Advice On Appeal

[helman35]

My claim yesterday went from Gathering Evidence to Preparation for Decision to Pending Decision Approval. I wake up this morning to have this. Now the Claim states back at Gathering Evidence stage.

Rated Disabilities

Disability

Rating

Decision

Related To

Effective Date

left ankle condition (claimed as left ankle injury)

Not Service Connected

respiratory condition (also claimed as acute respiratory distress condition)

Not Service Connected

residuals, traumatic brain injury (claimed as head injury and nausea)

Not Service Connected

rhinitis (claimed as respiratory condition)

10%

Service Connected

01/21/2015

Meniere's Syndrome (also claimed as vertigo, dizziness, and bilateral peripheral dysfunction)

Not Service Connected

migraine headaches

Not Service Connected

tinnitus

Deferred

right ankle condition (claimed as right ankle injury)

Not Service Connected

chronic sinusitis

0%

Service Connected

01/21/2015

seizure condition (claimed as seizures)

Not Service Connected

What is the best way to Appeal. Hire an Attorney or go through American Legions? I did not even get a C&P exam on Bilateral Peripheral Dysfunction, Tinnitus. I am really supprised they did not Service Connect since I have several injuries, and one that had me off my feel for 3 months in Germany. At the C&P exam the Nurse Practioner didnt do much of an exam and didnt do any measurments. Asked me if I had swelling versus looking.

I have googled VA Disability Attorneys but Mississippi doesnt offer alot. Any suggestions.

[broncovet]

Since it sounds like this is your first RO decision, I think its premature to hire an attorney at this point. Many/most Veterans have a DRO review, or hearing, and/or even go to the BVA representing themselves. The least expensive at this point is to simply file a NOD on all the disputed issues, AFTER you get the envelope.

You see, the VA has to give a "reasons and bases" for decision. You use those reasons, along with your cfile, to prepare your NOD. Relax, order your Cfile, and wait for the decision. Even if you do hire an attorney, he will want your cfile.

[rootbeer22]

helman35

Sorry to hear this and keep fighting....lots of good advice on this board to help you do a DRO and take other options. I've been looking at disability trends for 2015 and unfortunately it appears that many claims seem to be getting denied or deferd right now during the "big push" to get the backlog down? Sure, there are some success stories but it looks like we'll have enough trend evidence to figure it out....soon...keep the and get your C-file...then you can move forward. My experience is that it can take some time get your C-file based upon whom your RO is. Some are really good others can take the better part of a year to produce a C-File....good luck and good speed...

[Gastone]

Your NOD clock is ticking, but don't hit the attorney Panic button just yet, way too early. If I've got this right, you filed and were Denied back in 1996/97 and just recently decided to try another tact but for basically the same issues, right. Was there ever any supporting SMR's or DX's even remotely linking your claimed conditions as service related? Appears your going to have an uphill battle with your appeal. Have you spent much time researching your claimed conditions in regards to tying them into a VA Service connected Award? The VA has a Duty to Assist but you have to do all the heavy lifting.

Your reading Hadit and that's a real plus. Just remember, this is all free lay advice, do your own due diligence when making a decision. You might want to check out Chris Attig's VetLaw.com site. I wish I had connected with his advice back in 08, give it a look and it's free.

What to do now? It's going to take you some time to make your looser into a winner. The DRO Review 1yr+ is too quick, especially if you don't have New & Material Evidence in your hand right now. I think the DRO Personal Hearing would give you 2-41/2 yrs to prepare. VA rules and regs can change along the way and might actually help you. Keep in mind, any New & Material Evidence that you actually submit to your VARO during your wait for the DRO Hearing should automatically trigger a VARO full review of your denied claim by a Sr Rater or actual DRO giving deference to the original decision. You could get awarded or a continued Denial well before your actual DRO Hearing is scheduled to be heard.

Semper Fi

Gastone

[rootbeer22]

Gastone

As always, great advice...I've saved this post for me to use in case things don't initially go my way on my claim and I have to take a similar course of action as helman35. I'm in the "pending decision approval stage" and I found out yesterday that my key SMR evidence that I provided during my CP Exams last month was lost or misplaced by the 2 examiners that I saw? We confirmed yesterday that it was not scanned into the VBMS system, nor can anyone locate it at the CBOC Clinic? This is despite the fact that I made special marked binders and personally handed it to the examiners and they acknowledged it. This kind of thing really perplexes me when it seems like it would be very important to do the right things for vets and their claims...

[helman35]

First thank you all three for the advice. I really appreciated it and the words of wisdom from you.

Broncovet, with a DRO what are the percentages of claims and contentions being reversed? Will I have to wait for the tinnitus to be decided in order to request my C-File? I have requested my 1996 C-File and still have not received it.

Gastone, yes in 1996 the American Legion filled a claim for me for dizzy spells and respiratory issues. I had developed a Acute Respiratory disease in 1987 and was hospitalized for 4 days. They ruled on my 1996 Claim in 1997 and denied it. In 1999 the VA finally did a EEG test and it said I had a Bilateral Peripheral Dysfunction to the greatest degree. I filed a claim in January of 2015 for this. Its easy to find on Hospital and College Medical Web Sites that this BPD can be caused by a upper respiratory disease and a viral infection. Like a Cold, Flu and or pneumonia. They didn't even send me for a C&P exam for this. My ankles I had 3 or 4 bad Severe Sprains, one in Germany that had me off my feel for 3 months. That was denied. I did have a C&P exam but honestly the Private Dr didn't review my records and had her Nurse Practioneer do the exam. No measurement, had to ask me if I had swelling instead of looking.

I did noticed they did schedule me today for a Hearing test for the Tinnitus.

Will I receive the denials on the remainder of my claims or will they wait to get results from the Tinnitus?

Should I have had a C&P exam of the Bilateral Peripheral Dysfunction? During the C&P could the Dr had said it was unlikely or likely this occurred with the respiratory issue I had in 1987?

thank you

Helman35

[lotzaspotz]

There is no objective hearing test that exists for tinnitus. It's pretty much a case of your word for it and legitimate evidence of exposure to excessive noise as part of your job in the military. It can also be an outcome of medications prescribed. Do some research on tinnitus if you haven't already before you go to your exam.