I'm Poking The Bear

[NavyWife]

I'm Poking the Bear

Hubby says I'm poking the bear by requesting an increase from VA. He is terrified that by requesting an increase the VA will take away his current rating. I explained to him that the evidence he presented has not changed and his situation has not changed and therefore they can't do that.

He had his appointment today with his private physician to fill out a DBQ. His rating decision was only three months ago so this DBQ will get uploaded into Ebenefits. It is New and Material Evidence and directly addresses the reason they did not give him a higher rating. The rater did have enough evidence to award a higher number 3 months ago, but in their judgment we didn't provide enough evidence, so here we are.

It's being submitted as an Increase -Reconsideration. I'm holding off on using an NOD as a last resort. I surely don't want to go into the appeals process if I can avoid it.

Any advice, thoughts or words of encouragement are appreciated!

Edited December 11, 2014 by NavyWife (see edit history)

[Mikemmlj]

If his rating decision was three months ago I can't imagine they would downgrade him with new evidence. But who knows....

[Berta]

"Hubby says I'm poking the bear by requesting an increase from VA. He is terrified that by requesting an increase the VA will take away his current rating."

That is what the VA wants us all to think.

A Reconsideration could certainly work but dont let them try to piss away that NOD deadline.

I actually thought the last reconsideration request I made would produce an award, but I was suffering from an illusion.

They did respond to everything I sent and responded to, making it appear as if they were actually working on the claim...but they weren't.

I filed the NOD within about a week of the deadline.

That claim was set for BVA transfer but the Nehmer Philadelphia RO awarded it...in three weeks.

The claim ( actually 2 claims) had sat at my RO in Buffalo from 2003 to 2011 at that point.

Others here have been far more successful with recon requests.

The claim and recon request I had was a CUE claim. The VA hates CUE claims.I dont blame them for stringing me along.

CUE is a collateral attack.I wanted to go to the BVA. But didnt have to, when Nehmer 2010 came along.

A disability claim recon request ,however, with a current DBQ , and from a Real doctor, is Definitely worth poking the bear!!!!!!

[john999]

I think a bearskin rug would look good on your floor. VA bearskin that is, heh, heh. Skin the bear before he skins you. If you went to DVA NSO he will beg you not to ask for an increase. I heard this for years. If you have the evidence then file the claim is what I think. I must have filed 7-8 claims since I got TDIU back in 2001. I won almost all because the evidence was there and I got IME to back me. I would not file a claim just for the hell of it.

John

[Notorious Kelly]

Most vets who are receiving their righteous amount of compensation didn't get there in one 'trip' to the VA, Navywife.

It came in increments over years/decades.

So- what you're doing is normal and accepted - and it's time we start makin the VA more afraid of Us.

You got this.

[john999]

There is a reason why they call him Notorious! What I got took over 35 years and I am still fighting. My shrink told me how they do it for MH conditions. Usually you get maybe 30%. Time goes by and you file for increase. Maybe you get 50% this time. Finally when you can't work any more you get 70%-100% and maybe TDIU or just scheduler 100%.

[broncovet]

This myth is perpetuated by many VSO's, some of which do it because they are lazy. You need to look at the VSO charter. They commit to "cooperate with VA" and, as asknod pointed out, many are compensated by the number of POA's the organiztion fills out.

The VA wants you to live in poverty and accept less.

There are many hoops the VA has to jump through to reduce you. There are rating protections at 5 years, 10 years, and the best is after you have been rated 20 years. 10 years protects "service connection" but not disability percentages, and 5 years or Permanent even offers some protections. That is, after 5 years they have to show your disability "actually improved under ordinary conditions of life" (you can look it up, but that means you are working, since "ordinary people" work, while "disabled" people do not. If you are permanent or over 5 years, your ratings have "stabilized", and the VA has to show sustained improvement vs "episodic" improvement. In other words any body can have a "good day", but did you get well or "actually improve".

Not filing for benefits you really deserve is not "poking the bear" instead its "poking the pooch" if you dont.

Just ask yourself this simple question: You and hubby know each other well. Does he deserve additional benefits? Does he have other conditions that are not service connected, (but should be) or is he 80% and not able to work (due to sc conditions)?

Honesty should prevail here...just tell the truth and you will be fine. Dont fake any doc reports, dont fake any illnesses, dont exaggerate symptoms. Do tell the doc how you feel on the worst day..something like this:

DOC How are you? On Tuesday, I was so sick I could not get out of bed, and my wife had to wait on me hand and foot. I have not worked since November of last year, and that is not good either (not that I could work considering I have PTSD and have xxx and yyy symptoms. (Notice..you tell him what happened Tuesday, or even last week or month...dont tell him you are fine today..tell him about when you were "not fine")

What not to do: Dont tell the doc you are "fine" if you are not. We have been taught not to give our complete medical history to someone who asks, but this does not apply to your VA doc. Do tell him your problems, just dont exaggerate em, and dont tell the doc you are "fine" if you arent.

Edited December 12, 2014 by broncovet (see edit history)

[john999]

We are taught not to complain which is the worst thing not to do if you use the VA. You must complain all the time about everything. The louder you complain the more money you get. The system is sick and hurts vets, but if you want the money you have to be Foghorn Leghorn when it comes to calling attention to your problems that might be SC.

It really is a system that is destructive to the moral center of us. If you get better you earn less. What kind of crap is that? When you get a rating that should be set in stone if you get better or not. If vets with 50% knew they rating could not be touched and they were actually helped to help themselves there might be fewer 100% vets. Who wants to be p&t at age 30? Nobody does but that is often what it takes just to survive.

John

[Pete53]

Don't poke him slap the crap out of him

[Philip Rogers]

I'm Poking the Bear

Hubby says I'm poking the bear by requesting an increase from VA. He is terrified that by requesting an increase the VA will take away his current rating. I explained to him that the evidence he presented has not changed and his situation has not changed and therefore they can't do that.

He had his appointment today with his private physician to fill out a DBQ. His rating decision was only three months ago so this DBQ will get uploaded into Ebenefits. It is New and Material Evidence and directly addresses the reason they did not give him a higher rating. The rater did have enough evidence to award a higher number 3 months ago, but in their judgment we didn't provide enough evidence, so here we are.

It's being submitted as an Increase -Reconsideration. I'm holding off on using an NOD as a last resort. I surely don't want to go into the appeals process if I can avoid it.

Any advice, thoughts or words of encouragement are appreciated!

Why request an increase? Why not file a NOD with their latest decision! An increase request causes a new claim date. Just sayin' . . .

pr

[rootbeer22]

NavyWife:

Although I'm fairly new and I'm very impressed at your posts and efforts, I'm seeing that there's a lot of risk in having one's claimed reviewed again by another set of eye's..such as in the case of your husband. Your husband us very lucky to have someone in his court like you. But, the problem is that you could get someone (a rater) that is not as favorable to what was already proivided to your husband? So, again, it's who gets his file to review and what I'm seeing nothing is easy in this process and being proactive is not always best...so as I've said before that it's the luck of the draw and you have a 50/50 chance of it going the wrong way.. I usually see the glass as half full but after my FDC claim was shifted 2.5 years longer to the right...anything is possible...any you take a big chance that it goes the wrong way....I'm much less optomistic than I was about the process a year ago...

Edited December 17, 2014 by rootbeer22 (see edit history)

[NavyWife]

PR--

I think in this case, because it is filed within a year of the last decision for the same contention, that it should go back to the date of the last decision--that's what a VSR told me. If not, then I have a backup plan for the effective date. I opened an informal claim on Ebenefits shortly after filing the 1st claim, to save the date, so at a minimum, it should go back to that date.

Honestly, I'm scared to go into appeals. I know they aren't even really working the appeals right now; they aren't even counted in the backlog & the focus is only on regular claims.

Plus it's so heartbreaking, when I read some BVA cases and the poor veteran waits 5 years in the appeal process and then gets denied anyway. He could have instead spent his time getting more and more medical evidence, piling it on until they can't say no anymore.

By the way, any update on your email to Bob?

Rootbeer22--

Sorry to hear this VA process is getting you down. It does that to all of us from time to time, so you aren't alone. You and I are at two of the slowest VAROs, so we have to have extra patience & perseverance! You are right, there is a lot of risk, but I feel like the risk is mitigated by adding additional positive medical evidence.

[Gastone]

Navywife: With recent award, I agree holding off on NOD is ok in your situation. With that said, I really don't think it matters that much. You mentioned that you were sending in what amounts to "New & Material Medical Evidence," Right? Any N&M Evidence received after a decision, all the way up to the BVA Evidence Cut off letter, automatically triggers a VARO Review of the decision by a SR Rater or DRO. Soooooooooo, even it you filed your NOD requesting a DRO Hearing (2-4 yr wait time) right now, any N&M Evidence triggers the VARO review. You'll either get the award your looking for or at the very least a Suplemental Stmt of Case if the Rating is continued. You'll know early on if your evidence is lacking. Don't take your eye off the NOD Deadline Date!! Go get'em.

I might have asked b-4, at 80% SC, has your husband given an IU claim any thought? Might be a hell of a lot faster than trying to get rating decision increase. At your current 80, you need a bump of 30% on a new condition to get to 86 rounded to 90% SC then a 50%'r to get to 95/100. Very difficult. Start researching IU if you haven't already done so.

Semper Fi

Gastone

[Dinnard]

I've been married almost 45 years and there are times I just have to do what is in his/our best interest. When I sent an email to Sec. McDonald it was without his knowledge because he thinks anything we do might "irritate" those working on his claim/appeal and they will just put it to the side and let it sit. He was a VSO until he had stop working so it was hard for me to disagree since he was "the expert" and his former boss is located in a Regional Office is his VSO. However, once I started researching I found there were things that could/should have been done differently and after 4 years of lots of tears and frustration I took a leap of faith. When the BVA attorney called him he told them he didn't know anything about an email but was sure if they called me I could provide all the information they needed. He took remarkably well and has admitted that I did good! Do what your heart tells you!

[Notorious Kelly]

Glad to hear it, Dinnard; it doesn't help anyone for vets to suffer in silence!

[Philip Rogers]

PR--

I think in this case, because it is filed within a year of the last decision for the same contention, that it should go back to the date of the last decision--that's what a VSR told me. If not, then I have a backup plan for the effective date. I opened an informal claim on Ebenefits shortly after filing the 1st claim, to save the date, so at a minimum, it should go back to that date.

Honestly, I'm scared to go into appeals. I know they aren't even really working the appeals right now; they aren't even counted in the backlog & the focus is only on regular claims.

Plus it's so heartbreaking, when I read some BVA cases and the poor veteran waits 5 years in the appeal process and then gets denied anyway. He could have instead spent his time getting more and more medical evidence, piling it on until they can't say no anymore.

By the way, any update on your email to Bob?

Rootbeer22--

Sorry to hear this VA process is getting you down. It does that to all of us from time to time, so you aren't alone. You and I are at two of the slowest VAROs, so we have to have extra patience & perseverance! You are right, there is a lot of risk, but I feel like the risk is mitigated by adding additional positive medical evidence.

NavyWife - no word yet - it's only been 3.5 wks - maybe he's waiting to give me a Christmas present?? lol

pr

[NavyWife]

Dinnard--

Thanks for the words of encouragement! And great job taking initiative on your husband's claim!

PR--

I suggest sending another email. Maybe it got lost in the shuffle. Most vets that email him get a response by seven days. I imagine yours is more complicated than others.

[Philip Rogers]

NavyWife - I sent a second email about 10 days ago. Time will tell. Thanks for asking, tho!

pr

[K9MAL]

NavyWife - The "poking the bear" is the same bullshit fear tactic that my DAV VSO laid on me in 2002. Following that advice did absolutely nothing but make me lose a decade of benefits after the VA denied me on the first go round. I reapplied for tinnitus and a messed up left knee this last go around in 2013 and both were approved utilizing the exact same information that was in my records from the previous attempt.

If you have solid information then don't be afraid to use it and ignore the naysayers. The VA and the bootlicking veterans who espouse being happy with the crumbs their master provides them should be drug out and shot. You have to be willing to fight and go the distance!

I know you're an intelligent woman and a fighter so stick with it!