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Nod Claim Dro Versus Traditional Appeal Process?

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LILS

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Hello Gurus,

I received a letter from the VA stating they received my NOD & they wanted to know if I wanted to have a Decision Review Officer assigned to my NOD or use the Traditional Appeal Process. Does anyone know if one is better than the other or does it even matter that much? Will one process take longer than the other? Any suggestions? Or pros/cons for each one? I have 60 days to let them know if I want a DRO assigned. If I don't let them know anything, they would automatically use the Traditional Process. THANKS!!!

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Hello and thank you for your post.

Yes there are varied opinions here and though I have mixed emotions about the VARO and the appeal process with DROs it did work for me on part of the claims process. I do believe that if you have multiple claims you may be better off with the DRO reviews. I believe the one last chance to review can mean a decision on a few and then the denials on the remainder claims can be Form 9 and appealed to BVA.

As Carlie pointed out the hearing in front of the DRO is a good option. I have not used the face to face meeting with a DRO, the hearing . I know that it was decided by my lawyer to just let the DRO make a decision and though I did receive an award, it was faulty and with error and had to be NOD on part of the award. The rest of the complex claim is going to BVA via the appeals process and Form 9. Remember that you can still receive decisions from DROs while the claim is being certified to go to the BVA. I am hoping that the mistake made on the award will be corrected at the RO level and not require the BVA to have to point this out to them. Your claim may take time to get it to the BVA depending on how complicated the claim is. If you disagree with any part of your claims decision from the Regional Office , your appeal process is still continuing if you will ask for the Notice to Reconsider before the claim is gone to BVA. That means they can still make a decision on parts or all of the claims. Especially if you have new medical opinions , test or evidence that is vital to making a difference with the claim.

I would remember the timeline schedules for appeals and make sure your timeline does not ever go beyond the 1 year from date of claims decision. And I think 60 days from the decision on a NOD , notice to reconsider from an initial decision letter. You would not want to have to start over and miss your retro because the Earliest Effective date was jeopardized. I posted the link below to give you the actual guidelines for VA.

Deanbrt also has another thought about shortening the process, by getting the claim moving onto the BVA without further wait from the Regional Office level. I think he is referring to the number of denials at the Regional Office level pretty much taking it to a level of adjudication that has a better chance of success. It is a decision that each Veteran must weigh and depending on how complex or how simple it is would require some thought on which way you want to go. I could see this step he has recommended as being away to cutoff the delay situations but risk NOT getting an initial decision of any kind. Tough Call here. But remember that no matter what happens , always take the stance of NEVER GIVE UP. God Bless, C.C.

http://www.va.gov/va.../va/pdf/VA9.pdf

Edited by Capt.Contaminate
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Thank you for the info! I selected a DRO review. We'll see what is next. One thing on the claim they didn't even mention was a definite mistake, so I already know I will eventually get my 50% added to my 40%.

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I would read the demial carefully and find out exactly what evidence they sya they need to award your benefits. Then I would go get that evidence and submit it along with a statement in support of claim saying I would like to withdraw my NOD and have the claim reconsidered based on the newly submitted evidence.

I did this (back in 2006) and my claim was awarded in 60 days. Initially, I did not provide any evidence but thanks to finding Hadit I learned that I needed an IMO. I went out and got one and submitted it. It saved me two years of waiting for appeal.

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Thanks for the info. They had all the evidence they needed, so I resent it with the rating schedule attached to each claim. They just screwed up, i.e., rating me for a hysterectomy scar, but not for the actual hysterectomy & ovaries removal. That's 50% right there. Plus I have 3 dependents & they rated me as single, so all this is EASILY verified, but I guess with the backlog it will take a while. What is an IMO, where do I find one, & is it even beneficial in this case?

I would read the demial carefully and find out exactly what evidence they sya they need to award your benefits. Then I would go get that evidence and submit it along with a statement in support of claim saying I would like to withdraw my NOD and have the claim reconsidered based on the newly submitted evidence.

I did this (back in 2006) and my claim was awarded in 60 days. Initially, I did not provide any evidence but thanks to finding Hadit I learned that I needed an IMO. I went out and got one and submitted it. It saved me two years of waiting for appeal.

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the dependents will catch up over time. they are very slow on that even if you supply everything from the beginning.

IMO= Independent Medical Opinion or even better IME= Independent Medical Examination

Basically it is a Dr's opinion relating your current condition to your military service based on a review (IMO) of the medical records or a review of the medical records and examination (IME).

What did the denial say about the hystorectomy? I would be cautious about characterizing it as EASILY verified. How did you word it when you resent the information? If you disagreed with thier decision then you have started the appeals process which could take years.

Could you post (remove personally identifying info like name, ssn) the denial? or retype it word for word.

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Hi,

They didn't mention my hysterectomy/BSO AT ALL, except the scar, so there is nothing to quote. They completely left it out of the decision! This is what I sent them in the NOD, along with my pathology reports & operative reports! It was ridiculous that that was left out completely.

1.
TAH-BSO:
I had a total hysterectomy AND BSO in Oct 2008; my records clearly stated that. I was a little confused why I was rated 0% for my hysterectomy scar, but nothing was mentioned AT ALL about the actual surgery. I have included copies of my records showing the actual evidence, including the pathology report
.

the dependents will catch up over time. they are very slow on that even if you supply everything from the beginning.

IMO= Independent Medical Opinion or even better IME= Independent Medical Examination

Basically it is a Dr's opinion relating your current condition to your military service based on a review (IMO) of the medical records or a review of the medical records and examination (IME).

What did the denial say about the hystorectomy? I would be cautious about characterizing it as EASILY verified. How did you word it when you resent the information? If you disagreed with thier decision then you have started the appeals process which could take years.

Could you post (remove personally identifying info like name, ssn) the denial? or retype it word for word.

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