Am I there yet?

[jamescripps2]

Yes I am there. My appeal only took eight months. In October , 2015, I was awarded loss of use of a hand and a foot and got the vehicle grant w/adaptive equipment and the SAH grant. I appealed that decision because upon any new 100% grant the VA is obligated by statute to consider A&A as an inferred issue and they failed to do that.

In December 2015, I appealed the decision because A&A was not considered as an inferred issue. My contention was,  I was awarded SMC "L" for loss of use of two extremities in the decision.  Had the VA considered A&A as an inferred issue at the time of that decision as they should have, I would have qualified for regular A&A. An A&A award is also a SMC"L" award. According to 38 CFR 3.350 and USC 1114 if you are entitled to two separate ratings between L and N you qualify for the "O" award. In my case I have two awards at SMC L that qualify for SMC "O". The A&A automatically goes to the R-1 rating if you obtain the prerequisite "O".

I got eight months retro but will appeal the decision for an earlier effective date of January 2011, the date that the loss of use claim was filed. More later.

Edited August 14, 2017 by jamescripps2 (see edit history)

[Buck52]

This is great news James, I hope other veterans read up on some of your post that is eligible  any type of SMC.

Good Work!!!

[jamescripps2]

I don't mind telling you that my strategy and resultant award was in large part due to some excellent advice given to me by Alex Gram, aka Asknod. The whole thing played out and is documented over on the SMC "M" thread. There are not many people who understand the SMC regulations enough to carry on a decent conversation on the subject but Alex has a pretty good handle on it. Thanks a million Mr. Alex Gram, you make a difference!

Without a call to the Veterans Whitehouse Hotline I would still be waiting for my appeal to be certified to the BVA. I owe Mr. Trump for that one!.

[broncovet]

Good job (again) Alex...and Mr. Trump.  My question is why did it take so long to have a "white house Hotline" for Vets?  Most of the problems we see here are hardly new, and VA should have provided their own "custormer service hotline" so the white house does not have to.  

To have to call the white house for action reflects exceptionally poorly on the VA.  They should be embarrassed when the president has to intervene, it indicates the agency is lacking in doing it themselves.  

[FormerMember]

My father gave me one piece of advice that I've borne well, I hope, James.

"Son, you haven't experienced life until you have done something for someone with no thought of recompense."

While I'll never fill his shoes, his actions and words inspire me every day. I'm very honored to be entrusted to do what I do. 

 

[jamescripps2]

My August 2017 grant was for SMC "O" and  A&A at R-1. It was a partial RO grant on my appeal. In the appeal I asked for the "O" and R-1 with a effective date of Jan 1, 2012, that being the date of the claim.

I did not claim A&A when I filed the 2012 claim. My contention is that the VA is mandated to consider and infer A&A upon any new 100% grant. If A&A needs to be developed based upon the evidence then the rater should invite the evidence to support the claim as it is the duty of the rater to maximize benefits. In the decision of December 2012, I was granted loss of use of a hand and a foot at SMC "M". I was granted the automobile grant with adaptive equipment and the SAH grant. A&A was not invited, considered or inferred by the rater upon that decision.

My contention is that A&A should have been considered, invited and inferred based upon my profound heart disabilities at the time of the earlier decision. Lately, August 2017, I was awarded the "O" and A&A at R-1 based solely upon heart disease. My heart disease that the A&A grant was based upon in the 2017 grant is exactly as it was in 2012 when the claim was filed, nothing has changed. My cardiologist states that there is no significant change between nuke stress test of 2012 and 2017.

I was paid retro for eight months instead of the sixty eight months that would have been due if the mandated A&A had been inferred in the earlier decision as I contend that it should have.

I have been given the option of withdrawing the request for the earlier effective date or doing nothing thereby letting the claim be certified to the Board and the EED date be adjudicated by the BVA.

Heart problems alone, in evidence of my C file and as noted in my VAMC records at the date of both the earlier decision of 2012 and latter decision of 2017 are as follows.

Chronic Systolic Heart Failure, Hyperlipidemia, Warfarin indicated, Biventricular automatic implantable cardioverter defibrillator, Chronic atrial fibrillation, ischemic congestive cardiomyopathy, Ventricular Tachycardia, Post CAGB 1997 and implanted stents. 

I think that I need to let it ride and take my chances of an EED at the BVA. It may not take too long with the President having signed the Appeals Modernization legislation today.

Any ideas or opinions on my chances of winning the issues of A&A as an inferred issue and the EED as a result would be welcome. Retro, if I win would be paid for 68 months vs 8 months as it now stands.

[Buck52]

James be careful  because they may come back and say you never applied for the A&A,Unless you have evidence that the A&A mandate should have been infrred   they will say you never applied for it.

with your medical evidence  this is telling you yes  but just be aware of them figuring out a way to deny because of some technicality  like Veteran failed to Apply for A&A on date so-so...if you can prove it should have been Inferred back when you was awarded 100% in 2012.

From what you posted  if it was me I'd go for it  you have the medical evidence and that is what wins claims and EED.'s

I wish you well.