Ok, Need More Advice!

[hmcquade]

Today I get the decision on my reconsideration the DAV filed for the denial of my PAD secondary to my SC DMII. I get the SC w/o compensation. The VARO wants me to be reevaluated by the VA Docs to see if there is anything that can be rated for the PAD.

So they give me the SC based on my private Dr's IME/IMO and that does not warrant compensation?

Could use some suggestions/feedback.

Thanks,

Hugh

[TiredCoastie]

I only filed for the PAD, It was the DAV that gave me the wrong information to ask my DRs for, hence the claim was denied on lack of supporting medical evidence,, no nexus and the C&P Drs. report. the whole thing was a cluster F. I filed the original claim in Nov. 2013. I do not know what the heck I can do to prove I am having problems due to the PAD, My DRS wrote in their new IMO/IME that I had Caudation, trouble walking, pain, etc. weak distal pulse of both feet.

Hugh

So it seems as if the DAV was trying to dig out the hole in which they tried to bury you and was halfway successful. They screwed it all up in the first place, you sent them a NOD, and they decided to work a deal behind the scenes. At least in this case, the DAV did what we all expect our VSO to do...fix something to our benefit...and without a huge amount of time or effort on our parts. But your claim should have never needed heroics to save it.

I don't think I'd immediately run out with a DBQ form and try to collect up new medical evidence at this point like Asknod said. But it still seems pretty odd that they'd find a service connection without any kind of rating decision. You might want to review the appropriate DBQ form but especially 38 CFR part 4 for the actual rating criteria to see what, if anything, was missed by either your doctors or the VARO. If the VARO has all the information needed to make a rating decision based on what you submitted, then the big question is what to do next. You can wait for a C&P. You could also appeal the non-rating decision they made and demand that they make a rating decision based on what they hold now. My gut says either the VARO screwed up or didn't believe your medical evidence and want to see for themselves. If you appeal, you'll likely wind up with a C&P anyway. Maybe the best thing to do is wait for the C&P? But I wouldn't be too patient...and if it drags on too long you may still need to appeal before the 12 months are up on your original PAD claim decision.

Based on the notice of the claim date in your notification letter, it also seems as if the VARO is mindful of that date as the effective date...which is fine so long as they remember AND you agree. So it doesn't appear that there's a reason to appeal this portion at this time unless you think it needs fixing. The effective date of the rating you eventually receive will be the key piece.

If it were me, I'd be on the phone to the AL in the morning asking how fast this C&P is going to happen. There does seem to be a difference in expectation and definition of certain terms like "at once". If that's not been scheduled yet, and the letter was signed on July 11, 2014, then I'd be jumping up and down that your expectation of "at once" isn't being met and make 'em at least define terms. You can probably see if anything is scheduled through eBenefits' "exam schedule" page...there's an exam requested link on that page too which shows when the VARO asked the VAMC to do the C&P.

Lastly, was there a statement enclosed regarding whether or not you could appeal their decision? If there wasn't, that could be a problem for the VARO but I'm not smart enough to tell you how to leverage that. And...have you seen your C-file lately to ensure that missing doctor's statement actually got submitted and filed correctly?

Hang in there, Hugh. We're praying and pulling for you.

Edited July 21, 2014 by TiredCoastie