Jump to content
  • Searches Community Forums, Blog and more

  • 0
bufloguy

Request For Reconsideration

Question

Not to sure how to wrtieup the request for reconsideration, any assistance would be greatly appreciated.

May 5, 2010

IM A Vet

My Town USA

CSS: 000000000

Dear Sir/Madame;

I ask that the VA to reconsider the decision of November 12, 2009 for the below conditions.

If my request for reconsideration does not properly resolve my claim issues, please consider this as a formal Notice of Disagreement.

1. Cervical condition rated at 20%.

-I feel that I should have been rated 30% for this condition due to frequent occipital headaches and the extreme pain that radiates into my shoulders and arms.

2. Right C7 radiculopathy rated at 0%.

- I feel that I should have been rated 20% for this condition due to the frequency of my hands becoming numb after only sitting or driving for 20 minutes. Furthermore I have lost hand strength.

3. Left C7 radiculopathy rated at 0%.

- I feel that I should have been rated 20% for this condition due to the frequency of my hands becoming numb after only sitting or driving for 20 minutes. Furthermore I have lost hand strength.

4. Denial of Post Traumatic Stress Disorder.

- There are several issues with the denial:

1. The claim was well grounded and plausible, but the rater failed to consider all the evidence presented. Furthermore, the rating authority failed to explain why they did not consider the evidence of record in the file which was favorable to my claim. Case law from (10-12-90) establishes in Gilbert v. Derwinski VetApp. 49 (1990) that the VA is mandated to explain its reasons or bases to the veteran its factual finding and its conclusion why the veteran was not entitled

2. I was not afforded a Compensation & Pension exam as stated in 38 USC 5103 - Sec. 5103A. Duty to assist claimants;

(1) The Secretary shall make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate the claimant's claim for a benefit under a law administered by the Secretary.

(2) In the case of a claim for disability compensation, the assistance provided by the Secretary under subsection (a) shall include providing a medical examination or obtaining a medical opinion when such an examination or opinion is necessary to make a decision on the claim.

Attached is a letter from Craig N. Bash M.D. which provides strong evidence for a favorable decision in this matter.

Respectfully,

I'm A Vet

Share this post


Link to post
Share on other sites

Recommended Posts

I suggest you type Request For Reconsideration at the top of this letter.

Also make sure-if they do not act on this within the year NOD time frame-that you formally file a NOD.

Just in case they try to get out of this request as a formal NOD too-(I have seen them do that)

Also -can yo refer them to specific medical evidence and attach copies of it for all points you have made?

Do you have any buddy statements from family members , employer, or any doctor to verify the numbing of your hands?

PTSD claim- no C & P? I don't know what to say here on that without more info as to why they denied the PTSD claim.

If Dr. Bash supported the rest of your claim-make sure they have copy of the IMO.

He does not do PTSD claims but his opinion should be considered on the rest of the claim.

Did they have his IMO but they ignored it when they made the decision?

Share this post


Link to post
Share on other sites

Ad

Bertha,

Thanks for your comments and questons. Was the Language of the letter ok? I'm not a very good writer.

1. Also -can you refer them to specific medical evidence and attach copies of it for all points you have made?

Good point, I can do that.

2. Do you have any buddy statements from family members , employer, or any doctor to verify the numbing of your hands?

I guess I can get some, I have an EMG that is positive.

3. PTSD claim- no C & P? I don't know what to say here on that without more info as to why they denied the PTSD claim.

Claim was based on a serious car accident that happened 20 years ago. Claim was well documented, but rater blew the claim off. At the time the rater acknoldged my nexus from my pdoc, acknowledged the accident happened, but would not acknowledge that I could still be suffering from PTSD.

4. If Dr. Bash supported the rest of your claim-make sure they have copy of the IMO.

Dr Bash supports the claim, stated that I should be 30 for neck, and 20 for each hand.

5. He does not do PTSD claims but his opinion should be considered on the rest of the claim.

He was able to do the PTSD as he claims it is secondary to my 70% TBI which occured the same accident. He provided a few great citations, and and with his training he can connect the dots. So I have a nexus from him & my pdoc.

6. Did they have his IMO but they ignored it when they made the decision?

No they didn't. I decided to hire the big guns after beig refused.

Thanks for everything!

Share this post


Link to post
Share on other sites

. He does not do PTSD claims but his opinion should be considered on the rest of the claim.

"He was able to do the PTSD as he claims it is secondary to my 70% TBI which occured the same accident. He provided a few great citations, and and with his " etc

GREAT -that ties in with his expertise- he mentioned to me a few times that he doesnt do PTSD claims so this is why I mentioned here-

Did they have his IMO but they ignored it when they made the decision?

"No they didn't. I decided to hire the big guns after beig refused."

Great- I know he is very expensive but I considered my IMOs from him as a good investment and they were.

VA ignored his IMOs however for over 4 years.The BVA read them for first time- and I won.

Share this post


Link to post
Share on other sites

Berta,

Which format is best for the Request for Reconsideration and NOD. Is the 21-4138 recommended or just a plain white piece of paper? And do I have to resubmit all my evidence, or will the Dr Bash letter suffice?

Share this post


Link to post
Share on other sites

They are familiar with the 4138 so best to use that

(I should talk- I have never used that form but I do feel that this form catches their attention maybe faster then a letter???? I found it used to be difficult to type onto the form-maybe easier these days)

I would refer to in the 4138 or letter- to the IMO and anything else they didnt consider yet or not list as Evidence in the decision.

On the NOD-I would mark your calendar well for the deadline date-but I would hold off on a formal NOD at this point- others here might disagree -

because if they overlook the recon request-the NOD might not be even read for a year or more.

Do you have a vet rep helping you?

If so have they seen any way the decision might contain a legal error?

Do they (VA) have copy of the EMG test?

I hope others chime in on this - would this test definitely show evidence of this veteran's numbing problems- which seems to be a form of peripheral neuropathy?

Edited by Berta

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Our picks

    • Sleep apnea- does the DBQ cover the "medically necessary/required" language?
      Hey everybody! Long time lurker, first time poster.

      My question is regarding the sleep apnea language that specifies that a prescription of a breathing assistance device is "medically necessary" for a 50% rating:

      Assuming that a vet is already prescribed a CPAP/APAP by the VA, does the sleep apnea DBQ portion under 2B "IS CONTINUOUS MEDICATION REQUIRED FOR CONTROL OF A SLEEP DISORDER CONDITION?" fulfill that language requirement?
      • 18 replies
    • VBA testimony and GAO report-C & P examiners
      As you all know, C & P exam results control almost all types of claims. VA employees have no choice but to go along with a negative C & P exam that will deny a claim. Some vets are quite willing to rebutt faulty exams and ask for a new C & P exam. For others, it will take a costly IMO/IME in most cases. Ben Krause has this article at his site today: http://tinyurl.com/y9co6zac
      • 9 replies
    • Lumbosacral Strain and Vertebrae fractures caused by osteopenia
      Hi.  I have a couple questions and welcome all recommendations for my disability claim.  I am currently 10% disabled for lumbosacral strain and deferred decision for this and vertebrae fractures caused by osteopenia.  I had a MRI February 2018 and results include moderate compression fracture of L1, mild to moderate compression fracture of L2, moderate to severe compression fracture of L3, mild compression fracture of T11.  Additionally, L3 moderate spinal canal stenosis, L2 mild to moderate retropulsion with mild spinal canal stenosis, multilevel degenerative changes, multilevel disc bulges, disc herniations, L1-L2 mild broad-based disc bulge with mild spinal canal stenosis, L2-L3 mild broad based disc bulge with mild to moderate spinal canal stenosis,  L3-L4 mild to moderate broad based disc bulge and severe bilateral neuroforaminal narrowing.   I have read that these malfunctions should have been claimed individually.  Will the VA evaluate/rate each condition separately?  If not, I may have to appeal or submit a new claim.  What are some thoughts and suggestions.  Do these disabilities belong in the lumbosacral strain or the vertebrae fractures caused by osteopenia.  I am totally in the dark on this stuff.  I am pretty sure no diagnosis codes have been assigned.  What can I do to support my claim?  HELP!!!!!
      • 1 reply
    • Ignore Members Who Annoy You - How To
      How To Ignore Members Who Annoy You

      I'd love it if we all got along, no one had a bad day and everyone respected each other however, living in the real world it just doesn't work that way.

      If you find a member adds no value to your knowledge on a topic hover over their name and then choose Ignore User. You cannot ignore moderators and admins but you can ignore others.

      Thousands of veterans have come here for over 20 years to find answers and support. I wish we could help each and every veteran, but some we cannot. Sometimes folks just rub each other the wrong way and that is where the Ignore User feature comes in. Ignore the user and move on...
      • 0 replies
    • Ignore Members Who Annoy You - How To
      How To Ignore Members Who Annoy You

      I'd love it if we all got along, no one had a bad day and everyone respected each other however, living in the real world it just doesn't work that way.

      If you find a member adds no value to your knowledge on a topic hover over their name and then choose Ignore User. You cannot ignore moderators and admins but you can ignore others.

      Thousands of veterans have come here for over 20 years to find answers and support. I wish we could help each and every veteran, but some we cannot. Sometimes folks just rub each other the wrong way and that is where the Ignore User feature comes in. Ignore the user and move on...
      • 0 replies
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
  • Our picks

    • Sleep apnea- does the DBQ cover the "medically necessary/required" language?
      Hey everybody! Long time lurker, first time poster.

      My question is regarding the sleep apnea language that specifies that a prescription of a breathing assistance device is "medically necessary" for a 50% rating:

      Assuming that a vet is already prescribed a CPAP/APAP by the VA, does the sleep apnea DBQ portion under 2B "IS CONTINUOUS MEDICATION REQUIRED FOR CONTROL OF A SLEEP DISORDER CONDITION?" fulfill that language requirement?
      • 18 replies
    • VBA testimony and GAO report-C & P examiners
      As you all know, C & P exam results control almost all types of claims. VA employees have no choice but to go along with a negative C & P exam that will deny a claim. Some vets are quite willing to rebutt faulty exams and ask for a new C & P exam. For others, it will take a costly IMO/IME in most cases. Ben Krause has this article at his site today: http://tinyurl.com/y9co6zac
      • 9 replies
    • Lumbosacral Strain and Vertebrae fractures caused by osteopenia
      Hi.  I have a couple questions and welcome all recommendations for my disability claim.  I am currently 10% disabled for lumbosacral strain and deferred decision for this and vertebrae fractures caused by osteopenia.  I had a MRI February 2018 and results include moderate compression fracture of L1, mild to moderate compression fracture of L2, moderate to severe compression fracture of L3, mild compression fracture of T11.  Additionally, L3 moderate spinal canal stenosis, L2 mild to moderate retropulsion with mild spinal canal stenosis, multilevel degenerative changes, multilevel disc bulges, disc herniations, L1-L2 mild broad-based disc bulge with mild spinal canal stenosis, L2-L3 mild broad based disc bulge with mild to moderate spinal canal stenosis,  L3-L4 mild to moderate broad based disc bulge and severe bilateral neuroforaminal narrowing.   I have read that these malfunctions should have been claimed individually.  Will the VA evaluate/rate each condition separately?  If not, I may have to appeal or submit a new claim.  What are some thoughts and suggestions.  Do these disabilities belong in the lumbosacral strain or the vertebrae fractures caused by osteopenia.  I am totally in the dark on this stuff.  I am pretty sure no diagnosis codes have been assigned.  What can I do to support my claim?  HELP!!!!!
      • 1 reply
    • Ignore Members Who Annoy You - How To
      How To Ignore Members Who Annoy You

      I'd love it if we all got along, no one had a bad day and everyone respected each other however, living in the real world it just doesn't work that way.

      If you find a member adds no value to your knowledge on a topic hover over their name and then choose Ignore User. You cannot ignore moderators and admins but you can ignore others.

      Thousands of veterans have come here for over 20 years to find answers and support. I wish we could help each and every veteran, but some we cannot. Sometimes folks just rub each other the wrong way and that is where the Ignore User feature comes in. Ignore the user and move on...
      • 0 replies
    • Ignore Members Who Annoy You - How To
      How To Ignore Members Who Annoy You

      I'd love it if we all got along, no one had a bad day and everyone respected each other however, living in the real world it just doesn't work that way.

      If you find a member adds no value to your knowledge on a topic hover over their name and then choose Ignore User. You cannot ignore moderators and admins but you can ignore others.

      Thousands of veterans have come here for over 20 years to find answers and support. I wish we could help each and every veteran, but some we cannot. Sometimes folks just rub each other the wrong way and that is where the Ignore User feature comes in. Ignore the user and move on...
      • 0 replies
  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Donation Box

    Please donate to support the community.
    We appreciate all donations!
  • Ads

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

×

Important Information

{terms] and Guidelines