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Draggin'

Nod Review And Medical Records

Question

OK so when you file a NOD and a De Novo review is performed (and this is verified in a letter by VA, not assumed)...does the reviewer NOT pull up your current VA medical records?

There are things that they say I have never complained about or sought treatment for that I in fact have (and have prescriptions for, etc.) over the last few months-year. My letter says the De Novo Review was performed 4-8-2011. Are they only looking at what was medical information was there when the original claim was made? Do they pull current medical files? Try to not laugh out loud, I know I'm probably expecting too much.

Everything in my NOD was denied...much of it based on nothing being in the "available medical records". We sent no evidence in along with the NOD. We did not get an interview with the De Novo reviewer as requested. We were asked for nothing else. In short we were told in the letter that we now have to file an appeal. Now what? Is this how it normally goes?

Draggin'

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4 answers to this question

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OH,

I see now that they only used my records up until Sep, 2009.

Why is that?

Also I see that the letter is an SOC - Statement of the Case - I've only researched this lightly but what I saw about SOC did not look promising.

Draggin'

Edited by Draggin'

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OK so when you file a NOD and a De Novo review is performed (and this is verified in a letter by VA, not assumed)...does the reviewer NOT pull up your current VA medical records?

Draggin - In a De Novo Review, no the DRO does not go out of their way to see if you have additional medical evidence

to consider, unless YOU SUBMIT IT TO THEM OR REQUEST THEY GET IT AND TELL THEM WHERE AND THE DATES, they wouldn't

even know it existed.

There are things that they say I have never complained about or sought treatment for that I in fact have (and have prescriptions for, etc.) over the last few months-year. My letter says the De Novo Review was performed 4-8-2011. Are they only looking at what was medical information was there when the original claim was made? Do they pull current medical files? Try to not laugh out loud, I know I'm probably expecting too much.

Draggin - sorry but I can't help myself - ha, ha , ha , ha .

Everything in my NOD was denied...much of it based on nothing being in the "available medical records". We sent no evidence in along with the NOD. We did not get an interview with the De Novo reviewer as requested.

Draggin - now you might have a leg to stand on here - if a request for a Hearing with the DRO was made in writing and it was not provided,

they HAVE to provide the Hearing as requested. I do not know nor have ever heard anything pertaining to "an interview with the De Novo reviewer".

If you have a VSO, maybe that's something your VSO TRIED to cook up.

We were asked for nothing else. In short we were told in the letter that we now have to file an appeal. Now what? Is this how it normally goes?

Draggin - I would meticulously check my records to verify if a DRO Hearing was requested in writing, if it was and didn't happen

this is what I would hang my hat on to keep it at the RO level for adjudication.

Now if you have a VSO, they may have spoken with the DRO who was doing the De Novo Review - and your VSO has you'r prior consent

to handle all issues of your claim so you might be screwed on this.

Hopefully other's will chime in.

JMHO

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Man, you sure do have to be on your toes to keep up with the 6th graders at the RO, don't cha? Hahahaha

Draggin'

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What stinks is that they said they didn't get the NOD in time, showed they didn't have it. (Of course) We had the proof it was submitted in time. We got a new veterans service officer, my wife said she wanted the help. They got it re-submitted for us but did nothing else. No reminder about supplying medical records. I do realize that this information is here and we probably should have caught that. I'm not complaining as much as I'm pointing out that it's better to stay on top of these things for yourself-a VSO may or may not remind you of such things.

It is becoming discouraging but we're going to keep working on this appeal. On the bright side, we still have a PTSD claim to appeal-this is just the beginning. Wait, is that a bright side?

Draggin'

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