Interesting Turn Of Events

[justrluk]

Good morning crew -

Some history: filed a claim for GERD in 2009. Have all proof in my service records AND an IMO from the treating physician. Had the C&P which showed the reaction on screen during the test (had to swallow the awful thick chalky stuff -gross). Been sending emails to my VSO, using IRIS to check status and getting nowhere. I'm now approaching the one-year mark on a claim that should have been a "no-brainer", and forwarded a form 9 to my VSO in preparation for the issue going to appeal. The following email transaction happens (please be patient - it's long):

VSO: Why a form 9? You use a form 9 after a statement of a case. You have not had a statement of a case

Me: I thought I had to submit within a year of notification letter denying the claim. In reading the instructions, though, it says I have a year or 60 days from the SOC or SSOC date, whichever gives me the most time. Since I've not received a SOC I assume the 1-year from notification stands? I can only guess that since they've not responded, or consider this claim closed I will end up with another appeal. I wanted to make sure the document was ready to submit as I'm getting close to the 1 year mark from the date on the notification letter denying the claim - I don't have it with me, but my email traffic with your note re: reconsideration started mid-April 2010. Let me know if I need to go in a different direction, or if I need to submit a different form.

VSO: Has the reconsideration been denied?

Me: Don't know. They insist there's been no reconsideration, so I can only guess and follow the next step in the process.

VSO: Dr. letter we sent on the GERD reconsideration in March of 2010 and the 4142 that claim was denied?

Me: I've enclosed the latest response re: the claim: (Inserted the IRIS response here) I have nothing from the VA since the letter in April 2010, and was under the impression that reconsideration was progressing. Regardless, if this is what the VA insists is the status of this claim, I'm running out of time and don't want to lose the claim date.

VSO: I have reviewed your file and the GERD has not even been touched by the VA so I have placed it in the VA system thru the Coach and you will be hearing from them immediately. the claim will have a date of claim of 1 year as of 3/10/2010. They are a year behind on the claim already so they have to jump on the claim now. So you will be really busy getting your claim completed and the other claim which has been pending also. The appeal which is certified is on hold until these claims are completed. If they are not completed prior to the file going to DC your claims won't have a chance of completing fairly without your original claim file.

My first reaction was - this is a joke, right?? My VSO's been telling me for a year that everything was fine on their end, just be patient. NOW I see this response, and don't know what to make of it. I assume this is a good thing as the claim will finally see the light of day. Any suggestions on what to do next? They should have everything they need for the decision. HELP!!

[fanaticbooks]

Justriuk,

Something to think about....

When you file a NOD, you can request a Decision Review Officer to review your case. You don't need to file Form 9 at this time. By using a DRO it keeps the review process within your RO and thus maybe have less of a wait for review.

If you don't like the decision of a DRO, you can then file a Form 9 to put your claim into the traditional appeal process that includes all claims from all RO's. (You can't go back after Form 9-traditional and request a DRO, just before the traditional)

I would not rely on your VSO to submit in a timely manner. File your NOD personally so you KNOW that it is in. The VSO should have been on top of this before this. Sounds like he is very busy and your claim could slip through his notice.

Something else to think about....

Have you requested a copy of your C-File? It might pay for you to see what is actually in it and what has been received and/or done. I did this for my hubby when filing a NOD and it really helped to instruct me in the areas that needed to be addressed/corrected in their evaluations.

just possibilities.

fanaticbooks

[COOL BREEZE]

Justriuk,

Something to think about....

When you file a NOD, you can request a Decision Review Officer to review your case. You don't need to file Form 9 at this time. By using a DRO it keeps the review process within your RO and thus maybe have less of a wait for review.

If you don't like the decision of a DRO, you can then file a Form 9 to put your claim into the traditional appeal process that includes all claims from all RO's. (You can't go back after Form 9-traditional and request a DRO, just before the traditional)

I would not rely on your VSO to submit in a timely manner. File your NOD personally so you KNOW that it is in. The VSO should have been on top of this before this. Sounds like he is very busy and your claim could slip through his notice.

Something else to think about....

Have you requested a copy of your C-File? It might pay for you to see what is actually in it and what has been received and/or done. I did this for my hubby when filing a NOD and it really helped to instruct me in the areas that needed to be addressed/corrected in their evaluations.

just possibilities.

fanaticbooks

[COOL BREEZE]

If you do this, do you have to worry about the 1 year you have to appeal, or is this included as you didn't like the DRO decision and its just another step in the appeal process.

[halos2]

You better hurry up and check your dates on everything! You must not be late with any of the information/forms/appeals/NOD/DeNovo's...not anything!! Check them all as it seems you are on the Merry-Go-Round now. We want you to win, so get off and work hard on your own claim. Your VSO has too many vets to deal with, and someone's might not be timely, DON'T LET IT BE YOURS !

[justrluk]

Thanks to all - really need your support this week (bad week health-wise on top of the stress of this claim). My question is: I plan to file the NOD for DRO review (thanks to your advise). Do I use a specific form? I've only had to do this via faxed document to my VSO, so I'm not quite sure here. Then, when I've filed the document, am I still limited to the one-year-from-notification date to file the appeal? If so, I'd end up with both in the works at the same time. Please help me clear this up (I have no doubt you all will). I'm taking Monday off to deal with this in person, and need to get it right.

THANKS TO ALL!!!

[fanaticbooks]

Just file the NOD, not the Form 9. If you file Form 9 you are sending it into the Traditional appeal system and bypassing the DRO. That can wait until after the DRO has seen your claim and made its SOC.

There is a form you can use to file the NOD (can't remember the number) BUT you can just write a letter also.

Mention in the letter:

1. Your Name/Address

2. Your Claim Number/SS number

3. Subject: Notice of Disagreement

4. Mention All decisions with which you disagree. Take from the VA decision letter.

5. Mention you would like a Decision Review Officer to conduct a deNovo review of the prior decision.

6. Sign it

7. Make a copy

8. Deliver it and get a date stamp receipt or send Certified, Return Receipt.

You then have time to gather additional evidence or make your case and submit it later. You do not have to submit it with the NOD.

To help you understand what process you are starting, here is a link to a topic I created on the VBN website. It covers

DRO Review Process, De Novo Review, Hearings, Informal Conference Procedures, Notice of Disagreement

DRO Review Process, De Novo Review, Hearings, Informal Conference Procedures, Notice of Disagreement in C&P - Compensation & Pension Exams and Appeals. Forum

I wish you good journey

fanaticbooks

Edited March 18, 2011 by fanaticbooks