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Claims At Rating Board


RockyA1911

Question

Is there a timeline or a threshold maximum time that a claim can sit at a rating board? I mean when a claim is labeled ready to rate and sent to the rating board, should it not be decided within 6 months, a year, two years. How long can the claim just sit there? I've seen other veteran's claims be decided in a year including from date of claim, C&Ps, etc.

Can the VA just leave your claim pending at the rating board forever and then just forget about you. Reason I say this is the veteran cannot obtain any further status once this happens and is just told to wait on the decision letter which should be soon. This has been going on for me for going on 21 months now and the claim has been at the rating board (farmed out to another RO) for going on 6 months.

How can one find out if it is being worked on or will just gather dust from here on out?

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You have 3 good avenues to take and both flow the same direction. First an IRIS inquiry. Ask a direct question as to the exact status of the claim and where is it.

Second is the dreaded Veterans Service Officer: This person should find out for you. These people are supposed to assist Veterans by doing these kinds of actvities.

The third option is:

You can also go to the regional office to speak with a counsler.

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jstacy,

I've used all three of those avenues over the past 21 months. The IRIS from the VSCM just states the claim is at the rating board and they are sorry they cannot provide any further information. I have done the IRIS thing recently and about every month since I have filed my claim. They used to say I would receive a decision in 45-60 days but now they cannot even estimate a date of when I will get the decision. Just soon.

Well soon so far is 21 months and counting.

The 800# says the same thing, claim went to rating board in Cleveland 28 June 06. And also they apologize that they have no further information.

The VSO only contacts the same folks and he tells me he has good news..........and that is my claim went to the rating board on 28 June 06.......Gee, he was the last one to tell me that as I had known that for 5 months now.

I have hit a brick wall and all three of your recommendations I have used just to end up back at square one, and that is no one knows or can tell me what is happening with my claim and why I have not received a decision.

What if this continues for years? There has to be some sort of method to break a bottleneck like that. If not the VA is allowed to just put the claim on a shelf under the guise of "at the rating board". What can someone do? There has to be some kind of limit as to how long the claim can stay there without a decision at all.

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Rocky believe me brother I feel your pain also. my claims too have been at VARO since March 2005 had C&Ps and everytime time I call 800# I get a different answer. I don't think they even try to find the info i think they just hold on and wait bout 45 seconds and come back and say what they want. You can't get your Congressman or Senator involved because they only slow it down more and they do absolutely nothing at all. I think you should be able to log on to VA site with an ID# and check on your claims and do away with 800 claims reps.

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Guest jangrin

I don't know the answer to this but,

Would it make any difference if the question was submitted in writing via certified mail. Sent to the SO and the RO asking the status of the claim?

Seems like computer IRIS ans telephone are ignored, but certified letters under the FOIA might do something.

What do you all think?

Jangrin

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Jangrin,

The answer to that is - my claim is not being rated by my jurisdiction VARO. They sent it to Cleveland RO for rating. If I contact Cleveland, they just refer me to the Chicago RO. Who in turn states my claim is located in Cleveland and they have no further information other than it is at the rating board. I cannot find out if it is being worked on or if it is just gathering dust. I asked the Chicago RO to contact Cleveland and find out what the deal is via IRIS and the service manager stated the same ole same ole. "Your claim is at the rating board at one of our service centers and you should receive a decision soon." I have five of those replies. No matter what I ask, that is always the answer.

I'm just trying to find out if there is some kind of statute or time limit that triggers a claim to be looked at once at the rating board for a long period of time without adjudication.

The way this is set up now it could go on like this infinitely unless there is some process in their system that triggers or red flags stragglers.

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Guest jangrin

Rocky and Kenny,

We were told that my husband claim would be going to the rating board following his C&P exam. We called a couple of weeks following the C&P and sure enough when we called they said the claim had been sent to the rating board. We asked how long it would be there and they said it sould be there about 90 days. That's three months. If your claims have been at the rating board for more than 6 months I would think that either something is wrong, like they are waiting for something for your file, or information to come in or that it was shelved and noone has followed up on it or something.

I think something is diffinately wrong with 21 months wait. I would send a certified letter to the SO and your POA and also the RO and I would cc a copy to your local congressmans office. I would ask about the file and what was happening. And I would do this under the rules of the FOIA.

I would do this every week and send a cc copy to my congressman every week until I heard from the RO on my claim. Eventually they will respond or there will be a heck of a mailing record of them ignoring your request that your local congressman can track.

Maybe this might get someone to give some attention to your claim.To me it sounds like your claim has been sitting on a shelf somewhere and everyone thinks someone else is working on it. At least this is a way, to start to make some noise.

Jangrin B)

Edited by jangrin (see edit history)
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We called a couple of weeks following the C&P and sure enough when we called they said the claim had been sent to the rating board. We asked how long it would be there and they said it sould be there about 90 days. That's three months. If your claims have been at the rating board for more than 6 months I would think that either something is wrong, like they are waiting for something for your file, or information to come in or that it was shelved and noone has followed up on it or something.

I and others have been told these same things. Let us know what happens in 90 days, o.k. Let's see the first time my claim was at the rating board with a decision in 90 days was 18 months ago around Sep 05. Then again in Feb 06 and again in April 06. Then had three more C&P exams in May 06. Was told everything is complete and nothing else is needed and off to the rating board in June of 06. That is where it has been ever since and it's a lot more than 90 days from June thru November.

There is nothing difficult or complicated in my claims, all C&Ps were highly favorable especially since I was already service connected for the TBI but they failed to make a decision back in 1976 or just plain missed it altogether that I had also claimed skull loss. The VA has had all this info ever since 1976 and was in my C-file as they sent me copies of it. Yeah I am claiming retro for 30 years back to 26 Nov 1976 and I have sent them their own 1976 files of my claim, C&P evaluations, ,medical and surgery reports from the Dept of the Navy, and their own VA Neurologist explicitly measured and stated the size of the skull loss greater than a 50-cent piece (all in 1976). So it is an open claim and the VA's own documents are proof of it.

These claims I filed back in Mar 05:

PTSD - C&P highly favorable (More likely than not) and IMO Psychiatrist (More likely than not)

Tinnitus - C&P highly favorable (More likely than not)

Cognitive Disorder - C&P highly favorable (More likely than not) attributed to SC head injury

Skull Loss - C&P highly favorable (More likely than not) plus three Navy Medical Boards

Scar - C&P highly favorable attributed to SC head injury

Encephalopathy - C&P highly favorable attributed to SC head injury

Barrett's Esophagus - No C&P, furnished IMO from private gastroenterologist

TDIU - Haven't heard a thing.

In addition the VA Neuropsychologist and IMO psychiatrist both stated I was unemployable both from TBI and PTSD. I spent 3 full days with the N.P. back in Dec 05 through Jan 06 before she wrote the C&P.

I even have a copy of the VA's Development checklist that has all these conditions except unemployability form I submitted. It also has all the blocks checked that records, medals, etc verified.

I am currently receiving 10% for TBI post concussion residuals effective 26 Nov 1976, the day I was discharged from the Marine Corps. The skull loss was on the same claim and I have their stamp on it too along with all the VA exams and everyone mentions the skull loss from the TBI surgery and crainioplasty. There was no mention of it in the rating decision except in the narrative. When it came to the award it was just for post concussion residuals. Skull Loss larger than a 50 cent piece is rated at 50% without brain hernia and 80% with brain hernia. I suffered brain hernia and it is also in the medical reports along with a brain debridement with fragments embedded in the brain. This last XRAY and MRI revealed there is still a surgical clip in my brain along with the encephalopathy caused by old blood according to the VA neurologist.

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Guest jangrin

Rocky,

I'm not implying by any means that the VA is going to rate our claim in 90 days. I'm just passing along to everyone what they said to us. But I will say that if my husbands claim is not rated in six months and we are still waiting for someone to tell us what is happening I will start making noise.

If after six months we are still waiting I will start sending letters to everyone I can think of. After an office gets copies of request of status for the 5th,6th,7th 8th time. People start to wonder what IN THE HECK is going on. And someone with some clout will follow through and at least find the dang file and get it gong in the right direction again.

Thats just me. I am not a very patient person when it come to people doing their job. There is no way that it should take 2-3 years to process a claim properly. My philosophy is that the squeaky wheel gets the grease. The least I can do is become a squeaky wheel, it may not make any difference but it will make me feel better. B)

Jangrin

Edited by jangrin (see edit history)
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Guest jangrin
how about a Writ of mandamus, would that work?

Tower_Rat,

I do not know enough about law to know whether this would work or not. B) I think it would depend on whether there had already been a ruling on the claim and a person was just tryng to get the VA to follow the ruling. I am not sure if it would apply to a case waiting an initial rating and service connection on a first time/initial claim.

You probably have much more knowledge on this than me. What are your thoughts on mandamus in this situation?

JANGRIN

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Jangrin

Once the C&P exams are done I would call about once every two weeks to check up and see what is happening. The VA will not call you and tell you that they are holding up your rating because they are missing something you could provide them. They will just wait and wait. I have said it before that the VA help up one of my claims because they said they did not have my DD214. This is complete BS, but if I had not called and then provided the VA with the DD214 I might still be waiting. I have three claims in now and I have been calling every few weeks. All my evidence is in and I am waiting for either a decision or a C&P exam. My diabetes exam a had 2 years ago was a joke. I was examined for DMII and peripheral neuropathy. The exams took all of ten minutes. Now I have claims in for two secondary conditions to DMII. It is going to take a while even though I have statement from my VA doctor saying my secondary conditions are direct results of my SC DMII. The doctor also inferred a higher rating for my PN saying it was severe. My initial rating said "mild". You know you just cannot trust the VA to do the right thing. They are only interested in minimizing possible compensation payments.

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  • HadIt.com Elder

Keep in mind a Writ of Mandamus is for extra extrodinary circumstances, and, generally, the mere passage of time doesn't warrant one. Furthermore, the Court very, very, very rarely ever grants one.

Having said that, if you do submit one to the Court, make sure you send a copy of it, certified return receipt, to your RO also. Even if it isn't granted by the Court, the regional offices hate getting those things and will really light fire under someones a$$.

Also, if you do decide to submit one to the Court, MAKE DAMN SURE YOU HAVE YOUR DUCKS IN A ROW. This is a legal document with tremendous implications. I would highly recommend talking to a lawyer and have them write one.

Vike 17

Edited by Vike17 (see edit history)
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Guest rickb54

Rocky

said," The VA has had all this info ever since 1976 and was in my C-file as they sent me copies of it. Yeah I am claiming retro for 30 years back to 26 Nov 1976 "

It is my understanding that the regional office can only approve retro back three years. and that for anything more it must go to the DC office... Vike17 might have more insight to this, but this is what I was told by a PVA represenative when I indicated I have a CUE claim requesting an EED back to 1986.

Also I know tha 21 months seems a long time for a claim to sit at a regional office. I think it really depends on what office is rating the claim as to how long it sits, backlogs differ from office to office. Since your claim was farmed out to another regional office, It is safe to assume they had no work of their own, and now they have work from everywere else and perhaps are swamped.

I have had claims take 3 years to get throught the system... in winston-salem

Yet in Waco Texas my claims took less than a year...

Who can say why a claim is held up? I know that calling, IRIS, congressmen, senators, and letters do no good to move things along.

One thing that I know helps is a letter stating a finiancial hardship exist and requesting they rush the claim ....

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  • HadIt.com Elder

My DMII claim took about a year at the St. Petersburg RO. That is really like lightening for that RO since it is the busiest. It took another year for the secondary conditions to be SC'ed. Their catchment area is huge with over a million vets. If the claim is complicated it could take years and years. If it is a easy one then it should go quickly, but who is to say for sure. They might lose everything a few times. That is one of the worst features of my RO. They lose everything at least once.

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I disagree that more then 3 years retro goes to Washington-

The VARO erred and I cued it years ago but didnt pursue this CUE on my offset -it seemed wrong-

then the Regional Counsel caught the error, cued their denial and I got about 7-8 years of DIC they owed me-forget how many years- much more than 3.

I helped a friend get about 9 years retro-(not a CUE) maybe it was more-and the decision on a remand came from VARO Buffalo and so did the cash.

Even if it is a CUE -in spite of the Bell V Derwinski limiting Constructive Rule there still have been some big retros from CUES three years that I posted here in the past.I dont get where the vet rep is getting this 3 year limit.

I think Myler V Derwinski was the oldest CUE retro I have seen- back to 1953

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  • HadIt.com Elder

My experience is that once you have gotten you C&P exam you get a decision pretty quick. 1968, how long has it been since your final C&P exam? I find that the VA likes to rate everything at once, so if you have a claim you filed 3 years ago and one you filed 2 months ago they will wait and rate them all together. I think it is best to file all your claims at one time since you are going to be waiting for the last one filed. I think they are waiting to rate my CUE along with my secondary DMII claims. This makes no sense to me but that is what the VA told me on the phone. Who the heck knows?

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Well,

Got another IRIS inquiry response today. It seemed I no sooner sent the inquiry until I received a reply within two hours. Anyway it's the same ole crap over and over. Now I'm back to 60 days at least, of course I have had that response several times over the past 18 months. Previously it was unknown and the VSCM had no idea of when I would receive a decision, now it's back to 60 days again....... Oh Lordy!!!!!!! The last records I sent them were a copy of the C&P for Tinnitus in June of '06, the other 8 packets I sent to them way back in 2005 and they just now received them?????? Bull, I have the postal confirmation of receipts that they signed for them over a year ago.

IRIS Response received today:

Dear Mr. XXXXX:

On November 2, 2006, we received six packages of evidence. We are now looking through all the recently received information and evidence. If you do not receive a decision within the next 60 days, please contact us and we will follow-up with the office that is making a decision on your claim. We understand that you are concerned about the length of time it's taking to make a decision, however, we are making every effort to make sure that you receive the most accurate rating possible.

We apologize for the delay and we appreciate your continued patience. Thank you for visiting our website.

Sincerely yours,

XXXXXX XXXXXXX

Veterans Service Center Manager

328/132

Veteran/Inquirer

11/24/2006 12:35 PM

Hello,

My existing claim is 609 days old and has been at the rating board in Cleveland for the past 150 days. There must be a reason this is taking so long for a decision. Please tell me what the problem is that is causing such a long delay in receiving a decision. If there is something holding it up please tell me what else is needed so I can furnish it. This is entirely too long of a delay. Is there anything that can be done to look into my claim located in Cleveland and find out exactly why they have not rated it?

Edited by RockyA1911 (see edit history)
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  • HadIt.com Elder

Rocky

Talk to the VA regional office directly and ask them if their is something that is holding up your claim. It could be as easy as them not having a certified copy of your DD214. How far do you live from your regional office. Can you go there and ask in person what is the hold up? Did your claim get shipped out to another VARO at some point? I just wonder where your evidence you sent in June has been for 5 months. I bet the evidence has been sitting in the file being ignored for the last 5 months.

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John,

Nope it's definitely not a missing DD-214, I have three of them and when I got a copy of my C-File all three were still in there from 1976 with that date stamped as received from the VA. Like I said previously I have been service connected and receiving comp for TBI awarded back in Nov 1976. Yes, my claim and file was farmed out to Cleveland on 28 June 2006. I have heard of the shennanigan of "Not associating the evidence with the file" on one of the OIG reports as one of the delay tactics. My VARO is about 250 miles from me and I feel I would get the same answer, "Cannot provide any additional information, your claim is at a rating board in Cleveland".

I don't understand why they can't check with Cleveland NOW instead of telling me if I don't get a decision in 60 days from now to contact them again and they will check into it with Cleveland. That would make 669 days my claim has been pending before they will put forth any inquiry to find out why the delay is so long.

From what I have read 669 days is the average timeframe for a NOD to be decided, but this is initial claims and two increases for already exisiting TBI.

I believe it was intentional my claim was farmed out to another VARO and all the evidence I've sent them over the past 18 months did not go with it. This is the second time. In Sep 05 they farmed out my claim to Seattle VARO for rating and was returned as deferred because they did not have the documentation for Skull Loss, Tinnitus, Skin Disorder. Seattle returned it back in Oct 05. Now they waited until June 28 06 to farm the claim out to Cleveland for rating. But again did not send them any of the evidence that was in the folder until 2 Nov 06.

I have been playing musical chairs and pin the tail on the donkey for beginning 21 months today!

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Just my opinion but I would have contacted the Senate Committee on Veterans Affairs in Washington D.C. by now..I'm going to pray for all of us because I am fed up as well. I have to try and make myself stay calm, so that I don't have multiple Anxiety attacks.

Just keep complaining to higher up; eventually they will have to decide something.

Michelle

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