I Think I Found The Way Into The System! (I Hope). Please Read

[cojolio]

OK, so after reading this board and another one that I won't promote here for two days straight (literary), I think I found a solution to my problem. (Re-opening my lower back & numbness of left hallux denied back in 08 without NOD)

Here are the quick facts (read my other two posts if you need more details plz, don't want to beat a dead horse).

In 2008, I was MEB Boarded under VA Code 5271 (Limitation of Motion with Deltoid Ligament Repair) 20% following Airborne injury.

While out processing, a lady told me to fill out a form listing everything I wanted to claim with VA: so I put lower back pain, right/left knee pains/ numbness of my left toe.

I ETS from service June 18,2008. The VA RECEIVED my claim on Feb 20^th as stated on the award letter. On the award letter DATED July 22th, 2008, they approved my ankle claim (remember MEB Board 20%...) WITH AN EFFECTIVE DATE of JUNE 19th, but denied everything else stating "we determined that the following conditions was not related to your military service, so service connection couldn't be established".

OK, so I get on Ebenefits and noticed the following:

Details on your Compensation claim received on 6/19/2008 (my award letter says feb 20th)

• Regional Office of Jurisdiction: Atlanta
• Power of Attorney: DISABLED AMERICAN VETERANS
• Status: Closed
  Where Should You Send What We Need?
  Department of Veterans Affairs
  Atlanta Regional Office
  PO Box 100021
  Decatur, GA 30031
  
  
  Contentions
  
  • chronic left ankle pain
  • lower back
  • (((((((missing numbness of left hallux, left/right knee conditions?)))))
    

What Have We Done?

Items Date Opened Suspense Date Follow-up Dates

Requested service treatment records. 6/26/2008 10/24/2008

So, they requested my service treatment records on 6/26 (but my effective day for my ankle is 6/19…with everything else denied, at this point I haven't been to any VA hospitals either). Although I don't know what a suspense date is, it is blank, as well as follow-up dates.

So, do you guys think that they made their decisions without having my service records and/or my MED Board paperwork as well? If they did not, can I reopen it using N&M or CUE or anything else since they didn't consider my srv records to begin with? What do you guys think? Or am I getting excited over nothing…I have been going to the VA hospital and my numbness in the toes and lower back pain is WELL documented (both in my srv records, medical board, and VA medical records) so I can prove its an ongoing issue...

PS. I would like to point out that on Ebenefits, there is a claim called "administrative review" but when I click it is basically the same stuff as I pasted above..Showing the same dates…is this important?

PS. For those wondering if I have the Bases and Reasoning for the claim…I don't…, never got it in the mail, never seen it. All I have is the notification letter they sent me after I call and asked them. I file a FOIA on 3/16/2011 and still on Phase 1 on ebenefits in an attempt to get the bases and reasoning part.

ALSO, I can post the award letter, or any other paperwork that might clear things up if need be...

Edited September 20, 2011 by cojolio

[cojolio]

Carlie, again, THANK YOU for your time!!

I was separated with severance pay, so, although rated at 80%, I'm only getting payment for 70% until they get their money back...which I dont mind...the money is not the important (in my case at least) for my claims...is to get them to recognize my illnesses are from service.

Carlie, if you have time please read my MEB Board Summary ( ) and noticed that the left hallux, and lowerback are mentioned by the doctors. And are well codumented on my srv records (2 years of therapy and ortho visits prior to being kicked out).

That is why I'm trying to figure out if they even bother to look at the srv records/med board when denying my June 08 claims because "srv connection couldn't be established"....

I will call and make an appointment at the FL VARO to see my C-file and ask them to mail me a conformation letter of my appointment. Will they make me a copy of it right then and there if I ask while at VARO?

co and pr,

I just went thru the notification scans again.

The following is shown in the Notification Letter (but there's still no R&B)

"We determined the following conditions was not related to your military service,

so service connection couldn't be granted."

lower back condition

numbness of left hallux

right knee condition

left knee condition

So for me the only question that remains is if the MEB evidence was of record

as the above conditions were obviously denied and not rolled into the grant & evaluation

percentage of degenerative arthritis of the left ankle.

Also, I did not realize until now that the OP is currently under Recoupment of Separation

Severance Pay until Sept 2021 - even tho it has no bearing on the current questions.

I'm editing this to add that if you want to go to ST.Pete VARO to view your c-file you MUST

contact them and get a scheduled time to do so, and I would want it in writing prior to driving

from Miami. This is my VARO and I am positive you will not get to view your c-file there

without it being scheduled prior to your arrival - also it should contain everything from the

Georgia VARO.

Edited September 20, 2011 by cojolio

[carlie]

co,

I see your profile is updated and shows 80 % SC -

What are all of your SC'd disabilities and the percentage for each.

BTW - the 1-800-827-1000 peeps should be able to tell you all of

the Diagnostic Codes (DC's) you are rated under as they are shown

on more VBA paperwork that the Rating Decision, it's also on the

blue sheet - and the Current Awards internal VA Form for finance.

Edit to add :

Now that I've seen and read the MEB report I would think that not only your

left hallux should be SC'd but also your back condition.

Again, it all goes back to what that Rating Decision says - denied - why

and what evidence was/was not considered.

JMHO

[Philip Rogers]

carlie - yes, there is, I'm giving him the benefit of doubt on the reasons and bases statement. As such, if the VA failed to give the reasons and bases, it's a bad decision and a CUE. I believe not listing the evidence used "may" be a CUE, also, and if not CUE the claim may remain open, based on the faulty decision. In fact, they may have made the decision w/o his SMR's even being there and just approved the ankle based on MEB award. We really need to see what kind of notice he received. jmo

pr

pr,

Is there a specific reason you suggest a claim of CUE over 3.156c for earlier effective date ?

All of the things I'm also considering on this one is:

Was the "numbness of left hallux" rolled into a condition that was SC'd ?

OR is it a separate issue OR was it considered and denied and Why ?

IMO if it is actually a separate issue from something that has already been SC'd,

was it claimed ? If it was claimed and denied due to not shown in SMR/STR's (to include MEB evidence)

then why not go with the 3.156c - for earlier effective date - when it does get SC'd ?

I hope I got this communicated OK.

Also, I agree and wouldn't sign a POA with a VSO - but I was thinking he might be able

to visit one and see if they can pull up the Rating Decision - but on second thought they

might require the claimant to sign the POA - so they can legally access the information.

[cojolio]

PR;

Personally, I think thats what the VA did back in 2008: just awarded the 20% based on the MEB result (which was also 20%), and denied everything else without having/or at least checking my service records. I say this because I ETS on June 18th, the letter dated July 22th denying everything seems way too fast for them to request, received, evaluate, then make an inform decision in about 30 days...specially knowing NOW how slow the system works...but I will just have to wait for my FOIA to get processed and see what they send me...

BTW, the only noticed i have ever gotten regarding my 2008 claims is the one I uploaded in this post...nothing more nothing less...

Carlie;

My ratings are:

20% from 2008 decision for Left ankle arthritis and limited ROM

70% from 2010 PTSD

10% from 2010 Tinitus

0% from 2010 Hearing Loss

I will call the 1800 # and ask them to mail me or at least tell me the Diagnostic Codes I am rated under and post them here

Thanks for reading my MEB Report... and giving me a little bit of confidence that my Left Hallux and Lower back should be SC. They are also on my serv records (specially my left hallux...thats on every visit I did to the ortho doctor...for two years).

I know I am beating a dead horse because without the Rating Decision (stating the reasons and bases for the denial), I cant/dont want to attempt o reopen these claims.

My VSO thinks that the current progress notes and EMG showing nerve damage and stiffness of the left hallux is to reopen it (numbness=nerve damage)..and as you guys/girls advise me to file secondary conditions for Peroneal nerve damage and atrophy, I dont want to "waste" this new evidence if they are just going to say...well your nerve damage was consider under your ankle, so denied again...

PS. REALLY, I Cant thank you guys enough for all the comments and help... I am an open book always willing to listen and learn, so I stay GLUED to this board now LOL...

PSS. Carlie and PR, I have an Open FOIA claim from March 16, 2011 at the FL VARO requestion the COMPLETE Rating Decision, to include the Bases and Reasoning behind their decisions (just my 2008 claim though). Called today, no updates, average time is 167 days (passed that). My question is...will requesting or filing another FIOA request for my ENTIRE C-FILE, delay/affect my already pending FIOA? or you recommend just waiting for this FIOA to get Process and then file another one?

Another filing a comp claim while having a claim open delays and "disrupts" the "system"...does this apply to FIOA requests?...

[carlie]

PSS. Carlie and PR, I have an Open FOIA claim from March 16, 2011 at the FL VARO requestion the COMPLETE Rating Decision, to include the Bases and Reasoning behind their decisions (just my 2008 claim though). Called today, no updates, average time is 167 days (passed that). My question is...will requesting or filing another FIOA request for my ENTIRE C-FILE, delay/affect my already pending FIOA? or you recommend just waiting for this FIOA to get Process and then file another one?

Another filing a comp claim while having a claim open delays and "disrupts" the "system"...does this apply to FIOA requests?...

I do not feel that going to view your c-file will hold up your claim any - after all your c-file is at

St.Pete VARO - the same place you are going to view it at.

ALSO - when you go to view your c-file - IF you find the Rating Decision in there - they will make you

a copy of it right then and there. Actually they will make copies of a few things right then and there

BUT

if you push for too many things they will tell you that you need to request a copy of the c-file which

you have already done.

JMHO

[cojolio]

Carlie,

I havent requested a copy of the C-File yet...my FIOA was for the 2008 decisions...I will call them tomorrow and ask them for an appt to see my c-file (basically to LOOK for the 2008 rating decision myself, and ask for a copy of it)...

I do not feel that going to view your c-file will hold up your claim any - after all your c-file is at

St.Pete VARO - the same place you are going to view it at.

ALSO - when you go to view your c-file - IF you find the Rating Decision in there - they will make you

a copy of it right then and there. Actually they will make copies of a few things right then and there

BUT

if you push for too many things they will tell you that you need to request a copy of the c-file which

you have already done.

JMHO