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Claims Being Processed

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Not sure if this is the correct spot on the forum to place this but I hope so.

My question(s) are about trying to understand what actually happens along the way when claims are filed and begins the journey to the final decision.

In May of 2010 I submitted an informal claim for IHD and other items. Then in June of 2010 I finished my work on putting the claim together and submitted the 21-526. All submitted and documented at my local Service Office.

Not having access to eBenifits until earlier this year I cannot say what the status was of any of the claims prior to access. I just sat back and waited. When I was asked to submit evidence other then what I initially did, I did so as soon as possible.

In one of the requests the VARO sent me the 21-8940 form. Note that I did not claim IU in my initial claim. Form was filled out and returned to my VASO the next day.

When I finally was able to log on and take a look, I saw that I had two claims listed and their status:

1. Compensation Claim-- Dated 7/6/10

2. Status Review Claim-- Dated 7/6/10

Now, under the "Compensation Claim" they listed: (abbreviated by me)

PTSD

Hearing Loss

Tinnitus

GERD

Left Hand Injury

Scar

High Cholesterol

IU

and under the "Status Review" claim they listed: (abbreviated by me)

IH

CAD

Heart Attacks

Severe Angina

Shortness of Breath

ED

Hypertention secondary to IH

GERD due to IH and PTSD

Not all these items were not listed on my initial claim but rather they were broken out apparently by the person who read my mountain of documentation that I sent with the claim.

In December of 2010 I had my C&P exams for all the above items.

One of my questions is this.

Up until 1-11-11 both those claims were listed as in the Development Stage

On 1-11-11 Both Claims were placed in the Decision Stage

Now on 1-19-11 The "Rating Review" claim has been "CLOSED" and the "Compensation Claim" has now been put back into the "DEVELOPMENT" stage.

Can someone explain what may be going on here? I have not seen anything in the mail nor anything in my bank account so I am kind of curious at to what this means. Still sitting back waiting for something to happen.

Thanks for all your help

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Thanks Berta, that is really encouraging. I sure hope that is the case.

I have been on PT SSDI since 1990 due to IHD/CAD. Hopefully they will take that into consideration.

Thanks so much for your help and all that you do for us.

I think they made some tentative awards and now are considering the TDIU claim.

TDIU is awarded at the 100%rate of comp so this is beneficial to you to at until the TDIU issue is resolved.They might well make an award and the check could get into the bank before you even get their letter.

In that case they will send yo a letter that will defer the TDIU or any other issues that are unresolved yet.

"In one of the requests the VARO sent me the 21-8940 form"

That is good because it could mean they have tenatively rated you at 70% SC by now and that is what usually always triggers them to send the form out.

It does not matter what rating a vet has to apply for TDIU themselves if their SC prevents them from working

but they dont want us to know that.

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Well, you all pretty much nailed it. I received my big brown envelope the other day. The ratings that I received totaled to 60%. Got a nice deposit the day before the envelope and that was nice.

I have some work to do as far as appealing a couple of the ratings that were given and have started the research already. For the most part I received SC for all but two of what I claimed. They did not give me IU at this point and that is one that I will be appealing. I did receive SC for IHD and PTSD at 30% for both. It's a start and I can't thank you all for the encouragement and guidance.

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GREAT NEWS BUT

"

They did not give me IU at this point and that is one that I will be appealing"

"I have been on PT SSDI since 1990 due to IHD/CAD. Hopefully they will take that into consideration."

If the SSDI is solely for the IHD?CAD and they didnt consider the SSDI but had knowledge of it, they have committed a clear and unmistakable error. (Washington V Derwinski)

How did they consider the SSDI award in the decision????

Were you ever denied bu VA in the past for the AO IHD or CAD?

If so have you contacted the lawyers at NVLSP?

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Berta,

To answer your questions in order;

Yes, my SSDI is solely for IHD/CAD. Has been from the start.

Nowhere within the decision portion of my letter did it say that they considered the SSDI award in the decision. It isn't even mentioned. Under the "Evidence" section of the letter is lists SS reports from 1978-2001.

No, this it the first time I have submitted a claim for compensation with the VA for anything medical. (education benefits way back when).

It is apparent that they used the "evidence of hypertrophy or dilatation" on an X-Ray as the key to the award. I have had several stress tests over the years and all have been in the high range (9-10) but all have been blunted results according to the doctors because I have been on heavy beta blocker meds at the time of the tests. In real life I can't do much exertion and in fact have been told by my cardiologist (noted in the C&P) to pre-medicate with nitro before doing any strenuous activity.

From all that I have read (about METS and stress tests), I frankly was surprised that they gave me an award over 0%. There was no question it was service related under the new regs.

And no, I haven't contacted the lawyers yet. I am away from home for another week and don't have my files with me.

Thanks for the response. You have once again given me hope.

GREAT NEWS BUT

"

They did not give me IU at this point and that is one that I will be appealing"

"I have been on PT SSDI since 1990 due to IHD/CAD. Hopefully they will take that into consideration."

If the SSDI is solely for the IHD?CAD and they didnt consider the SSDI but had knowledge of it, they have committed a clear and unmistakable error. (Washington V Derwinski)

How did they consider the SSDI award in the decision????

Were you ever denied bu VA in the past for the AO IHD or CAD?

If so have you contacted the lawyers at NVLSP?

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"Yes, my SSDI is solely for IHD/CAD. Has been from the start.

Nowhere within the decision portion of my letter did it say that they considered the SSDI award in the decision. It isn't even mentioned. Under the "Evidence" section of the letter is lists SS reports from 1978-2001."

Did you specifically tell them either on a TDIU form or in any other correspondence yopu sent to them like the 526 form-that you receive SSDI solely for the IHD?

If VA is completely unaware of evidence you have or that SSA has -they cannot obtain it.

If they were fully aware of an SSDI award for IHD and didnt get those records they have committed a CUE to your detriment.

DO you have copy of your C file and copies of all you sent to them or they sent to you?

DO you have a vet rep?

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In at least two places during the application process I have advised them about SSDI and IHD. Within some of the documentation that I sent were the doctors responses to Social Security about IHD and my continued disability caused by it.

Here are some of the excerpts from the 21-526 form submitted.

"…As the attached records will document, I was unable to continue to work due to the progression of the IHD and in May of 1990 I was placed on Permanent Total Disability by the Social Security Administration…"

"…The attached records show that any periods of exertion, standing or sitting for long periods of time or anything other then the most sedentary activities will bring on angina, edema, shortness of breath and other symptoms of Ischemic Heart Disease. Thus my continued Permanent Total Disability status with Social Security…"

Here is an excerpt from the form 21-8940

"…You will see from the records from Social Security, I was placed on Total Disability on May 1, 1990. According to you letter, you have requested those records from Social Security…"

Yes, I have the C-File and it is complete up to the records that they have obtained from Social Security. When I return to where my records are stored I can be more exact and I will request an updated file.

Yes, I have been working with the local rep. I will be seeing him upon my return home. He hasn't seen the award letter yet and we will go over it when I return.

"Yes, my SSDI is solely for IHD/CAD. Has been from the start.

Nowhere within the decision portion of my letter did it say that they considered the SSDI award in the decision. It isn't even mentioned. Under the "Evidence" section of the letter is lists SS reports from 1978-2001."

Did you specifically tell them either on a TDIU form or in any other correspondence yopu sent to them like the 526 form-that you receive SSDI solely for the IHD?

If VA is completely unaware of evidence you have or that SSA has -they cannot obtain it.

If they were fully aware of an SSDI award for IHD and didnt get those records they have committed a CUE to your detriment.

DO you have copy of your C file and copies of all you sent to them or they sent to you?

DO you have a vet rep?

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