Lincoln Ro Local Opinion <--- What Does This Mean?

[mekon1971]

My regional office is Waco, TX and file was transferred to Lincoln, NE and both were at "preparation for decision" then the Waco part changed to "Gathering of Evidence" then when I looked deeper it said "Lincoln RO Local Opinion" with a 2 month deadline. What is this?

[harleyman]

Your case was brokered out to Lincoln, NE to have them make a rating decision. Once someone decides the file is complete and they believe all the evidence was gathered correctly, they sent it to Lincoln to have the rating decision completed.

If there is even one missing item the file will be return to the Waco RO to have whatever work done that the file is missing. I am telling you this because, you posted many examinations here on the forum, and your file has many issues all of which require specific development before a decision can be made. There are instances when the doctors forget to actually add the opinion portion to an exam. If that happens everything stops and the file has to go back to gathering evidence, and that is Waco's job.

The RO's previously deferred issues that needed more development or were missing evidence for whatever reason. But the RO's are not allowed to defer decisions anymore. They have to rate on the evidence of record or do a "provisional rating decison", or gather the missing elements and rate the entire claim and all contension at once.

EBenefits, is hard to know because you have two RO's entering data into the system now, because your case was brokered. Please post again if and when the description changes in eBenefits. I don't know if your file was returned or if Lincoln has actually made a decision. If I had to guess I think your file may have been sent back to Waco for more development. Please post if the eBenefits changes again. Also, how old is your claim?

Edited September 7, 2013 by harleyman

[broncovet]

Harleyman

Interesting. You posted, "RO's are not allowed to defer decisions anymore". I did not know this, and thank you for that valuable information. Does this mean they are not allowed to defer issues within a decision either? Very often the RO would even state in the RO decision they decided xxx issue and "deferred yyy issues for more development". This is one way those decisions got sooo old, is they deferred them and then, sometimes at least, forgot about them. I think its part of this new plan to get all decision done over 2 years old.

The new initiative to get decisions done over 2 years old is particularly puzzling to me. Wasnt it already the policy to work claims "in the order received", so that would mean the older ones would already be worked first?

[harleyman]

Harleyman

Interesting. You posted, "RO's are not allowed to defer decisions anymore". I did not know this, and thank you for that valuable information. Does this mean they are not allowed to defer issues within a decision either? Very often the RO would even state in the RO decision they decided xxx issue and "deferred yyy issues for more development". This is one way those decisions got sooo old, is they deferred them and then, sometimes at least, forgot about them. I think its part of this new plan to get all decision done over 2 years old.

The new initiative to get decisions done over 2 years old is particularly puzzling to me. Wasnt it already the policy to work claims "in the order received", so

that would mean the older ones would already be worked first?

So the short answer is:

WE do not defer at all at out RO anymore, as it causes claim stats to look very old when in fact they may not be. And I suspect all RO's are on board with this, but I cannot be certain.

THE LONG answer is:

Yes, at the RO the Rating Decisions must be complete with NO deferred issues. That is part of the reason there are so many older claims, (called the backlog).When a claim is deferred the original claim "tracking end product" called an EP followed by a 3 digit number (indicating what type of claim) and the date the claim was received, is kept and the deferred is continued to be tracked by this original tracking EP. This EP keeps the original date of claim until all issues are determined/adjudicated. Thus, there are alot of things occuring at the same time.

So here is an example,

In June 1,2011 a veteran files a claim for:

hearing loss

tinnitus

lumbar injury

rash

diabetes mellitus

on January 1, 2012 , he gets granted for all except the diabetes so diabetes is deferred.

VA is busy trying to confirm Vietnam service or exposure, due to whatever...

The Veteran is tired of waiting and decides to file another claim; so....

he adds neck condition with headaches- which is added to the original date of claim on June 1, 2011, because it was not closed due to deferred condition of diabetes.

so the VA develops for the neck and headaches and sends him 5103 (VCAA) letter and orders exams, because the records show he had a brick fall on his head and caused a cervical spine injury, which also may have caused a TBI injury resulting in headaches and he has been treated regularly at the VA for these symptoms since service.

But in the meantime the Diabetes is ready to rate so they rate the diabetes on August 1, 2012, because the Veteran records show he was in Thailand as a miltary police and stood guard duty on the perimeter of the base in the year indicated by the JSRRC that the Veteran could have been exposed to AO. So this is rated.

We are now over a year and some months into the claim, due to the defered, and now the claim should have been completed, except we still have not receved the opinion examination from the VAMC for the TBI, but we can grant the cervical spine. So do we wait or defer. Oh, and by the way the Veteran's diabetes is worsening and he has filed a claim for PN and Vision problems due to his diabetes. So those conditions are added to the June 1, 2011 claim, even though this new claim was filed in NOvemebr of 2012. it is still part of the original claim never yet closed /completed.

So now we have new claim for increases and a defered for TBI--

So we rate the increases as they usually are quick, but somehow because the TBI deferred got buried in the file, they missed the decision and so it needs to go back to the rating board for a decision on the TBI that was lost but found.

Now the Veteran learns he can file a claim for his knee condition secondary to his lumbar spine and now we need an opinion exam, by the way we are still working on the original claim. DOES THIS SOUND LIKE WE NEVER WORKED THE FILE? We are now 1.5 to 2 years into an original claim. Most importanlty, multiply this by about 500 and you have a typical workload for a VSR/RVSR for workload tracking .Plus any new claims added daily, and some that are closed daily as well.

And we have multiple rating decisions and multiple new and increased claims all tracked under the original date of claim. (don't get confused between date of claim and EFFECTIVE date of a decision for service connection.)

Now we have Veterans reading Ebeneftis trying to figure where thier claim is in the system, but we have multiple claims working and any one of these issues can make the SUSPENSE tracking reason change. It really depends on what the claim is and when the claim was filed to figure out what is happening from a suspense reason is ebenefits.

So when you hear from those folks in congress and on the news casts saying we have all these pending claims two years old, do you really think the claim is two years old?

FYI- this is not an exception, this is the standard until the two year old initiative began and General Hickey said no more of this. We will rate and we will close out the EPs.

So when the Veteran files to re-open a claim he/she will have a new date of claim. There are problems in doing this, and I have tried to bring those to the attention of those here at Hadit. The biggest problem I see is VA examinations are not being ordered like before, and it is affecting decisions. (this is a whole other topic we can address ) but to ME, examinations are the key to a successful claim or not. SO... if not VA exams for the veteran, then the Veteran will need to pay for IMOs.

Edited September 7, 2013 by harleyman

[harleyman]

Harleyman

Interesting. You posted, "RO's are not allowed to defer decisions anymore". I did not know this, and thank you for that valuable information. Does this mean they are not allowed to defer issues within a decision either? When something is deferred it is deferred in a decision. Sometimes the Veteran is told why it is being deferred and sometimes the veteran is not told a reason, the Veteran is just told it is being deferred.

Very often the RO would even state in the RO decision they decided xxx issue and "deferred yyy issues for more development". This is one way those decisions got sooo old, is they deferred them and then, sometimes at least, forgot about them. I think its part of this new plan to get all decision done over 2 years old. The VA never forgets about a deferred, it's just misplaced,and would like to be forgotton about. It can get lost in the file or ignored but it is there somewhere. That is why it is important for every veteran to get a complete copy through the FOIA request of his/her claims file and REVIEW it yourself for errors.

The new initiative to get decisions done over 2 years old is particularly puzzling to me. Wasnt it already the policy to work claims "in the order received", so that would mean the older ones would already be worked first? All the two year old claims except about 200 have been completed. But remember as we speak there are claims every day rolling over and turning 2 years old. So these claim are HIGH priority as they turn over they are added back into the two year old claim status in the stats. So right now stopping a rollover claim from turning two years old and working the claims with dates of claim 12/1/2012 and older are the priority through September. Then new priorities start on the first of October. I forgot what they are going to be, but I will let you all know, when my memory kicks in.

OH I just remembered the new priority, starting October 1, 2013.

The RVSRs will be rating FDC claims as a priority, and the VSRs priority will be doing development on the claims received after 12/1/12, as the development has not been done completly enough to rate the cases.

Edited September 7, 2013 by harleyman