Hi. Here's what I've got. In 2014 I sought SC for SLE. The VARO inferred secondary conditions listed in my supporting statement. Because they did that I submitted DBQs from docs stating those were secondary to SLE. I also submitted STR evidence that I had symptoms of both SLE and the secondaries in service. The SLE was denied July 10, 2015 and also secondaries of Fibromyalgia and Sjogren's Syndrome. A third secondary for Raynaud's remained open, and I had a C&P exam on July 17, 2015 which opined that my service records were not specific enough for DIRECT SC, and it said nothing about secondary since the SLE was not on the table, having been denied the week before. The examiner did not review my claims file or private medical records, including the DBQs noting that my Raynaud's was secondary to SLE. I sought reconsideration of the SLE claim denied July 10 with a THIRD expert opinion on the symptoms in my STR. That was granted on September 11, 2015. In the same letter my Raynaud's secondary condition was denied, but only contained a discussion of lack of specific symptoms for DIRECT SC. But of course the back of the rating letter lists my expert Raynaud's DBQs as secondary to SLE as "in evidence." It seems clear to me that they denied the Raynaud's on a sort of separate track from the SLE that they granted, and once they granted the SLE they neglected to go back and consider my Raynaud's as secondary to my now SC SLE. I had 2 or 3 expert opinions linking the SLE and Raynaud's. Is this CUE?
As for the Fibromyalgia and Sjogren's... the originally had inferred these secondary conditions to SLE but denied them on a direct basis at the same time as my SLE denial on July 10, 2015. Once they upon reconsideration granted my SLE in September of 2015, was it CUE not to infer those conditions also for reconsideration? They had inferred them in the first place. They also had listed my numerous expert reports linking those conditions to my SLE, but did no analysis of them because they had denied my SLE claim on the same date of July 10, 2015.
Also on these secondaries, I have found one Board opinion stating that a rating decision on the primary condition itself is New and Material Evidence to support a request to reopen a claim for a secondary condition to it. But is anyone aware of any better CAVC or more "official" opinions or regulations about this policy?
Also, on CUE, do you think it was CUE to deny a secondary depression claim outright for a missed C&P for which I did not get notice? They had my homeless certifications in my file. And the regs say that they cannot deny an original claim solely for a missed C&P. I had submitted statements on my status, my granted SSDI records finding depression secondary to SLE that they obviously considered severe, and also my therapists SSDI questionnaire. And there were a few VA notations of me "appearing depressed" as well during other treatment visits. So I argued to the VARO that it was CUE not to at least just grant the SC with a zero percent rating. Even if they had gotten a C&P exam, I had two experts, one an SSDI doctor, stating that my depression was secondary to SLE. Is that not CUE?
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uturn
Hi. Here's what I've got. In 2014 I sought SC for SLE. The VARO inferred secondary conditions listed in my supporting statement. Because they did that I submitted DBQs from docs stating those were secondary to SLE. I also submitted STR evidence that I had symptoms of both SLE and the secondaries in service. The SLE was denied July 10, 2015 and also secondaries of Fibromyalgia and Sjogren's Syndrome. A third secondary for Raynaud's remained open, and I had a C&P exam on July 17, 2015 which opined that my service records were not specific enough for DIRECT SC, and it said nothing about secondary since the SLE was not on the table, having been denied the week before. The examiner did not review my claims file or private medical records, including the DBQs noting that my Raynaud's was secondary to SLE. I sought reconsideration of the SLE claim denied July 10 with a THIRD expert opinion on the symptoms in my STR. That was granted on September 11, 2015. In the same letter my Raynaud's secondary condition was denied, but only contained a discussion of lack of specific symptoms for DIRECT SC. But of course the back of the rating letter lists my expert Raynaud's DBQs as secondary to SLE as "in evidence." It seems clear to me that they denied the Raynaud's on a sort of separate track from the SLE that they granted, and once they granted the SLE they neglected to go back and consider my Raynaud's as secondary to my now SC SLE. I had 2 or 3 expert opinions linking the SLE and Raynaud's. Is this CUE?
As for the Fibromyalgia and Sjogren's... the originally had inferred these secondary conditions to SLE but denied them on a direct basis at the same time as my SLE denial on July 10, 2015. Once they upon reconsideration granted my SLE in September of 2015, was it CUE not to infer those conditions also for reconsideration? They had inferred them in the first place. They also had listed my numerous expert reports linking those conditions to my SLE, but did no analysis of them because they had denied my SLE claim on the same date of July 10, 2015.
Also on these secondaries, I have found one Board opinion stating that a rating decision on the primary condition itself is New and Material Evidence to support a request to reopen a claim for a secondary condition to it. But is anyone aware of any better CAVC or more "official" opinions or regulations about this policy?
Also, on CUE, do you think it was CUE to deny a secondary depression claim outright for a missed C&P for which I did not get notice? They had my homeless certifications in my file. And the regs say that they cannot deny an original claim solely for a missed C&P. I had submitted statements on my status, my granted SSDI records finding depression secondary to SLE that they obviously considered severe, and also my therapists SSDI questionnaire. And there were a few VA notations of me "appearing depressed" as well during other treatment visits. So I argued to the VARO that it was CUE not to at least just grant the SC with a zero percent rating. Even if they had gotten a C&P exam, I had two experts, one an SSDI doctor, stating that my depression was secondary to SLE. Is that not CUE?
Sorry to ask so many questions at once.
Thanks very much.
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