Blind Denial - Want to avoid flat-out appeal. What would be your course of action?

[K_C]

Hello all and thanks again in advance for the advice. I can engineer and troubleshoot complex enterprise and service provider networks, reclaim compromised systems, and develop robust web applications, but what I have not managed to do is understand and navigate the VA. It's like spaghetti in my mind that constantly gets stirred. The more I learn, the more confusing it gets.

So, most recent claim I got a C&P for one condition but not for the other two, which were denied. I call it a Blind Denial because the reason they gave for the decision was obvious I did not even look at your claim material.

Since the decision, I have acquired a favorable IME. There are a few things I know I can do, but I'm still not clear on the pros and cons of each, and that each offers its own benefits in certain situations. My primary goal is expediency and I am willing to sacrifice claim date, etc., to simply get a service connection and rating. I believe at least one of the denied claims is rock solid. As in, there's no way I can see a rational person could even approach denying it after having actually looked at it.

The options I think exist (please feel free to skip this part, I'm just showcasing my ignorance really):

1. NOD Appeal to BVA - Wait in line for years - Want to avoid as much as possible
2. Ask for local hearing? - I'm not actually clear on this, I've been told different things. Can I request a local hearing and actually get one in less than a year?
3. Reconsideration - I think this is where there has to be New and Material Evidence, no? I'm not even sure if there are speed advantages here
4. ??? - I've heard of other things here and there, some I think are just different names for the same thing. Hence my persistent state of confusion

If someone has time and knows all the options I have at this moment, I would greatly appreciate a plain [for dummies] list of those options and their pros and cons/pitfalls in this context (or a general context)? If you were me and your primary goal was speed over all else, in which order would you personally pursue each option? If not, something also helpful would be a knowledge article or other forum post that covers the general options available immediately after an original claim decision is rendered (I have as of yet been unable to pin one down).

Thank you in advance for your help. Best of luck to all on your claims. If your name was Mr. Lockheed Martin or Ms. General Dynamics, you'd have no issue squeezing millions out of the DoD in the name of patriotism. But us, well, on we fight! 

[K_C]

I started a diagram based on what I've learned from all of you and a little digging through the CFR. Is this in the right ballpark? I don't know how many others there are that overlook their options or don't understand what they can do, deadlines, etc., so if this can be corrected and refined it might be helpful to others and save everyone here from having to lay out the basic flow of things to others wandering souls such as myself. Thank you!

P.S. What is a "simultaneously contested claim"?

§20.501   Rule 501. Time limits for filing Notice of Disagreement, Substantive Appeal, and response to Supplemental Statement of the Case in simultaneously contested claims....

[EDIT: Re-uploaded with white background]

EDIT #2 - I'm particularly interested in missing options in this stage and any deadlines that I haven't noted.

Thank you in advance.

Edited September 19, 2015 by K_C

[bluevet]

Right....MFR is only regarding a decision from the BVA.

A request for reconsideration is what a claimant can file on a VARO decision.

New and Material evidence is required and the Request must be filed within the one year NOD time frame, and then, if not acted upon, the NOD must be filed in timely fashion.....within one year after the decision.

Berta, can a veteran file a request for reconsideration if he/she has already submitted a NOD and is pending DRO review? Would doing so have a chance of getting a faster result? 

[broncovet]

I like the flow chart!

I would make some changes, however.  Looking for CUE is not first, you only normally file CUE after everything else fails (since CUE is harder to prove than a regular appeal)   

Exception:  Berta has had good luck with asking VA to cue themselves.  

Simultaneously contested claims normally means when heirs are arguing over who should get the money.  YOu know..brother A thinks its his, and brother B says its his.  

 

 

[K_C]

Thanks broncovet. I am looking to make it accurate and all inclusive of the options.

The order you see options isn't necessarily the order of preference, it's in order of most available options to least. That's why I have [OPTION] next to everything, so that it's clear this is just an option you have, but could continue further whether or not it's an option. I could draw an arrow from the termination point back to the next decision to make it clearer.

IIRC, CUE was the only way you could appeal a claim older than a year, which is why I put it above the "older than 1 year?" decision.

N&ME is next because it allows for you to choose whether you want to execute that option (N&ME) or you can choose any of those further down the chart.

Then it's asking for a hearing (I'm actually not even clear on the pros/cons of this or if it's even an option outside of a NOD. The CFR made it sound like it might be?)

Finally, at the bottom of the chart you're out of options, upward appeal is all that's left. That is, of course, if I'm not missing any other options which I probably am.

Is the "order of available options" accurate? If so, would it still make sense to order it differently? What if an emphasized bullet point on the "CONS" list identified "Very difficult to prove" or something of that nature? Would that make it more obvious to us considering our options?

[K_C]

Updated with changes previously mentioned.

[Berta]

Bluevet asked:

"Berta, can a veteran file a request for reconsideration if he/she has already submitted a NOD and is pending DRO review? Would doing so have a chance of getting a faster result? "

I would think the DRO review would address anything that a formal request for reconsideration would involve......and I dont recommend filing a recon request after a formal NID has been filed...........

meaning the NOD has already raised argument and evidence for the issue, (I hope)  or subsequent argument and evidence could be considered by the DRO. ....maybe....

A DRO hearing is often better then a review.Many here have gotten DRO reviews that were just copy and paste jobs of the decision.