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GuaymasJim    129

In June 2013 I was awarded SC Agent Orange IHD and PTSD claims with SMC (k) deferred.  About a week before the $ hit the bank and the award letter, I had received a telephone call from a gentleman who I believe was the rater telling me that my claim was about to be finalized and was there anything I wanted to add.  He told me what the %s and effective dates were going to be as well as the award of SMC (S) based on 100% + 60%.  I agreed with the %s but not the IHD effective date, but he and several hadit members convinced me that I was wrong. This young man was polite professional, and appeared willing to spend as much time as necessary to resolve any outstanding issues I might have.

Several months later, I received notice of a C&P exam for the deferred claim.  I made the appointment, but when the C&P examiner saw that I had filed a FTCA claim 7 years earlier, she conferred with the C&P administrator and the two of them decided that they would "get in trouble with the RO for conducting a C&P exam with a possible "conflict of interest" involved.  The day ended with denial of "temporary lodging" denied" and "travel pay" for 750 mile round trip denied because a C&P was not actually performed.  I was informed that another exam at a different location would be arranged and I would be notified.  Several weeks passed and I received a telephone call informing me that a new C&P was being arranged at a location that would require a 1300 mile round trip.  I informed the caller that an unreimbursed 1300 mile trip would impose a major financial hardship on me and my family; and asked if a closer location couldn't be arranged.  She informed me that she would check and get back to me.  I heard nothing for several months.  In June 2015, I received notice that the deferred claim had been denied because I had failed to appear for the 2nd C&P.  The denial was dated January 9, 2015 but not received until early June 2015.  Since all my VA calls are logged, recorded, transcribed and translated into Spanish, I was able to reach the "rater" immediately.  He could not explain the use of the ancient address used for the C&P notice nor the delay between the actual denial and receipt of the denial award letter.  However, he insisted on sending me a copy of 2nd C&P notice and the USPS "Return to sender" stamped envelope, which he did.  As you can tell, I was really impressed with this guy's attitude and professionalism.  It was real refreshing!

So now as it sits, everything but the 2nd C&P notice was sent to the correct address (hasn't changed in 15 years!) and the denial was based solely on failure to appear.

Well friends, what's my next step?  File a NOD and get in line in the rapidly expanding "Appeals" backlog; IRIS a complaint and ask for a reconsideration; call Sen. McCain's office, or just say "Screw it" and wait for the next life?  I was going to write to Allison, but that route is now gone with her resignation.

Very interested in any suggestions!

Semper Fi

Edited by GuaymasJim
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lotzaspotz    314

I think the following might help you.  This is copied from Alex Graham's blog under "Presumption of Regularity" (pertaining to mailing stuff).  


I would do several things.  

First, I would file an NOD.  Make sure you include a copy of the cancelled stamped envelope showing the wrong address, the stamp cancellation date vs. the date of the denial.  

Second, send an IRIS complaint, not an inquiry.  

Third, and I know some disagree here but it's helped us, get in touch with your local Congressional representatives and ask them to monitor the situation on your behalf.  Our Congressman helped us find out a few years ago that the VA withdrew a BVA appeal my husband had filed; he never withdrew it, turns out the VA attributed that to a clerical error.  They never checked to see if they had anything in writing from my husband, and the canned IRIS response we got said the appeal was decided and we'd be hearing from them shortly.  The fact was we were never going to hear from them until our Congressman got involved over what we incorrectly thought was merely an unreasonable delay.  THEN, they couldn't move fast enough to reinstate it.  

You may be able to keep this simple, but just in case not, you need the NOD to follow protocol.  NOD's are supposed to automatically trigger a review of the denial. 


Edited by lotzaspotz

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