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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

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      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
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AF_Comm_Vet

Need some guidance -scratching my head on a denial

Question

-  Filed a year ago for a lumbar spine condition caused by a severe auto accident in-service. After an initial denial, the claim was finally approved after doing a re-open and submitting an new IME.  The NEXUS was made between the Lumbar spine injury and accident based on civilian ER reports where I was transported.  Was scheduled for a C&P exam prior to decision, and the C&P physician actually rated higher than I expected (after doing X-rays) at 40%. 

-  Several years ago I started having headaches, neck stiffness, and occasional  Pins & needles in the arm, not severe or constant so blew it off.  Four months ago it became severe, started missing work left and right, and pain prevented even sleep without heavy meds. Was referred to an Orthopedic doc and later an Ortho Surgeon.  MRI's and X-rays were accomplished in Jan with bad news, severe degenerated discs and cervical bone structure.  The Surgeon said this was pretty severe for my age, and after describing the accident he agreed it was likely the cause of the damage which had been brewing for years. 

- Filed a FDC for Cervical  Spondylosis and degenerative cervical disease.  I referenced the earlier evidence of the accident in-service. I also had a thorough IMO done by one of the Physicians mentioned in the forums often (not including the name), the IMO was very thorough with a NEXUS statement and citing previous cases.  Submitted the FDC in Early Feb.

 

 Well, I after I saw the FDC move from Review to Decision process les than tend days after submitting I became concerned. Sure enough, it was returned denied as "Not Service Connected".    

 

OK, I get it....an IMO doesn't guarantee anything, but based on my evidence and previous related injury  I thought I would at least be granted a C&P before the case would be tossed back in my face.    Any thoughts?? 

 

Thanks

 

 

Edited by AF_Comm_Vet
qeqweqww

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I hope you hear back from, IRIS soon (or your VARO)

I am so busy these days that I missed this until today

 "I could have hade a buddy letter from Sun Tzu, doesn't do any good if they don't read your submitted evidence. "

YEAH...you are right! I studied a little of Sun Tzu at AMU and still have one of his books.

Just like if a vet had a PTSD diagnosis from Sigmund Freud...after 2010 new PTSD regs came out ,.they still want a VA doc to make that diagnosis.

That is why, as a civilian,I graduated from a military school. In 2007. and the VA paid for the 30 college credits I needed for my degree, under Chapter 35. Ha Ha!!!!

That enhanced my ability to succeed in my claims and hopefully help others here realize we are on a true  battlefield, and are in combat over a war of the words.

 

 

 

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On ‎3‎/‎15‎/‎2016 at 10:17 AM, Berta said:

I hope you hear back from, IRIS soon (or your VARO)

I am so busy these days that I missed this until today

 "I could have hade a buddy letter from Sun Tzu, doesn't do any good if they don't read your submitted evidence. "

YEAH...you are right! I studied a little of Sun Tzu at AMU and still have one of his books.

Just like if a vet had a PTSD diagnosis from Sigmund Freud...after 2010 new PTSD regs came out ,.they still want a VA doc to make that diagnosis.

That is why, as a civilian,I graduated from a military school. In 2007. and the VA paid for the 30 college credits I needed for my degree, under Chapter 35. Ha Ha!!!!

That enhanced my ability to succeed in my claims and hopefully help others here realize we are on a true  battlefield, and are in combat over a war of the words.

 

 

 

Berta:

Just  received a reply to my IRIS (Three weeks later)...

Well, typical response, they misunderstood the intent of my CUE request, instead they interpreted my request as a formal intent to appeal the decision (NOD).  They sent me plenty of information on how to "Properly" appeal a decision..!!

 

So now that the "CUE via IRIS" route is closed....I do have one more option to try, would like your thoughts:

--  I am going to RESUBMIT my IME as "NEW EVIDENCE" and RE-OPEN the case..... Since the RO NEVER reviewed the IME or listed it as evidence I think I am on solid ground re-opening the case based on new evidence.   To prevent confusion I will submit a sworn statement with some verbiage explaining that WHY the IME is considered new evidence even though it was submitted with the original claim.

 

What do you think?

 

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If you tell me what RO this is I might have contact info for their director.

 

Was the IRIS request filed as an IRIS complaint?

I filed my last CUEs with the Director via Fax and as an IRIS Complaint as well. You are right that you could submit the IMO again as 'new evidence' but that adds time to an error that they can and should corrected.

I will try to find the template I used for this maneuver and post it here

 

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31 minutes ago, Berta said:

If you tell me what RO this is I might have contact info for their director.

 

Was the IRIS request filed as an IRIS complaint?

I filed my last CUEs with the Director via Fax and as an IRIS Complaint as well. You are right that you could submit the IMO again as 'new evidence' but that adds time to an error that they can and should corrected.

I will try to find the template I used for this maneuver and post it here

 

 

 

Yes Berta...Was filed as a complaint...that's why I rolled my eyes when they replied that I need to file a NOD...

I will PM the RO/VARO info when I get home from work..

 

THANKS!!!

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File the IRIS as a Complaint (they have a pop down box there for complaints) as I found this to be far better than just  a regular IRIS request.

IRIS complaints as far as I know, go to VA Central, so they cant ignore them.

State :this is a request for the ( name) VARO to CUE their recent decision dated (date), under the auspices of 38 USC 5109A ,prepared by (put  the initials here that appear in the alphanumeric thing on the decision), because the VA has violated 38 CFR 4.6 (copy off the part of this regulation that should be readily available here under a search,as the decision does not consider the IMO they have from Dr......, dated, that supports my contentions. The VA also ignored:

(in this part explain what you referred to here:"The IMO/NEXUS I submitted (which was obtained at great expense) and the initial ER room report (which caused the injury) were not listed as evidence being considered. Even more laughable was their statement that there was no evidence of the accident .....  Even though I have a screen shot of those same reports uploaded to their system and attached to the claim, and found both documents contained within my C-File.")

Say that in your own words as to the proof of the injury as well as the probative IMO ,which are all in VA's possession (per the screen shot) were completely ignored by VA in violation of the above regulation 38 CFR.4.6 and this error has caused a detrimental manifested outcome ,due solely do to VA's clear and unmistakable error.I fortget if you can even attach the screen shot to an IRIS...???

Thanks for perusing the info on CUE here.....You sure  know this is a CUE yet many vets think they have a CUE basis but never read all the stuff available here.

 

 

 

 

Edited by Berta

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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 0 replies
    • Exams that were being sent strictly to contractors before, due to VAMCs not being open, are starting to be routed back to VAMCs. This is going forward from last Friday- not sure if prior scheduled exams will be re-created for VAMC vs vendor.
      • 7 replies
    • Mere speculation in your VA C and P exam

      M21-1, Part III, Subpart iv, Chapter 3, Section D – Examination Reports III.iv.3.D.2.r. Examiner Statements that an Opinion Would be Speculative Pay careful attention to any conclusion by the examiner that an opinion could not be provided without resorting to mere speculation (or any similar language to that effect). VA may only accept a medical examiner’s … Continue reading
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    • It's time to ask for help from the community. If you can help with a gift it would be very appreciated.

      Fund HadIt.com Veteran to Veteran LLC


      Give a financial gift to help with the upkeep of HadIt.com. HadIt.com is NOT a non profit. Gifts are not tax deductible, they are just gifts. 
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