John46 Posted July 17, 2010 Share Posted July 17, 2010 I have been told numerous times that when a denial is not appealed then it becomes final, that is not the case here. Everytime I have filed for an increase for my SC right knee I have always filed for SC for the left knee. Always denied but not the case this time. I had a C&P for IHD and an increase for right knee and again SC for left knee. I had my exam for both knees and IHD and received a second letter for another C&P. I went to the exam and told them that I didn't know what the second exam was for. The examiner stated that the exam was to determine whether or not my left knee was SC (secondary). The final result was in my favor even though I had submitted no new edvidence. I said all that to say this: Never give up, never back down, and pray that you have a C&P doctor who cares. When I found out that I was getting an increase from 30 to 70% I was very emotional and my wife thought something was wrong. Never give up and file again if you think you have a case. I plan to file for an increase on DVT (green filter) that is currently rated SC at 0%. I am still working and am determined to get 100% without TDIU. P.S. I love this forum! Link to comment Share on other sites More sharing options...
Geo4K Posted July 18, 2010 Share Posted July 18, 2010 I'm very happy for you John, and I understand the Never Give Up. After a denial, I get a bit put down, then I come here and read some, then I get irratated with the VA and the fight is back on! Link to comment Share on other sites More sharing options...
carlie Posted July 18, 2010 Share Posted July 18, 2010 I have been told numerous times that when a denial is not appealed then it becomes final, that is not the case here. Everytime I have filed for an increase for my SC right knee I have always filed for SC for the left knee. Always denied but not the case this time. I had a C&P for IHD and an increase for right knee and again SC for left knee. I had my exam for both knees and IHD and received a second letter for another C&P. I went to the exam and told them that I didn't know what the second exam was for. The examiner stated that the exam was to determine whether or not my left knee was SC (secondary). The final result was in my favor even though I had submitted no new edvidence. I said all that to say this: Never give up, never back down, and pray that you have a C&P doctor who cares. When I found out that I was getting an increase from 30 to 70% I was very emotional and my wife thought something was wrong. Never give up and file again if you think you have a case. I plan to file for an increase on DVT (green filter) that is currently rated SC at 0%. I am still working and am determined to get 100% without TDIU. P.S. I love this forum! John46, The C&P examination itself is New & Material evidence. This should be addressed in the Rating Decision by way of the effective date granted for SC of your left knee. Here's the 38 CFR reg on "Status of Claims". § 3.160 Status of claims. The following definitions are applicable to claims for pension, compensation, and dependency and indemnity compensation. (a) Informal claim. See § 3.155. (b) Original claim. An initial formal application on a form prescribed by the Secretary. (See §§ 3.151, 3.152). § 3.200 © Pending claim. An application, formal or informal, which has not been finally adjudicated. (d) Finally adjudicated claim. An application, formal or informal, which has been allowed or disallowed by the agency of original jurisdiction, the action having become final by the expiration of 1 year after the date of notice of an award or disallowance, or by denial on appellate review, whichever is the ear- lier. (See §§20.1103 and 20.1104 of this chapter.) (Authority: 38 U.S.C. 501) (f) Claim for increase. Any application for an increase in rate of a benefit being paid under a current award, or for resumption of payments previously discontinued. [27 FR 11887, Dec. 1, 1962, as amended at 31 FR 12056, Sept. 15, 1966; 55 FR 20148, May 15, 1990; 58 FR 32445, June 10, 1993] Link to comment Share on other sites More sharing options...
John46 Posted July 18, 2010 Author Share Posted July 18, 2010 John46, The C&P examination itself is New & Material evidence. This should be addressed in the Rating Decision by way of the effective date granted for SC of your left knee. Here's the 38 CFR reg on "Status of Claims". § 3.160 Status of claims. The following definitions are applicable to claims for pension, compensation, and dependency and indemnity compensation. (a) Informal claim. See § 3.155. (b) Original claim. An initial formal application on a form prescribed by the Secretary. (See §§ 3.151, 3.152). § 3.200 © Pending claim. An application, formal or informal, which has not been finally adjudicated. (d) Finally adjudicated claim. An application, formal or informal, which has been allowed or disallowed by the agency of original jurisdiction, the action having become final by the expiration of 1 year after the date of notice of an award or disallowance, or by denial on appellate review, whichever is the ear- lier. (See §§20.1103 and 20.1104 of this chapter.) (Authority: 38 U.S.C. 501) (f) Claim for increase. Any application for an increase in rate of a benefit being paid under a current award, or for resumption of payments previously discontinued. [27 FR 11887, Dec. 1, 1962, as amended at 31 FR 12056, Sept. 15, 1966; 55 FR 20148, May 15, 1990; 58 FR 32445, June 10, 1993] Is it possible to get the effective date from the date I first filed for SC for left knee as secondary? Link to comment Share on other sites More sharing options...
carlie Posted July 18, 2010 Share Posted July 18, 2010 Is it possible to get the effective date from the date I first filed for SC for left knee as secondary? John46, When did you first file ? Probably the only possibility (if a few years ago) would be a CUE claim. Keep in mind that the only the evidence that can be used in a CUE claim was the evidence of record at that time. There is a rule where you MIGHT be able to get SC'd effective date up to 12 months prior to what effective date might be on your rating decision. See - 38 CFR 3.156 and 38 CFR 3.157 jmho. Link to comment Share on other sites More sharing options...
gba Posted July 18, 2010 Share Posted July 18, 2010 I have sent notice of disagreements -three times- with evidence of clear and unmistakeable error--by registered mail --signatures indicate reciept Regional office denies reciept geginning in Nov 2009 Link to comment Share on other sites More sharing options...
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