Possible Incorrect % Disability Effective Date

[chrisw]

I first wanted to say thank you to everyone that is involved in keeping this forum going. It's a great wealth of information. I wish I new about it several years ago.

I've got a question about the effective date of a claim.

I filed a VA disability claim for migraine headaches back in November 2008 and received my results of service connected with 0% in July 2009 effective November 2008. I felt 0% was not commensurate and sent the VA a request for reconsideration in August of 2009 along with some new medical evidence. I recently received my results and they granted me 30% but they put the effective date of August of 2009. Is this correct? Since it was a request for reconsideration I thought my effective date would remain November 2008.

When I filed my request for reconsideration I also mentioned that I would be requesting an increase in compensation for another service connected disability. Do you think that since I mentioned this they lumped them together as a new claim?

One other thing I wanted to mention is some of the medical evidence I submitted with the request for reconsideration was after original effective date of July 2009. Would the new medical evidence have anything to do with the effective date? Can I only appeal the effective date?

Also, I'm going to appeal the percent disability on something else. Would it be best to group the appeals together?

[broncovet]

Berta and Testvet are right. The VA often manipulates the effective date to make it appear you applied later, by doing things like "interpreting" your Motion for Reconsideration as a new claim.

The effective date of your claim, in non-lawyer lingo, is the LATER of the date you applied or, the date the doc says your disability occurred. (The one year "look back" period normally only applies if you have just gotten out of the service in the past year).

Many, many Vets appeal the effective date, and you should, too, if you think its warranted, that is, if the evidence supports it.

I think QTC docs are often in cahoots with the VA on this. For example, you go for a C and P exam and the doc opines that you have x condition, "at least as likely as not due to military service". He dates the exam and thats the end of it.

If/when you finally get rated, they often use the C and P exam date..not the date you applied. This is bogus. This suggests you were well when you walked into the C and P examiners office, then got sick and disabled while in his office. This does not happen. You have likely had a chronic problem with this since the military, and the "onset" of this disease/disability is not the C and P exam date..it is often much much earlier. The examiner should opine something like, "The Veteran suffers from PTSD most likely due to military service in 1973, and has had repeated treatments for PTSD between 1973, and the present. Based on my professional opinion, and the patient medical history, this Veteran has been suffering from PTSD since 1973".

They dont do that. They say you have PTSD, but do not put any date on it, so the VA assumes its the date of the C and P exam, even tho you may have suffered with it for years or even decades.

[john999]

I went from 0% to 60% for CAD by basically just filing a NOD and going to a DRO Hearing. I did get some more tests, but I did not think I had the evidence for such an increase. I say when in doubt file that NOD. Often by just using the system's appeals you can win more compensation. Many vets never appeal. Big mistake.

[VetsLady]

QUOTE FROM BRONCOVET

Many, many Vets appeal the effective date, and you should, too, if you think its warranted, that is, if the evidence supports it.

I think QTC docs are often in cahoots with the VA on this. For example, you go for a C and P exam and the doc opines that you have x condition, "at least as likely as not due to military service". He dates the exam and thats the end of it.

If/when you finally get rated, they often use the C and P exam date..not the date you applied. This is bogus. This suggests you were well when you walked into the C and P examiners office, then got sick and disabled while in his office. This does not happen. You have likely had a chronic problem with this since the military, and the "onset" of this disease/disability is not the C and P exam date..it is often much much earlier. The examiner should opine something like, "The Veteran suffers from PTSD most likely due to military service in 1973, and has had repeated treatments for PTSD between 1973, and the present. Based on my professional opinion, and the patient medical history, this Veteran has been suffering from PTSD since 1973".

They dont do that. They say you have PTSD, but do not put any date on it, so the VA assumes its the date of the C and P exam, even tho you may have suffered with it for years or even decades.

END QUOTE

From VetsLady

Totally agree with this Bronco 100% - case in point, my husband received sc for AO related illness in 4/08 - he filed for it 5 years prior. QTC did an exam early in '08 and that examiner stated blah, blah this and that and they gave him a % for his sc that is way off base.

The medical records in his file prove the QTC wrong on the effective date of the %.....as if he were such and such % when he walked into the office for the exam, and when he walked out, he was a little worse. The proof is in the pudding on his claim to get an

EED with a higher % - just waiting for a rating to come back on an appeal decision to poke the fires again. One thing at a time.

Edited August 23, 2010 by VetsLady

[john999]

They like to do this with DMII. You go for the exam with high glucose levels. You come out with DMII DX and that is your effective date. Your PCP never stated in your records that you had DMII all those years when you had high glucose. I think they must warn the doctors not to make the DX.

[Chuck75]

Just to add more confusion to the issue--

The "standards" for formal diagnosis of diabetes have changed (lowered glucose levels) over the years.

If your records show that you had glucose levels associated with "prediabetes", treatment "should" have commenced at the time those levels were reached.

The usual "treatment" by most doctors was to tell a patient to lower the intake of sugar.

The VA likes to discriminate between "prediabetes" and diabetes, with the attitude that prediabetes is not covered as "presumptive", and is not "SC'd".

The VA/DOD treatment guides and NIH documents indicate that Diabetes likely exists on the average of ten years before it reaches the level used for a "formal" diagnosis.

During this ten year period, the incidence of heart and coronary artery problems (CAD), along with PAD has a very large increase.

Naturally, the VA C&P process ignores all of this.

I'd say that an NOD is needed as to effective date.

They like to do this with DMII. You go for the exam with high glucose levels. You come out with DMII DX and that is your effective date. Your PCP never stated in your records that you had DMII all those years when you had high glucose. I think they must warn the doctors not to make the DX.

[broncovet]

Wow, Vetslady, no one has ever agreed with me before..just kidding..

In a nutshell, DONT LET THE VA MANIPULATE your effective date to the date of the C and P exam, at least not without a fight. Its one of the tricks the VA uses, and often gets away with it.

In your appeal, I may suggest something like this.

Appeal of Effective Date of Benefits

The Veteran disagrees with the Effective date of benefits, and plans to contest the result with a BVA hearing. The VARO inappropriately cited the C and P exam date as the effective date for benefits, which is contrary to the law. The law states (paraphrasing) that the effective date shall be the Later of the date the condition occurred, or the date applied, and does NOT state the effective date shall be the date of the C and P exam. There is absolutely no evidence the Veterans condition first began at the C and P exam on June 1, 2009. This would actually suggest the C and P examiner caused the Veterans SC condition. To the contrary, the Veteran received treatment for the condition from Jan. 1973 through the present, but the C and P exam was to establish Service connection ONLY, since the C and P examiner failed to indicate an "onset of symptoms" date. The C and P examiner did not suggest this was a "new" condition, but rather even cited that the Veterans medical records were reviewed, which suggested the Veterans condition was chronic and began in military service in 1973.

The Veteran applied for benefits on June 1, 2002. A C and P exam was not ordered until 7 years later on June 1, 2009. The Veterans condition did not begin on June 1, 2009, but rather originated much earlier, with treatment for the condition dating back to January, 1973. The C and P examiner did not opine a date that the Veterans began on June 1, 2009, only that the condition was present on that date.

Therefore, since the Veteran was first diagnosed the condition in 1973, but did not apply until June 2002, the effective date should be June, 2002.

Edited September 11, 2010 by broncovet