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triman8654

FDC Claim & DBQ

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Requesting an increase on e-bennies, near the end it has the add button for a DBQ form. If I don't have a DBQ completed by a physician,  will the claim still be FDC

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Dont worry if its a FDC or not.  FDC means "Furiously Denied Claim".    VA says there is no risk to a FDC, that if further development is needed it will be converted to a "regular" claim.  

FDC's are a futile attempt to reduce the backlog, and favor "new" claims to older claimants which is the exact opposite of the way it is supposed to be, clearing out the older claims before the new ones.  Time after time we have seen 

"rushed" claims to mean "denied claims" sent to the appeal pile where it takes another 4 to 5 years to wait your turn on the BVA.  

IMHO, you should hope your claim is not decided before all the evidence is in.  Its unclear to me how the Veteran is supposed to know if all his evidence has been submitted..is the Veteran supposed to be a claims expert?

If Veterans have the expertise to know whether their claim is fully developed, then why does the VEteran simply not decide his own claim?  

Edited by broncovet

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File  intent to file claim first...then you have a year to add your evidence and send in a claim  ''21-526ez'' and also a statement in  support of claim.''21-4138, be sure to attach it to your claim and also at the end of your SSOC write a note ;;''Also if I am awarded my claim please rate it as my symptoms and disability warrant INin my  MEDICAL EVIDENCE to the highest percentage allowed by Law.

broncovet   your jumping the gun a little bit here  not all FDC are denied.

 

jmo

 

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

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I have uploaded some DBQs, but most of the time the VA will get the DBQs filled out by Doc at time of C&P exam. Good luck and keep us posted

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File  intent to file claim first...then you have a year to add your evidence and send in a claim  ''21-526ez'' and also a statement in  support of claim.''21-4138, be sure to attach it to your claim and also at the end of your SSOC write a note ;;''Also if I am awarded my claim please rate it as my symptoms and disability warrant INin my  MEDICAL EVIDENCE to the highest percentage allowed by Law.

broncovet   your jumping the gun a little bit here  not all FDC are denied.

 

jmo

 

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

if on ebenefits and you START to fill out an increase but dont submit it and just "save and exit" it will automatically generate an intent to file shortly after in the next few days, if after a week you dont see it, send in a FORM 21-0966 that is the paper copy of the "intent to file".  send certified/return receipt.  This saves your spot in line for retro.

Requesting an increase on e-bennies, near the end it has the add button for a DBQ form. If I don't have a DBQ completed by a physician,  will the claim still be FDC

FDC is not all that quick.  The fact is all the FDC does is say "I dont have anything else to send in for my claim".  IF and IF and IF the VA decides all of your evidence is sufficient to SC and rate it then you will not have a need for a DBQ and a C&P exam etc.  However unless you go and get a IME and DBQ from a private physician they will probably still order one.  depends.  If you have a plethora of evidence showing say you got your foot crushed in service and then years of private/va physician notes showing treatment, pain, etc you may not need one. depends on your claim evidence.

 

Example to illustrate the differences.

You had your foot run over by a 7 ton, that's in your SMR.  you were treated in the military.  It causes major pain issues, etc.

After you got out you went to see a private orthopedic surgeon, foot docs, etc.  You hav ebeen going to them for 2 years and now found out you can get compensated by the VA so you are starting your claim.

In your claim you write a statement talking about your pain and how you have been seeing DR. Jimbo John from Orthopedic's R' Us in your sheyboganville and he told you that your pain will not get better and you will eventually need a cane or walker full time to walk any distances. 

STANDARD CLAIM:  VA will contact you for a release form so they can contact Dr. JIMBO to obtain his records for you.  They have to make a "reasonable effort" to obtain these and any other records for you about this.  What "reasonable effort" means is vague, mostly from what i see is that means they ask you to sign a form and then they send that signed form to your doc.  If you dont get it to them in a timely manner or your doc doesnt then they dont consider that evidence. 

FDC CLAIM:  You reference DR. JIMBO but include no copies of the exams, because it is FDC THEY WILL NOT ATTEMPT AT ALL TO CONTACT THE DR.

This is the main difference and is "supposed" to make claims go quicker because raters, etc dont have to spend time tracking down docs and records.

 

Truth is you should be gathering and compiling and sending all your own evidence anyways, i even copy my VA records i want to MAKE SURE THEY SEE even though they CAN do this themselves and have access to your VA record. Do the leg work this is your claim.  file it FDC if you want, i havent seen much of a difference.  Especially when i file FDC and then they wait 3 months to then schedule me for a C&P that is another 6 weeks out....

 

Remember even if you file FDC you can still send in evidence later.  the FDC program isnt all its cracked up to be.

Also i would still go and get a DBQ/report from a private physician, will only help you more.

 

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Requesting an increase on e-bennies, near the end it hFas the add button for a DBQ form. If I don't have a DBQ completed by a physician,  will the claim still be FDC

 Triman, When you file an FDC, you are simply certifying that you have submitted all available evidence with your claim. This allows the VA to avoid certain time requirements in processing your claim. For example, the VA's duty to assist requires them to seek any medical records that you identify for them and after they request them from a doctor or hospital, they must wait a specific amount of time before moving forward. By telling the VA that you have collected all of your evidence yourself and that you have no further evidence to submit, you are waiving these required waiting periods. This allows them to process your claim much faster, but an FDC is not always your best course of action.

When the VA receives your FDC claim, they will still schedule a C&P exam for you, just like any other claim. This exam will result in a DBQ, so you don't need to send in one from a private doctor, but it's a good idea to have your own if you can. One real problem with FDC claims is that they put the VA rater under a lot of pressure to get your claim "completed" within 125 days. If they wait a month or two before scheduling your exam, and then the C&P provider is a little slow in returning  the results, the VA will get your exam results at the same time that this target deadline is looming.

Given the high number of C&P exams that are seriously flawed and need to be redone, this sets up a situation where the rater is often holding an exam that they know is "inadequate" to use in making a decision, but ordering a new one would negatively affect their own statistics on the completion time of FDC claims. This happens all the time! What do you suppose the rater does in scenario? They protect their own stats, by denying your claim and leaving it to you to jump into the 2+ year long DRO review or appeals line.

I always recommend that veterans should not file FDC claims unless they have supporting evidence from a private source, such as an IME or IMO from a private doctor.

Edited by bluevet

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 Triman, When you file an FDC, you are simply certifying that you have submitted all available evidence with your claim. This allows the VA to avoid certain time requirements in processing your claim. For example, the VA's duty to assist requires them to seek any medical records that you identify for them and after they request them from a doctor or hospital, they must wait a specific amount of time before moving forward. By telling the VA that you have collected all of your evidence yourself and that you have no further evidence to submit, you are waiving these required waiting periods. This allows them to process your claim much faster, but an FDC is not always your best course of action.

When the VA receives your FDC claim, they will still schedule a C&P exam for you, just like any other claim. This exam will result in a DBQ, so you don't need to send in one from a private doctor, but it's a good idea to have your own if you can. One real problem with FDC claims is that they put the VA rater under a lot of pressure to get your claim "completed" within 125 days. If they wait a month or two before scheduling your exam, and then the C&P provider is a little slow in returning  the results, the VA will get your exam results at the same time that this target deadline is looming.

Given the high number of C&P exams that are seriously flawed and need to be redone, this sets up a situation where the rater is often holding an exam that they know is "inadequate" to use in making a decision, but ordering a new one would negatively affect their own statistics on the completion time of FDC claims. This happens all the time! What do you suppose the rater does in scenario? They protect their own stats, by denying your claim and leaving it to you to jump into the 2+ year long DRO review or appeals line.

I always recommend that veterans should not file FDC claims unless they have supporting evidence from a private source, such as an IME or IMO from a private doctor.

I was not aware of the time requirements to gather evidence in a standard claim.  thanks!

I concur with the last sentence.

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