Question about Appeal Process

[Austin0520]

Hi Everyone,

Thanks again to everyone for contributing their experience on this site, it has been so helpful in getting through the process! 

My claim was recently denied (again). This time, for the first time, I appealed and decided to get help from Dr. Bash and a lawyer. I’ve been battling these claims on and off for 5 years and this was my last try...had to make it a good one.

My question is what happens next? I just filed the NOD and the lawyer submitted the form requesting a DRO. Does anyone know how long is it taking these days for a response from the DRO? Is this where I wait 3-5 years? Just not sure what to expect from the appeal process. 

Also, does anyone know how long the CUE process takes? I’m assuming the 3-5 years or longer?

Thank you again to everyone for sharing.

 

[Austin0520]

Vetquest,

Thank you for the firm and name, I see that he has won several appeals (thanks for the tip Berta!). 

[Buck52]

On 6/19/2018 at 9:29 AM, Austin0520 said:

Hi Everyone,

Thanks again to everyone for contributing their experience on this site, it has been so helpful in getting through the process! 

My claim was recently denied (again). This time, for the first time, I appealed and decided to get help from Dr. Bash and a lawyer. I’ve been battling these claims on and off for 5 years and this was my last try...had to make it a good one.

My question is what happens next? I just filed the NOD and the lawyer submitted the form requesting a DRO. Does anyone know how long is it taking these days for a response from the DRO? Is this where I wait 3-5 years? Just not sure what to expect from the appeal process. 

Also, does anyone know how long the CUE process takes? I’m assuming the 3-5 years or longer?

Thank you again to everyone for sharing.

 

The VA (Usually the DRO assign to your case) will write you a letter letting you know the time and date of your DRO Hearing within 30 days or so after they recieve your DRO Request...Generally it depends on how backlog your R.O. is  as for as giving you a time frame....the DRO Letter will let you know the time and date and location of your Hearing.

If the DRO Denies your claim  he/she will issue a SOC (Statement of Case) after you receive this you have 60 days to Appeal on to the BVA

As for as CUE if you win CUE it will be process upon Grant of the Appeal.

but some CUE claims may take longer (years) than the other b/c most claims are based on all probative evidence and the way the claim is presented. (jmo)  

retro may take a lot longer. if its over 25.000 $$$?    which I'am sure you won't mind...

Edited June 20, 2018 by Buck52

[Buck52]

Austin0520

if you can post a redacted copy of your denial letter , we all here can help you better and you may not need an attorney?    the reasons and bases of your denied claim  or ( What We Decided)

Cover your name and claim # 

[Austin0520]

Hi Buck52,

Thank you for the information! This is so helpful.

I kind of have a few things going on....

In basic training (1998) I fell off one of the walls in the confidence course and fractured my foot. In 2004 I tranferred from active duty to the Reserves and in my exit physical had no pain or issues (this is what’s haunting me today). From 2006-present I’ve been seen by podiatrist, chiropractors, and several MD’s for pretty bad pain in both feet, hips (bilateral early arthritis diagnosed at 37 years old), and back. The only rating was for the foot I broke, but everything else has been denied because they say it’s not connected to service. Doctors tell me it’s related to my injury, but I couldn’t get anyone to write it on paper until Dr. Bash. So...I just got the awesome letters and filed the NOD. Hoping for a better outcome this time.

Then...during the review with Dr Bash, he recognized the reactive hypoglycemia that I was rated 0% in 2004 and denied 10% because the VA said I was not on a restricted diet. I was on a diet that the endocrinologist and dietician described in notes. This is the CUE I’d like to file.

Dr Bash also mentioned a possible CUE for my previous hip and back denials. I’m not sure about this one? 

And finally....I had PRK surgery in 2002 and still have severe dry eyes (they seal shut at night). Also starbursts that make it difficult to drive at night. I was denied because the VA said it was elective and dry eyes are a normal side effect. Dr Bash recommended the 1151 because of “not intended outcome”. I think he thought it would help to get the claim approved.

I had so much going on and became extremely overwhelmed. I wish I would have know about this site a long time ago. Everyone on here is so great and it really helps. This experience has made me want to go to school to be a claims officer to help people!

Thanks again!

 

 

[Buck52]

1 hour ago, Austin0520 said:

Hi Buck52,

Thank you for the information! This is so helpful.

I kind of have a few things going on....

In basic training (1998) I fell off one of the walls in the confidence course and fractured my foot. In 2004 I tranferred from active duty to the Reserves and in my exit physical had no pain or issues (this is what’s haunting me today). From 2006-present I’ve been seen by podiatrist, chiropractors, and several MD’s for pretty bad pain in both feet, hips (bilateral early arthritis diagnosed at 37 years old), and back. The only rating was for the foot I broke, but everything else has been denied because they say it’s not connected to service. Doctors tell me it’s related to my injury, but I couldn’t get anyone to write it on paper until Dr. Bash. So...I just got the awesome letters and filed the NOD. Hoping for a better outcome this time.

Then...during the review with Dr Bash, he recognized the reactive hypoglycemia that I was rated 0% in 2004 and denied 10% because the VA said I was not on a restricted diet. I was on a diet that the endocrinologist and dietician described in notes. This is the CUE I’d like to file.

Dr Bash also mentioned a possible CUE for my previous hip and back denials. I’m not sure about this one? 

And finally....I had PRK surgery in 2002 and still have severe dry eyes (they seal shut at night). Also starbursts that make it difficult to drive at night. I was denied because the VA said it was elective and dry eyes are a normal side effect. Dr Bash recommended the 1151 because of “not intended outcome”. I think he thought it would help to get the claim approved.

I had so much going on and became extremely overwhelmed. I wish I would have know about this site a long time ago. Everyone on here is so great and it really helps. This experience has made me want to go to school to be a claims officer to help people!

Thanks again!

 

 

What you need to do is find a Veteran Friendly Dr in the field of medicine your claiming  (podiatrist)and some MDs...

You need to be open and honest with these Dr's and let them know your trying to get service connected for these old injuries that you had in the military...take medical records to them  hi-light the paragraphs you need them to read  (don't take a thick stack of records to these Doc's) ask them to examine you and read these records that pertain to your injury ONLY, and Ask to write  their impression/opinion on rather or not these injuries that occured in the military are given you some problems today and ask them to use this sentence in there report, I have examine this Veteran and read his medical records and in my opinion while in the military these are related to your problem today   (it  is least likely as not)   that theses injuries you suffered on left foot/ right foot  ect,,ect,,  while in the military  he/she may go into short detail as to his explanation,  but by him/her using these words is (least likely as not)' that is the key for most service connections that happen in the military years earlier.

I use to call around or my spouse did it for me until we found a Veteran Friendly Dr...When you speak to the front desk of a Dr office nowadays if you don't have  good insurance its hard to get in to see one because they don't accept cash, so make this clear to them..some Dr's will accept cash and some won't,  usually a Veteran Friendly Dr will accept cash  unless he is in a group like most young Dr's are today.  so a  private Dr with his own Medical Practice  would be better...just have to fish around and see what's biting?

but they are Dr's out there that will help Veterans  as Most of us had to do this very same thing.

[Austin0520]

Thanks Buck 52, I had never thought to do that....