Rod died, they never mentioned the TDIU form and I realize now they probably never even considered the form nor contacted his employers.

His medical evidence could have stood alone for the 100% award anyhow but still-

if a vet applies for TDIU and VA fails to contact their employers, the VA has assured themselves that they can send out a fast denial.

My point is that this is VA game playing when they manipulate either a claim or the evidence or the lack of evidence-which they themselves caused to occur.

I feel this is one of the VA deliberate ways of denying claim-s they often dont even obtain SSA records or records from other VA hospitals and we have to make sure that either they DO take these proper steps or that we will do it ourselves as claimants.

Do you have a vet rep?

Edited February 14, 2010 by Berta

[AimHigh1986]

The DAV helped me with my initial claim. Everything was settled relatively quickly, so I was satisfied. About 3 years later my health declined (heart disease, heart bypass surgery), so I filed a reopen claim by myself. Everything seemed cut and dry: heart disease/heart bypass secondary to my SC hypertension. Seemed like a no-brainer. The VA got the ball rolling with my C&P exams like clockwork. Everything was going as planned until suddenly I dropped off of their radar last December. If I don't hear from the VA within the next week, I will find a vet rep thru the DAV. But in my gut feeling, I truly believe this was not a conspiracy to make my claim go away. What do they (the VA) have to gain by denying my claim? If anything, I may have been the victim of a lazy, careless, irresponsible rater who was more focused on the Xmas holidays than adjudicating the claims on his or her desk. When I was active duty, I supervised an Air Force Claims Ofice for many years. I know first hand how some people let things slip thru the cracks. I'm hoping that my inquiry will put things back on the radar.