Just got my appeal won but they reopened a denial from 2008-why

[Dave143mtg4life]

I just got my appeal for my smc won last week and my retro deposited. Right after that I checked ebenefits and it says open claims and it says new claim from 2008. I called ebenefits and it says it’s a new claim but it’s an internal new claim from a denial they gave me in 2008. How would they do that and why? I am already 100 percent and maxed out on my smc so why would they look at my denials from 2008 and why would they open a denied claim from that time without even telling me they were?  Does that mean it will be approved but that won’t change my money or anything.

[broncovet]

Congratulations on your win!!!  If hadit members or Tbird or this site helped you, remember Tbird..she asked for donations because she needs them.  Having this site hosted is "not" free.  

Did you get the VARO decision?  That may tell you why.  

Possible:  SMC K, or sometimes Vets keep on a going with new SC's even when maxed out because, if you die from a SC condition your spouse can get DIC.  It is also possible that it helps you if some of your other conditions improve and you get a reduction.  

What the VARO calls "moot", sometimes is "not moot".  In my case, when I got awarded 100 percent, they said TDIU was "moot".  I appealed, because my claim for TDIU "could" result in an earlier effective date (it did, upon appeals) and because TDIU can become a bases for SMC S. 

So, they could have reopened something that was in error, which "could" result in an earlier effective date for SMC S.   The VA has a duty to "maximize your benefits", but, of course that usually means they lowball you.  

Edited June 8, 2018 by broncovet (see edit history)

[Dave143mtg4life]

In 2008 they denied me for one condition for my lower back. I then got approved for multiple conditions in 2010 which made me 100 percent with Housebound and smc L. I just got my appeal awarded because I had tbi and seizures at 100 percent so they awarded me the max smc at smc t 2 so they can’t smc me any higher than that but once the appeal was granted it opened up a denial from 2008. I just didn’t know why because it wouldn’t change my percentage because I have 5 disabilities at 100 percent and maxed out on my smc unless the the change of the change of the denial from 2008 would of given me an approval than I would of gotten some money from 2008 to the increase in 2010 when I became 100 percent. I just didn’t understand why they would open it and why they wouldn’t even tell me or is that normal?

[broncovet]

What did the VARO decision say the reason for reopening it was?  If you have not gotten it yet, then you will have to wait for the envelope.  

According to VA's website, yes your comp maxes out at T2.  https://www.benefits.va.gov/compensation/resources_comp02.asp

 

Its a over 8000 per month, so your retro check should be hefty if it was very many months.  

[Dave143mtg4life]

Hi. I got the letter for the approval and yes it is for smc t2. It was for 23 months so it was a good thing. It didn’t say why they reopened a denial from 2008 or why or that they even were. I just had a weird itch to look on ebenefits and it said open claim from 2008. I called the va and they said that it was an internal claim from the denial from 2008 that was opened. Didn’t know they could do that or why they would even do that. All that would happen would I would get another retro from 2008-2010 for what they denied me for that disability but was wondering if they even do that

[broncovet]

"Sometimes" they do that.  You see, SMC is always an inferred claim, so  you dont have to apply.  Your effective date is the "date you met the critiera". 

Now that I know you are reading from ebenefts, basically no one knows what/if will be posted on ebenefits as its notoriously unreliable.  If in doubt, remember I told you that ebenefits is unreliable.   

Yes, its possible you met the criteria earlier, or there could be a "middle ground", that is, SMC that is more than you were getting, but less than R2, depending upon your disabilities, and when they occurred.   This is referred to as "Fenderson" or "staged ratings".  You know, they award 50 percent from 2003 to 2005, then from 2005 to 2010, its 70, percent and after 2010 its 100 percent, for example.  The same can happen with SMC..you could be eligible for a higher level than what you got in 2008.  

It is cue for the VA "not" to infer SMC when you meet the applicable criteria.  

So, yes its possible you have retro coming if the claim opened in 2008 is decided in your favor.  

[Dave143mtg4life]

Thank you for that information. Also how do I contribute to this website for this valuable information. I always have questions and my vso takes months to talk to. Yes your information is information and you might tell me it’s just that but what you said made me realize and understand it so I now am not scared that what they just approved me for my 2 year smc for the appeal won’t be taken away. I got scared that after two years and the approval they open a case for some totally different thing that makes no sense from a denial from 2008. You know the saying. Once you get what you want don’t keep putting in claims or you open up a can of worms so I didn’t understand why it would just open a claim 

[FormerMember]

It has nothing to do with SMC. In this day and age of .pdf OCR text recognition, they have algorithms they can run on a  VBMS claims file, VAMC CAPRI records and any of the correspondence---or other older ratings from 2008 in your case.  By law, they have to carefully and sympathetically develop a claim to its optimum if anything such as new evidence is submitted now (2018) that might be an "inferred claim" for an older claim. In that case, they file it for you. Once the evidence is in the file, if VA notices it, they can award you the disability but only on the day the evidence was associated with the claims file. Here we have active proof of VA now awarding you anything and everything finally that they screwed up and missed in the past. I find it interesting that this close inspection of our files only occurs when we can no longer benefit from it.  If it is added to your then-existing ratings, I'll bet $5 it will not yield any retro. It will be a paltry 10% or less. 

I recently had a client in almost exactly your situation- two different SMC Ls bumping him up into the R/T plateau. When my Vet got there, they showered him with inconsequential 10%s, 20%s and a 30% for dual incontinence and sagging facial muscles etc. etc. on top of R2. It's like getting five Purple Hearts. The extra oak leaf clusters look cool but they don't buy a bigger cup of coffee.  Personally, I like to roam around in really old VBMS records from the 60s and 70s. The VA thought they were a law unto themselves and hosed us Vietnam Vets on ratings. They are a goldmine waiting to be uncovered.

Edited June 8, 2018 by asknod (see edit history)

[Dave143mtg4life]

That makes sense. From 2007-2010 I was rated at 20 percent. Then went up to 100 percent. That denial was from 2008 so prob best I just wait to see what it says as long as it has nothing to do with the approval I just got from my two year appeal approval then I am good. I just know that they always say never put in more claims once you have what you need to get the medical attention you need for you disabilities and the amount to survive. I am not greedy. I have what I need for my care and the aid I need. That’s why I got worried when they opened up another claim from 2008 by themselves that’s all 

[Dave143mtg4life]

And you are absolutely correct. They keep giving me 100 percents like it means extra cash. I know the more service connection is better just Incase I die from it that it will help my wife but and I am not greedy with having smc RT but to go back to a claim from 2008 and have the manpower to open a claim to let’s say review it and let’s say grant it when there are thousands of veterans who are in desperate need of service connection is crazy. 

[Oceanbound]

Congrats!! I'm in the process of the same TBI journey you went through, I lawyer up knowing that I "HADIT" with the VA and not being properly rated at R2/T when I originally filed 16 years ago.