Great Claims Advise

[Berta]

The other day Broncovet made a statement in a reply in a sub forum here that was so important I wanted to copy and post it in Claim's Research but I had satellite dish problems lately and couldn't save it and still cannot find where he posted it.

He made the point that many claimants do not read their decision carefully enough to understand why the VA denied. That ,to me, is the main reason many claims go on and on for years in the appeal process.

I am sure he also made the point that the VCAA letter must be read over carefully. Not just when you receive it but at many stages of the appeal process when you prepare any responses to VA or seek more evidence.

Supplying the VA with what they ask for in the VCAA letter (which might well mean the claim will require an IMO) and carefully assessing everything as stated in the SOC or SSOC, then checking the evidence list to see if something critical was not listed in it, and then to focus on the denial ,word for word ,– making sure the C & P results are properly reflected in the VA's Reasons and Bases.....these are the keys to succeeding in a claim.

One good reason to have a vet rep is that he/she could readily tell if the VCAA letter is deficient and could cause a BVA remand years down the road. Probably almost every VCAA letter is properly prepared these days as the BVA remands due to improper VCAA letters has sure calmed down in the past few years.

The VCAA letter is almost like following a recipe.

If you leave one ingredient out, the result will be awful.

Thanks Broncovet for the way you had put this in your brief post the other day.

You stated in less words then I did here, the main reason in my opinion, that many claims end up in the appellate process for years and still fail :because the VCAA letter was not followed nor did the claimant fully take the time to comprehend the VA denial as to the Reasons and Bases and then adequately respond to it.

And again I need to make this point. An IMO doctor needs to have not only all available medical records ( some claims require that they review the SMRs too),they should also have all SOCs,SSOC, and VA C & P results and prepare the IMO with the specific terms and wording that VA is familiar with, as explained in our IMO forum.

The VA can and will reject any medical opinion, even from the VA itself, that is too speculative.

Following the IMO criteria here can prevent a costly IMO from being rejected by VA due to speculation, because the IMO doctor might not have had all of the medical facts.

Edited July 13, 2012 by Berta

[carlie]

Mortarman, had all t.b.i. test ,the c&p look more like p.t.s. d. issues.could the d.r. o. increase my p.t.s.d. to ahigher rateing.at 30% at this time.

Sure they can - it will depend on what evaluation the medical evidence supports.

[broncovet]

One of the reasons to read the "reasons and bases" for decision carefully, is you may just find a gem. You see, the VA is supposed to give ALL the reasons they denied you.

So, if they deny you based on your SMR's not mentioning any symptoms of the claimed disability, this could well be good news! You may have gotten past a hard part!

And, then you need to "refute" their reasons and bases, something like this:

I disagree with the decision dated 1-12-2012 on all issues. Specifically, the R and B stated the claim was denied "because my SMR's were negative" for any symptoms of PTSD.

To the contrary, I have enclosed a copy of a medical report, done while in service where the doctor stated...........

....

You get the idea.

[john999]

The "reasons and basis" for a denial gives you the exact hints as to what it takes to win your claim. The VA serves it up to you on a silver platter. Considering how the often the VA denies claims the first time they do give you a roadmap on how to win it the second time around the game.