Odar Judges

[unique]

I live in the state of Georgia. Why is there such a difference in the number of cases that are approved versus the number of cases that are disapproved?

[Berta]

"Why is there such a difference in the number of cases that are approved versus the number of cases that are disapproved? "

I dont think this is has anything to do with the state you live in.

Although VA ,nationwide, makes many errors and denies many claims that can succeed on appeal-

to me the main reason claims are denied is due to lack of competent probative medical evidence and//or proven service nexus.

The VCAA letter a claimant gets should tell them exactly what they need for the claim.

Unfortunately some claims require getting an independent medical opinion as that is often the only way to combat a negative C & P exam sometimes.

A lack of service nexus means the veteran must ake sure they have their SMRS as well as CA does, to mae sure something in the SMRs are not overlooked by VA.

Some nexus situations require getting a buddy statement, from someone who served with you at time and place of the stressor, accident, or incident and can give an eye witness account of what happened to you.

[stillhere]

I assume you are asking about SSDI? If that is correct I lot of it I think goes back to the old adage I can't. When someone finds something that they can't do anymore they form a mindset that they "can't do anything" In other words while I can't handle stress anymore even of the smallest amount. Some dr's figure I could be able to be a soda jerk or a hamburger flipper! But in my case even that too is out of the question because of my other disabilities!

Anyone applying for SSDI has the burden to virtually proof they can not work at anything! Do that and you get approved, don't do it then they will tell you what you could do or just disproved.

Getting a lawyer helps quite a few and usually is not done until after the first denial. This to adds to the ratio being so one sided. I was fortunate to be approved in less than 4 months but I also did a lot of homework and presented my case with plenty of back up.Do that and you will be approved!

[Bonzai]

If you are referring to the large differences in approval rates between Administrative Law Judges (ALJ), then the answer would be that ALJs are by and large fairly autonomous. Although they are supposed to be bound by SSA's rules and regulations, it doesn't always happen hence Social Security Appeals Council and Federal District Court. ALJs are human and bring their own experience (or lack) and biases with them. Some are good and others bad. With SSA, it is just a roll of the dice on which type you get.

[unique]

Yes I am referring to SSDI. Both of my doctors have submitted RFC's in my favor but I was still disapproved at the initial and reconsideration level. Now I am at the hearing level hopefully I'll get approved at this level and yes I do have an attorney who is working with me on my case.

[stillhere]

Hmmm I would ask your lawyer what is going on??

I see you are listed as 70%. Have you applied for P&T or IU from the VA? Having that will enhance your chances with SSDI!

What is your age that really plays a big part. The VA also offers rehab. If you have applied for that and been turned down by them that can help a whole lot.

Almost sounds to me like your lawyer is dropping the ball if you have two docs saying you can't work!

Just my opinion!

Good luck!

[Chuck75]

"I live in the state of Georgia" usually equates to the Atlanta (Decatur GA) VARO for veterans.

SSA is another can of worms. Generally, it is faster and perhaps overall more "fair" than the VA.

SSA individual cases show the same lack of consistency across the country as VA decisions.

Being "nice" to the SSA interviewer/ case worker can have a large positive impact.

You will likely find that there is a great deal of difference from one case worker to another.

(I had one senior case worker that would "bend over backwards" to help a claimant, and another junior worker that was just the opposite,

in the same office, no less.)

I had to appeal an EDD, and would likely not have been successful as quickly and simply without the help of the senior case worker.

Past history of this VARO, as well as my experience with it - - -

A "simple" claim goes through the system fairly quickly, although it may have been "low balled".

Complex claims can result in deferrals, failure to read all the evidence, including service medical records, loss of records, Etc.

Denials of claims with ignored evidence of in service treatment, military doctors statements saying "duty related", and so forth.

Dismissal of expert IMOs as "speculation", even when the IMO is in accordance with the requirements of the appeals courts.

Failure to notify NLSVP of Nehmer case members, even when the veteran already has adjucated claims that fall under Nehmer.

Loss of records, and so forth, including "redaction" that destroyed documents that by law, are to be in the veteran's claim folder.

(Records of such things as past denials that did not meet the requirements, regulations, practices, and law in effect at the time.)

(It's hard even for lawyers to prove something happened when the records disappear!)

Hopefully, all the current scrutiny, combined with outside review of Nehmer cases, has improved or will improve the Atlanta VARO's speed and accuracy.

Deferrals can be a particular problem. I might suggest that the veteran consider a reply to a deferral stating to the effect that the VA should use "evidence of record", and decide the claim(s). At least this encourages the VA to make a decision, allowing the next step to be taken if the decision is a denial.

Many of the conditions resulting in a VA claim are not "static". So ongoing evidence of changes (treatment, severity, etc.) can be assumed. The VA can use this (if they so choose) to delay/defer a claim while awaiting "current evidence". Naturally, the ridiculous time the VA takes on a deferred claim can render "current evidence" a never ending problem.

Edited May 2, 2012 by Chuck75