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By J McB
Ok, so I started requesting copies of my c-file in 2013 or 2014 after filing to re-open my 1993 claim in August 2013. My repeated requests went unanswered, and I ended up having to make a Congressional Inquiry through Senator's office to get a copy.... and now I request a copy every time the VA makes a decision (via Congressional inquiry).
Here's what I've figured out and what I'm not sure how to deal with, and a question about c-file contents.
1. I have, I think, 4 or 5 CD's of my c-file. I received the first Spring of 2015! 😡. The problem is that documents that were in the c-file CD that I received in 2015 aren't in the one I received in April (2019)... Documents that were in my c-file CD from last summer (2018) aren't in the one I received in April (2019)...
Anyone have an explanation for that?
2. Alternatively, I cannot figure out why Congressional Inquiries correspondence that was made while I was still active and the 4 years after aren't in my USAF/VA? 🤔...
Yes!, (and again to the dismay of the VA) I do have hard copies of that Congressional Inquiry correspondence...
Granted, as one of my previous "Question to the Elders" noted, I have had to find friends and my ex to write letters attesting to my filing a claim and seeing a VA doctor in 1993 because the VA has lost the files, so it doesn't surprise me that the VA sucks at filing documents in c-files. However, in the April 2019 copy I received, I noticed they seem to have "piecemealed" what letters/correspondence from the Senator's office, who is my intermediary for the VA, is copied into my c-file...
Anyone have an explanation/solution for that? Granted I have all the correspondence to/from the Senator's office and the VA, but it makes me wonder what they've sent to the BVA...
3. Is there an option for me to view what is on VBMS? I ask this question because the c-file I received summer 2017 included a "Rating Decision" page which I never received from the VA and at the bottom of the page I noticed a note that read, "VSR: Please see the deferred issue in VBMS as to the "appeal" noted on the VA Form 21-4138 (dated August 1, 2016) with attachments and tabbed in VBMS documents. Veteran notes the appeal regards "an earlier effective date as to the service connected conditions." The Veteran's "appeal" received on August 2, 2016, should be addressed by the Appeals team."
There was no appeal filed at that time. The Form 21-4138 they reference makes clear the documentation I was submitting was being submitted in support of my 2016 claim, which the VA closed. I have since requested the VA correct their error and attach the document to my NOD, and now to BVA appeal.
But this makes me wonder what other *&^% ups they've made that I can't see in VBMS? I went to the D.C. VARO office last week and the dude who is working at the front desk said I can't access/view VBMS...
No, I do not have a VSO... haven't had a good experience...they don't seem to have read 38CFR, know or keep up on case law, and only seem to know 'surface' information... (i.e. File such and such on this form).
Curious if anyone here has gone through the FOIA and had to ultimately sue the VA in Federal District Court to force them to provide their C-File in a more timely manner? FOIA's are required to be fulfilled in 20 business days by law assuming no special circumstances. Obviously the VA isn't going to respond to anything in 20 days but when it goes on for 6 months or longer that is ridiculous and slows our ability to address claim denials/issues quickly. I just filed a FOIA appeal and was sent a letter from the Office of General Counsel, Veterans Administration that my FOIA request was DENIED under FOIA Exemption 6 but remanded to be provided via the Privacy Act. The issue is that the Privacy Act process has no deadline so they can take as long as they want, while the FOIA actually has deadlines and a process for relief when they don't do what they are supposed to. From my understanding, this is a tact the VA uses to confuse people into thinking it is a Privacy Act request and not a FOIA request.
Any thoughts would be greatly appreciated.
Here is an odd question about the C-file.
Is EVERYTHING done by the VAMC supposed to end up in your C-file?
I do mean everything.
The reason I ask, is that in other posts here I have mentioned missing records from the VAMC New Orleans.
When I saw my new VA Primary Care Doc for the first time, she asked tons of questions, which was great.
In answer to one of them I mentioned that the VAMC New Orleans lost a bunch of my records and I was pissed about it.
She had her unit's Social Worker call me to offer assistance on the issue.
It turns out there is something called the Joint Legacy Viewer, which is an application that has insight into every medical record the VA has on you no matter what system it is in. Apparently there are several different systems your records could be in depending on location and year you were seen.
When I went yesterday for a follow up on my foot surgery, I went to the Social Workers office and in a couple minutes he pulled up a set of treatment notes about the VNG I had for my vertigo back in 2013 that VAMC New Orleans says is "lost".
Those notes are not in my c-file.
So I am curios if anyone knows if some files are not put in the c-file. These notes I found don't follow the typical format that VAMC uses and happens to list the Procedure Codes associated with each treatment or test done. For example for the Vertigo they list procedures 92540 through 92547 as being done and the results appended elsewhere.
i am going to make an appointment to spend a day searching those files, but I also want to get all of them so I need to figure out that path
Okay so my C-file arrived, and did so amazingly fast. Less than two months, not bad time.
Going through all the files and sorting them but one of the first things I need to get together is the claim on OSA.
I know the rules have changed about OSA ratings and now the med file must have a doctors saying specifically OSA is a medical condition
From the MR21-1MR
“When determining whether the 50-percent criteria are met, the key consideration is whether use of a qualifying breathing assistance device is required by the severity of the sleep apnea.”
“Use absent a medical determination that the device is necessary does not qualify. The regulation requires that the device be necessary and this is a medical question.”
So here is my situation.
On 07/07/2013 I had my initial PTSD C&P which noted serious sleep problems, chronic fatigue, hypersomulance but it did NOT mention the SLEEP STUDY diagnosis given on 4/13/13
At that time the simple issuance of a CPAP was considered sufficient to getting a 50% rating for OSA, but as the change listed above notes that is not the case now.
I have already filed a claim for OSA secondary to my PTSD. I did this before my Review C&P for PTSD exam, which resulted in getting bumped to 100% PTSD P&T.
With the change in MR21, I suspect they may disapprove the OSA claim.
If they do, would my path be to file a CUE because the record showed the apnea existed and a cpap was issued when they rated me for PTSD. The retro pay would be awesome!
That would seem to be an error on their part and under the old standard I would have gotten a 50% rating for OSA as well as my 70% for PTSD and 10% for Tinnitus. The 70+50+10 calculation is 87 which rounds up to 90 for pay purposes and getting that retro 20% difference for 60+ months would be a nice holiday or new years present to me 🙂
In the alternative, would I submit a NOD with the same information?
or would I have to get a DOC to say that the CPA was medically necessary and would that mean I needed another Sleep Study?
Thanks in advance. I am just trying to get things ready for whenever they make a determination on the existing claim.
Let me start by saying thank you in advance for any help or information provided.
The first time I filed was in May of 2012(I lived in El Paso, Tx at the time), it was for PTSD, bursitis in hips, carpal tunnel, and a slew of other joint problems, however life happened and I missed a C&P exam that I was unaware of and the claim was denied at the beginning of 2013. I understand that this is my fault, but I did learn that the VA found nothing in my army records to justify a claim for any of the physical problems.
The second time I filed was in Feb of 2015(I lived in Tacoma, Wa at the time), it was for PTSD. I had a C&P thru QTC at the beginning of APR 2015 and attended, however during the C&P the doc diagnosed me with major depression and anxiety rather than PTSD. Also during that C&P I was made aware that the dates for one of my deployments was incorrect and did not match the stressors I had listed and thus he did not recommend a service connection and I was denied at the end of APR 2015. It should also be noted that I received no diagnosis or treatment prior to during the claim process(I still had no idea how the VA worked and was under the impression that I needed to be service connected.) Of note on this claim I attempted to use a VSO thru DAV, however when I went to the office I was given booklet titled "Federal Benefits for Veterans Dependents and Survivors" and the representative highlighted the address of the vet center near me and the ebenefits website instructing me that I needed to file the claim there.
In JAN 2018 after a low point I finally went to the American Lake VA office to see what treatment was available to me. This is when I discovered I qualified for no copay visits and partial copay of medication. I went through the intake exam at the behavioral health clinic there and have been in individual counseling sessions almost weekly as well as attending a few of the group counseling programs offered. I have also been put on various medications to combat the anxiety, depression, and insomnia. Since starting the sessions I have been diagnosed with chronic severe PTSD, chronic severe MDD, chronic severe anxiety, and chronic severe insomnia.
My third and current claim I put in on 02/27/2018(I live on Joint Base Lewis-McChoord, WA). It is for PTSD, MDD, anxiety, insomnia, as well as an application for TDIU. I listed the MDD, anxiety, and insomnia as secondary to the PTSD. I included my DoD service records and my DoD payment records to show that the dates of the deployment on my DD214 were incorrect. I uploaded my medical records from the VA American Lake office just in case there was going to be any issues for them to obtain them, they were reviewed and accepted on 04/04/2018. I had the C&P in MAR 2018, while there the doc said he was recommending all issues be service connected. I filled out the 21-4192 Request for Employment Info on 04/25/2018 the best that I was able and added an attachment to it explaining that my last employment was over 8 years ago and the reasons why I haven't been employed. On 05/03/2018 I submitted a 5103 Claim Decision Request.
In FEB 2018 I requested my military medical records, when I received them the only document there was the medical exam from MEPS, the one you do prior to joining. However while in service I was treated for bursitis over a period of two years(physical therapy and medication) I had the occasional trip to sick call, and at one point had an in grown toenail removed.
I filed my current claim as a new claim, however they reopened my 2015 claim instead.
My ETS was in FEB 2007 after being extended 7 months due to deployment.
I spent my entire time in the military at Fort Hood, TX as part of the 4th Infantry Division(the division has since relocated to Fort Carson, CO)
Q. Is there a way to obtain the medical records that are missing from my file so that I am able to claim the bursitis and joint issues?
Q. I am planning to move from JBLM, WA to somewhere in Iowa(Wife's decision) at the end of AUG 2018. This will change my regional office. Will it effect my claim and what do I need to do to ensure my claim doesn't disappear?
Q. Will them reopening my older claim instead of accepting a new one have any effect, beneficial or not?
Q. Should I request my C-File now or wait until the claim is complete?
Q. Does contacting the 800 number or using IRIS to check claim status affect my claim in any way? (I'm curious where it's at because it has passed the estimated date, and the last date it seems anything was done is 04/04/2018 when they reviewed medical records.)
Thanks you again for any info or suggestions able to be given.
Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
Vync posted an answer to a question,I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:
2003 asthma denied because they said you didn't have 'chronic' asthma diagnosis
2018 Asthma/COPD granted 30% effective Feb 2015 based on FEV-1 of 60% and inhalational anti-inflamatory medication.
"...granted SC for your asthma with COPD w/dypsnea because your STRs show you were diagnosed with asthma during your military service in 1995.
First, check the date of your 2018 award letter. If it is WITHIN one year, file a notice of disagreement about the effective date.
If it is AFTER one year, that means your claim has became final. If you would like to try to get an earlier effective date, then CUE or new and material evidence are possible avenues.
I assume your 2003 denial was due to not finding "chronic" or continued symptoms noted per 38 CFR 3.303(b). In 2013, the Federal Circuit court (Walker v. Shinseki) changed they way they use the term "chronic" and requires the VA to use 3.303(a) for anything not listed under 3.307 and 3.309. You probably had a nexus and benefit of the doubt on your side when you won SC.
It might be possible for you to CUE the effective date back to 2003 or earlier. You'll need to familiarize yourself with the restrictions of CUE. It has to be based on the evidence in the record and laws in effect at the time the decision was made. Avoid trying to argue on how they weighed a decision, but instead focus on the evidence/laws to prove they were not followed or the evidence was never considered. It's an uphill fight. I would start by recommending you look carefully at your service treatment records and locate every instance where you reported breathing issues, asthma diagnosis, or respiratory treatment (albuterol, steroids, etc...). CUE is not easy and it helps to do your homework before you file.
Another option would be to file for an increased rating, but to do that you would need to meet the criteria for 60%. If you don't meet criteria for a 60% rating, just ensure you still meet the criteria for 30% (using daily inhaled steroid inhalers is adequate) because they are likely to deny your request for increase. You could attempt to request an earlier effective date that way.
Does this help?
Buck52 posted an answer to a question,Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.
The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.
Picked By66 bricks,