NOD denied and errors to boot! Need opinions

[Navy4life]

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

[Navy4life]

2 hours ago, Berta said:

 

Yes, I feel you should request a formal hearing on a 21-4138.

 

Berta;

I hired John Dorle today.  I am tired of fighting this on my own.  He knows what he is doing so I am entrusting him :)

Edited September 5, 2016 by Navy4life

[Navy4life]

Thank you all for your help and support.  I hope now that I have JD, I will win this once and for all!!!

Edited September 5, 2016 by Navy4life

[Navy4life]

**UPDATE**

I just received a call from the Office of Secretary for Veteran Affairs.  I got my newly appointed rep, John Dorle on the phone and we explained the whole situation regarding the DRO Steve Wilbur at the WACO appeals office.  The lady we spoke to said that she is sending an email to the WACO appeals office to have another DRO other than Steve Wilbur call me to relook at my claim that he denied.  We pointed out all the errors that the DRO did in the SOC and furthermore his character to boot.

I have been told that someone will call me by 9/19/16 and if I do not get a call by then, to call her back and let her know.

This is my only chance for a hope of overturning this horrible denial by DRO Wilbur.  Please Please keep me in your prayers!

 

[Berta]

You bet. This is good news!

 

 

 

 

[Buck52]

Good for you Navy4life Way to go!

I think any time a Dr or C&P Examiner ,DRO don't read the evidence that is supportive of the claim and the claim is denied   this is good evidence for error and is in considered an error big time when they do that.

JMO

.....................Buck

Edited September 7, 2016 by Buck52

[Navy4life]

Just got a call from the WACO office, a DRO called to see about mailing the SOC to me.  I told him I already had it.  I got my representative on a 3-way call with the DRO.  He was very nice and my rep. explained to him what was going on.  The DRO went to speak to his Coach and he came back a few minutes later saying they wanted to make sure I got the SOC because I stated I hadn't received it in my email to McDonald, which at that time I hadn't.  He went on to tell my representative to send him an email with our argument regarding the denials in the SOC and that he would get all of it to the Coach so she would have it before our call with a DRO.  He also told my rep. to call him after the email was sent so he could print it off for the Coach.  The DRO said that the Coach was assigning it to another DRO and that someone would be calling me back soon.

My rep just called me and told me he spoke to the DRO and that he got the email, printed off the documents and would give them to the Coach.  Now we wait and see...hopefully a call today or tomorrow at a minimum to present our argument.  The main argument is the fact that the DRO dismissed my Nexus letter, which was from a VA Podiatrist!

Our argument is the fact that the DRO unfairly adjudicated the issues per the VA requirements of CFR 3.102 reasonable doubt, has not adequately applied CVA precedent opinion Moore V. Derwinski, relative equipoise was not adequately addressed and Dr. XXXX's highly probative IMO was not reconciled by the CP exam refuting opinions.  Possibly the most error by the DRO, is that the DRO denied basedon the DRO's own "non-medical" opinion.  The DRO is not qualifeid to refute an IMO opinion of Dr. XXXX's stature.

I just hope we finally get a good DRO to see the erroenous errors that this other DRO committed.  Since there are three cases now that this DRO has blatanley denied without good cause, we have all come together to make sure an inquiry is done regarding his ethics.  You don't call a Veteran to tell them you are denying them.  That is so cruel and unheard of!