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Speeding Up Claims Processing

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  • HadIt.com Elder

One of my claims went through the DRO process. The DRO "rubber stamped" the RO's decisions, based upon the timefram e. Nehmer review reversed all the denials affirmed by the DRO.

However, the Nehmer review SC'd several conditions as secondary at 0%. Most should be assigned at least 10%. I believe this was done to make sure that SMC was not added to the retro.

As a result of the DRO "rubber stamp" I completely agree with - -

"My opinion is that the DRO is going to continue to support the prior decision that their buddy made. "

Just for clarification in my prior post of,

" In VA claims adjudication, there shouldn't be a need for a specific college levelof education. There is a need to know how to read and comprehend what is read,

then apply the regulations correctly."

This was posted only as my opinion and not supported by any regs or instruction.

I am very much in agreement with pr, they just want sheep to follow the instructions from

higher up.

Something else for consideration is:

Let's say a claimant receives a Rating Decision, disagrees with something in the decision

and files a NOD which starts an appeal. The claimant receives a SOC from the decision maker

and then request a DRO Hearing.

The DRO hearing is scheduled, the DRO has never adjudicated any prior issues for this

claimant BUT the DRO's decision maker buddy (at work and lunch or drinks after work),

is the same decision maker that made the decision being appealed.

Is the DRO going to actually rate with the medical evidence of record and the regs,

which will go against their buddy's prior decision

OR

Is the DRO going to continue the decision or low ball, with the VBA attitude that

they have a very generous appeals process.

My opinion is that the DRO is going to continue to support the prior decision that their buddy made.

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