Jump to content

Ask Your VA Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules 

  • tbirds-va-claims-struggle (1).png

  • 01-2024-stay-online-donate-banner.png

     

  • 0

FDC Claim & DBQ

Rate this question


triman8654

Question

Recommended Posts

  • 0
  • Moderator

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
Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

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

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

Link to comment
Share on other sites

  • 0

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

100% PTSD

100% Back

60% Bladder Issues

50% Migraines 
30% Crohn's Disease

30% R Shoulder

20% Radiculopathy, Left lower    10% Radiculopathy, Right lower 
10% L Knee  10% R Knee Surgery 2005&2007
10% Asthma
10% Tinnitus
10% Damage of Cranial Nerve II

10% Scars

SMC S

SMC K

OEF/OIF VET     100% VA P&T, Post 911 Caregiver, SSDI

 

 

Link to comment
Share on other sites

  • 0

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.

 

70% - PTSD

->50% - OSA (Secondary to PTSD)

30% - Bilateral Pes Planus w/Plantar Fasciitis

30% - Migraines

10% - Tinnitus

20% - Back

0% - bilateral shin splints

 

 

Link to comment
Share on other sites

  • 0

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
Link to comment
Share on other sites

  • 0

 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.

70% - PTSD

->50% - OSA (Secondary to PTSD)

30% - Bilateral Pes Planus w/Plantar Fasciitis

30% - Migraines

10% - Tinnitus

20% - Back

0% - bilateral shin splints

 

 

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • Lebro earned a badge
      First Post
    • stuart55 earned a badge
      Week One Done
    • stuart55 earned a badge
      One Month Later
    • Lebro earned a badge
      Conversation Starter
    • Sparklinger earned a badge
      First Post
  • Our picks

    • Caluza Triangle defines what is necessary for service connection
      Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

      This has to be MEDICALLY Documented in your records:

      Current Diagnosis.   (No diagnosis, no Service Connection.)

      In-Service Event or Aggravation.
      Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

      They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.  

      This is not true, 

      Proof:  

          About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because  when they cant work, they can not keep their home.  I was one of those Veterans who they denied for a bogus reason:  "Its been too long since military service".  This is bogus because its not one of the criteria for service connection, but simply made up by VA.  And, I was a homeless Vet, albeit a short time,  mostly due to the kindness of strangers and friends. 

          Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly.  The VA is broken. 

          A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals.  I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision.  All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did. 

          I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt".   Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day?  Va likes to blame the Veterans, not their system.   
    • Welcome to hadit!  

          There are certain rules about community care reimbursement, and I have no idea if you met them or not.  Try reading this:

      https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/

         However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.  

         When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait!  Is this money from disability compensation, or did you earn it working at a regular job?"  Not once.  Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.  

          However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.  

      That rumor is false but I do hear people tell Veterans that a lot.  There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.  

      Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.  

          Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:

      https://www.law.cornell.edu/cfr/text/38/3.344

       
    • Good question.   

          Maybe I can clear it up.  

          The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more.  (my paraphrase).  

      More here:

      Source:

      https://www.va.gov/disability/dependency-indemnity-compensation/

      NOTE:   TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY.  This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond.    If you were P and T for 10 full years, then the cause of death may not matter so much. 
×
×
  • Create New...

Important Information

Guidelines and Terms of Use