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...

[carlie]

I'm hoping that my inquiry will put things back on the radar.

Aim,

Yes indeed, I would be sure this issue remains on the table

and has not been adjudicated as deemed denied.

Does your 15 Dec 09 Rating Decision address any other issues

in the Reasons and Bases Section, other than your Migraines ?

jmho,

carlie

[AimHigh1986]

The 15 Dec decision letter only covered my migraines. No other issues were addressed.

The letter stated:

REASONS FOR DECISION

Evaluation of migraine headaches currently evaluated as 30 percent disabling.

The evaluation of migraine headaches is continued as 30 percent disabling. {38 CFR 3.321(a); 38 CFR 3.321(:D(1)}

Period. That's all. They go on to describe my C&P exam on 20 Nov and how my migraine diagnosis has not changed. Nowhere in the letter is there any reference to my heart disease, heart bypass surgery or hypertension.

[broncovet]

I agree with Berta. It just can't be coincidence that "errors" keep popping up over and over and over, and they are almost never in the Veterans favor. If they were just "errors" there should be an equal number of errors in the Veterans favor, and that is simply not the case. Overwhelmingly, the "cards" are stacked against the Veteran.

I also agree with Carlie in that it would appear that your claim was never adjudicated and still pending. Because the law is still quite fuzzy, and in constant change, I recommend filing a NOD on an issue never adjudicated on the basis it was "deemed denied".

Reason:

It is the safest way for you. Surely, you dont want to miss out on any retro that is owed to you. If you dont file a NOD within a year, then the court could rule your issue "deemed denied" with an expired appeal period. You could potentially loose out on tens of thousands, or even hundreds of thousands of retro dollars.

However, if the courts ultimately decide that "deemed denials" are illegal (which they should be), then your NOD would be meaningless. All you would have lost is the time and postage invested in filing a NOD.

[AimHigh1986]

Thanks for the good advice! If I file a N.O.D., you don't think that they would make me go thru another battery of C&P exams for my heart do you? I don't think I could endure that. :D

[AimHigh1986]

Still no response from the VA. It's like they're waiting for me to die. Last night I submitted an inquiry through IRIS. Maybe now things will get moving.

[Berta]

It doesnt pay to depend on an IRIS inquiry to get things right.

They never even answered my last Iris at all.

If the IRIS does verify your heart claim is still open-then that is good hard copy evidence that it is,in fact, still open-

however-"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." That seems absurd.

I feel you might need to contact DAV again or any vet org who has office in or near your VARO building to see what is what with the heart claim.

Did you get a VCAA letter on the heart claim?

Carlie asked a good question:

"Does your 15 Dec 09 Rating Decision address any other issues

in the Reasons and Bases Section, other than your Migraines ?

jmho,

carlie "

"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 migra etc"

It is obvious that when the RO made the migraine decision they didn't have or consider the results of the heart claims C & Ps.

This heart issue could well be pending for a decision now based on the C & P but I am concerned that many told you the migraine decision covered the heart disease.

The IRIS might take 5 days or more for reply- one of mine took about 2 weeks.

If the migraine decision truly covered the heart disease claim -as Carlie pointed out- there would be statements to this affect in the decision and I bet they didnt say a word about it.

Have you requested a Copy of the C & P results on the heart disease?

The VA would not order a C & P if they had already denied the heart claim which they should not do without having a valid C & P done first.