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So Lost Paperwork, Never Filed Appeal


benny215

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I filed my original claim myself and after getting my decision was advised to get representation. I took all my documentation and met with the VFW department service officer. I handed everything over to him, signed a power of attorney and other forms and was told he would submit everything.

Every few months I checked in with him and every time he told me I needed to have patience, and that I would hear something before he did.

I didn't hear anything, over a year went by and I told him I haven't received anything and the VA's counselor said I didn't have anything pending in the system.

He finally looked into it and told me he was missing a bunch of paperwork and accused me of never actually meeting with him, but after pointing out that the VFW was listed as my rep with the VA, he then accused me of not giving him all the paperwork he needed. He told me the deadline had lapsed and there wasn't anything I could do.

I've tried refiling my claim myself in a few different ways but get shut down by VA every time saying the decision is final.

Other service reps I've met with tell me flatly that I got screwed and without additional evidence there's not much that can be done.

I have serious issue with my digestive system (severe pain, bleeding) and PTSD from Fallujah. I don't have the money to keep paying for meds and doctor myself anymore and I don't know what to do. I've had multiple colonoscopies from VA but they haven't been able diagnose anything.

I haven't been able to keep a real job in over 5 years, been homeless on and off and I've run out of options. I'm desperate for any ideas anyone has.

I'd appreciate any advice anyone can give me. Thank you.

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  • HadIt.com Elder

"I've tried refiling my claim myself in a few different ways but get shut down by VA every time saying the decision is final".

Do you get PTSD treatment?

Can you scan and attach here their Reasons and Bases for the last denial? (Cover C file #, name and address prior to scanning it )

You mentioned being homeless...is it possible the VA sent you a VCAA letter and you didn't get it?

"I handed everything over to him, signed a power of attorney and other forms and was told he would submit everything."

Do you still have copies of 'everything' and a copy of the claim he said he filed.?

When VA says a decision is final, it could be based on a lack of evidence that the VCAA letter called for but the appeal deadline passed without response or NOD.

Your rep should have a copy of the VCAA letter if you didn't get it.

You need to re-open the claim with New and Material evidence...something VA has not seen before (or something they might have ignored when they made the last decision.)

Every claim is a story at first and then we have to expand on the story with proof and the VCAA letter tells us exactly what they still need.

Did you get the 30% without a vet rep? I did better long ago when I dumped my vet reps.

If we see the decision we can help more.

What is the 30% for?

There is by far more information and knowledge here at hadit then most vet reps have.

There are plenty of good reps out there but they are overwhelmed.

YOU are the best rep you will ever find.

The PTSD regs changed in 2010 (in our PTSD forum) but I still think most service in Fallujah would involve 'fear of hostile activity'.

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Benny215: Just because your claim denial decision became final, doesn't preclude you from filing a new claim. New evidence, in the form of VA DR DBQ, would be GOLD. You just can't go back against the original claim that was denied. I suggest you begin a "New" claim on your E-Ben site. This will establish your new filing date and you have up to 365 days to complete, but the "Claim File Date" is established. You can talk to a VA Credentialed Attorney about any legal recourse available, regarding your 1st claim.

You mentioned being unable to work and being homeless. I think you should consider (2) immediate courses of action. !. Apply via E-Ben for the "VA Vocational Rehabilitation Program," your eligible if it's been less than "?12 yrs" since your last SC compensation award. Check out the VA Voc Rehab Sect 38 program on-line for further info. Even if you can't work due to your SC conditions, A Voc Rehab "Denial" letter would prove your currently "Individually Unemployable." VERY IMPORTANT! If your denied Voc Rehab, your still eligible for the "VA Independent Living program," which has a pl urethra of services and benefits.

Even though your current 30% SC doesn't qualify you to file a claim for Schedular IU compensation, Your overall SC disability picture may qualify you for an"Extra-Schedular" SC IU claim.Talk to your VSO regarding this claim. It's not easy, I don't have any experience with it, but it's there. You may or may not be able to perfect this type of IU claim, remember, it would pay SC Comp at the 100% rate. I think it's definitely worth your time and effort. Keep me posted on your progress. Good Luck!

Semper Fi

Gastone

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Benny,

I believe your biggest mistake was just turning everything over to the VFW service officer and trusting him to do what is right. You have to stay involved with your claim, especially making sure everything is submitted and meeting all deadline requirements. As Berta said above, "you are the best rep you will ever find."

I would not be surprised if other veterans have had similar problems with the same VFW service officer that you trusted with your claim. I do not know if you have any recourse for having an incompetent or negligent VFW rep but you should. Even if you could prove negligence or incompetence by the VFW rep, I have a feeling the VA would tell you it was still your individual responsibility to make sure your claim with all relevant evidence was filed according to VA policies and all time deadlines related to your claim were met.

I agree with the above posts by Berta and Gastone, you need to re-open your denied claim with new and material evidence. Please respond to the questions Berta cited in her post because Berta and others may be able to offer more suggestions once they see your responses.

Good luck to you.

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I'm not sure if this is where this should be for starters. My 90 year old father submitted a claim back in 2012 for aid and attendance. He is service connected USN 100% disabled vet and has been since Feb. 1980. The VA doctor that filled out the paperwork included all his medical problems EXCEPT for the 2 that showed his service connected award in 1980. At that time my father did not understand what was really going on and let the appeal date go by. I have since submitted a new claim using a DAV rep. who was so very helpful. My father has Home Based Primary Care and no longer leaves the house. My questions are as follows: Why would the VA Dr. list everything but was necessary to get the approval? The DAV rep. said the Drs. at the VA know exactly what to include in order to get the approval and it looked to him that it couldn't have been anything but intentional. After the DAV rep. looked at my dads paperwork within 10 min. he saw the problem and opened another claim which he says there shouldn't be any reason he will get denied. Can we go back and appeal/dispute wrong doing by the VA Dr. so as to get retro from the date of the first claim? I quit my job and have been full time caregiver for my Dad for 3 1/2 years. Any input would be greatly appreciated.

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