Reviewing Claims

[meghp0405]

Folks, I have to add this;

About 3-4 months ago, a veteran visited me and I put his claim together and we sent it to the VA. After completion, he had asked me how much % did I think he would obtain. I told him as I tell each veteran, I can not tell due to the VA's process and how they determine the service-connected disability. I did review my 38 CFR, chapter 3-4, and I told him that I would be suprised if he didn't receive 30, maybe 40 %. Do not hold me to that.

This veteran came in and seen me this past week. He was happy and he told me that the VA awarded him 70%. I'm thinking to myself, wow, I'm not normally that far off, but I did ask him to see his rating decision. He gave it to me and I reviewed his claim. I was flabergasted! I asked the vet when he had a hysterectomy? He looked at me puzzled and said never, he then asked me why I asked that. I told him that the VA awarded him 50% for having one.

I did a 21-4138, pointed out the mistake and submitted it with a 21-526ez.

Now, I have seen this before, and I really question the raters, the supervisor(s) that should of reviewed this before notification. They do a have a review phase, why not use it? These are the folks that are determining the outcome of these claims.

Need I say more???

[tanker2]

i am surprised he got a decision that fast period

[carlie]

Crap - he could have kept his yap shut about it -

held the rating for 20 years and then the rating

would have been protected from severance or reduction.

LOL - but true

[USMC5811]

Sorry that's just screwed up, but too funny - male veteran getting 50% for a hysterectomy. Must have had two files on his desk, pretty sad that it got through checks without it being caught. I thought there was a female vet who posted not to long ago on hadit.com that said they never rated her for her hysterectomy...maybe that's where her rating went?

[meghp0405]

tanker2, I did his initial claim and submitted it on a VA FM 21-526ez (fully developed claim). Thes claims are taking around 90 days from start to finish.

Just curious if this would of gone 20 years without raising flags. I guess it could have if he never ever filed another claim...

Edited January 20, 2013 by meghp0405

[71M10]

So riddle me this Batman! If He held the rating for at least 10 years, and they did a re-exam could they take the rating away from him? I doubt he would show improvement, I am pretty sure he would still be sans Female reproductive organs. At 10 years the service connection is protected. What could or would they do?? I guess it would be a 0% rating. The worst part about this is some Female veteran probably received a denial for complete hysterectomy because there are no medical records in Her file indicating she had a hysterectomy (they are in this other Dudes file!)

Best regards,

[boomer2]

If after ten years they did a reexamine and found that he was a male the VA would probably try and get him for fraud when it wasn't his fault at all.