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basham

What Should I Go With Dro, Reconsideration Or Appeal

Question

I was granted 50% schizoaffective,10% tinnitus and 0% bilateral hearing lost with the fnding of incompetency. The board denied me PTSD, major depression, general anxiety disorder,agoraphobia and ADHD. My claim was put in while i was in the VA hospital for 6 months in Alabama. All of the illness had been diagnosed by my Doctor from the VA. I was told that I was denied these other illness because they will only grant you compensation 1 mental illness. Even though I dont know the system but it seems but all the illness is related to ptsd but i guess i got granted schizoaffective disorder. Also why would they rate me incompetent and exspect me to go into any kinda job. April 2011 is when my claim was process. In May 1 month later later I put in for a reconsideration. During the 18 months my claim was in I was Put in a Program called Mental Health Intensive care management. A nurse came to my home once a week to check on my condition, help me keep my medication straight. She reported back to a team where my Doctor was over the team. My condition became more severe, medication wasnt helping. The doctor diagnosed me with the same things in my first claim to include unemployable.

For the past 7 months i thought they were doing a reconsideration, The doctor did diagnose me with schizophrenia. From reading up on it it was basically the same as schizoaffective and schizophrenia even though from reading my doctor notes schizphrenia is more severe. I had alot of addtional evidence that was not reviewed. basically they admit to the mistake even though I did not have a full rating to request for unemployability, DAV said put it in because in some case they have the authority to grant it without the 70%. With in 3 months i had a C&P set up for mental Illness and hearing. the examiner went along with my doctors note for the past year and a half. My hearing was shot this time to the point where the examiner said I could problems in certain condition. I was a ammunition Inspector. Had alot of ranges and demolition. Now they have sent me a letter to saying if i have additional evidence send to them and they will treat it as a reconsideration, a DRO or a traditional appeal. I am confident with the evidence I have. what should i do to ensure everything is where it should be and what will bethe quickest best route to take. BASHAM

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3 answers to this question

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Whatever you decide to do, the denial date determines the time frame you have to appeal. A DRO review may eat up the time left. Unless you get a favorable outcome from the other options, make sure that you file any appeal before the deadline.

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You are absolutely correct Basham-if you are incompetent due to SC then you are unemployable.

"even though I did not have a full rating to request for unemployability, DAV said put it in because in some case they have the authority to grant it without the 70%. With in 3 months i had a C&P set up for mental Illness and hearing. the examiner went along with my doctors note for the past year and a half. My hearing was shot this time to...."

Your DAV NS0 is right.It doesnt matte4r what your SC rating is, if that SC renders you unemployable.

Have you formally filed for TDIU? ( VA form 21-8940)

VA will only consider TDIU with a 70 % rating or with receipt of the TDIU form.

The first vet I ever sent the TDIU form to had no rating at all from VA.He was awarded TDIU within a few months.

He had a SSA award solely for PTSD, and also years of private psychiatric care. His stressor was verified easily.

"I had alot of addtional evidence that was not reviewed."

"A nurse came to my home once a week to check on my condition, help me keep my medication straight. She reported back to a team where my Doctor was over the team. My condition became more severe, medication wasnt helping. The doctor diagnosed me with the same things in my first claim to include unemployable."

If this was solely due to your SC schizophrenia- the DAV rep should ask them to consider you as Housebound for the SMC S award along with the TDIU.

Did the doctor mentioned above document you are unemployable solely to your SC condition of Schizophrenia?

Can you scan and attach here the last decision you got from the VA?

(Cover the personal identifying stuff)

I am baffled that the VA could declare you incompetent yet not have rated you higher than 50% for the schizophrenia.

"Now they have sent me a letter to saying if i have additional evidence send to them and they will treat it as a reconsideration, a DRO or a traditional appeal. I am confident with the evidence I have. what should i do to ensure everything is where it should be and what will bethe quickest best route to take. BASHAM"

Make sure you send them everything with a Post office proof of mailing and put your name,address and C file number on everything you send.

Mke sure your NSO also has copies of it all and proof that you sent it in.

Make sure you send them (keep copy of the filled out form too) a 21-8940.

Unless the DAV did that already.

If not- check Yes to question # 18 and apply for SSDI. Do you get SSDI already? If so, what it is for?

If so is it for the schizophrenia, as this would be prime facie evidence of TDIU.

Under Remarks # 25 refer them to separate page with your name, address, C file number on it and tell them anything else they should consider for TDIU such as VA has deemed you incompetent already, tell of of the medication problems and any side affects of those meds and anything else that would support TDIU (paid at the 100% rate of comp).

Also the VA wants us to believe they are working on Reconsideration Requests when the reality is-sometimes they just pretend to be working on these requests hoping to piss away our NOD year deadline.They did that to me.

But I filed my NOD the last week I had left under the year NOD rule in 2007 and I was told a decision on that claim is due any day now as that issue fell under Nehmer.

A Reconsideration request does NOT stop the NOD clock, ticking since their last decision.

As CHuck said, these deadlines are critical.

In your case this might not occur at all and they would act on the request before the NOD time frame runs out.

"I was granted 50% schizoaffective,10% tinnitus and 0% bilateral hearing lost with the fnding of incompetency. The board denied me PTSD, major depression, general anxiety"

It would help us here if we could read the VA's actual words as to why they only granted 50% for the schizophrenia.

"I was told that I was denied these other illness because they will only grant you compensation 1 mental illness" That is correct.

Unless you or your rep has specified to them that in the event the recon request isn't granted, please accept the request as a formal NOD.

Edited by Berta

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Considering your post and not seeing the statement of case it looks like you were lowballed especially if you are not working.

If you are working 50% may be good.

I would ask for a DRO Hearing if it was my claim.

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