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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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danangmonkey

Need a Bit of Help... Clock Running out -- HELP!

Question

Hi:

Have had four separate claims on appeal to the DRO for several years.  I received a DRO denial (after 4 separate C&P exams) in late September on all four claims conditions.  As usual the SOC was as flawed as the original decision; evidence not considered, incorrect diagnosis, conflicting opinions with board certified physicians that provided a IME, etc. .     I think I have a very good chance of winning all four on appeal, if I can spot the easy errors an attorney should have no problem. 

HERES THE PROBLEM:  I had major surgery in late August and was in no condition to take care of business for a few months.  Now I only have 18 days to file an appeal or the clock will run out. I have sent out messages to several local attorneys to try to move this forward but concerned I will miss deadline. Yes, my fault for waiting, but there was a valid reason for the delay.

HERES THE QUESTION:    Do I have to file a FULL appeal, or can I just send in the Appeal Form with basic information to stop the clock and then have the attorney send follow up with the complete appeal package?  I doubt an attorney can provide an intake interview, and prepare and send a formal appeal in just a few weeks.       or can I send a request for a delay myself, and if so is there any special format for the submission.                     Appreciate ANY and ALL responses !!     

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Once an SOC is issued, the DRO process is complete.  If the appeal continues, it is now under the Traditional appeals process.  DRO authority does not extend beyond the issuance of the SOC.

In order for a Veteran to continue the appeal, the VA must receive a Substantive (Formal) appeal, which is a VA Form 9, Appeal to Board of Veterans’ Appeals, or an equivalent statement of intent to continue the appeal.  There is no legal requirement that a specific VA Form must be received in order to continue an appeal, but VA must receive some form of communication in writing from the Veteran or his Representative indicating an intent to continue the appeal.

A Veteran has EITHER the remainder of one year from the initial decision notification letter, OR 60 days from the date the SOC was mailed, to file his Substantive appeal.  Otherwise, his appeal rights for those issues expire, and the NOD is closed.

If the Veteran has filed a timely Substantive appeal, the next step in the appeals process is to certify the appeal to the Board of Veterans’ Appeals (BVA), which is to transfer jurisdiction of the appeal to BVA.

However, the Regional Office cannot physically send the claims file to BVA until all pending NODs and all pending claims have been decided.  There can be no appeal issues pending before the Regional Office at the time the claims file is sent to BVA; otherwise, BVA will issue a Remand instructing the Regional Office to issue an SOC on any pending appeals.

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You said:

 "I think I have a very good chance of winning all four on appeal, if I can spot the easy errors an attorney should have no problem. "

Since you know what the errors are, the appeal should not take you too long to prepare.

Focus on the reasons they denied and then refer the BVA to evidence that you feel should award each claim and to any error the RO made.

An appeal does not have to be lengthy but there is very little room on the form so, if you need to add an additional page, refer them to that page on the initial page one of the form and make sure your C File, Name, Address, Contact #s are on the additional page. 

You stated :;" evidence not considered, incorrect diagnosis, conflicting opinions with board certified physicians that provided a IME, etc. ". ...

did they completely ignore any IMEs you had in the denials? 

 

 

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Back in May we had this discussion here:

http://community.hadit.com/topic/65701-need-some-guidance-scratching-my-head-on-a-denial/?page=8

Is the Appeal for a denial of the CUE claim?

Did you ever file the CUE claim I suggested?

Did you ever contact anyone of the multiple contact #s I gave you for your VARO?

It seems that they denied without receipt of the IME,in time to alter the initial denial.But if it was a timely submission,per the SOC deadline, they should have considered it.

Or they might have considered this as a re opened claim when they got it?

Are they still questioning proof of the injury you claimed in service?

If so, VA is not really required to go forward with  evidence supporting an inservice event that is not proven yet.

There are many posts her on your situation. Do any of them contain an attachment of the reasons for the actual denial? And the evidence list?

..... I just read many of the multiple posts here...

The claim was denied because they said they had no proof of the inservice injury. I assume they never gave you a C & P exam for this.But they didnt have to.

If you did file the CUE as I suggested, did you enclose the medical record(s) you had from the inservice event, that was in the 500 pages of your C file- thus in VA's possession at time of the denial?

 

 

 

 

....

 

 

 

 

 

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
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    • 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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      Fund HadIt.com Veteran to Veteran LLC


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