Very Disappointed...

[Cherie33]

As some of you might remember, I was here seeking advice on my current sc of 50% (major depression) and 10% (IBS) to be raised. Then I received a letter from the VA proposing a decrease. I had to obtain a letter from the Psych doctor and a letter from my primary care doctor.

Well, the VA sent me a letter the other day saying that my current 50% rating will remain the same. (I'm sure because of the doctors note).

Now, when I received the first letter proposing to decrease my 50% rating to 30%, they also said they were leaving my 10% rating the same, so I appealed that. I received a letter asking if I wanted it to be appealed through the traditional measure or with a Decision Board. I have been tring to reach my DAV rep since before Christmas. First he was on vacation, then he just wasn't in that day, til now, he retired. I have run out of time and don't know what to do. Can anyone offer some help?

Thanks,

Cherie33

[Vike17]

Cherie33,

If you disagree with the VA's decision outright, in this case I mean with the evidence of records that VA used to reach thier decision, you should file a Notice of Disagreement (NOD). Your best bet is to ask for a DRO review of that decision. This gives someone senior and really experienced another chance to look at your claim(s). Then they will either render a new decision granting what you seek, or keep reaffirm the prior decision.

If you sent in your NOD already, but didn't indicate what route you wanted your appeal handled then, as the VA did, will send you a letter asking which avenue you want to have your appeal handled. The "traditional" route is sending your appeal to the BVA. If you choose this, the VA will send you a Statement of the Case (SOC) and then you have 60 days from the date of the SOC to submit VA Form 9 to "prefect" you appeal, which means they will send your appeals to the BVA. If you don't respond to the letter within 60 days, the VA will process your appeal the traditional way.

If you choose the DRO review, as I said above, someone with more experience than a normal RVSR will review your appeal that had no prior doings with the the revious decision. He/she will either render a new decision and grant whatever you are seeking on appeal, or reaffirm the previuos decision. If you do not like the DRO's decision, you can still fill out VA Form 9 within 60 days of receiving thier SOC and have your appeal forwarded to the BVA.

Another avenue of a approach is, if you have further or "new" evidence that VA was unaware of at the time of thier prior decision, you can ask the VA to reconsider thier previous assesment. If you ask for a reconsideration within the one year of the rating decision and the reconsideration is granted, the original effective date is retained. A reconsideration generally goes quicker then an appeal because your c-file goes back to the Rating Activity and is worked according to your original effective date.

Hope this helps

Vike 17

Edited January 11, 2007 by Vike17

[Pete53]

I agree with Vike17 file your Notice of Disagreement and ask for a DRO Hearing. If you are unable to work you should bring up TDIU also. Good Luck

[carlie]

Hey there Cherie,

It's carlie here - in your face again about that DRO hearing I know you want. lol

Question ? ? ?

What evidence do you have to present the DRO for an increase ??

Get those little duckies lined up.

carlie

[sixthscents]

I and Terry have agreed to disagree on this point. Personally, I have handled most cased simply with a NOD and a DRO review. Its expedient compared to the BVA process, lets another consider the claim, and you can still go for a formal appeal if it doesnt get you what you think is correct.

Terry has been thru some.. well extraordinary circumstances for a vet I think and his experiences have shaded his outlook a bit. Personally I just keep try and keep claims at the DRO level as much as possible. While it is not always the best route, it certainly in my opinion is the first of many steps that I would take before even considering a BVA traditional appeal. There are several reasons and I'll list just a few:

1. DRO reviews normally process much faster than a formal appeal.

2. The original SOC indicated WHY the original rater made the decision the did... you can provide the DRO with additional evidence that can streangthen your claim, be it anecdotal or factual. Since you know what needs addressed, you can simply adrees those issues and normally the DRO will respond, but not necessairily by increasing the claim.

3. DRO's are held at the local RO, and your file is there as well so any additions can be made - on the spot, and normally do get added in prior to review if you are expedient in providing them.

4. I normally get what I think is a fair rating simply by going thru the DRO... now thats my experience. You do not have to disagree with all the ratings either. You may simply disagree with some of them, in a multi-injury claim.

5. For me the BVA process is the last step. Either I fundamentally disagree with the VA's decison and believe that I have a very strong case, or the veteran insists that it go. If a veteran insists I file with the BVA I will, reguardless of my personal opinion, but... I won EVERY one of my claims, with rating I felt were fair simply by going thru the RO, and DRO.

So.. heres my opinion...

Generally it is not the rater which is at fault... though they do screw up plenty... plenty. It is a lack of evidence which supports the conclusion or finding that you feel is warrented. When a mistake is made, a DRO review mostly corrects them, if they are pointed out and sufficient evidence is provided as to what determination should have been made and why, and what evidence supports such a conclusion.

Is this doing the DRO's job for them? Sure, but if you want something done right... Also, you are WAY more familiar with the claim than the DRO so you should be able to point out WHY the judgement was in error. So my NODs normally develop the claim for the DRO. Simply put I follow a format...

1. State the RO decision.

2. State what you believe the decision should have been.

3. reference your belief to CFR 38 guidelines

4. provide supporting evidence, and point out supporting evidence to the CFR 38 guidlines for establishing that decision

5. make the DRO aware of evidence that the RO failed to consider, missed or that has been added

6. summarize the NOD...

so.. its a fixed formula, and is specific to the claim... and like I said, I VERY seldom go thru BVA... I either win at the DRO level, or in my opinion the claim is not supportable, or it involves an "interprtation" of CFR 38, rather than the established facts of the case....

Anyway that my opinion. I dont rely on the RO, or DRO... its my job to make sure that what I am claiming is supported etc.

Even then raters make dumb decisons... obviosly WRONG decisions... but if they do my experience has been that the DRO NORMALLY corrects these if tehy are pointed out and shown to be clearly in error...

They dont like CUE claims any more than we do...

[gwvet90]

We did the DRO - after nearly a year - got decession = all denials & a very very rude SOC that disreguarded their own C&P examiners diagnosises.

We just filed form 9 box A - no hearing - just have BVA review.

Along with it, we sent in copies of 8 tests done & ask they be considered "new & material" evidence - as the SOC said " there is no proof of any test ever being done & the C&P examiner based his diagnosis on inaccurate information given by you" - Quite frankly after being accused by the RO of lying to the Dr - & the RO discrediting their own Dr's diagnosis, we wanted no further dealings with the RO.

That is our experiance so far - it really depends on the RO you are dealing with as to what your next step should be. Some RO are dead ends & you never get a proper rating, others are much much better.

Look at the RO stats - link was posted here a while back...... Our RO was one of the very lowest rated for satisfaction, & highest for denial - yet very low for volume of claims. That combined with our experiance with them told us it was best to get our file away from that office.

Edited January 11, 2007 by gwvet90

[john999]

GWvet90

Did you have a face-to-face hearing with the DRO or a DRO Review. I find the face to face hearing mode the best. Some of the De Novo reviews are just cut and paste jobs.