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Cue-Claim Big Surprise

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RAFA

Question

I was awarded 100% SC compensation on a re-opened claim (80% and IU P&T) effective date 01/2010.

Previously, on 01/2010 --- I was awarded an additional 30% for anxiety disorder, NOS --- effective date 08/2001 (I had a 30% since 1985 for physical conditions and an Illness adjustment disorder combined with it).

Discontinued working due to my S/C conditions in 1991 and started receiving SSA benefits on 1993 for major depression.

They kept the 30% for anxiety disorder, NOS combined to my physical conditions and didn't pay me.

I appealed this the same day and stated that this needs to be separated according to regulations, they still haven't paid me, I also appealed the effective date for IU.

During the original claim there was a remand by BVA dated 09/30/1997 instructing RO how to proceed.

A Supplemental Statement of the Case was completed by RO on remand orders dated 07/23/99-- this my representative forgot to appeal in time and the only recourse for us was to submit a Motion-for-Reconsideration on 12/20/2000 this was denied by BVA on grounds that it was final.

In the Motion-for-Reconsideration we pointed out all C&P errors and due process of law, in addition to being bias towards me, that (they were judge and executioner) they didn't follow instructions and blindly stood their ground attacking me and RO adjudication went along with it, so did BVA.

I decided not to continue fighting a system that had obsolute power so I felt helpless and hopeless. On 03/08/2007 I submitted a new claim and it was re-opened and like I said on 01/2010---I was awarded 30% for anxiety disorder, NOS---effective date 08/2001 and I haven't been paid for it yet.

On 11/02/2010 I was increased from 30% to 70% for anxiety disorder,NOS along with my physical s/c condition this gave me 80% IU P&T.

On thursday 09/08/2011 my wife and I decided to go follow-up on my appeal on effective-date-of claim for IU, and went to see VFW rep.

On VARO lobby I picked-up the phone and dialed the extension # to VFW reps office, I told VFW rep I was waiting to see him and he quickly told me that I HAD TO WAIT.

VFW rep still Smiling called on me and I told him that I brought my wife so he can meet her, still smiling he greeted her and we went to his office.

I told him that I was there following up on my claim, rep still smiling said he knows everything about my claim and I told him if he have checked into it.

VFW rep Still smiling told me that recently Rating Specialist told him that my claim is being handled as a CUE claim for 100% up to 1997 and was being sent to Washington for further authorization.

Questions:

1). Did my appeal for effective-date-of-claim for IU trigger a complete review of my claims folder?

2). If so did the motion-for-reconsideration I submitted on 12/20/2000 alleging all of errors of due process and case law, but denied by washington because of finality of claim? Was this motion reviewed by RO and RO had duty to assist, that triggered this CUE?

The Illness Adjustment Disorder I had combined to my physical conditions for over 10 yrs was severed by RO alledging Alcohol, I appealed to washington and BVA told RO that they can't do this, cause I had this condition for over 16 years at the time and it was awarded by a different jurisdiction and can't be severed in the absent of fraud, so Washington agreed with me.

At this point RO couldn't use the ALCOHOL issue anymore so they had to seperate the illness adjustment disorder and rated me with Anxiety disorder, NOS.

This condition (Anxiety disorder, NOS) was diagnosed by C&P themselves in 1996, but they always stuck to ALCOHOL as willful misconduct.

This is the same diagnosis that I was awarded 80% IU P&T (100%) effective date 01/2010.

Today, C&P reports state that alcohol use is a non issue that it was secondary to my illness and that the anxiety disorder, NOS---impeded me from working in my profession or any other work (C&P psychiatric report of 02/2010).

I have calculated over $300,000.00 this is a LOT OF MONEY, my rep told me it's a done deal. Is this going the right way?

Sorry, for writing so much, but I am finally excited, until it reaches an end I am not jumping up.

Thanks,

Edited by RAFA
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In the 2000 decision it says:

Based on this information, the RO granted service connection

an adjustment disorder, secondary to the veteran's

service-connected disorder, and granted a 30 percent

disability rating for benign recurrent cholangitis, status

post cholecystectomy, with adjustment disorder.

And:

“A VA neuropsychological report dated in June 1993, reported

diagnostic impressions of an organic mental disorder, not

otherwise specified, and dysthymia. A psychiatric report

prepared for the Social Security Administration in March

1994, found severe major depression, single episode.

Thereafter, the veteran was diagnosed with schizoaffective

disorder and schizophrenia.”

and then:

“Although the Board has considered assigning a separate,

compensable evaluation for an adjustment disorder secondary

to the veteran's service-connected benign recurrent

cholangitis, status post cholecystectomy, the most recent

evidence of record reports that the veteran does not

currently have a psychiatric disorder associated to this

service-connected disorder, to include an adjustment

disorder. Accordingly, a separate compensable evaluation for

an adjustment disorder, secondary to the veteran's

service-connected benign recurrent cholangitis, status post

cholecystectomy is not warranted.”

WTF???? You have obviously been through a lot here- there are numerous MH diagnoses in your record and it looks like the VA cant get it right.

ORDER

The claim for entitlement to service connection for an

acquired psychiatric disorder is denied.

The claim for entitlement to a total disability rating based

on individual unemployability is denied.

(then in 2004 decision)

In part:

“REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

I. Entitlement to Service Connection for an Acquired

Psychiatric Disorder, Other Than an Adjustment Disorder

Associated with a Gallbladder Disability”

I went back tpo the 1997 decision:

In part;

“A report of a VA psychiatric examination dated in August 1996

indicated that the veteran had an anxiety disorder with

depressive features. The veteran has submitted reports from

private psychiatrists which indicated that he had a

disability from schizophrenia, schizoaffective disorder, and

severe major depression. The Board is of the opinion that a

remand is necessary for an examination to determine whether

the veteran has a neuropsychiatric disability from

schizophrenia, schizoaffective disorder, and major

depression. If such disabilit(ies) exist, it will be

necessary to determine whether such diagnos(es) represent a

progression of the prior diagnosis, or development of new and

separate conditions. 38 C.F.R. § 4.125(b) (1996).”

With the receipt of SSA for Depression, did any vet rep ever suggest that you should file for SC for depression due to the SC condition and causing TDIU?

“A VA neuropsychological report dated in June 1993, reported

diagnostic impressions of an organic mental disorder, not

otherwise specified, and dysthymia. A psychiatric report

prepared for the Social Security Administration in March

1994, found severe major depression, single episode.

Thereafter, the veteran was diagnosed with schizoaffective

disorder and schizophrenia.”

How did VA jump from depression to schizophrenia? Does that BVA statement mean the VA then diagnosed you with schizophrenia and treated for that? 2000 decision

At the time of the alleged CUE what meds were you prescribed for the MH issue?

Something is WRONG here and I hope other here will take the time to read these BVA decisions from this vet.

It looks like they were pulling stuff out of a hat while keeping their heads in the sand.I didnt read any of the alcohol crap. You did succeed “(80% and IU P&T)” so you overcame that point of denial VA tried to use.

Here are the links for all interested in this case:

http://www.va.gov/vetapp97/files4/9733363.txt 1997 BVA decision

http://www.va.gov/vetapp00/files2/0010860.txt 2000 BVA decision

http://www.va.gov/vetapp04/Files2/0418456.txt 2004 decision.

Was your EED (earliest effective date) for the TDIU award based on the date you filed for TDIU?

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  • HadIt.com Elder

Is the VA right when they say you have nothing in your SMR's regarding DX or treatment for a mental health issue? It sounds like you were sick as hell in the Army from various things. I hope you win your CUE. I also have had many DX'es changed over 40 years from personality disorder to schizophrenia to bipolar and then back to schizophrenia with four other disorders throw in just for the hell of it. The treatment I got at VA back in the 70's was so bad my private shrink told me to stay away from there or I would end up in an institution.

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With the receipt of SSA for Depression, did any vet rep ever suggest that you should file for SC for depression due to the SC condition and causing TDIU?

The answer is "NO" nobody claimed Depression for me and I didn't understand the process then as I understand it today, I personally decided to educate myself and I have been doing it everywhere and anywhere I can, to make a wrong a right.

How did VA jump from depression to schizophrenia? Does that BVA statement mean the VA then diagnosed you with schizophrenia and treated for that? 2000 decision

The Schizoprenia and Depression were diagnosed by my private psychiatrist.

No, I always tried to stay away from treatment for Mental Health at the VA, because I feared them, back in 1970's there were horrors stories coming out of our local VA Mental health clinic concerning Vietnam era Veterans it was all over the newspapers.

The only treatment I received in mental health was for an Illness Adjustment disorder therapy at another state, so I could cope and continue working it lasted for 5 years.

Bassically I stayed away. Today this has changed a lot for the better, thank god.

Was your EED (earliest effective date) for the TDIU award based on the date you filed for TDIU?

I file for TDIU several times along the way in this process and for this last award of 01/2010.

I am alleging an earlier effective date for TDIU other than 01/2010 and I am also claiming to be paid for an adjudicated 30% Anxiety disorder, they are trying to keep this combined to my physical conditions, they need to be separated according to regulations, effective date 08/2001.

Anyway, hospital records shows it's separated because I file for reimbursement of prescription drug copayments back to 08/2001, they confirmed it and submitted an audit also my VFW rep file an inquiry.

Since this is a reopened claim I feel that the earliest effective date should go back before 08/2001 when I was given C&P exams for TDIU, I don't have the application date when it was submitted.

At the time of the alleged CUE what meds were you prescribed for the MH issue?

Today

Zoloft 100mg 1 day

Restoril 30mg 1 at night

Abilify (Aripiprazole) 10 mg 1 a day

Then

Paxil 20 mg

Haldol ? mg

Deopakoke 250 mg

Thank you for your response and help Berta.

Edited by RAFA
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I'm trying to stay on top of this story and I need a little more clarification about the cue.

Am I correct in assuming the va has cued themselves, or did it come into play by some other ??????

I seem to think now it might be the latter.

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Yes, like Cooter said the VA seems to have CUE themselves according to the information given to me by my VFW rep, I only submitted for an earlier effective date for TDIU and 30% retro pay they owe me.

Edited by RAFA
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  • HadIt.com Elder

Even if you get an EED I would have some lawyer eyes shine on all your decisions since you were discharged. There are some good lawyers out there and if the VA admits a CUE and EED you may, in fact, be entitled to much more. They do try and cover their tracks to avoid an even bigger retro payment.

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