ptsd Runaround -delay Or Just Sluffing It Off?

[Guest jangrin]

Berta,

I moved this topic to a new post so we didn't hi-jack Jim's PTSD post....

Also, I took some snipets of your post and pasted it here.

Berta stated, This is another thing I dont understand Jangrin-

In the beginning of 2006 my AO claim went through numerous hands at the VARO-

from January to July- appeals team, predetermination team, in and out of rating board, Dro to coach, back to adjudication, 3 authorizations on three different days- supervisor ,coach, and then rating again- and then to my POA----at one point in March an 800 vet rep who always seems on the ball told me it looked like I would have a decision in days-he said the 3 signatures showed it had not been denied.But then more action took place for 4 more months-

How can -in some cases- a claim isn't stagnant but is getting some sort of attention as it goes from person to person- yet the evidence still remains unread?

The only way this can happen is if the VA employees are passing this claim from desk to desk and from department to department just to avoid having to work on the claim. This could be intentional or it could be because it is percieved to be a difficult case on no-one wants to tackle it.

When the claim came back they immediately appeared to start working on it again-appeals team, rating, coach, regional counsel, rating, RC, rating board, appeals team- sameo sameo-

The case finally got farmed out but then was immediately back on the road again going from desk to desk.???

In all this time I supplied more evidence and now have 3 IMOs to support the AO claim yet have no idea whether any of it has actually been read yet. By Feb it will be 4 years since they got this claim.

Still no one has read or rated or done anything of substance with this claim. ummm?

Berta,

Four (4) years is a very long time time to wait for a determination on a claim. I can't help but think the problem here is not the "meat" or "substance" of your claim. I am sure you have provided ample evidense to support every aspect of this claim in order for a rightful determination to be made.

I believe that there is a problem with "sorting through some cases". Either the cases are too complex for the adjustor, who is over loaded with claims and he doesn't have time to sort through the evidense or,

the files are full of too many very old records and the adjustors don't want to work the file sorting through the SMRs for service connection, or the file is percieved as being just toooo difficult.

The idea of having a file float from office to office so it is percieved as being worked on, with an ocasional computer notation, does not seem too far fetched to me. With everyone hopeing like crazy someone else will finally work that darn claim.

There is no penalty to these people, employees, adjusters, raters, file clerks, government benefit job types ,

for not doing their job. This file is perceived as being too complex and too difficult to rate with too many secondarys for the claims people to sort out. It is far easier to shuffle the file.

If you remember back a few years, I'm not sure if you would have heard about this or not. But the same thing happened in the California court system. There were somany filed law suits that would never be brought to court, because the people involved just kept postphoning the trial date, or asking the court to put off discovery, or for a bunch of different reasons. The cases just never got through the system and it was clogging up the whole legal system in the state.

What happened is the state filed some new admistration laws for the court system and we ended up with what was called FAST TRACT. This made the court cases move through the system whether the attorneys were ready or not. By implementing Fast Tract, the court calenders started to clear out and there were openings for scheduling trials and criminals were once again being prosecuted and trials began proceeding through the courts.

I believe that is the problem with your claim and many others. There are so many difficult cases that they are clogging up the system. The claims people are afraid to try and work the file, or it's easier to bury the file on a desk than to work it, or move it around so it looks like it is being worked. Ask any lawyer how they build a case or work a file. Someone is ultimately responsible for maintaining the file and logging the information so the file can be prepared for trial or settlement.

It seems that there are a lot of people in the file but no one who is ultimately responsible to answer for the condition of the information or the status of its readiness to proceed for rating.

THERE NEEDS TO BE EITHER A PENALTY FOR NOT PROCESSING THE CLAIMS WITHIN A SPECIFIC TIME PERIOD OR THERE NEEDS TO BE AN IMPLEMENTATION OF FAST TRACT TO START MOVING THESE CLAIMS THROUGH THE SYSTEM

I think your claim is too difficult and the people are afraid to rate it. They keep hopeing someone else will work your file. There has got to be some way to make the VA work the claim?

Is there anything that we are missing??? Any laws or regulation with time limits??? I have never heard of a system that does not have time limitations for making decisions.

Jangrin

Edited November 30, 2006 by jangrin

[Pete53]

The Peter Priniciple......

Otay..... THE PETER PRINCIPILE !!!!!......interesting take on the subject....

Ha Ha My Name is Peter

[Guest jangrin]

Ha Ha My Name is Peter

Now , now,

No Way , your Pete53

jangrin

[Guest jangrin]

The Peter Priniciple......

Otay..... THE PETER PRINCIPILE !!!!!......interesting take on the subject....

I really am serious you guys.

I have attached the following link for your review. I really,honestly think this is what has happened to the VA government employee system.

Enjoy the reading

http://en.wikipedia.org/wiki/Peter_principle

Jangrin

[Berta]

"How much time lapsed between the time you won you 1151 case with substantial award and the time you file the AO case which I believe you said is substantial retro"

FTCA award 1997, Section 1151 award 1998.

"Initally, was it the same SO for both claims?"

Good question- I had just switched from DAV to NYSDVA when I knew the award was coming.

The DAV had gotten credit for 100% SC P & T posthumous award but I switched my representation.

My new vet rep-but an experienced vet rep who I had know by then for many years-said that the Sec 1151 award(which he was thrilled about but did not do anything to get it) was missing something- they had failed to pay accrued for the veteran's 1151 disabilities at over 100% disablities.

Then he just shrugged his shoulders and did not say to NOD this decision.

I knew nothing in those days about SMC.

He meant that the VA had failed to consider SMC as an accrued award based on the veteran's Sec 1151 claim-which I had re-opened when he died.

My CUEs are based on this.He was right and I found a OGC pres op to support this and 5 BVA decisions.

If the VA awards Section 1151 they also must consider and award -if the evidence requires- SMC under 1151. He was promoted some time ago and he is the one who told me he had presented my initial IMos to the DRO and she could not understand the medical info (she was a new DRO) so he suggested getting a VA opinion. But he assured me by phone that the VA doctor would be given my IMOs- she wasn't.

His main office has no documentation whatsoever of this meeting he had nor what he told me.

The VA stated only this meeting occurred and a VA opinion would be rendered-but my IMos were never mentioned and never listed as evidence or addressed in the subsequent SSOC.

"ALso I know you wouldn't probably know, but could it have been assigned the the same claims adjuster that handled the 1151"

Another excellent question Jangrin- I have no idea on that.

The Court found that a veteran with a similiar situation- (he claimed direct service connection but had been awarded Sec 1151 on another disability)-

The court (COVA) found that the prior Sec 1151 award had directly prejudiced the proper adjudication of the direct SC award. Look V. Derwinski.

"The CUE claims, are they part of the AO case or the 1151?"

The are part of legal error involving the Sec 1151 decision and will also kick in under Nehmer for direct SC.

"You switched to a new SO, has he stated whether or not he has read or even seen any of your (3) IMO's"

He read and sent the last IMO from August to the VARO with a 4138 in support of it. This was the first 4138 I ever got from my POA. The other IMos are not in my POA files.

Also the main boss switched the vet rep that had the DRO conference to a different rep there at the VARO.

"The destruction of property case, is that the case they have until February 28th, to do something about?

Has the councel for the VA contacted you at all?

Does the SO know about the law suit for destruction of property"

Only the local SO knows of this-but he didnt understand it. I called counsel myself and we discussed this all.

My claims file has been with counsel twice since the remand but I dont know what for-maybe for the FTCA claim--

I told counsel that this damage claim is a ploy to get my evidence read as in the past I went through a lot of crap with this VARO over my evidence disappearing from the files.But I sure will go to fed court if needed.

I reminded him that not only do the IMOs support the claim, but the VA has already admitted they could not diagnose the veteran's heart disease, and strokes,and gave him improper meds so it is more than likely they misdiagnosed his diabetes too.

I am glad I called because the Section 1151 award covers "ALL" misdiagnosed conditions and I could not formally sue the VA again over the diabetes misdiagnosis.

He had all my FTCA stuff right there.

Jangrin -as I told the RG- this is unfair to any veteran or widow- these IMOs can be very costly and the VA has no right to ignore any probative evidence.

And in my case the VA doctors buggered the vet anyhow so I needed IMOs to have "competent medical evidence." The VA med recs do not hold any competency whatsoever on the part of VA doctors.

"Hove you done a request of records for the AO case only- under the FOIA recently"

No.

"When you started recieving DIC, was that awarded under the 1151-AO-or totally seperate?

Could you explain Nehmer and how it affects this case.?"

I had an offset to my DIC. When the withheld amount was recouped via DIC checks that I never saw-

they were generated by then recouped,

I began to recieve my DIC under Section 1151.

Nehmer- the IMOs state that the veteran died due to misdiagnosed diabetes with no know etiology but for Vietnam service and exposure to Agent Orange and that the diabetes contributed to the conditions that caused his death.

If this was just a regular DIC claim- the award -because of Nehmer would be retro to the veteran's death.

The VA has a prohibition on duplication of benefits.

On the surface that means that a veteran or widow cannot receive two payments for the same disability award.

However Sec 1151 awards are unlike direct SC awards.

I know of a vet who gets 100% VA SC and an additional award and payment as comp under Section 1151.

In this case a successful direct SC award of DIC is not at all the same award as wrongful death DIC.

NVLSP said VA has to pay the DIC under 1151 as well as under AO-two distinctly separate awards.

The Nehmer decision comes into play because in 1997 and 1998 VA decisions listed the veteran's disablities

due to Agent Orange as NSC under Sec 1151 as well as death under NSC Sec 1151.

Had the VA not listed the disablities at all-Nehmer would not be a factor in the SMC CUE claims.

I dont know how long they will continue to string this out- I told Regional counsel I am prepared to play their game for as long as it takes.

At least I finally know exactly how they caused my husband's death and the IMOs did give him some peace with honor -I hope.

There is honor in an AO death, but not in a Section 1151 death.

Because of my initial Section 1151 claim- I immediately recognized, a few months after Rod's death , that they almost killed his best friend and co-worker at the same VA he worked at.That veteran still reminds me that he would not have 100% under Sec 1151 and SMC and also much better VA care if I had not prepared a Sec 1151 claim for him. He did not understand the claim at all.His award came in less then 4 months after mailing it. He was in desparate financial need at the time and the award for negligence was a shock to him.

If Rod had not died I dont think I could have even recognised they had malpracticed on this vet.

[Guest jangrin]

Berta,

Thank you very much for answering those questions.I am still trying to sort through all the legal lingo that we use here at Hadit. Also the sequence of events and the remedies of each filing and remand. So still alot of this is just figuring out who has jurisdiction over what and then where does the file go. It is a bit overwhelming for us who are involved with our very first claim and the first time dealing with the VA and military, ever.

So once again, I fired off alot of questions but I do thank you for taking the time to reply. Just a few more questions for you, please.

The cue claims are on the 1151, wronful death case that you won. When you won the 1151 do you get a lump sum settlement amount or is this based on a rating of disability such as 70% and then based from the time you filed or the time of the initial determined VA blunder and missed diagnosis as decided by the court?

He was promoted some time ago and he is the one who told me he had presented my initial IMos to the DRO and she could not understand the medical info (she was a new DRO) so he suggested getting a VA opinion. But he assured me by phone that the VA doctor would be given my IMOs- she wasn't.

So the VA got their own IMO of your husbands condition (cause of death) without ever seeing the IMO's that you provided to the VA?

Also, does this mean that if you win your cue claim, would that give the 1151 case, retro to military discharge as a SMC (service medical condition?)? If this is correct that is one cue, what is the other cue?

If your IMO's were never mentioned in the ssoc for the cue for 1151 smc, then don't you have another cue for not having considered all the evidence for the of the 1151 initial cue?

1. one cue taking the case back to SMC.\

2. second cue for not considering the evisdence supporting the cue for the 1151?

Is this correct or am I messed up here?

I have more questions but I am going to get this clarified first. Than we will move on. If thats OK with you. Thanks Berta.

Jangrin

[john999]

We used to say at the Post Office that two things rose to the top: Cream and scum! At the VA and USPS it is scum. Most of the leaders should be fired since they are just dogs.