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Proposal to reduce my benefits

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amirsun

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What is being reduced?  Did the VA have you attend a C&P examination before they proposed to reduce your rating?  How long have you held a rating for the condition the VA wants to reduce?  Do you have any evidence to contest the VA's grounds for reduction?  Do you have a VSO helping you with this hearing?  You've requested a hearing, so make sure you show up for it prepared.  If the hearing doesn't go your way, you'll need to file a formal Notice of Disagreement if you haven't already and then a Board Appeal as the next step.  Pay attention to deadlines.  Sorry, but the attachment doesn't answer these questions, so I'm asking for the information we'd need to assist you.

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please give us more background and upload the decision letter that would have come months ago that would have laid out the VA's case for reducing you.

I just went through this at the beginning of the year and can help you out, but we need all the information.

As far as that letter goes, you need to show up for that hearing.

What i am guess happened, is that you filed for an increase or you had a re-examination and after that they sent you a decision letter stating that they were proposing to reduce you benefits.

What you need to do now is (and will have better info once we get all the info from you) go out and get a IMO/IME from a specialist in your field, they need to make sure that they touch on the specific symptoms that the VA listed as "getting better" and thus put you in a lower ratings bracket.

You need to also get ALL you evidence together and make copies to bring to the hearing.

You also need to request a new C&P examination.

Thats the best i can do with the information i have.

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Also, if you are the same vet who asked a Voc Rehab question here, this hearing is more important that that issue and could impact on your Voc Rehab status.

Can you scan and attached here ( cover identifying info first) the Reasons and Basis part of their proposed reduction and the evidence list they used.

Do you have a rep or anyone who can go to the hearing with you?

It helps if you have your evidence clearly tabbed in manila folders, that you can refer to without fumbling around with them (or have some else hand them to you as needed.)

Do you have any additional evidence that needs to get into the record?

Have you gone over their Evidence list in the proposed reduction carefully, to determine if they have missed probative evidence they had?

 

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Have you gone over their Evidence list in the proposed reduction carefully, to determine if they have missed probative evidence they had?

 

That is important to always look at when you get a decision and a reason to keep good files of all your claims and what you sent and when.

example:

In your claim you sent in

  • Private doctors exam notes dated jan 1 2015 (2 pages)
  • private doctors exam notes dated jan 5 2015 (4 pages)
  • medication prescriptions for (X medication, Y medication and Z medication) - 1 page
  • Independent Medical Exam dated 2 February 2015 (15 pages)
  • VA exam notes dated 15 February 2015 (2 pages)

on your decision letter you see under their "evidence list"

  • Private doctors exam notes dated jan 1 2015 (2 pages)
  • private doctors exam notes dated jan 5 2015 (1 page)
  • medication prescriptions for (X medication, Y medication and Z medication) - 1 page
  • VA exam notes dated 15 February 2015 (2 pages)

You would see the problem and why they proposed to reduce perhaps since they only got 1 of 4 pages for the second private exam and did not consider the IME and its 15 pages.  You could then go back and part of your evidence in your hearing produce the certifeid mail and return receipt (proving you sent it in the time frame and a VA REP RECEIVED IT!!!) and say hey i sent it, you got it, it wasnt considered, here it is.

I have found looking back over past decisions that some evidence i sent was not considered.  at the time i did not do the certified mail w/return receipt so i couldnt have really challenged them.

Always send in evidence via this method WITH A EVIDENCE LIST OF YOUR OWN.

read the PDF i attached about submitting evidence, but in that i have this example of a evidence list

Page 1 of 31

JOE SMITH

VA FILE NUMBER: 123-456-7891

Date Submitted: 1/1/2015

Evidence List

 

 NOTE: You will see in the top left hand corner BATES NUMBERING (i.e. 000001, 000002, etc) to denote page number. A Total of 29 pages of evidence is to follow this cover page listing all evidence to be considered.

Contains names of individual evidence, how many pages per file and brief description of evidence contained.  I REQUEST THAT THIS LETTER AND ALL EVIDENCE SUBMITTED BE INCLUDED IN MY C FILE.

TOTAL INCLUDING THIS EVIDENCE LIST, PAGES OF EVIDENCE: (31 PAGES)

FOOT PAIN: (13 pages)

Dr. JIMMY BOB EXAM NOTES 2/5/2015 (3 pages)

Initial examination for Foot pain, indicates bilateral flat feet with plantar fasciitis present

Dr. JIMMY BOB EXAM NOTES 2/14/2015 (3 pages)

Follow up examination,  goes over treatment options as well as request for orthotic inserts.

X RAY (2 pages)

Copies of X rays of feet

SWORN DECLARATION-SELF (1 page)

Illustrates symptoms of disease, chronology of pain and how affects daily life

SWORN DECLARATION –SPOUSE (1 page)

Illustrates symptoms and pain noticed by spouse and how it affects personal and family life

Independent Medical Exam-DR JIMMY BOB (3 pages)

Exam conducted by DR JIMMY BOB DSR,PMS, ETC, illustrating chronology of symptoms and connection between current disability and inservice event.

 

As you can see if you make sure this evidence list is sent along with it the VA cannot deny that they did not know evidence was not considered as you LIST exactly what was sent and how many pages. so when you go to a hearing they will see for themselves that YES in my evidence i submitted that you received i listed all of the evidence to be considered and a failure to consider it all is not my fault but yours.

HADIT UPLOAD EVIDENCE HOW TO.pdf

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Need more information.

but from what I can understand you must have had a recent C&P EXAM or been seen at the VAMC  BY YOUR PCP or a specialized Dr??

or been hospitalized at the VAMC.

that the doc put in his/her report that your disability has shown improvement.

RO gets these reports and puts an urgency on it if they think they have reason to reduce a veterans benefits

that's about the only way RO would knew  unless your TDIU & went back to work and SSA reported your tax....>.VA checks this yearly.

 

if a Dr has reported your disability has shown improvement

you need to go get a IME/IMO and have  a specialized private Doc to address all the contentions of your disability  using the hadit format of  C&P exams to show no improvement.....make copies send them in and take copies of them with you to your Hearing.

Sometimes a DRO Hearing is a good thing you can walk out with a better rating  instead of a reduced rating, DRO's are there to help you solve this problem and should assist you in anyway he/she can

DO NOT MISS THAT HEARING!

 

jmo

 

............Buck

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SUPERB Advice USMC-VET

Do you mean this is a Kindle e-book on your profile?

Over the years I would  often send a small donation to vets orgs.I wanted to get the name/address stickers from them, to use on every page of my submissions, so I wouldnt have to keep typing or writing that out on each page.

I always used Yard sale colored stickers to mark the evidence but instead now I use professional Exhibit stickers.

I know you covered this but I also mark anything I send as page one of 10, 2 of 10 etc etc at the bottom of each page, in any cover letter I send and then I always list the exhibit list at bottom of the cover letter thus:

Exhibit # A    August 13,1988 ER Certificate 1 page

Exhibit #B   August 13, 1988 EKG                  1 page

Exhibit # C  September 5,6, 9, 10, 1988  1988 ,ER certs. 5 Pages

(that is basically the beginning list of evidence of my original 1995 FTCA and  1151 death claim.)

It doesn't matter how a claimant does this but Evidence is Everything.

As I well know, it does not matter how meticulous a claimant can be on submissions and carefully listed evidence, the VA can and will often overlook the most critical evidence you have.In 2003 the BVA was the only entity at VA who acknoweldged 4,000 bucks worth of my IMOs. and awarded.( had a double DRO review and still these IMOS were ignored but the VA.

These days however I use CUE under 38 CFR.4.6 if they violate this reg right off the bat,in order to erroneous deny any of my claims.

My recent April (2015)1151 HBP denial was reversed in mere weeks after I used the reg in CUE against them.

In my pending issue I want them to properly apply other regulations I cited as pertinent to that claim, and I was promised a claims expert at my RO would read and call me on Monday....so far no calls...

I asked him to even contact the General Counsel VA because they know what those regulations mean.Twice before the RC and GC at VA had to send them the same regulations I sent them,( in 2003 and in 2010) to get them to properly apply them to my claims.

Hopefully everyone here with a spouse has tried to give them a good handle on their claims and what the DIC process is like,and also how accrued benefits work, when they are no longer here.We have a new member, a widow, and unfortunately she did not give us any concrete info yet as to what she can expect from the VA.I gave her all the info I could but it was just guessing because we don't have the facts. I hope others here will help her, when she returns.ALL of us need to be up to speed on DIC.

(had to edit , I almost forgot.....I put my C file number on EVERYTHING I send , on every page too, unless it is a medical record or past decision on which it already appears.

 

 

 

Edited by Berta
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