FDC rigmarole

[HowIWish]

On August 27th I finally completed and submitted my husband's FDC. We used Valor 4 Vets for an IMO, and I submitted over 1800 pages of medical records. Michael at Valor was great to work with, and he assured me I had covered all the bases with everything we submitted. I'm not sure my husband even needed the IMO, but once I had all the records, buddy letters, DBTs (3 of them,) and family letters, it all looked overwhelming and disjointed to me. I felt having one letter tying everything together from Bethanie at Valor 4 Vets would help tie everything together since my husband had so many providers giving opinions over a one-year span. Also since the VA had denied his mental illness diagnosis and has refused to test him for PTSD, or allowed him to even TALK about his combat experiences, I thought the IMO wouldn't hurt.

Since his claim has been submitted his status has been "gathering evidence." Three weeks ago there was a request for additional records. However ebenefits didn't specify what they wanted. A week later we got a letter from the VA requesting medical records from all of the doctors we had already submitted all of his records from. 

My husband called the VA (when I wasn't home of course, and his mind isn't the best,) and he spoke with a man who confirmed they had all the records they were requesting. He said he made a note of it and told my husband to fill out releases for the VA to get any other records they need, or click the "request a decision" button on ebenefits. Since we've already given them all the records, we clicked the "request a decision" button.

That was 2 weeks ago and the request for all of his medical records is still on ebenefits, and it says they're past due. His completion date keeps moving back. All of the records show up in his uploaded files.

Is this normal? I'm worried they are going to make a decision using no records! 

Also, ebenefits shows that they requested a C&P exam on October 3. But then nothing. No appointments have been scheduled. I'm guessing that's normal, but it seems like after almost a month there would be something scheduled?

If anyone has experience with this please let me know. If there is something else we need to do to make sure the VA utilizes the 1800 pages I've already uploaded but they keep requesting!

[Buck52]

 Yes they absolutely can make a decision using no records (DENIED)

I'm not sure why the VA has not read his records ?but sending in 1800 pages of medical evidence  no rater is going to read  all of that.....they simply don't have the time...what you should have did was only send in the favorable reports from the Dr's that have seen your hubby,  reports that get right to the issue on hand. ( no long drawn out reports)  EVEN HIGH LIGHTING THE PARTS YOU WANT THEM TO READ...1800 pages is just way to much for a Va rater to sit and read.

VA Requires a PTSD Diagnose from only the VA MH Dr's

Not sure what all your hubby is claiming?

Treatment records help like therapy sessions and hey can be from VA or private. (that are favorable evidence)

Mostly Dr's Reports that are short and to the point.

If your hubby was denied it would help to post that denial on here for members to better help you *reason and basis )&( What we decided).(cover all personal information) claim # and names /address

I am sure you guys have an appeal on-going?

We need more information on what he is claiming and why he was denied.

Thank you  for helping your hubby and Welcome to Hadit.

Edited October 28, 2017 by Buck52

[broncovet]

Yes, many of us have had similar issues.  A rating specialist has "minutes" to crank out a claim, even tho it may take months for it to finally make it to him.  Do the math here.  If a "fast reader" can read a page in 2 minutes, that is 3600 minutes just to read your 1800 pages.  3600 minutes divided by 60 minutes per hour is 60 hours...and that is just to read your claim, not decipher the data.  

As I said, when it weaves its way to the decision maker, he will have 15 minutes, not 60 hours to read it.  So, your claim, like mine, will be "top sheeted", where they read only what catches their eye, and then denies it 85 % of the time.  

Before it gets to the decision maker, a half dozen or so "underlings"...people training to become raters, will "check" to see if everything is there.  

Now, stuff gets posted to ebenefits in the most disorganized and unreliable method VA could come up with, probably done by teens in trouble who were ordered by the judge to Volunteer, and the VA seemed like a good place.  

Now that you know the reality that VSO's dont tell you, here is the good news.  

Most Veteran claimants who apply AND PERSIST with appeals eventually win their benefits.  

So, my advice is to "hunker down" for a long fight, and stop beleiving your VSO who tells you that your check should arrive in 4 to 6 weeks from date of application. 

Whenever a FDC asks for more evidence, your claim automatically  moves out of the FDC realm...without any notice to you.  FDC is the "fast lane" which allows only a couple pages, not 1800 pages.  That is like bringing 3 filled to the brim shopping carts to the grocery stores "5 item limit" express lane.  

Your VSO should not have let you think this is a FDC.  

Now, this is just my opinion...you have already heard your VSO opinion.  Time will show which of us is right.  For your sake, I hope he is correct, that you get a check in 4 weeks, and I get to say "Congratulations on your win", and apologize for suggesting it would take much much longer, as your VARO and VSO obviously have it going great, and Im the one who has no clue.  

SOURCE:  15 years of applying for benefits through multiple VARO decisions, multiple BVA appeals, and even several CAVC trips.  I won my claims about 15 percent of the time, (at the VARO level, much higher at the BVA level), which is consistent with what Alex Graham and others say:  85 percent of first time claimants are denied.  VA isnt posting that number..on purpose.  

[HowIWish]

This is his initial claim and he hasn't been denied. It isn't an appeal. 900 pages was from the VA records, but I had the entire file in my possession so I uploaded it because, well, it's the VA. The length of his medical record is why I had an IME done. It simplifies everything and ties up his evidence into a few pages, citing all the parts in his records that make the claim.

We don't have a VSO. I did the claim myself.

He's claiming PTSD, Bipolar disorder, MDD, Cyclothymia, Sleep apnea, ED SMC, and hearing loss. The reason for the multiple MI claims is specifically because of his VA records. Outside of the VA there has been no question of his diagnosis, but the VA doctor who treated him was all over the place. It simply covers the bases. Also, I realize that sleep apnea is a long shot, but I included it because we already had the records and documentation and there is a clear link between psych meds-> weight gain-> severe sleep apnea. Yes, he probably won't have it awarded.

We know that the VA has to diagnose his PTSD, but up to this point they refuse to. They literally won't even let him be tested. He's been diagnosed with PTSD from 5 or 6 different doctors (one family doctor and 5 psychiatrists) outside of the VA and none have ever had any question he has it due to his combat. So the goal is to force the VA to address the issue in a C&P exam. He served in combat in Iraq in 2003 as a machine gunner with the 101st Airborne. He was in multiple documented gunfights, was shot directly at multiple times (documented in buddy letters,) and over half of his squad from his deployment are unable to work at all due to PTSD. I won't say more about his deployment here out of respect to my husband, but he was involved in some ugly situations. All honorable and following orders, but life-changing nonetheless. 

A few guys in his squad we weren't able to contact, a few have been able to hold minimum wage jobs (i.e. Delivering pizzas) and only 2 that we know of can hold regular full time jobs. But most are in bad shape and are in situations similar to my husband's. so we got buddy letters and VA decisions from the ones we could. 

So we got DBTs and an IME. There's nothing else we could do at this point. The VA's treatment of him has been nothing short of malpractice. We simply have to pray the C&P goes well and take it from there. 

I am very confused about what you're saying that an FDC should be a few pages. A fully developed claim means it contains all the records and the VA doesn't have to obtain them. If I didn't submit the records myself, the VA would have obtained them and it would have been the same amount of pages. It's his medical record. 97% of it is only from the year preceding my filing of the claim. There are less than 30 pages from prior to 2016. How could an FDC not include all of his records? 

[HowIWish]

Broncovet, do you think they requested the records they already have simply to move the claim from FDC to not FDC? I know your opinion on FDC claims anyway from reading so much in this forum, and I know filing an FDC doesn't mean much, but it really ticks me off if the worker did that just to push the claim back and get more time. They literally requested the exact records I already provided.

I've been known to raise hell at Dayton VAMC anyway, and because of the crazy things they've done to my husband (including kicking him out of support groups for PTSD) my husband and in-laws are convinced they've "flagged" him and make things extra difficult for him. Because of this website I tend to think he just gets treated the same crappy was as all vets. Especially ones with no rating yet. From friends' experiences, it seems like once you have a rating they don't give you such a hard time. That's what we're hoping for because he really needs PTSD treatment, and the VA does excel at that. But for now he's stuck getting care at our county board of mental health. 

[SangreJoven]

On 10/28/2017 at 1:53 PM, HowIWish said:

We know that the VA has to diagnose his PTSD, but up to this point they refuse to. They literally won't even let him be tested. He's been diagnosed with PTSD from 5 or 6 different doctors (one family doctor and 5 psychiatrists) outside of the VA and none have ever had any question he has it due to his combat. So the goal is to force the VA to address the issue in a C&P exam. He served in combat in Iraq in 2003 as a machine gunner with the 101st Airborne. He was in multiple documented gunfights, was shot directly at multiple times (documented in buddy letters,) and over half of his squad from his deployment are unable to work at all due to PTSD. I won't say more about his deployment here out of respect to my husband, but he was involved in some ugly situations. All honorable and following orders, but life-changing nonetheless.

Since your husband was directly engaged in combat he should have been awarded a Combat Action Ribbon, or some other form of commendation for it.

This is the breakdown of recognized combat decorations right from the M21-1MR.

If your husband has any of these decorations, be sure to inform the VA about it. If he has one, the VA will order a PTSD exam based on that alone because it's considered definitive "proof of combat."

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwit7_yz06DXAhWMTCYKHbtiDfoQFggpMAA&url=https%3A%2F%2Fwww.benefits.va.gov%2Fwarms%2Fdocs%2Fadmin21%2Fm21_1%2Fmr%2Fpart4%2Fsubptii%2Fch01%2Fch01_secd.doc&usg=AOvVaw2cTyz2ngnxWPgmf4q1DXnP

 

When a Veteran has received any of the combat decorations listed below, VA will presume that the Veteran engaged in combat with the enemy, unless there is clear and convincing evidence to the contrary:   ·   Air Force Achievement Medal with “V” Device ·   Air Force Combat Action Medal ·   Air Force Commendation Medal with “V” Device ·   Air Force Cross ·   Air Medal with “V” Device ·   Army Commendation Medal with “V” Device ·   Bronze Star Medal with “V” Device ·   Combat Action Badge ·   Combat Action Ribbon (Note:  Prior to February 1969, the Navy Achievement Medal with “V” Device was awarded.) ·   Combat Aircrew Insignia ·   Combat Infantry/Infantryman Badge ·   Combat Medical Badge ·   Distinguished Flying Cross ·   Distinguished Service Cross ·   Joint Service Commendation Medal with “V” Device ·   Medal of Honor ·   Navy Commendation Medal with “V” Device ·   Navy Cross ·   Purple Heart, and/or ·   Silver Star.   Important:  ·   Receipt of one of the decorations cited above is not the only acceptable evidence of engagement in combat. ·   If a Veteran received a Global War on Terrorism Expeditionary Medal, Global War on Terrorism Service Medal, Afghanistan Campaign Medal, or Iraq Campaign Medal, but not one of the combat decorations cited above, develop for the claimed stressor as shown in M21-1MR, Part IV, Subpart ii, 1.D.14.  Receipt of these campaign medals alone does not generally indicate engagement in combat.

[HowIWish]

Sorry it's been a long time! I just saw the notification on your reply.

My husband has the CIB/ Combat Infanty Badge. He has 3 C&P exams this week, PTSD/mental health, Sleep Apnea and Audiology. I'm a nervous wreck because he's been really messed up the past 2 months. He stopped taking his meds and is saying "The VA was right, I have personality disorders and don't need these meds." But he's in a really bad place and is delusional. I joined a PTSD veteran wives group on FB and he fits in exactly with what their husbands experience, with him being at the more extreme end of PTSD. 

 It really upsets me the way the VA has treated him. They basically invalidated everything he experienced in Iraq. He was involved in serious combat and many firefights. He saw some really bad things, some of which she hasn't told anybody about that I know about because some of his military buddies have told me. 

 He's refusing to prepare for the C&P exam,  and I'm really nervous that the doctor is going to do with they are known to do. Get him all worked up about how bad I am, and then say that all of his issues are marital issues. That's what the doctors have done so far. They told us we need marriage counseling.  

 Marriage counseling doesn't help somebody who's extremely paranoid and angry and delusional and thinks that their wife is the enemy.  Every single doctor he is seeing outside of the VA is very clear about what his issues are. And they all say he needs to get help from the VA because they have the best treatment for his issues.  I just pray that he gets a good doctor that doesn't screw us over.