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By J McB
Ok, so I started requesting copies of my c-file in 2013 or 2014 after filing to re-open my 1993 claim in August 2013. My repeated requests went unanswered, and I ended up having to make a Congressional Inquiry through Senator's office to get a copy.... and now I request a copy every time the VA makes a decision (via Congressional inquiry).
Here's what I've figured out and what I'm not sure how to deal with, and a question about c-file contents.
1. I have, I think, 4 or 5 CD's of my c-file. I received the first Spring of 2015! 😡. The problem is that documents that were in the c-file CD that I received in 2015 aren't in the one I received in April (2019)... Documents that were in my c-file CD from last summer (2018) aren't in the one I received in April (2019)...
Anyone have an explanation for that?
2. Alternatively, I cannot figure out why Congressional Inquiries correspondence that was made while I was still active and the 4 years after aren't in my USAF/VA? 🤔...
Yes!, (and again to the dismay of the VA) I do have hard copies of that Congressional Inquiry correspondence...
Granted, as one of my previous "Question to the Elders" noted, I have had to find friends and my ex to write letters attesting to my filing a claim and seeing a VA doctor in 1993 because the VA has lost the files, so it doesn't surprise me that the VA sucks at filing documents in c-files. However, in the April 2019 copy I received, I noticed they seem to have "piecemealed" what letters/correspondence from the Senator's office, who is my intermediary for the VA, is copied into my c-file...
Anyone have an explanation/solution for that? Granted I have all the correspondence to/from the Senator's office and the VA, but it makes me wonder what they've sent to the BVA...
3. Is there an option for me to view what is on VBMS? I ask this question because the c-file I received summer 2017 included a "Rating Decision" page which I never received from the VA and at the bottom of the page I noticed a note that read, "VSR: Please see the deferred issue in VBMS as to the "appeal" noted on the VA Form 21-4138 (dated August 1, 2016) with attachments and tabbed in VBMS documents. Veteran notes the appeal regards "an earlier effective date as to the service connected conditions." The Veteran's "appeal" received on August 2, 2016, should be addressed by the Appeals team."
There was no appeal filed at that time. The Form 21-4138 they reference makes clear the documentation I was submitting was being submitted in support of my 2016 claim, which the VA closed. I have since requested the VA correct their error and attach the document to my NOD, and now to BVA appeal.
But this makes me wonder what other *&^% ups they've made that I can't see in VBMS? I went to the D.C. VARO office last week and the dude who is working at the front desk said I can't access/view VBMS...
No, I do not have a VSO... haven't had a good experience...they don't seem to have read 38CFR, know or keep up on case law, and only seem to know 'surface' information... (i.e. File such and such on this form).
Curious if anyone here has gone through the FOIA and had to ultimately sue the VA in Federal District Court to force them to provide their C-File in a more timely manner? FOIA's are required to be fulfilled in 20 business days by law assuming no special circumstances. Obviously the VA isn't going to respond to anything in 20 days but when it goes on for 6 months or longer that is ridiculous and slows our ability to address claim denials/issues quickly. I just filed a FOIA appeal and was sent a letter from the Office of General Counsel, Veterans Administration that my FOIA request was DENIED under FOIA Exemption 6 but remanded to be provided via the Privacy Act. The issue is that the Privacy Act process has no deadline so they can take as long as they want, while the FOIA actually has deadlines and a process for relief when they don't do what they are supposed to. From my understanding, this is a tact the VA uses to confuse people into thinking it is a Privacy Act request and not a FOIA request.
Any thoughts would be greatly appreciated.
Good afternoon. I am waiting on my supplemental claim results from the VA. Nothing has updated in e-Benefits and on va.gov it the status shows that the VA has made a decision (under the status tab) and under the issues tab it says "currently on review - compensation issue".
Has anyone seen this and know what it means?
Here is an odd question about the C-file.
Is EVERYTHING done by the VAMC supposed to end up in your C-file?
I do mean everything.
The reason I ask, is that in other posts here I have mentioned missing records from the VAMC New Orleans.
When I saw my new VA Primary Care Doc for the first time, she asked tons of questions, which was great.
In answer to one of them I mentioned that the VAMC New Orleans lost a bunch of my records and I was pissed about it.
She had her unit's Social Worker call me to offer assistance on the issue.
It turns out there is something called the Joint Legacy Viewer, which is an application that has insight into every medical record the VA has on you no matter what system it is in. Apparently there are several different systems your records could be in depending on location and year you were seen.
When I went yesterday for a follow up on my foot surgery, I went to the Social Workers office and in a couple minutes he pulled up a set of treatment notes about the VNG I had for my vertigo back in 2013 that VAMC New Orleans says is "lost".
Those notes are not in my c-file.
So I am curios if anyone knows if some files are not put in the c-file. These notes I found don't follow the typical format that VAMC uses and happens to list the Procedure Codes associated with each treatment or test done. For example for the Vertigo they list procedures 92540 through 92547 as being done and the results appended elsewhere.
i am going to make an appointment to spend a day searching those files, but I also want to get all of them so I need to figure out that path
Okay so my C-file arrived, and did so amazingly fast. Less than two months, not bad time.
Going through all the files and sorting them but one of the first things I need to get together is the claim on OSA.
I know the rules have changed about OSA ratings and now the med file must have a doctors saying specifically OSA is a medical condition
From the MR21-1MR
“When determining whether the 50-percent criteria are met, the key consideration is whether use of a qualifying breathing assistance device is required by the severity of the sleep apnea.”
“Use absent a medical determination that the device is necessary does not qualify. The regulation requires that the device be necessary and this is a medical question.”
So here is my situation.
On 07/07/2013 I had my initial PTSD C&P which noted serious sleep problems, chronic fatigue, hypersomulance but it did NOT mention the SLEEP STUDY diagnosis given on 4/13/13
At that time the simple issuance of a CPAP was considered sufficient to getting a 50% rating for OSA, but as the change listed above notes that is not the case now.
I have already filed a claim for OSA secondary to my PTSD. I did this before my Review C&P for PTSD exam, which resulted in getting bumped to 100% PTSD P&T.
With the change in MR21, I suspect they may disapprove the OSA claim.
If they do, would my path be to file a CUE because the record showed the apnea existed and a cpap was issued when they rated me for PTSD. The retro pay would be awesome!
That would seem to be an error on their part and under the old standard I would have gotten a 50% rating for OSA as well as my 70% for PTSD and 10% for Tinnitus. The 70+50+10 calculation is 87 which rounds up to 90 for pay purposes and getting that retro 20% difference for 60+ months would be a nice holiday or new years present to me 🙂
In the alternative, would I submit a NOD with the same information?
or would I have to get a DOC to say that the CPA was medically necessary and would that mean I needed another Sleep Study?
Thanks in advance. I am just trying to get things ready for whenever they make a determination on the existing claim.
Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
Vync posted an answer to a question,I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:
2003 asthma denied because they said you didn't have 'chronic' asthma diagnosis
2018 Asthma/COPD granted 30% effective Feb 2015 based on FEV-1 of 60% and inhalational anti-inflamatory medication.
"...granted SC for your asthma with COPD w/dypsnea because your STRs show you were diagnosed with asthma during your military service in 1995.
First, check the date of your 2018 award letter. If it is WITHIN one year, file a notice of disagreement about the effective date.
If it is AFTER one year, that means your claim has became final. If you would like to try to get an earlier effective date, then CUE or new and material evidence are possible avenues.
I assume your 2003 denial was due to not finding "chronic" or continued symptoms noted per 38 CFR 3.303(b). In 2013, the Federal Circuit court (Walker v. Shinseki) changed they way they use the term "chronic" and requires the VA to use 3.303(a) for anything not listed under 3.307 and 3.309. You probably had a nexus and benefit of the doubt on your side when you won SC.
It might be possible for you to CUE the effective date back to 2003 or earlier. You'll need to familiarize yourself with the restrictions of CUE. It has to be based on the evidence in the record and laws in effect at the time the decision was made. Avoid trying to argue on how they weighed a decision, but instead focus on the evidence/laws to prove they were not followed or the evidence was never considered. It's an uphill fight. I would start by recommending you look carefully at your service treatment records and locate every instance where you reported breathing issues, asthma diagnosis, or respiratory treatment (albuterol, steroids, etc...). CUE is not easy and it helps to do your homework before you file.
Another option would be to file for an increased rating, but to do that you would need to meet the criteria for 60%. If you don't meet criteria for a 60% rating, just ensure you still meet the criteria for 30% (using daily inhaled steroid inhalers is adequate) because they are likely to deny your request for increase. You could attempt to request an earlier effective date that way.
Does this help?
Buck52 posted an answer to a question,Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.
The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.
Picked By66 bricks,
JKWilliamsSr posted a question in VA Disability Compensation Benefits Claims Research Forum,A couple months back before I received my decision I started preparing for the appeal I knew I would be filing. That is how little faith I had in the VA caring about we the veteran.
One of the things I did is I went through the entire M21-1 and documented every CAVC precedent case that the VA cited. I did this because I wanted to see what the rater was seeing. I could not understand for the life of me why so many obviously bad decisions were being handed down. I think the bottom line is that the wrong type of people are hired as raters. I think raters should have some kind of legal background. They do not need to be lawyers but I think paralegals would be a good idea.
There have been more than 3500 precedent setting decisions from the CAVC since 1989. Now we need to concede that all of them are not favorable to the veteran but I have learned that in a lot of cases even though the veteran lost a case it some rules were established that assisted other veterans.
The document I created has about 200 or so decisions cited in the M21-1. Considering the fact that there are more than 3500 precedent cases out there I think it is safe to assume the VA purposely left out decisions that would make it almost impossible to deny veteran claims. Case in point. I know of 14 precedent setting decisions that state the VA cannot ignore or give no weight to outside doctors without providing valid medical reasons as to why. Most of these decision are not cited by the M21.
It is important that we do our due diligence to make sure we do not get screwed. I think the M21-1 is incomplete because there is too much information we veterans are finding on our own to get the benefits we deserve
M21-1 Precedent setting decisions .docx