diabetes Just Curious

[Greg88]

So I had my C&Ps in Sept. (I'm Diabetic Type 1 for 36 years) this was the 1st C&P in 15 years for Diabetes and it's complications, I've been 100% for 15 years. C&P generally agreed with everything my private MD had put down on the Diabetes DBQ that I had fill out. My claim was sent from NY to Nebraska for a "Review" on Oct 2, and was closed on the 26th, it was sent back to NY and now is in a new claim 'Rating Review", I called the 800 number and was told the decision was made and I should see something in the mail. I know Ebenefits is sketchy at best and I'm wondering if the 800 number just basically tells you whatever will get you off the phone. I'm just curious about how long after they make the decision, that they mail you something.

[carlie]

I know Ebenefits is sketchy at best and I'm wondering if the 800 number just basically tells you whatever will get you off the phone. I'm just curious about how long after they make the decision, that they mail you something.

Yes

VBA has no timeframes that they must reply within.

We find out when we finally get either the $$ or the decision.

[Greg88]

So I checked Ebeneifits and see that the the original claim went from Pending decision approval to Gathering of Evidence, if though the 1-800 number told me the decision has already been made, it also says that a development letter has been sent, but nothing as of yet. It seems that Ebenefits is really out of the loop as far as whats really going on.

[broncovet]

Greg

For people who can accurately predict "when the VA will do something", becoming a billionaire on the stock market would be a breeze.

I would estimate that at least 40% of the questions on this and other VA websites involve "when" the VA will do something. The answer to that has always been elusive.

The VA has 3 "deadlines" and all of these are ones the Veteran must meet and none of them that are required of the VA:

1. The Veteran must file a NOD to his RO decision within a year.

2. To keep the appeal alive, the Veteran must respond to the VA's SOC within 60 days.

3. Finally, if the Board of Veterans Appeals denies you, you have 120 days to appeal.

That's it. I can assure you, that the VA requires Veterans STRICTLY ADHERE to these deadlines. On the other hand, the VA can take as little as 4 months to process your claim, or, it can be a decade or more. The VA even had "special procedures" for claimants due MORE THAN 10 years of Retro, that has since been "struck down" by the courts. You can read about it here:

http://thomasandrewslaw.blogspot.com/2010/08/macklem-eap-equals-cue.html

[Greg88]

So I called the 1-800 number and was told that the Regional office wants to see the Medical Records I submitted during my C&P exam, I asked what about the decision that was already made the response was "no decision was ever made" Ebenefits now has me listed as Gathering Evidence. I called DAV, did not get an SO, the receptionist is checking the computer and trying to make sense of things. I guess the only way to get a straight answer at this point is to go down to the Regional Office and ask questions.

Edited December 7, 2012 by Greg88 (see edit history)

[ButchC130]

Greg, were u 100 % for your DM 1 ? Were you claiming SMC and needed an increase in your other percentages to have the 60% needed plus the 100 % ?

[Greg88]

No I was at 100% for the DM Type 1, the VA had not contacted me at all for 15 years (except COLA increase letters) then in January of this year, I got a letter stating they wanted Reevaluate my case, C&P in Sept. which confirmed the original 100% (except now things have increased in severity and a few more complications have popped up all were noted on the C&P DBQ) I know from all the reading if the VA is not bothering you, just leave them alone and don't rock the boat. On Ebenefits it has me listed a Diabetes mellitus (New), 36 years of being SC and they still consider it a new problem.

[cham1968]

Greg88 Not sure about anything I hear from the VA. If it walks like a duck quacks like a duck then it could be a chicken is my take on most of the information I've received from them. With that said hopefully it all in your favor and they have not changed anything relating to your percentage. Good luck and God Bless

[ButchC130]

No I was at 100% for the DM Type 1, the VA had not contacted me at all for 15 years (except COLA increase letters)

There is a 10 yr time frame, which means if you have been receiving benefits for 10 yrs they can not take away or make it lower except in fraud. 9 I think that is how it works anyway)

[USMC5811]

There is a 10 yr time frame, which means if you have been receiving benefits for 10 yrs they can not take away or make it lower except in fraud. 9 I think that is how it works anyway)

Just so there is no confusion for those that are unsure....the following was taken from another thread - Carlie wrote this which explains things very well concerning the 10 and 20 year rule:

10/20 Year Service Connection/Ratings Protection

The 10 year mark for is for service connection. A condition that has been service connected for 10 years can not be severed unless fraud is involved. The clock starts ticking for conditions based on the effective date(s). This does not mean compensation can't be reduced.

The 20 year mark protects ratings. Absent fraud, disability ratings can not be reduced after they have been going 20 years. See your award letter for effective dates on each disability. Combined ratings are also protected after a 20 year period.

Example: You have been rated 50% for Condition A since 1990. You apply for SC for 4 more conditions and VA grants them in 2007. Because of VA granting them your new combined rating is 100% as of 2007. Condition A is protected from severance in the year 2000 and protected from reduction in the year 2010. The new service connected conditions would be protected from severance in 2017 and reduction in 2027. The clock started ticking on your combined 100% in the year 2007 so it would be protected from reduction in the year 2027.

If you apply for an increase for Condition A and are bumped from 50% to 70%, the 50% number is still protected from 1990 but the new 70% would start a new clock ticking (using the dates above). Meaning until you have held that 70% rating for 20 years, the lowest they can reduce you is back to 50% based on the fact that it was in effect for 20 years.

Even if a rater plugged the wrong numbers and wrongly awarded a combined 100%, they still can't reduce. Again, this is all assuming no fraud is involved. You can do the math by using the effective dates on your award letters.

"P&T" can be established at any time regardless of how long ratings have been held (via 100% scheduler or TDIU). If VA plugs all of your conditions and there are no future exams scheduled, then entitlement to Ch. 35 and ChampVA will be granted. If VA determines that there is a chance of improvement, there will be a future exam scheduled and "P&T" will not be established.

[Greg88]

Hi Everyone,

So far I have not received a bit of documentation from the VA or DAV, calling the 1-800 gets me a different story each time, I called 2 days and was told it could up to a year before any decision is made. DAV who is my POA has not returned a call or email in 4 months, so I think I'm going to make a visit to my Congressmen and let him deal with it. Looking at my case it's pretty cut and dry, Diabetes for 36 years (all insulin dependent) 40-60-100% progression all well documented by the VA, a new DBQ and letter from my private MD of 16 years stating this is P&T and is getting worse, then a C&P in Sept. showing the same things my private MD stated in his DBQ and letter. I figured with all the overwhelming evidence, they would be finished and done. But this is the VA where even the simple becomes complicated.

Greg