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Improper handling of 1999 VA Compensation Claim

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ardodd

Question

Improper handling of 1999 VA Compensation Claim

I will do my best to present this in a short and respectful manner. I will do my best to truthfully represent all facts and evidence as it was presented in 1999 VA Claim. It is therefore I am seeking help in identifying any missing documents, missing evidence, non compliance of VA Regulations, etc...

I will post the photo copies of the record on my C-file which I received in 2015. I will present the Claim as it was filed through the local VSO in Farmerville, Louisiana County/Parish: Union

 

Subject:

VA Compensation Claim for Albert Dodd

Dated: 15 June, 1999 

Copy of Claim Submission: ** ( All files are in PDF format and saved to my Google Drive ) ** ( View Only ) **

https://drive.google.com/open?id=1d9HHYJHe3fgLuItJ6INugPqWLAZDg1am

VA Claim submitted on: 15 June 1999

VA Claim Received on: 18 June 1999 ( Dept of Veterans Affairs New Orleans, LA )

ATTACHMENTS:

VA Form 21-526 Pg. 7

https://drive.google.com/open?id=1bHb95IPMv6DGTVftK2qLeoYo-rv1miAv

VA Form 21-526 Pg. 8

https://drive.google.com/open?id=1cWw-3sJygTIhnCgrRZFl4B7XSXC0nnE-

VA Form 21-526 Pg. 9

https://drive.google.com/open?id=1P8tgJ0rcUz8MJoInHEMLuv06raHckdZK

VA Form 21-526 Pg. 10

https://drive.google.com/open?id=15P1YoMfREici-kHFHgbz1TttyuzCMLim

Authorization and Consent Included: 

VA Form 21-4142 Pg. 1

https://drive.google.com/open?id=1YXTaDasjAdrfXN8abclQX9a_8v7kM5G4

VA Form 21-4142 Pg.2

https://drive.google.com/open?id=1Ux9UvrEplp2tTkKc6xrZsMCkUSi2e0z4

 

** ( Notes of Interest ) **

Supporting Evidence Attachments:

1) Certified copy of DD 214

2) Copy of Discharge Account Summary ( Severance Pay ) ** ( My Certified True Copy from SMR ) ** 

3) Copy of Findings of the Physical Evaluation Board ** ( My Certified True Copy from SMR ) **

4) Copy of SMR's to support S/C Claim

 

** Physical Evaluation Board Decision **

Pg. 1

https://drive.google.com/file/d/1Ius0W2ZDp-Ls1_fiQxoqfxRWBSor_viU/view

Pg. 2

https://drive.google.com/file/d/1fYqy9fh6kjD0-cXAfK_T6KGoyszVeJNP/view

Pg. 3

https://drive.google.com/file/d/1DsAwqqLecFc6C_HsZghIaZ7D33E37Qf6/view

Pg. 4

https://drive.google.com/file/d/1UJOIGk1DJuNKNR-RRgfXIswVjWLex_jF/view

Pg. 5

https://drive.google.com/file/d/1h6GgoGlDbJ9sEOT7V1CXorWXEKB5rxG4/view

 

All Evidence and Supporting documents where sent in along with the Authorization and Consent ( VA Form 21-4142 ) for Release of Medical Records on June 15, 1999

 

**** Dept of Veterans Affairs New Orleans, LA ****

Intake of Evidence for VA Claim for Compensation for Albert Dodd

Dated: 18 June 1999

**** Timeline for Review of Evidence and Decision ****

June 18, 1999 VA Claim Received

 

June 25, 1999 VA Claim Reviewed

https://drive.google.com/open?id=1LaYkJdHDmZ9ofzA8CJD7ZTCNwOqzVX9N

 

July 08, 1999 Rating Decision ( R.M. LaCOMBRE, Rating Specialist )

Rating Decision Pg. 1

https://drive.google.com/file/d/16cS_DJ6QCut61LVj-jbzolQghHh4StDF/view

Rating Decision Pg. 2

https://drive.google.com/file/d/1MfG-kcASP_2lruDY22eSMGCgKbI6x-_b/view

Rating Decision Pg. 3

https://drive.google.com/file/d/1pUJXAHT_Zguk0WR2R4xTEi8c0EAXLgHs/view

 

July 10, 1999 Compensation and Pension Award **( VA Form 21-8947 ) ** Signed into record

https://drive.google.com/file/d/1JP-MXHlCsjsGlL9M9qP09XSK_OJJC14P/view

 

July 12, 1999 Notice of Decision mailed out  **( Cover Sheet ) **

https://drive.google.com/file/d/1OG7fNoJWMzF79NQ1AI04Z-wz5QrspY7g/view

 

**** Questions for CUE ****

1) Duty to assist **( Did not attempt to help get copies of Hospital stay )**

2) Duty to assist **( Failure to assist by not scheduling a medical exam for current medical condition(s) )**

3) No Development Letter **( Failure to Notify Veteran of any further evidence needed to substantiate Claim )**

 

I Albert Dodd do swear that all information is correct and included. If you or someone you know has information that would help me in getting the VA to correct this wrongful Decision please post your comments. 

 

 

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Ardodds wife-

Ps, in case I cant get back here today-

I do understand how difficult it has been for your husband to deal with these issues.

I dealt with the same problems when my husband was alive (100% SC PTSD and also 100% stroke)

Neither my husband or your husband has/had any problem with their intellect-they are both obviously smart men -and many  MH vets ,once they get a handle on the VA War of the Words,  can successfully fight back.

But the VA , in my opinion, will take full advantage of a veteran who has valid issues, yet who either does not appeal in time or appeals in the wrong way, because they know the veteran has a MH issue, and this VA stuff can become overwhelming for them.

After my husband messed up an EEOC case he had against VA ( I rehearsed the Main question I knew the EEOC investigator would ask him, and his answer was always Yes)-

but for some reason at the deposition ,when the investigator asked him the same question, he said 'no, not really' and althjough his case was superb ( I had prepared it all with plenty of evidence) the investigator turned and gave me a hideous smile when he said that- the case was lost, EEOC knew it and I knew it.

When he had an ADA EEOC matter years later I did all the legal work myself and luckily he did not have to talk to the EEOC lawyer, who talked to me because I had prepared the case and evidence for him.

He won. It was the first ADA EEOC discrimination case awarded in NYS.

The federal contractor EEOC found against  due to discrimination due to SC disability ( within a few months) had to make a cash settlement.

These things happen because anyone with a major MH disability  can have memory problems, can often mix up the timeline of events, and even get mind set over one way to proceed with a claim, but there might be many ways to proceed that they didnt think of. 

I am so glad you are helping your husband. SC MH disabilities are never the fault of the veteran. But between having this type of disability and dealing with the VA can become very convoluted.

It would be great if vet reps ( as a fresh pair of eyes on complex issues) could simplify claims issues better.

But many of them dont have a clue or if they are good reps, they are burned out most of  the time.

I think the best vet rep anyone could have is who they see in their bathroom mirror every morning.

It might be a reflection however of their Spouse!

Thank yu for supporting your husband. I know spouses who could care less aout their vet spouse's claims issues...

yet their attention, help and  input could alter their lives.

 

 

 

 

 

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1 hour ago, Berta said:

In the other thread it states that VA awarded 50% for depressive disorder.(EED 2/26/2016)

Did your husband appeal that decision?

@Berta Thank you so much for helping Albert. He comes and goes and I know he means well. i do apologize if he has not fully understood and acknowledge any of your questions. I will do my best to help fill in any missing information that can not or does not remember. I will do my best to answer all of your questions as best as i can possibly do.

1) Depressive Disorder Claim for 2/26/2016 Award him a 50% disability. 

a) No Appeal

b) We Filed a Notice of Disagreement 07/25/2016

c) Statement in Support of Claim 09/06/2016

d) VA C/P Exam 11/08/2016

2) Depressive Disorder Increased 11/29/2016  Awarded 70% disability Retro-active to 07/24/2016

**We did not seek NOD or Appeal after increase was Awarded**

1 hour ago, Berta said:

If so has he been set for a C & P exam on Depressive Disorder?

And if so, I think that should be the focus ,at this point, of your help.

Does he have any other issue on appeal that might have been set for a C & P exam?

1) Recent C/P Exam 12/02/2017 this past Saturday

a) C/P Exam was for PTSD - Military

b) C/P Exam also covered PTSD - Personal Traumatic Experience

c) Phsyciatrist during the Exam also covered his Depressive Disorder and questioned him and myself regarding his condition.

2) Awaiting Decision from VA

2 hours ago, Berta said:

Is he employed now? If not he should apply for SSDI if he fits into their SSDI criteria . Their criteria for SSDI is at their  SSDI web site.

He is not employed.

He is getting SSDI Awarded to him effective 07/01/2014 Retroactive

1) Intent to File dated 02/07/2017 - Claim finally submitted on 11/17/2017

a) PTSD - Military

b) PTSD - Personal Traumatic Experience

c) Asbestosis - Reopen Claim

d) Traumatic Osteoarthritis - Previously denied as Bilateral patellofemoral Syndrome left knee - Increase

e) Traumatic Osteoarthritis - Previously denied as Bilateral Patellofemoral Syndrome right knee - Increase

f) Tinnitus

g) Chronic Fatigue Syndrome

Secondary Disability claimed:

a) Hip Condition - Filed individually for Left Knee Secondary

b) Hip Condition - Filed individually for Right Knee Secondary

c) Back Condition - Filed individually for Left Knee Secondary

d) Back Condition - Filed individually for Right Knee Secondary

e) Neck Condition - Filed individually for Left Knee Secondary

f) Neck Condition - Filed individually for Right Knee Secondary

g) Hypertension - Filed individually for Left Knee Secondary

h) Hypertension - Filed individually for Right Knee Secondary

i) Diabetes - Filed individually for Left Knee Secondary

j) Diabetes - Filed individually for Right Knee Secondary

k)Temporary Total Disability - Filed for Left Knee

l) Emphysema - Secondary to Asbestosis

j) Bronchitis - Secondary to Asbestosis

l) Asbestosis - Secondary to Asbestos exposure

Claim for Disability 12/04/2017 

a) Parkinson's Disease - Camp Lejuene water contamination

b) Malignant Neoplasm - Camp Lejuene water contamination

c) Neurological Disorder - Camp Lejuene water contamination

d) Renal Disease - Camp Lejuene water contamination

I believe that is as accurate as I can be since the pending 2015 Appeal was Denied because we missed the Deadline.

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  • HadIt.com Elder
8 hours ago, ardodd said:

@Lemuel, @Berta, @asknod

10% Service-Connection for "Traumatic Arthritis" previously Denied as "Bilateral Patellofemoral Syndrome" for Right Knee

2017 Appeal 

Denied for missing Deadline to File VA Form - 9

Can I send in a NOD for the 2017 Appeal? 

Grounds for NOD: Mental Competency and Memory Loss 

this is ardodd's wife and i am the person behind helping him. as he is not fully competent to understand what he is doing or what the VA is doing to him. he may be mentally aware one day and not know what or where he is the next day. 

I would say yes, you can take over and claim the failure was due to "mental competency."  I don't know the specific way to do that without doing a new claim.  Specifically the problems he shows plus look for "denial" being in his neuro-psychological assessment reports if you can find them.   A full load may not have been done and you can ask for one done according to the protocol. I'll post the one done according to protocol in 1985 on me.  One was attempted on protocol in 2010 in Japan but fails in translation.  Too often they do a short version that misses a lot.  There is a diagnosis, anosognosia.  Look the word up and see if it applies which from this side it seems to a good deal.  He is grasping some of his limitations but probably has been resisting you taking over and helping him.

Read the denial letter carefully.  It should tell you what you can do but it may not because it is a "finale decision."

Don't stop with the NOD.  Get the DAV to help submit a CUE, TDIU and new claim based on new evidence if possible.  Write to your Congressman for assistance.  State your hardship case.

In another thread he presented a Military Medical Board decision granting 10% for the knee problem.  It is a clear CUE if he is not continued the rating for that and a Claim of CUE referencing the Medical Board should be immediately submitted.

To go through the schedule and figure out where he is for Total Disability Individual Unemployability, TDIU we would need to see his last rating decision.  But if he has a 50% mental rating and it has gotten to the point you have to take over submitting a claim for an "extra schedular" award for TDIU would work to get things moving again.  That would be slow because it has to go to the Director of Compensation Services for a decision. You need to have him let you take over.  He is acknowledging he is not getting the job done.  If he can't perform in presenting his case any better than he has here now he rates a higher rating.

From his threads, I'm guessing he should be at 70% which would make him eligible for TDIU at 100% presumptively.

"38 CFR § 4.132 Schedule of ratings-mental

disorders...."

PSYCHOTIC DISORDERS…

"...9209 Major depression with melancholia.

9210 Atypical psychosis.

General Rating Formula for Psychotic Disorders:

Active psychotic manifestations of

such extent, severity, depth, persistence

or bizarreness as to

produce total social and Industrial inadaptability ................ 100

With lesser symptomatology such

as to produce severe impairment

of social and Industrial adaptability ................... 70

Considerable impairment of social and Industrial adaptability ........... 50

Definite Impairment of social and Industrial adaptability .................. 30

Mild impairment of social and Industrial adaptability .................... 10

Psychosis In full remission ............. 0

Convalescent rating In psychotic disorders:

Upon regular discharge or release to

non-bed care from a hospital where a

beneficiary has been under care and

treatment for a continuous period In

the hospital of not less than 6

months, an open rating of 100 percent

will be continued for 6 months. A

VA examination is mandatory at the

expiration of the 6-month period, after

which the condition will be rated in

accordance with the degree of disability

shown. Where the beneficiary

has been under hospital care and

treatment for less than 6 months and

is not ratable at 100 percent under

the rating formula, consideration

should be given to §4.29

With a claim for CUE or TDIU you can submit a Freedom of Information Act letter for a copy of his complete file.

I hate to bring up similarities between his case and mine but to give you an idea of what to look for here goes:

My attorney ask for a BVA De Novo review once we got my appeal certified and a expedited BVA docketing because of my age.  And drew a good Judge so most of my issues have been remanded to the Agency of Original Jurisdiction, (back to the local rating Officer.)  I think I posted my means of getting the VA's attorney to respond regularly on a different thread.  I have to call her today to see if she wants to talk.  She has 15 days to respond to the Court or I will probably win.  And that is an extension of half of what I offered to not contest.

I went through more than 30 years that I should have been treated with a seizure medication and wasn't.  MY file now looks very similar at times to probably what your husbands looks like now.  At times I was lucid and made sense while at other times I rambled and failed to make a point other than rigidly focusing on one item and rambling on others that were not connected.  I couldn't get to the point.

I had a claim closed in 1995 for failure to submit an I-9.  I was also out of it a little with partial and complex partial seizures aggravating my mental situation.  In addition I had multiple requests for evidence that the VA Medical Division had but in a non-denial denial  kept giving me reports instead of pictures which hadn't been fully described or had an etiology attributed to them in the reports.  I also requested EEG tracings which had suddenly become benign and I was diagnosed with "pseudo" (fake seizures).  There are reports in my record that negate that diagnosis.  I was unable to get second opinion's on the EEG's or use the pictures to point out the left lateral blowouts of two discs were consistent with the T-bone MVA accident were I was held into the blow at rib height (fractured 2 ribs) and hyper-extended to the right through the shoulder seat belt but held into the blow by the lap belt.

So the most important thing I could help you with is an analysis of his record on these points.  To see where he should be at compensation wise and to see if there are any mistreatments such as a wrong medication, failure to examine with an EEG on evidence that should have occurred, etc or enough evidence of failure to assist in gathering evidence.  Berta's quotes, above, show he can use failure of duty to assist.

His mental problem now may be more than just Parkinson's.  Partial and complex partial seizures cause mental problems.  You don't say if his Parkinson's is the service connected reason of his 50% mental rating or what the specific diagnosis he is rated under is.

Look up the definition of "complex partial seizures" also and see if you have noticed any.

I'm 80% better having been medicated with Keppra for my non-convulsive seizures.  I still have enough depression that a clinician gave me a call and ask if I wanted to come into therapy based on a questionnaire I filled out.  But I am already in therapy.

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  • HadIt.com Elder
23 minutes ago, ardodd said:

@Berta Thank you so much for helping Albert. He comes and goes and I know he means well. i do apologize if he has not fully understood and acknowledge any of your questions. I will do my best to help fill in any missing information that can not or does not remember. I will do my best to answer all of your questions as best as i can possibly do.

 

This post is much clearer.  He can ask for TDIU presumptively because of his current rating.  He probably hasn't previously claimed it.

That would be the first claim to get in.  I had requested TDIU in 1987.  It had never been developed as some of your husband's claims haven't.  But it enabled me to get a BVA decision on May 11, 2017 granting me TDIU back to my first combined rating of 70%.  But I was appealing that claim dated in July of 2009.  Back pay of 8 years.  And, additionally, a remand to develop my first claim for TDIU.

So look through his record carefully.  Even if he said he was "unable to work"  in a letter or on a claim from it is an informal claim of TDIU and they should have developed it.  If they did try and because of his mental state he didn't do the necessary follow up it is as Berta presented above.  An ADA case.  They took advantage of his disability to deny him compensation.

It is clear Mr. Dodd was highly mentally functioning at some point and still has enough left to get Berta and I to know there was a real problem with the way he has been treated.  Keep in touch here and we'll do our best to help.

Edited by Lemuel
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8 minutes ago, Lemuel said:

You don't say if his Parkinson's is the service connected reason of his 50% mental rating or what the specific diagnosis he is rated under is.

I filed this for him last night as I read about Marines exposed to water contamination. I know in my heart that was exposed to those chemicals. He started experiencing symptoms shortly after he got out. Doctors back then did not know why he had such violent tremors which would last for days without any sleep or medications. One private doctor finally put him on Levadopa medications which seemed to help for a few short months, then he went right back to medications not working.

It has been a long battle neurologically and he was finally put on Mirapex (Pramipexole) 0.5 mg And as time progressed to today he has to take 1.5 mg twice a day which is double what is recommended to help him. He still suffers even taking the recommended dosage with episodes and tremors which are very hard to watch him in so much pain.

I will be able to spend more time this afternoon re-reading what you suggested. As I do have to get him into the shower and try to wash him before he has therapy on his leg today.

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As Lemuel said, this post is clearer to read.

Lemuel is Correct as to the TDIU!

The form 21-8940 is available here under a search.

When  the form asks about any disability retirement, they mean in part ( but never clarify that) if the vet gets SSDI and if so what is it for.  

If SSDI awards are for solely SCdisabilities, that is highly probative evidence for TDIU. 

Still an SSA award could become probative, if the conditions that are not SC for the SSDI- to become SC down the road.

So far even with the past rigamorale about the NWG claims, your husband has done very well at this point.

When they awarded the 70%- 80% did the VA ever mention TDIU in those decisions? Or was he still employed then?

Asbestos and Bad Water USMC Le Jeune- lots of info here on that -I will try to find my posts...many on asbestos claims. I had a beauty I helped a former vet rep with (who didnt have a clue)  but the vet died with no spouse . 

Some info here and the PIES list is now here as well

https://community.hadit.com/topic/1269-asbestos-related-diseases/#gsc.tab=0

Does he have the asbestos diagnosis yet? If so can you tell us the exact medical terminalogy they diagnosed him with?

Can he prove his MOS put in near asbestos?

Did he ever , as a Marine, have any active duty on any USS ship?

What was her name and when was it- if he did?

I know- MORE questions, but this is often the way to success and you have time to support those newer claims.

I hope you realize the VA will pay for only one MH  issue but that also means they might have to diagnose PTSD with the depression as  contributing  , or the depression with PTSD,contributing  ......maybe...or better yet just rate him as high as they can for either the depression or the PTSD. ... at TDIU or at 100%.

But tht is my opinion and no one knows what VA will do.

If the PTSD C & P was done at a VAMC, then he can request a copy of it from the Records Access officer ( Or FOIA/Privacy Act officer. They will probably have a short form that he has to fill out and sign.

I(f the exam was farmed out,VA wont release it until they render a decision- anyone here know if that  VA BS changed?)

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