Claim Questions?

[chrisbal]

I called the VA today to check the status of my temporary 100% claim for surgery and they stated “it was ready for decision”. What does this mean and how long does it usually take? I am rated 0% for the condition I had surgery on.

Also, will the VA set me up a C&P exam automatically to determine where I stand? My Veterans service officer stated that I don’t need to file for an increase because they would set that up automatically? Any advice?

[chrisbal]

Sorry posted this twice by accident.

[Berta]

Is the "0" % a SC Zero or NSC ?

"A total rating will be granted following hospital discharge,

effective from the date of hospital admission and continuing

for a period of 1, 2, or 3 months from the first day of the

month following such hospital discharge if the hospital

treatment of the service-connected disability resulted in (1)

surgery necessitating at least one month of convalescence;

(2) surgery with severe post-operative residuals such as

incompletely healed surgical wounds, stumps or recent

amputations, therapeutic immobilization of one major joint or

more, application of a body cast, or the necessity for house

confinement, or the necessity for continued use of a

wheelchair or crutches (regular weight-bearing prohibited);

(3) immobilization by cast, without surgery, of one major

joint or more. 38 C.F.R. § 4.30(a).

A total rating under this section will require full

justification on the rating sheet and may be extended as

follows: (1) Extension of 1, 2, or 3 months beyond the

initial 3 months may be made under paragraph (a) (1), (2), or

(3) of this section. Extensions of 1 or more months up to 6

months beyond the initial 6 month period may be made under

paragraph (a) (2) or (3) of this section upon approval of the

Veterans Service Center Manager." 38 C.F.R. § 4.30(.

Do you have a claim pending for a higher rating then "0" of the disability requiring temp convalescence?

"My Veterans service officer stated that I don’t need to file for an increase because they would set that up automatically? Any advice?"

I dont know how he came to that conclusion.

"Also, will the VA set me up a C&P exam automatically to determine where I stand? "

Do you mean they have not given you a C & P at all for the "0" % SC that you had the surgery for?

and filed the temp claim for?

[jbasser]

http://ecfr.gpoaccess.gov/cgi/t/text/text-....26&idno=38

[broncovet]

I agree with Berta. If a VSO tells you, "you dont need to file for an increase, it will be done automatically" that is a BIG RED FLAG. I know of NO regulations that allow

an "Automatic Increase". Does anyone else?

It sounds to me like you need to file for an increase, and maybe file for another VSO, as I dont see how it could "hurt" you and could possibly help you. About the only thing I know that is "automatic" in the VA is a denial, altho the VA wont admit to that.

Even things that are "supposed to be" automatic are not. For example, the VCAA requires a letter be sent out whenever the Vet makes a claim. That does not happen every time, and even when it does, the letter is not always correct. Remember, if the VA followed all their own regulations, we would not need an appeal system, or if we did have one and the VA followed all the regulations to the letter, every appeal would be denied. Instead, way over half of Veterans receiving benefits got them in some level of one or more appeals.

Edited March 4, 2010 by broncovet

[MikeR]

No, I have been fighting the clowns for 12 years now, and have read all of 38 CFR and there is no automatic increase to my knowledge. Sounds like someone is lazy, and does not want to be bothered.

[chrisbal]

I specifically asked my VSO and he stated I did not have to file for an increase for TMJ. I was a bit confused by what he was saying. He stated once the decision is made to grant the temporary 100% the VA would send me a notice for the C&P. I talked to him today and he stated I did not need to file anything. I'm thinking about switching to the DAV. I am pretty sure I need to file for an increase for my SC disability.