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Everything Got Denied!


ranger11bv

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ranger11bv,

According to the VA, they denied your claims because your SMRs did not contain evidence of the conditions you claimed and you also failed to report for a VA C & P exam.

If your SMRs contain evidence of your claimed medical conditions, you should fight the denial. If they did not, you will need some strong evidence showing your conditions were incurred in or caused by your military service. A strong IMO showing a nexus might work but it will have to be supported by reasonable medical rationale.

In regards to failing to show up for a scheduled C & P exam, if this is true, you made a big mistake. Always show up for C & P exams. If the VA scheduled an exam and you missed the exam because the VA failed to notify you, you should have let the VA know you were not notified so they could have rescheduled the exam.

If you have additional info you can post which can give Hadit members more insight into your claims, perhaps we would be in a better position to help you.

GP

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You can hit them up with a NOD, and let them know what circumstance existed that prevented you from going to their C&P examination, and request another date. Meanwhile, probably will be a good idea to go out and get a privately done Independent Medical Examination with an accompanying IMO to help trump any VA sponsored examination results.

Have a great weekend, and keep up the fight!

Mark

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Sorry to hear of your issues bud, but I have to agree with Georgia on this one. I just had to drive over a thousand miles in one week with my family to multiple C&Ps at 2 different VAs, which sucked. Good luck and I wish you the best.

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  • HadIt.com Elder

I can tell you that the real reason for the denials was for not showing up for the C&P exams. Are you a combat vet and have any combat medals, badges or ribbons? If you were the reasoning for the denial of PTSD is bogus. One thing is that once you file your NOD you can hire a lawyer to help you. The most important thing is to show up for the exams and if denied to file a NOD. You might be able to agree to come in and take the exams and ask the VA to take a second look.. However, you must file a NOD within one year of this decision regardless of what else happens. If there is one dot you don't agree with file the NOD and include every condition you claimed. The fact I did not file a NOD in 1973 probably cost me a could of hundred grand over the years. Also, you should go to the VA for treatment of all you claimed SC conditions. This will set you up for evidence for appeals and goes along with Chronicity and continuity of your disabilities.

John

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First I'm sorry to hear about your denials, but there is guidance in your denials.

They actually for most of the issues spelled out the reason for denials and how service connection could be warranted.

I would actually recommend you visit a VSO and let them examine your file.

Filing a NOD is fine; however you have to rebuke the very issues stated for denial.

Simply, first make sure you have a current medical diagnosis of everything you claimed (very important).

Next, see if the issue claimed or similar symptoms of what you are claiming is listed in your SMR's.

Last, if the first two are accomplished, complete the triangle with one of the following.

a. have the doctor provide treatment notes and a nexus (linking current condition to military condition/symptoms).

b. Chronicity (noted to be chronic on active duty and noted to be chronic since leaving service).

c. continuity by symptomology (complaints or issues are underdiagnosed while on active duty and the current medically diagnosed issue has now become chronic in nature. you have to link the issues, complaints, or diagnosis to the chronic diagnosis)

Its a little work , but it can be done.

Two of the issues Lumbar Spine condition and Cervical Spine condition were denied.

But active duty treatment was noted for the issues; however no permanent residual or chronic disability subject to service connection is shown by SMR or evidence following service.

I take this to mean you need a current medical diagnosis showing continuity of care (treatment notes) or you need a current medical diagnosis showing the issue has been become chronic in nature (if chronic in nature, doctor should include residual effects).

The issues are listed in your SMR's and all you need is to complete the triangle.

"NEVER GIVE UP"

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Excellent advice given by Fat.

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As i read these posts, Im going through my VA and military files. PAGE BY PAGE!!!! If I find ANYTHING, ill note the date and what it was for.

Edited by ranger11bv (see edit history)
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ranger11bv,

You not only need to look for a diagnosis of your claimed conditions but also any symptoms of your medical conditions in your SMRs. For example a veteran who was diagnosed with sleep apnea after beng discharged would still have a chance of winning a claim for service connected sleep apnea if their SMRs noted symptoms of sleep apnea such as snoring, gasping for air, stopped breathing briefly during sleep, daytime tiredness, etc. Your SMRs do not necessarily have to show a diagnosis for a specific medical condition for the condition to be service connected but the SMRs would need to show continuing complaints and/or treatment of the symptoms of the medical condition. JMO

The information listed by Fat in his post above is good information to guide you as to what is needed to succeed with your claims.

Good luck to you.

GP

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as others have stated, sorry to hear about your denials, but now is the time to become your own advocate. You will need to do the work. You can go to a VSO, but ultimately you are best to put in the effort for the success you are seeking.

Finding treatment or complaints in SMRs is key but not the only thing. Do you have any combat or war zone experience?

Merely hurting yourself in the serivce won't always get you service connection unless you have a current medical diagnosis, whether it is from te VA or a private doc. You may need to seek IMO's for most of the disabilities you are seeking as well. This is merely my own opinion. Doesnt mean I am right, jsut trying to help.

PTSD, you need proven stressors, if you werent in a war zone and even in a warzone you need them, at least I did, that they can verify (they won't just take your word on it).

What was your MOS in the service?

Length of military?

Branch?

Deployments overseas/warzone?

How long have you been out?

WHat treatment have you sought for your injuries prior to filing your claim?

This website is very helpful. You need to look up each of the conditions you claim, and what criteria is needed. I know this may seem discouraging, but just plug away and make sure you NOD in a timely manner. THis won't resolve itself overnight, but if you can provide the correct info, you may get what you are seeking.

I wish you good luck in your journey and if I can be of any assistance, I am here to help.

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as others have stated, sorry to hear about your denials, but now is the time to become your own advocate. You will need to do the work. You can go to a VSO, but ultimately you are best to put in the effort for the success you are seeking.

Finding treatment or complaints in SMRs is key but not the only thing. Do you have any combat or war zone experience?

A- Unfortunately.....no. I dont even get PTSD counseling at the VA!! I was in from 85'- 92.

Merely hurting yourself in the serivce won't always get you service connection unless you have a current medical diagnosis, whether it is from te VA or a private doc. You may need to seek IMO's for most of the disabilities you are seeking as well. This is merely my own opinion. Doesnt mean I am right, jsut trying to help.

PTSD, you need proven stressors, if you werent in a war zone and even in a warzone you need them, at least I did, that they can verify (they won't just take your word on it).

What was your MOS in the service?

A- 11B

Length of military?

A- 6 years 10 months

Branch?

A- Awmy

Deployments overseas/warzone?

A- Yes, Hawaii

How long have you been out?

A- Since 1992 23 years......

WHat treatment have you sought for your injuries prior to filing your claim?

A- All through the VA hospital.

This website is very helpful. You need to look up each of the conditions you claim, and what criteria is needed. I know this may seem discouraging, but just plug away and make sure you NOD in a timely manner. THis won't resolve itself overnight, but if you can provide the correct info, you may get what you are seeking.

I wish you good luck in your journey and if I can be of any assistance, I am here to help.

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thanks for the reply. You have the MOS for lots of physical injuries. I think the lack of wartime, clearly hurts you. I understand getting treatment when not service connected can be tiresome. The 23 years you have been out, have you continued to get treatment off and on? have you always complained about these ailments? if so, that will help, but ultimately you need to connect the dots to your service records. You more than likely since you were denied will have to do it via the IMO route, which can cost you some $$. They don't do it for free, unfortunately. I saw one of your previous responses you were going to go through you SMRs and take notes (make stickies) whatever, so you can reference it in a appeal. The IMO doc will review your SMRs, any VA progress & diagnosis notes and your denial claim. They will connect the dots for the VA and cite references within your medical history, potentially cite any potential cases or studies if they can relate it to service.

Do you currently have diagnosis for everything you claimed now from doctors? you need current diagnosis to go to the next steps preferrably from the VA.

Orthopedic

Pysch

audiology

and any other depts that fits the bill

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So far, this is what I got out of my SMR:

Chest pain/wheezing Bronchitis 8/20/91

hearing - 7 reports. The first one is in basic: 0's across the board. When i left; the left ear- 5,10,10,5,15,35 right ear- 10, 5, 10,10,10, 25 This is pretty much me: http://www.audiologyawareness.com/hearinfo_agshl.asp

several trips to the unit medic for joint pain

Several for migranes

Eyes got injured by PVS-7's

found out the one of my testes is smaller then the other........ :(

SINCE SERVICE..............

1st, 2nd metatarsals in both feet deformed Nov 7 92

shoulders, elbows pain Sep 17 98

CTS(carpel tunnel syndrome) Sep 2 98

iliotibial band syndrome Jan 25 95

Tripartite patella Feb 2 04

Rt ankle pain July 6 00

knee effusion Sept 9 03

RSD Aug 17 02

Gerd (Gastrointestinal reflux disease) July 19 02

Varus deformity april 26 07

Spur on left heal march 14 15

Atlantoaxial instability March 14 15

MOS 11b Airborne and Air Assault

Units:

1/75 Rangers

2/34 Inf "Layte Dragoons"

3/7 Inf "Cotton Bailers"

5/14 Inf "Golden Dragons"

So, what should I do and HOW!!!!!

Edited by ranger11bv (see edit history)
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Join the club...

Your not the only one who got denied, i did to0.. big brown envelope was a grim reminder of how the VA will fight Vets to there death. I really feel bad for those who have contentions that are ignored by a Medical opinion and that the conditions did happen and warrant service connection, i know no body forced us all to sign the enlistment papers but is was us all that held up the constitution that allowed the VA to stand and be there for US. All i can say is read and read and reachout to Vets and never ever quit, keep re tunning your claim!

My claim was denied recently and probably like you Ranger, i was shocked and annoyed, i have been at this since 2000. I will use one example of what we deal with .. One of my claims was for sleep apnea and they denied it, There is nothing in my records that stands out to me of any time of sleep disturbances or sleepiness. I was able to prove to the VA that i fell 9 feet to my face broke a tooth and fractured a tooth. I was denied this 3rd time for the tooth and apnea. The tooth is clearly in my records broken as a result of the fall, the xrays are in my file and it references the tooth number #9 it's awful that the VA uses the Number of the tooth in there denial of any records that indicate this injury was in service and when i mean awful, they know i fell, they acknowledged this and gave me 30% for headaches(after i fought with them on 2 denials) do to the concussion/fall/ trauma. But wow they mention the tooth# because they looked at my records and verified tooth#9 but they say sory denied it never happened.. what a joke.

I even went to a DRO hearing were the hearing officer said 1) Not sure about your sleep apnea as per your nose broken if this can be related or the triggering factor but the need to

check with Dr... blah bla bla.. the DRO also said well " you know we don't give money for teeth(compensation) but i can clearly get this service connected and you can get dental treatment.. ha ha ha.. well he denied it.. said it never happened.. wow.. also i have a DBQ from a chief neurologist from the VA who puts on the DBQ that he reviewed my medical records and states he found evidence that sleepiness occurred in service and can relate this to my sleep apnea.. the VA ignored this and used there Medical doctor's opinion that stated that even if a broken nose was found to have happened in the service and they say "which its possible"" hahahaha the VA does not compensate for broken nose because it can heal, and again if it did happen sleep apnea does not relate to this injury.. blah.. i have ENT DBQ that supports my sinusitus and rhinitus as a factor.. and it's ignored to..

Ranger you got to keep fighting and hopefully there will be light at the end of the tunnel..

God bless and good luck.. you and i both need that.

it took me from 1988 at 10 % until 2011 to get to 100% unemployable. i never stopped researching and fighting.

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Looks like the only issue that advanced any is SC for Right Hernia Repair

was granted, but since you did not attend the C&P it is only at zero %,

which is still at least SC'd.

Also, several issues read to be of reopening and nothing of record was

viewed as N&M evidence.

Not attending C&P exams and no continuity of care in the record, really

axed chances at any advancement.

§3.655 Failure to report for Department of Veterans Affairs examination.

(a) General. When entitlement or continued entitlement to a benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination, or reexamination, action shall be taken in accordance with paragraph (b) or © of this section as appropriate. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, death of an immediate family member, etc. For purposes of this section, the terms examination and reexamination include periods of hospital observation when required by VA.

(b) Original or reopened claim, or claim for increase. When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. When the examination was scheduled in conjunction with any other original claim, a reopened claim for a benefit which was previously disallowed, or a claim for increase, the claim shall be denied.

© Running award. (1) When a claimant fails to report for a reexamination and the issue is continuing entitlement, VA shall issue a pretermination notice advising the payee that payment for the disability or disabilities for which the reexamination was scheduled will be discontinued or, if a minimum evaluation is established in part 4 of this title or there is an evaluation protected under §3.951(b) of this part, reduced to the lower evaluation. Such notice shall also include the prospective date of discontinuance or reduction, the reason therefor and a statement of the claimant's procedural and appellate rights. The claimant shall be allowed 60 days to indicate his or her willingness to report for a reexamination or to present evidence that payment for the disability or disabilities for which the reexamination was scheduled should not be discontinued or reduced.

(2) If there is no response within 60 days, or if the evidence submitted does not establish continued entitlement, payment for such disability or disabilities shall be discontinued or reduced as of the date indicated in the pretermination notice or the date of last payment, whichever is later.

(3) If notice is received that the claimant is willing to report for a reexamination before payment has been discontinued or reduced, action to adjust payment shall be deferred. The reexamination shall be rescheduled and the claimant notified that failure to report for the rescheduled examination shall be cause for immediate discontinuance or reduction of payment. When a claimant fails to report for such rescheduled examination, payment shall be reduced or discontinued as of the date of last payment and shall not be further adjusted until a VA examination has been conducted and the report reviewed.

(4) If within 30 days of a pretermination notice issued under paragraph ©(1) of this section the claimant requests a hearing, action to adjust payment shall be deferred as set forth in §3.105(h)(1) of this part. If a hearing is requested more than 30 days after such pretermination notice but before the proposed date of discontinuance or reduction, a hearing shall be scheduled, but payment shall nevertheless be discontinued or reduced as of the date proposed in the pretermination notice or date of last payment, whichever is later, unless information is presented which warrants a different determination. When the claimant has also expressed willingness to report for an examination, however, the provisions of paragraph ©(3) of this section shall apply.

(Authority: 38 U.S.C. 501)

Cross References: Procedural due process and appellate rights: See §3.103. Examinations: See §3.326. Reexaminations: See §3.327. Resumption of rating when veteran subsequently reports for VA examination: See §3.330.

[55 FR 49521, Nov. 29, 1990; 58 FR 46865, Sept. 3, 1993]

I don't know if there is anything or enough in the record that the following

reg might help with.

3.326 Examinations.

For purposes of this section, the term examination includes periods of hospital observation when required by VA.

(a) Where there is a claim for disability compensation or pension but medical evidence accompanying the claim is not adequate for rating purposes, a Department of Veterans Affairs examination will be authorized. This paragraph applies to original and reopened claims as well as claims for increase submitted by a veteran, surviving spouse, parent, or child. Individuals for whom an examination has been scheduled are required to report for the examination.

(b) Provided that it is otherwise adequate for rating purposes, any hospital report, or any examination report, from any government or private institution may be accepted for rating a claim without further examination. However, monetary benefits to a former prisoner of war will not be denied unless the claimant has been offered a complete physical examination conducted at a Department of Veterans Affairs hospital or outpatient clinic.

© Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination.

(Authority: 38 U.S.C. 5107(a))

Cross Reference: Failure to report for VA examination. See §3.655.

[60 FR 52864, Oct. 11, 1995, as amended at 66 FR 45632, Aug. 29, 2001]

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I couldnt read the PTSD, Anxiety decision well. I did catch something that seemed to infer the stressors were not credible.

For PTSD claims, you MUST have a VA MH diagnosis and then provide evidence of the stressor(s)

I think you will need Buddy Statements for some of these conditions , and surely for the PTSD claim.

Buddy statements are easier to get these days on the internet than in the olden days....Every unit seems to have a web site, and many have reunion rosters, lookin' for areas, and there is Facebook and a few vets here found buddys simply by googling their names.

You might need buddy statements for not only the MH issues, but even for the sleep apnea issues.as many have had their inservice manfestations of SA bolstered by buddy statements.and even notations intheir 201 files., that they were sleepy on duty, late for duty, snored loudly in the bunk, etc etc.

.

Edited by Berta (see edit history)
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Just curious ranger11bv

what was the reason you missed your C&P??

I Believe you can request another one if you have good cause that you missed it.

nothing is impossible with the VA and nothing is impossible with us veterans so keep fighting.

you need medical evidence to back up your claim's & Dr's Opinions obviously!

so fire back at'em.

jmo

........................Buck!

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