How To Propose A Rating To The Va

[justrluk]

I'm trying to see if anyone has been successful in their appeal by sending a proposed resolution to the VA. This particular appeal has a claim date of 3/08. All I really want is for the VA to award the original 40% that was reduced to 20% because they said it was a pre-existing condition (it wasn't - there's nothing in my records about the condition until late in my career.)

If I'm not mistaken, Carlie posted a sample of a proposal she had either sent or was going to send stating something like: "In regards to the appeal dated MM/DD/YYYY, I will consider the appeal resolved to my satisfaction if the percentage assigned to (condition) in the decision dated MM/DD/YYYY was restored to the originally assigned percentage as this condition was not pre-existing (see evidence enclosed). I will not pursue this appeal further as I would find the assignment of 40% as originally granted as having fully satisfied this appeal".

Any opinions would be greatly appreciated.

[jbasser]

That is called lets make a deal.

You can do it but the VA cant.

If you are sure thats what you want and according to the part 4 you deserve than go for it.

I did it 5 years ago and won.

Basser

[justrluk]

Basser -

Thanks for the feedback. Does the language sound right? Yes, it's really all I want. They reduced it from the 40% to 20% based on their assumption that it was pre-existing. I just want the original 40%.

[jbasser]

It sounds like they changed it to aggravation.

They pay only to the extent of the aggravation.

You may want to prove its not pre existing and get an attorney,

J

[justrluk]

It sounds like they changed it to aggravation.

They pay only to the extent of the aggravation.

You may want to prove its not pre existing and get an attorney,

J

J -

I've written a 21-4138 outlining what I want and my rationale. I've also put together some tabs for the document supporting my rationale. Here's the tricky part: I was on Active Duty from 1984 - 1987. I joined the ANG for a few years, transferred to the AF Reserve and started working as an Air Reserve Technician. I was then brought back on active duty in 2000. They're saying that the condition pre-existed my RETURN to active duty, but made no mention of previous periods of service because my STRs were missing/lost right after my PEB in 2004. My contention is that since I entered in 1984 and the entrance medical exam (I have a copy) didn't mention this condition, then it must have started while on active duty. The grey area is the ANG/Reserve time between the two periods. I have also printed and enclosed a point summary which shows all the time spent in an active status: weekends, TDYs, Annual Tour, etc. I'm banking on the statutory presumption of sound condition when I entered A/D in 1984, and all of this started while on A/D and worsened during the time as a reservist. If you could take a look at the copy (redacted), I'd really appreciate it. If they reverse the decision to reduce to 20% from 40% and I end up with the original 40%, It puts me over 100% schedular. This is a big deal to me.

[carlie]

just,

On the 4138 you refer to the "rating decision" and I would refer to it as

the" decision that made a reduction in benefits" dated XX/XX/XXXX.

A very small point but I am anal.

I am on holiday and will look at it more this coming weekend.

[justrluk]

Thanks, Carlie. As you are well aware, language is everything...

J - I'm hoping that the proof is in the absence of the condition being mentioned in my initial enlistment docs. I was also commissioned and it's not in that physical either. The problem is the loophole of being a guardsman/reservist for 13 years between active duty periods. Granted, I pulled a lot of duty in that time and have the point summary included to paint that picture, but it could go either way. I'm not trying to be pushy, but this has been in the hopper since 2008 and I'm ready for resolution.

I guess if I'm not successful, I could always file for an increase as I'm on weekly injections of Humira and daily use of Leflunomide and steroids to keep it under control. I can't really function well without the meds. I'm just trying to preserve the date of claim along with a substantial retro if I'm successful.