diabetes How to file unadjudicated claim.

[syne7]

I was medically discharged from the army in 1997.  I got SC 10% for Asthma & SC 0% for limitations of motion in left ankle.

I never appealed or filed a NOD. 

In 1998 I was diagnosed with diabetes t2.  A few years later friends mentioned I should go to the VA and see if my diabetes was service connected.

I called the VA and they told me to send them a letter.  I sent the following (which was part of my c-file in September).

This is what I sent (Stamped received 5/7/01 in my file and they never replied to me:

((VA Waco Office Adress))

Hello,

I would like to ask that my claim for service connected disability be re-opened.  I have recently been diagnosed with diabetes.  I would like to request that my service medical records be examined, specifically blood tests etc... that may show a high glucose level in my blood or other indications of diabetes.  My intent is to see if perhaps I may have developed this condition while I was in the military and apply for the appropriate level of VA benefits. 

Here is my administrative info:

XXXXXXXX
xxxxxxxxxx

My VA file number is XXX-XXX-XXXX

My current Doctor is:

((Name address and contact info for doc with phone))

Thanks in advance for your help and consideration.

 

Does this look like I have an adjudicated claim?

I am filing for upgrades and other new stuff in an FDC.  Do I just include this and summary declaring an adjudicated claim?

 

THanks

 

[broncovet]

38 CFR 3.156 (reopening due to N and M evidence) is MOSTLY about the effective date.  

You said you were not seeking an EED.  

Here is my take on this:

   When you have an unadjuticated claim, this means VA never made a decision.  If you submit it all over again, then the VA might make a decision this time, but, they also may not.  

    There is much here about unadjuticated claims, which the CAVC refers to as "deemed denials".  I dont like that phrase at all.  The CAVC says, that, when the Veteran applies for multiple benefits, and the VA does not adjuticate them all, the rest are "deemed denied", and the appeal period begins to run.  However, 38CFR 3.103 says:

" § 3.103 Procedural due process and appellate rights.

(a) Statement of policy. Every claimant has the right to written notice of the decision made on his or her claim, the right to a hearing, and the right of representation."

    In my opinion, this "deemed denial" violates 3.103, above.   I do think that more recent cases on deemed denial seemed to have weakened this case, and now the deemed denial only counts if "the claimant could reasonably tell that his claim had been denied".  

Huh?  How would you know it has been denied, unless you get a decision specifically denying it??   

[broncovet]

What I finally did, when the VA REFUSED to adjuticate an unadjuticated claim, I (eventually)  filed a writ of mandamus.  The Writ looked very bad for my RO, and I amazingly won my 100 percent benefits within about 3 months after filing the writ.  Coincidence?  Hardly.  

Yes, the writ was dismissed (denied), but only AFTER the VARO responded to my issues where they basically promised to adjuticate them and asked for a dismissal.  

So, I fought VA for 7 years to adjuticate an unadjuticated claim.  No dice.  Then I file a writ...and "poof" VA promises to adjuticate and the writ is dismissed.  They could no longer hide the unadjuticated claim.  

Edited April 10, 2016 by broncovet

[broncovet]

Dot is correct.  Whenever you "can" get a "presumptive" you should go for it.  Of course the trouble is that VA is SUPPOSED   

to consider presumptives when ever we apply.  In other words, if I applied for benefits based on IHD, and I had service in Country in Vietnam during the applicable period, then VA should consider my claim a presumptive as long as I met the presumptive criteria.  They dont always do that.  

You see that with SMC a lot.  You dont have to "apply" for SMC.  When You meet the criteria, you get it.  No application is necessary.  If you lost use of your foot, then you should get SMC for the loss of use of your foot.  

A lot of this is about forcing VA to do what they are already legally required to do.  

[syne7]

I have been looking.  I moved from New Orleans in 2001.  I did not enter the VA system for healthcare until 2015.  I did not know I could get free healthcare thill then.

[syne7]

42 minutes ago, Dot09 said:

If there is no documentation but hints of in service problems i.e. Buddy statements, medical appointments that could be connected ect. I would go the route of a presumptive claim. 

Was any of your private medical examiner notes sent to the va for treatment?

No, Even though I gave the VA the information for my doctor in 2001.  They never contacted him.  I stopped using him in 2003.  he has moved on and no one has his records.  They are only recquired to keep them 5 years.

[syne7]

40 minutes ago, Dot09 said:

Better yet my question is that the va would have to see some type of information in order to treat your diabetes? Therefore, if you were getting medication there has to be a record some where I would think.

No unfortunately, I was not aware I could use the VA for healthcare.  I did not enter the VA healtcare system till 6 months ago.