Improper handling of 1999 VA Compensation Claim

[ardodd]

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. 

 

 

[Lemuel]

My farmed out neuropsychological assessment was farmed out.  I was given to us with the SOC.  So we didn't get it until after the appeal to the BVA was certified.

Don't know what the rules are.

[Lemuel]

I just received an email from the VA re pro bono legal services. There are 4 clinics in Alabama.  Don't know if they will take your case, adodd.

https://www.va.gov/ogc/docs/LegalServices.pdf

 

[ardodd]

Thank you @Berta and @Lamuel 

I will answer your questions in my next reply.

In my research tonight I found a few things by going through his SOC. And that is the 2015 Appeal we missed the deadline on. The first thing I did come across what the Definition of a Chronic Disease.

Medical Board Discharge 07/10/1990

Reason: Bilateral Patellofemoral Syndrome 

Definition:

Quote

Chondromalacia patella is abnormal softening of the cartilage of the underside the kneecap (patella). It is a cause of pain in the front of the knee (anterior knee pain). Chondromalacia patella is one of the most common causes of chronic knee pain. Chondromalacia patella results from degeneration of cartilage due to poor alignment of the kneecap (patella) as it slides over the lower end of the thighbone (femur). This process is sometimes referred to as patellofemoral syndrome.

https://www.medicinenet.com/patellofemoral_syndrome/article.htm

What we have never noticed til right now is that what he was diagnosed with while in service is a "Chronic". If I am reading the VA Guidelines correctly his In-service and Medical History fall under "Chronic Diseases" 

I was able to locate these Guidelines online:

Quote

 

38 CFR 3.303 - Principles relating to service connection.

§ 3.303 Principles relating to service connection.

(b)Chronicity and continuity. With chronic disease shown as such in service (or within the presumptive period under § 3.307) so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. This rule does not mean that any manifestation of joint pain, any abnormality of heart action or heart sounds, any urinary findings of casts, or any cough, in service will permit service connection of arthritis, disease of the heart, nephritis, or pulmonary disease, first shown as a clearcut clinical entity, at some later date. For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word “Chronic.” When the disease identity is established (leprosy, tuberculosis, multiple sclerosis, etc.), there is no requirement of evidentiary showing of continuity. Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim.

https://www.law.cornell.edu/cfr/text/38/3.303

 

While researching his Due Process Rights I was able to find the correct Guidelines for Processing a Claim and a Veterans Rights to Notification.

Quote

 

M28R, Part III, Section C, Chapter 2

2.06 Procedures for Providing Due Process

a. Definition of Terms

1. Due process in the administration of VA benefits requires that the case manager inform the beneficiary of a proposed adverse action that could reduce, deny, or terminate benefits, and provide the beneficiary with the opportunity to provide additional evidence to contest the action, and/or request a meeting with his/her case manager.

2. An adverse action denies benefits and/or services, reduces or otherwise lessens benefits or services, or terminates benefits.

b. Entitlement to Notification The following parties are entitled to notification of any decision made by the VA that affects the payment of benefits or the granting of relief:

• Beneficiaries • Guardians of minor beneficiaries • Fiduciaries of Veterans rated or deemed incompetent • Beneficiaries’ designated representatives

c. General Notification Requirements for an Adverse Action or a Proposed Adverse Action When feasible, the case manager will meet with the Veteran to discuss any adverse actions. However, this personal discussion does not replace the written notification to the Veteran as required by 38 CFR 21.420.

Every notification letter for an adverse action or a proposed adverse action must include the following elements:

1. Nature of the decision

2. Effective date of the decision

3. Reason(s) for the decision

4. Evidence that was considered, and the right of the Veteran to present new evidence, request a personal meeting, and have representation

5. Veteran’s right to present new evidence, request a personal meeting, and have representation within a 30-day period from the date of the notification letter

It is important to note that VAF 4107 does not need to be sent with the notice of proposed adverse action. The case manager must only send VAF 4107, Your Rights to Appeal Our Decision (see Appendix O, VA Forms), with the final notice of adverse action once the action has taken place.

https://www.benefits.va.gov/WARMS/docs/admin28/M28R/Part_III/III_C_2.pdf

 

By Law he should of received a Notification Letter giving him instructions on what was needed to Approve/Deny the 1999 Claim.

That Law was Violated under this Code:

M28R, Part III, Section C, Chapter 2

2.06 Procedures for Providing Due Process

Second reason I feel he was wrongfully Denied in his 1999 Claim for Compensation and the continuation is because the VA failed to follow Guidelines set forth for "Chronic Diseases" 

38 CFR 3.303 - Principles relating to service connection.

§ 3.303 Principles relating to service connection.

 

[ardodd]

31 minutes ago, Lemuel said:

I just received an email from the VA re pro bono legal services. There are 4 clinics in Alabama.  Don't know if they will take your case, adodd.

https://www.va.gov/ogc/docs/LegalServices.pdf

@Lemuel unfortunately we live in Louisiana. I have applied for Legal help thru the VA Portal for him but so far we have not been able to anyone that will help.

Of course that is probably because he has been trying to do it himself. And like we know he is not able to present his case in a manner that anyone would understand or feel strong enough to stand with him.

I do have a very busy day today. As @Berta and yourself mentioned the only way he will get the right help is if I step in and help.

So today I will be setting in front of the computer trying to put into words what Law's and Guidelines where violated. And to organize a simple letter that states what was not done correctly so when we sit down with the DAV representative tonight he will be able to understand.

I will from time to time need to ask a few questions and maybe find a simple form that would help organize the letter so it is not too confusing.

[Lemuel]

Sounds like a good approach.  Is this the office you tried?  I'm going to give them a call for myself.

The Veterans Consortium Pro Bono Program
2101 L Street, NW, Suite 420
Washington, DC 20037
Telephone: 202-628-8164
Toll Free: 888-838-7727
Fax: 202-628-8169
E-Mail: mail@vetsprobono.org
www.vetsprobono.org

 

[ardodd]

7 minutes ago, Lemuel said:

Sounds like a good approach.  Is this the office you tried?  I'm going to give them a call for myself.

I filled it out on eBenefits for him. Not exactly sure but it likes you have a better approach through that website.

Of course it is storming here today so it makes the internet slow and unavailable.

But will try to keep things updated as best as I can intermittently.