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NOD denied and errors to boot! Need opinions

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Navy4life

Question

I posted this in my other ongoing thread but I want this brought to the forefront.  I was recently denied by WACO DRO Steve Wilbur and I believe I was retaliated because I simply asked Robert McDonald in an email to step in after 6 months of waiting for a decision when the DRO told me in the informal hearing to give him 60 days.  My hearing was 45 minutes long and I was well prepared.  The DRO Steve Wilbur has a very bad reputation at WACO for denials.  I received a call from DRO Wilbur on August 18th, 2016 stating he received my request for a decision.  He told me he would be deciding it within the week but in fact he had already decided it that day!  Now I have yet to received the SOC but I have a Women's Outreach Coordinator in St. Petersburg VBA who is a very close friend of mine and happened to see the denial in my records.  This idiot DRO failed to put a cover letter with my SOC and no date on my SOC.  He simply submitted it to Evidence Intake and never mailed it to me!  If it wasn't for my connection I would still not know and would not be within the 60 days to file the Form 9.  I emailed Robert McDonald earlier this week, firing off my distaste for this DRO and my local congressman.  I plan to further put him on front street when I do file the Form 9.

As for my NOD, I filed it back in 2014 for right foot (5th metatarsal fracture), right ankle condition, and left toe condition.  I am attaching a lot of documents and I know we all have busy lives and I have helped a lot on here and now I need help please!  I need your opinions on this situation.

Original denial for toe condition was on decision letter in June 2014.  They put the denial of the toe condition on the wrong foot!  It was noted on the right foot when it should have been the left foot.  I pointed this out since my right ankle and right fracture had yet to be decided on.  November 2014 received denial for right foot/right ankle and toe condition noted on left toe continued to be denied.  This was after I had a C&P exam July 2013 where I provided TWO DBQ's from my current outside podiatrist stating my injuries to my feet/ankles/toe was all in-service injuries and I was still affected by them to this day.  That was 2013.  I was s/c in June 2014 and was able to start getting treatment by the VA.  My primary had X-rays completed and in 2014 it showed an old fracture to my right foot, the 5th metatarsal.  The C&P examiner made a rationale that stated he noted diagnoses in the C&P exam.  He felt comfortable with the DBQ's from what I gathered.  November 2014, a medical opinion by some doctor I never saw but supposedly reviewed my records determined either I was healed and no further treatment or that I had in-service injuries but no loner had issues.  So I filed NOD November 2014 citing the errors and why I felt the denial was incorrect.  Fast forward to February 2016, I had my informal hearing with DRO Wilbur.  I had submitted a Nexus letter dated February 12th, 2016 from my podiatrist indicating he reviewed all my SMR's and my current conditions were all related to in-service injuries.  During the hearing, DRO Wilbur even stated that a fracture in s/c with no further residuals is at least 0%.  He further went on to review the Nexus letter noting that my Podiatrist stated all three contentions were in fact in-service, continuity continued.  DRO Wilbur told me 60 days to decided.  DAV rep was present.  I felt good......WELL, then I was denied last week.

Here is the evidence I submitted to the DRO for review.  I am just lost for words on this!

 

DBQ ankle conditions_Redacted.pdf

DBQ foot conditions_Redacted.pdf

medical opinion w-o exam_Redacted.pdf

Timeline for NOD hearing.pdf

Nexus letter-redacted .pdf

NOD - Denial Letter .pdf

NOD evidence notes.pdf

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First off you all are amazing and a well of information!  I am going to take heed to all that has been given to me and make sure my Form 9 is filled out correctly.  I will try and get ahold of John or Alex to see if they can help me.  I need to revoke my POA with the DAV too.

Should I put the CUE regarding the SOC in the Form 9 citing the CFR 38 4.6?

UPDATE - just got a call from my local congressman's office and he is asking me to sign a Privacy Act Form to step in on my behalf.  I know I am about to start WWIII with the WACO office so here goes nothing!

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  • HadIt.com Elder

yes navy4 do as Ms berta suggested 

 

''The CUE would be a violation of 38 CFR 4.6. You could attach copies of the SMRs with the probative parts highlighted with a magic marker, to support the CUE claim''.

 

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1 hour ago, Berta said:

 Broncovet said:

"If the VA has not responded to your request to amend records, per 3.1579, then so state in your I9.     Later, if the VA does amend the records (or if they refuse), then submit that as new and material evidence, per 38 cfr 3.156." I agree but also asking them to CUE the SOC might work too.

It looked to me that they might have listed the SMRs as evidence but completely overlooked any SMR entrees. 

The CUE would be a violation of 38 CFR 4.6. You could attach copies of the SMRs with the probative parts highlighted with a magic marker, to support the CUE claim.

 

Berta;

I am typing up on letter as we speak to my congressman and I just noticed that there are issues with the C&P exams done back in July 2013.  Can you look at them attached in my original post?  I want to point out to you the feet C&P exam and the ankle C&P exam.

During my claim process I had two C&P exams.  In July 2013 I had a C&P Exam for feet and ankles.  During that exam I supplied two DBQs that were filled out by my private Podiatrist Dr. James Hurst.  Those DBQ's were solid and my Podiatrist stated my diagnoses for all my issues were while I was in-service.  The C&P examiner Dr. Tesfaye Tetemke stated in the remarks section on BOTH C&P exams for feet and ankles, stated there is for claimants condition of right foot condition, there is no diagnose because the claimant does not claim the condition.  This is an error because my original claim of May 2013 states ankle and foot conditions.  He goes on to say that the Left Foot and Left Toe Condition on Left foot, the diagnose is already noted in the diagnose section.  He noted under diagnoses the mortons neuroma as of 1992, he noted avulsion fracture of the RT 5th metatarsal as of 6/23/2013.  This is incorrect! 

 

He then did a C&P exam for ankle conditions.  He then puts in the diagnoses section, right ankle sprain, 1993 for both, right 5th metatarsal fracture, 1993, left ankle synovitis, 1992.  The fracture he states as of 1993 here but states it as 2013 in above C&P exam.  He clearly made errors here!  He goes on to say in remarks that the right and left ankle conditions are noted in the diagnoses area.

This should have warranted me a new C&P exam right?

Furthermore, the DRO Steve Wilbur stated, 

We have opinions relating this condition to falls in the military and also falls related to your service-connected left ankle condition after service.  Both opinions lack a rationale sufficient to support a grant of service.  The two rationales he is referring to be the letters from my VA Podiatrist indicating my contentions were in fact service related.  This in its self should have warranted me a new exam!  The one letter is attached for your review.

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Okay so I just sent my congressman all I think I could to help me out.  I am emailing Robert McDonald again but this time with all what I just sent my congressman in hopes they get this resolved at the RO level.  

 

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Just got this from Robert McDonald's office via email!

 

Ms. XXXXX,

 

The Secretary has received your emails dated 31 August 2016.  He has forwarded your inquiry to VA leadership for review and direct feedback to you.  Thank you for your communication. 

 

Office of the Secretary

Department of Veterans Affairs

810 Vermont Ave NW

Washington DC 20420

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