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Fully Developed Claim

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OSC

Question

Fully Developed Claim

This is more of a rant than a question as the answer really is: that it will be done when it is done.

In September 2014, I submitted a simple single item Fully Developed Claim (FDC) for an increase of benefits immediately upon discharge (2 days) from my hospital care at the Las Vegas VAMC and VA approved follow-on treatment. This claim was for (1) Secondary Service Connection for a single new contention of my SC Diabetes and (2) Temporary 100% Total Disability for this hospital stay. All my paperwork, including admission and discharge dates, was submitted at once and all treatment was under the VA.

Now 4 months later, the VARO is finally looking at my claim. There was movement on eBenefits where my claim jumped from Under Review to Gathering of Evidence with notes that they will be sending a Development Letter and a request for additional evidence which is the reason for me being here today.

The additional evidence they want is and I quote:

  • In support of your claim for a temporary 100% evaluation, we need medical evidence showing you had surgery and/or received medical treatment for a service connected disability which required a convalescence period of at least one month, or hospitalization of at least 21 days.

So after a delay of 4 months where my claim sat with no movement, the VARO is now asking me to send in the same information they already have. The medical side of the VA was involved 100% of the way from the ER to my actual stay at the VA Hospital to the transfer to the VA approved outside care facility.

This makes absolutely no sense to me why this kind of a delay happens on a simple single item claim, in which all of their investigative work and research has been done, submitted and available at the Rater’s fingertips.

THEY have to approve the Service Connection first before I can submit this “additional evidence”; so two hours after seeing the notice on eBenefits, I resubmitted to them the admission and discharge documents along with a letter showing the dates equaling 31 days. I felt like singing the Arlo Guthry song Alice’s Restaurant by submitting “8 by 10 glossy photos along with circles and arrows”….

One additional thing the snail mail letter did say was that they would be scheduling me for a C&P exam which was expected.

The good news is that there is movement in my claim, but the length of time to get here is ridiculous when everything was done already

Of course I leave for the Philippines in 2 weeks, so the hoop jumping will probably start all over again but then again maybe changing VAROs might actually be good…who knows.

Thanks for listening.

OSC

60 Nephropathy w/Hypertension

60 PN Upper Left

40 PN Lower Left

40 PN Lower Right

30 IHD

20 DMII

20 PAD Lower Left

20 PAD Lower Right

10 PN Upper Right

10 Scar L/R Carotid

10 Scar Abdomen

0 Hypertension

0 Surg Rt Ring Finger

100% P&T plus SMC (K-1)

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Sorry to hear of your troubles bud, and we all certainly feel your pain. Good luck and keep us posted. God Bless and be safe on your coming journey

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OSC,

Just a suggestion. Send an e-mail to Robert.A.McDonald@va.gov or Allison.Hickey@va.gov and tell them what you told us in you post.

Based on positive posts I have read on this website, I think there is a fairly good chance you might get a reply before you leave for the Phillipines.

I wish you good luck and thank you for your service.

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I think one of the potential problems, Chief, is that eBenefits shows what the RO thinks it needs rather than what it actually holds. It's not supposed to work like that, but does due to internal procedure within the RO. Your best bet is to either invest a part of your day on hold with the 800# or send an IRIS email asking if the the RO has the records they requested.

I've had this problem in the past. I've provided the RO with a pile of documents, forms, records, etc. Then eBenefits shows up with a list of what they say they need that includes those exact same documents, forms, and records. It seems pretty common. This is one portion of eBenefits that no one can trust, right next to the "expected completion date" which is completely spurious.

There was a rater on here at one time that explained that within the RO's electronic systems, the rater creates a list of required documents. But because the rater can see within the file what is there and not there, it is very common to not check off those documents as present. It seems that this internal procedure is the root of the problem. If they would check off those documents on the checklist, eBenefits wouldn't display that they are required and missing.

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Thanks for listening and the responses.

georgiapapa...Yes, I have heard the same, so I did as you suggested in sending a copy of my posting to the Secretary and Under Secretary.

I'm not asking for anything special, but if this kind of stupidity is causing delays for me, then it is happening to most if not all the vets. When the RO keeps asking for information they have (this is not the first time this has happened to me) it not only creates this obvious delay in the claim process but also creates anxiety and sometimes a major financial impact with the vet.

This is one area that really needs fixing.

Sure am glad there are forums like this for both to rant and get some great information.

Thanks again

OSC

60 Nephropathy w/Hypertension

60 PN Upper Left

40 PN Lower Left

40 PN Lower Right

30 IHD

20 DMII

20 PAD Lower Left

20 PAD Lower Right

10 PN Upper Right

10 Scar L/R Carotid

10 Scar Abdomen

0 Hypertension

0 Surg Rt Ring Finger

100% P&T plus SMC (K-1)

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I understand your frustration OSC. Same thing happened to me where the RO kept asking for information and documents I had already sent to them certified mail return receipt requested. I actually hand delivered another set of the same documents to the RO and had them date stamp my file copies of the documents. We can only hope the new VA Secretary eventually addresses this problem and the many more being experienced by veterans.

Hang in there. Good luck on your claims and thank you for your service.

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