Filing A Reconsideration

[hmcquade]

So I get the Service connection for my PAD but the VARO rules "non compensable". Well I won the service connection with a reconsideration of new medical evidence, so here we go again.

Hugh

[Navy04]

Remember that is a good thing, you can always go back and request an increase on a SC condition. I have 6 or 7 0%s, and down the road when those conditions get worse, atleast I wont have to fight the VA on SC. Congrats and good luck

[NavyWife]

Why did they say it was rated a 0? Did you have a DBQ filled out? If so, was it done by VA or private doc?

[hmcquade]

Why did they say it was rated a 0? Did you have a DBQ filled out? If so, was it done by VA or private doc?

The VA sated in the decision letter there was not enough medical evidence to show how severe/debilitating the PAD was. The VA also stated in the decision letter that the VARO would be contacted and I will be sent for a medical evaluation to see if I could be compensated. OK that was in July and no one has contacted me.... so far.

Hugh

[NavyWife]

So, a DBQ has never been filled out? either at a VA C&P appt or by your doc?

Are you saying your doc did the nexus statement but not the DBQ?

If so, then that is why there is a 0 rating. Have your doc fill out the DBQ for you

[Gastone]

HMC: What medical evidence, DBQ's IMO's Physical rehab medical reports or anything else do you have to indicate how you compare to the 38 CFR 4 ratings for your condition. I would think you need a DBQ from an Expert Specialist MD or DO maybe with a PHD thrown in to trump the opinion of the C&P's DBQ. Was the VA C&P Dr a specialist or just a primary care type Dr? Have you requested a copy of the C&P DBQ from the VAH that has your VA Medical records?

What is this talk about "Filing A Reconsideration?" How long did your last "Reconsideration request" take? I think the appeal clock continues to tick or were you actually already on appeal?

Semper Fi

Gastone

[Carl the Engineer]

Gastone,

Get on MyHealthyVet and get a premier (?) account access and then go the "Blue Button" route.

My last DBQ questionnaire is on there and the "back and forth" from the C&P doctor and the rater is on there too. They just started adding them to the blue button record.

Also, as US VET says, service connection is big, really big, even at 0%. Your in the door for that issue. I also have been initially rated at 0 and later it was increased. I asked for a increase, not a reconsideration.

I think a reconsideration would be for a denied claim. You are looking for an increase of your current rating. They should send you to a new C&P and you will get what that Doc finds out. Remember, you already are service connected.

Also, if you have other issues downstream (related) to the 0% issue, claim it as secondary to the first issue. I have a 20% secondary to a 10% condition. Which was a big surprise to me.

Good luck,

and I think you won more than you know already, just keep plugging along.

Hamslice

[Gastone]

HAM: Roger that. Once a Vet gets the initial Award/Denial letter, he/she has 2 options as far as I'm concerned, besides doing nothing and allowing the decision to become final after the 12 month APPEAL clock runs out. If he/she disagrees with any denied or award issue, a NOD must be filed before the Claim Decision becomes final.

The "Request for Reconsideration" has no effect on the Appeal Clock. Some say they've used "Reconsideration" with success. I guess if you have something the rater obviously didn't consider, your VSO Rep could ask the Rater to look at it. If done immediately after the Decision date and it works, your a winner. I advise the Vets I meet with, to have their NOD requesting DRO Review including a Personal Hearing, ready to file. Hope for the Best, Plan for the Worst.

Semper Fi

Gastone

[hmcquade]

So, a DBQ has never been filled out? either at a VA C&P appt or by your doc?

Are you saying your doc did the nexus statement but not the DBQ?

If so, then that is why there is a 0 rating. Have your doc fill out the DBQ for you

In all of my disability cases none for my DRS filled out a DBQ and I won on there medical evidence, IME/IMO.

This is the same, and I am miffed that the VA did the non compensable yet they SC based on my DRS IME, and my DRS did put in there IME/IMO the serenity of the PAD.

Edited October 2, 2014 by hmcquade (see edit history)

[hmcquade]

HAM: Roger that. Once a Vet gets the initial Award/Denial letter, he/she has 2 options as far as I'm concerned, besides doing nothing and allowing the decision to become final after the 12 month APPEAL clock runs out. If he/she disagrees with any denied or award issue, a NOD must be filed before the Claim Decision becomes final.

The "Request for Reconsideration" has no effect on the Appeal Clock. Some say they've used "Reconsideration" with success. I guess if you have something the rater obviously didn't consider, your VSO Rep could ask the Rater to look at it. If done immediately after the Decision date and it works, your a winner. I advise the Vets I meet with, to have their NOD requesting DRO Review including a Personal Hearing, ready to file. Hope for the Best, Plan for the Worst.

Semper Fi

Gastone

The turn around for the Reconsideration was a month, very fast, I very good medical evidence from my DRS

[hmcquade]

HMC: What medical evidence, DBQ's IMO's Physical rehab medical reports or anything else do you have to indicate how you compare to the 38 CFR 4 ratings for your condition. I would think you need a DBQ from an Expert Specialist MD or DO maybe with a PHD thrown in to trump the opinion of the C&P's DBQ. Was the VA C&P Dr a specialist or just a primary care type Dr? Have you requested a copy of the C&P DBQ from the VAH that has your VA Medical records?

What is this talk about "Filing A Reconsideration?" How long did your last "Reconsideration request" take? I think the appeal clock continues to tick or were you actually already on appeal?

Semper Fi

Gastone

The turn around for the Reconsideration was a month, very fast, I had very good medical evidence from my DRS. I have never had a DBQ filled out with any of the claims I won,( I have won all of them) all I had was very good IME/IMO from my DRS who had been treating me for years.

I was against the Reconsideration when the claim was first filed, but the DAV went ahead and did it anyway, my VSO believed I had very strong IMO/IME's and that I should win... I did win the SC but now I have to prove once again the severity of the PAD.

Hugh

[Gastone]

Hugh: I screwed the pooch on my 1st 2008 claim. Relied on an overworked VSO Rep, didn't really get involved and educated regarding VA Claims and appeals until the 9th month after denial letter arrived. I certainly wouldn't recommend the VSO Rep I used but all the blame is on me. Trust but Verify.

Regarding your "Reconsideration" success. The IMO's and IME's you referenced above, were they included as evidence in your original claim, or were they obtained and added after the denial. If they were already in your claim and the VA Rater for some inexplicable reason didn't take them into consideration, good catch on your part, guess that's what "Reconsideration" is all about. You still had plenty of time to get your NOD in. Yours is definitely a "Reconsideration" success story. If used the way you did it, a couple months can't really hurt, DRO Hearing are taking upwards of 30+ months. I must refer back to a recent young lady that posted she was worried if Filing her husbands NOD during the 11th month of his appeal window, would hurt her "Request for Reconsideration." I don't think she ever explained her "Reconsideration Request" as far as who suggested it and why.

Semper F

Gastone

[hmcquade]

Hugh: I screwed the pooch on my 1st 2008 claim. Relied on an overworked VSO Rep, didn't really get involved and educated regarding VA Claims and appeals until the 9th month after denial letter arrived. I certainly wouldn't recommend the VSO Rep I used but all the blame is on me. Trust but Verify.

Regarding your "Reconsideration" success. The IMO's and IME's you referenced above, were they included as evidence in your original claim, or were they obtained and added after the denial. If they were already in your claim and the VA Rater for some inexplicable reason didn't take them into consideration, good catch on your part, guess that's what "Reconsideration" is all about. You still had plenty of time to get your NOD in. Yours is definitely a "Reconsideration" success story. If used the way you did it, a couple months can't really hurt, DRO Hearing are taking upwards of 30+ months. I must refer back to a recent young lady that posted she was worried if Filing her husbands NOD during the 11th month of his appeal window, would hurt her "Request for Reconsideration." I don't think she ever explained her "Reconsideration Request" as far as who suggested it and why.

Semper F

Gastone

My DAVSO screwed up the 1st claim and NO I did not have the IME/IMO need to win. When I filed the NOD with a DRO I had plenty of Medical evidence. Unfortunately the VA did not have the evidence to give me compensation only the SC, now I have to file IME for a reconsideration with new IME/IMO to try and get the compensation.

Hugh

[Fat]

"NEVER GIVE UP"

[Gastone]

Hugh: Are you proceeding on the Comp and Reto as a "Reconsideration" or a new claim for Increase? Where are you at time wise, on your original Claim Denial?

Semper Fi

Gastone

[hmcquade]

Hugh: Are you proceeding on the Comp and Reto as a "Reconsideration" or a new claim for Increase? Where are you at time wise, on your original Claim Denial?

Semper Fi

Gastone

filing a reconsideration for the comp. with more medical evidence. I still have about 9 months to apply. I am just waiting for my DRS IME/IMO

Hugh

[Gastone]

Hugh: Did you say in your 10/2 8:31pm post that you have already filed a NOD requesting DRO Review. Brother, that could be a problem. My understanding of the DRO Review process is that his/her decision is your final bite at the apple on the VARO level. If you disagree with any of the DRO's decision's, your next appellant stop is at the BVA. That also changes basically what you have done claim wise. Correct me please, but it now appears to me that you filed your original claim for 1 or multiple issues and received a partial grant/denial determination from the rating department at your servicing VARO. Now it appears that at some point you filed a NOD requesting a DRO Review but without stipulating a request for a personal hearing. The main requirement of a VARO DRO Review with or without a hearing, is "NEW Evidence" that was not available for review by the original VARO Rating Specialist at the time of "Official Claim Decision." In essence, it appears to me that the Medical Evidence you refer to, was submitted after the original VA Claim Decision Date, right? If so, great but you didn't get a "Reconsideration." The DRO starts from the beginning of your claim file with no consideration given to the 1st VA Rating Specialist decision. If you hadn't supplied the "New Evidence" you probably wouldn't have received the SC by the DRO.

At my 06/27/14 DRO Informal Hearing, after being awarded everything I was really concerned about, I dropped (2) minor issues that I figured were losers anyway. 0% on SC Hearing impairment and an error on location of Neuropathy, VSO listed hands instead of feet. Filed new claim right away for PN feet.The DRO informed me that regarding these (2) issues I could proceed to the VBA if I disagreed with his decision. Hope I'm wrong Bro.

Semper Fi

Gastone

[hmcquade]

I already won my case for the PAD SC non-compensable. I am now filing for compensation by reopening the case with more medical evidence. I am asking once again for a reconsideration on the VA Decision as that worked to get the SC.

Thanks,

Hugh