Had The Dro Conference, Nod Still Alive, Now What?

[MartyL16]

I am confused.

After many years of getting unsatisfactory ratings, I finally got a clear enough brain (still depressed but the light is on) to NOD my rating from 2011. I asked for DRO video conference and had that this past June. Made it formal and have a transcript.

The rating was June 2011, my NOD was timely and about 1 week before the clock ran out(2012).

My confusion is this: I read in M21 that the RO (of jurisdiction) should have given me a SOC. My understanding is that the DRO actually has "jurisdiction" now (he is NOT from my local RO) and the rating was actually "performed" at San Diego under Nehmer. I am almost 5 months after the DRO and 17 months past the NOD.

Shouldn't I be asking for a SOC regarding that rating the NOD and DRO refer to ? I can't be sure on my appeal content because the rating contained DENIED statements but no codes, or definitive reasons for denial.

I was left with ''Evidence shows ...." and "VAMC records showed no treatments for.....". Considering the facts that I use TRICARE, and CIGNA, and others, I was "dumbfounded and angry". Read below concerning those records.

The 2nd issue is the DRO office, is requesting the same documents(evidence), that they should have in their possession already, as they are the same medical records files, same clinics, same doctors, exact same years, actually "referenced" in this rating, incuding my USAF RECORDS,

I want them to inform me whether they still have the files ref'd above, or did they lose them, or what. Maybe they are still not paying attention, or just making me jump thru "hoops".

Even during the DRO conference, I fully explained where the correct "evidence" was in those records, for my claims, almost down to the months and years, doctors at that time, specific words and phrases used in those documents, medications prescribed, etc. San Diego referenced nothing and denied all.

Some of those medical records may have been destroyed because of their 10 year rule at various HMOs or HIPAA, or whatever. I don't use VA doctors for much.

Any ideas?

[JT24usn]

Any denied claim can be reopened based on "new" evidence. Whether it is truly "material" or bears weight or credence on the previous decision is at the raters discretion. Whether to order a new C&P or confirm and continue the previous denial. Jmho

[FormerMember]

​When you attempt to reopen a claim, you must first pass a two-step test. Is it (evidence) truly new as in never seen the light of day? As for material, does it have a bearing on the claim that, in and of itself, would illuminate the accumulated evidence more clearly and possibly, when combined with prior evidence, lead to a win? If you pass those two tests (and they are far easier than twenty years ago), then the claim is reopened and you move on to the credibility issues. ROs are reknown for refusing to reopen and many successes only occur at the BVA. They are then remanded back to the RO for adjudication and a few more trips on the hamster wheel. But this has nothing to do with DROs and SOC timeliness so it would be advisable to move it to the appeals area. Sorry guys.

Edited December 10, 2013 by asknod

[john999]

AskNod

Even if VA denies you most basic due process you are stuck with initial rating for staged rating if you don't file a NOD? The whole idea for CUE is that you now appeal a final rating. I got so much poor advice after initial rating I had no idea what to do. My original shrink thought the VA was toxic to me, and wrote in his opinion that continued in-patient treatment would result in institutionalization. The VA used my in-patient VA doctor's notes to decide my claim. Ignorance of the law is no excuse. How about just plain ignorance or psychosis? I do see some kind of staged rating in my future if somehow I win at CAVC.

John