hypertension Confused

[htforjc]

Hello everybody, I have asked for an increase on one of my disabilities that was rated a 0% in 2006. The VA received my claim for increase on 3/18/2013 with medical evidence. The original claim completion date was 1/13/2014 to 7/9/2014. I now have an updated claim completion date of 9/28/14 to 3/30/2015. The VA further states that they never received my 5103 waiver. I contacted the VA at the 1-800 number in July 2013, the day I received the notification about the 5103 waiver. They basically said it is just a form to see if I had anymore evidence to send in. I stated that I have already sent in everything. The lady at the VA 1-800 number stated to me that she could take my statement over the phone saying I have no further evidence to submit, and to go ahead and process my claim. This took place in July of 2013. Now, e-benefits is stating that they have never received a reply from me in regards to the 5103 waiver...which is posted below. I contacted the VA today at the 1-800 number and the person states that they have in the computer my statement from July 2013 stating I have no further evidence to submit and to process my claim. So, now e-benefits has backed up my claim completion date, and saying that my claim needs further review. I received a letter from the regional office (RO) today saying the average processing time is 9 months, and they apologize for the delay . I am now over 12 months and counting, with my claim showing gathering evidence. I don't see how the VA is going to meet their processing goal by 2015 with this kind of lackadaisical work ethic. Any ideas/thoughts in regards to all this. P.S. I am sort of new here and this is my first post.

Claim Received: 03/18/2013
Claim Type: Compensation
Estimated Claim Completion Date: 09/28/2014 to 03/30/2015

Contentions: hype

hypertension (New)

Claims Status Process

Change of Status: We determined that your claim needed additional review. If additional evidence is needed from you, you will receive a letter from us explaining what is needed.

Next Steps:

We will review all available evidence and make a decision on your claim upon receipt of all requested information as outlined in the headings, "What Do We Still Need from You?" and "What Have We Done?".

Several factors will determine the duration of the "Development" phase, including:

• type of claim filed
• number of disabilities you claim
• complexity of your disability(ies), and
• availability of evidence needed to decide your claim.

Additional Details

• Your Designated Power of Attorney

  AMERICAN LEGION

• Regional Office of Jurisdiction:

  Montgomery

• Send Documentation To

  Department of Veterans Affairs Regional Office
  Regional Office
  345 Perry Hill Road
  Montgomery, AL 36109

What Do We Still Need From Others?

This is a list of all items that have been requested from 3rd parties.

Items From Date Requested Due Date Follow-Up Dates 03/17/2014 05/16/2014

What We Have Never Received from You (solicited)

This is a list of items that have never been received from you and that have been closed.

Items Date Requested Date Closed 5103 Waiver Review 07/01/2013 03/17/2014

[TiredCoastie]

Really sorry this is happening to you. Certainly can't be helping your hypertension!

The basic options open to you are the same. The trick is to either get new results into the raters directly from you or trigger a new C&P exam to obtain new results which should result in a determination in your favor. Maybe there's a way to get the C&P examiner to find the original results, but if so, it's beyond me.

1. Get your doctor to fill out a DBQ along with your more recent medical records showing your BP as high and that you are on medication for your condition. Submit the DBQ either with a new claim or, better, with a Notice of Disagreement.

2. File a NOD with a full description of what happened as you described above and wait for the RO to trigger a new C&P.

3. Submit an IRIS inquiry and see if they'll fix the problem administratively or informally.

Unless you're absolutely confident that your diastolic pressure average will be above 100 at your next C&P, no matter when it's tested, I would recommend using what you can get out of your doctor. However, seeing as your care comes from the VA and VA doctors can be reluctant to fill out a DBQ, you may be limited to another C&P exam. Either way, when you file the NOD, be sure to obtain as much of your record history about your hypertension as possible and submit that as evidence that your BP is within compensatible limits and you are on medication.

A possible end-around option is option #3, especially if you can figure out a way to forward records to the RO. It may not hurt to try option #3 as a first step to see what happens. If you do not receive a satisfactory response, then file a NOD and begin the appeals process but be sure to do so along with your own submitted proof of where your hypertension stands.

By all means, do not rely on the VA to find your records or do the right thing by you without you driving your claim to the maximum extent possible. You don't drift your small boat or cutter into the channel trusting the wind and current...you drive it. Same principle applies here.

Hopefully something here will help.

[DustyAO105]

Got an award for PTSD at 100% they never mentioned the 60% for Lower insistence. I filed a NOD due to CUE .suppose to be retro for SMC-S and request a earlier date for PTSD because of CUE . Instead of a NOD or appeal I got a Change of status WE determined your case needs additional review. and the 2 dates when it should be completed . Gathering Evidence now . what does that mean gathering for or against me. ...?

Edited December 8, 2014 by DustyAO105

[Berta]

What does 'lower insistence' mean?

Do you mean they awarded 100% solely for the PTSD,

but you also had a prior established award for a separate disability at 60%?

If so, and they did not infer the mandate of SMC, they have committed a CUE.

I won a CUE on that basis and it is in our CUE forum.

1998 decision. Cue for no rating for IHD and no diagnostic code

wrong rating for CVA (stroke)

and wrong diagnostic codes

lack of application of SMC S Mandate as an inferred issue.

My husband had posthumous 100% SC P & T award for PTSD.

The CVA was finally rated properly in 2012 ,100% 1151

100% PTSD plus over 60% 1151 (as if SC) CVA equals SMC S

"what does that mean gathering for or against me. ...?"

Hard to say. My CUE ( 4 CUES)were filed in 2003 and one in 2004.

In 2011 they were set for BVA transfer.

Then Nehmer happened.

I was a Nehmer claimant and asked the Nehmer RO to adjudicate the opening cues becayse they were filed prior to the AO IOIHD death claim and because those cCUEs were contingent of the outcome of the AO IHD claim.

The VA had paid for malpractice on the IHD as well as th CVA my husband had but never properly gave the IHD any rating or percentage at all, at th Buffalo VARO.

In 3 weeks, the Nehmer RO awarded the AO IHD claim and also the 1151 SMC CUE claim.

It could be that VA discovered their error that you pointed out in the NOD (it is a Violation of the SMC regulations . I even sent them a copy of a printout from NVLSP on the mandate ,when SMC should be an inferred issue)as well as evidence from M21-1MR on the mandate)

and will fix it.

On the other hand they might try not to fix it.

I am quite sure that the regulations I used are here in our CUE forum.

I have a pending CUE on the Nehmer award as well, because it was legally incorrect for another reason.

[Navy04]

Congrats Dusty,

I currently have my 4th claim which is an FDC. 3 out of 4 of my claims has had Additional Reviews. Most of the time that is where the big wigs want to review a claim for accuracy. It can be a good or bad thing, just depends on the raters and the claim. Take what advice Berta gives as Gold, and just make sure you have all your ducks in a row. As many of us have learned thru the claims process, even when the VA is wrong, they will go the extra mile to discourage us. Good luck and God Bless

[DustyAO105]

I was 60% TDIU & PT for Anal fistula and was awarded 100% PTSD minus the un-employability but still Total and Permanent . I was being treated for PTSD since 1989 . I started with talk sessions then group and medication . Stressor was verified in 2003 . With the anal fistula I had one unsuccessful surgery while on active duty and another unsuccessful one after being discharge and the surgeries caused sphincter weakness as a result there is unknowingly uncontrollable discharge, and I get almost a case of disposable undergarments monthly. I try to avoid the actual description due to being embarrassed so I just say lower intestine . But may the Lord bless you all and I shouldn't be ashamed over what I had no control over and I know that you and everyone here is to help . Thanks ....... so I was advised to file a For a EED for PTSD because it's on record that the RO clearly influenced 2 C&P examiners both were for PTSD and for not being given a fair C&P Exam. and CUE for not being given SMC-S when I was awarded 100% for PTSD. I will keep you posted. sorry If I'm jumping around just trying not to forget important issues. Thanks Berta and Navy04

Edited February 7, 2015 by DustyAO105

[DustyAO105]

Can someone tell me in 2002 my stressor was verified for PTSD but claim was denied ,the RO negatively influenced the examiner decision by instructing the examiner to consider inconsistencies in my prior exam. I'm now 100% for PTSD but I'm appealing for a EED 2002 due to CUE . need some guidance my claim is with the DRO and I'm wondering was that the best way to go .