VA asking questions on injury background. Warranted?

[Scottish_Knight]

Greetings all,

I served from 1988 to 2009, roughly 18 of those 21 years were as an Army CID Special Agent.  In 2001, I was shot in the leg, which destroy the femur.  This occurred on a US military installation, however I was taken to a civilian hospital for the surgery and was later transferred to a MEDDAC.  The bullet traveled through the femur, so a rod was inserted with two lower and two upper screws.  I lost not only length in the leg (2cm) but my hamstring atrophied.  Since then, I've encountered continued pain in my knee and hip.  All was documented in my military medical records.  Often times, the pain would have me seek medical attention about 2 times per year, which again is documented.

I underwent surgery last year to remove one of the screws (all are now broken) that was pressing against a tendon causing extreme pain.  The surgeon explained the others will need be replaced and I will also need a hip replacement in the coming years.  The pain continues.

My VA exam was in 2009 and at that time the length difference in my legs was disclosed to me for the first time and as xrays were obtained, the screws were discovered to be broken.  The VA Rating Decision gave me 0%. 

Unknown to me was the appeal process.  Last year, I found someone who is helping me with the appeal.  I live in a remote part of southern Germany, so connection to other retirees and vets is nil.

This week, through my appeal representative, the VA has contacted me.  They want all the background information on the shooting.  They require the who, what, when, where, why, and how of this incident.  I am also to supply them with records I have that they don't.  First, they have a copy of my entire medical record.  How am I to know what they don't have?  Second, the Rating Decision states that this injury was service connected and in the line of duty, so why is the background information required?  Had I been shot while in Afghanistan would they be asking the same questions?

Perhaps I simply do not know exactly how the VA adjudicates the claims.  As this is not a presumptive matter, evidence of the injury must be presented.  They have that in the form of my military medical records.  Do the circumstances behind the shooting hold weight on determining the extent of either the injury or the level and percentage of my disability?  Does the background on an injury play some part of the adjudication process and awarded disability to which I am unaware?

Thank you in advance for any insight into this.

Edited October 26, 2018 by Scottish_Knight

[Buck52]

It Seems VA can make up the rules on this  if I didn't Appeal within 1 year after the claim was Adjudicated …which I never did.

They have this rule  if claimant does not appeal  within 1 year (Time limitations)

 

INFORMATION

ON

38 U.S.C. 5102
APPLICATION FORMS FURNISHED UPON REQUEST;
NOTICE TO CLAIMANTS OF INCOMPLETE APPLICATIONS

This section is taken from:
https://www.govregs.com/uscode/38/5102
 

Title 38 U.S.C. 5102

APPLICATION FORMS FURNISHED UPON REQUEST;
NOTICE TO CLAIMANTS OF INCOMPLETE APPLICATIONS
 

¶5102 - Application forms furnished upon request; notice to claimants of incomplete application
 

(a)   Furnishing Forms.—

    Upon request made by any person claiming or applying for,

    or expressing an intent to claim or apply for,

    a benefit under the laws administered by the Secretary,

    the Secretary shall furnish such person,

    free of all expense, all instructions and forms necessary to apply for that benefit.

 

(b)   Incomplete Applications.—

    If a claimant’s application for a benefit under the laws administered by the Secretary is incomplete,

    the Secretary shall notify the claimant and the claimant’s representative,

    if any, of the information necessary to complete the application.

 

(c)   Time Limitation.—

    (1)   If information that a claimant and the claimant’s representative,

       if any, are notified under subsection (b) is necessary to complete an application is not

       received by the Secretary within one year from the date such notice is sent,

       no benefit may be paid or furnished by reason of the claimant’s application.

    (2)   This subsection shall not apply to any application or claim for Government life insurance benefits.

I may could reopen this claim ask for an audit and ask to correct any errors to include a new EED, ...but it would be a fight...//its leaning in there favor as I can't say why the other page is missing and I got the 1st page .

they can come back and say this application is incomplete due to the second page missing  or some bs like that.

I am fairly sure this was file by my voc-rehab counselor..but he has since Retired.

I have his name and his office location  or as they call it field location office...but the people in there now are all Newbies and I have no Idea where my va voc-rehab counselor is?

 

[pacmanx1]

Buck, have you requested a copy of your Voc Rehab records? Keep in mind they are separate from your C-File. I had to request a copy of my Voc Rehab Records after I completed my course and my Counselor refused to send me a copy and I had to remind her of the Privacy Act of 1974. She then sent me a complete copy of my Voc Rehab school records.

A copy might be in your Voc Rehab records.

Edited May 7, 2021 by pacmanx1

[Buck52]

No pacmanx1  I never requested these records from my voc-rehab BUT i MAY NOW...

Right now were working on my spouse A&A Claim

Few months ago broncovet and I were thinking about filing an audit  to check for any errors in my claim that may or may not warrant a EED...THIS APPLICATION  FOR IU   is what I need   the second page is missing...I don't ever remember filing it so my Voc Rehab counselor must have filed it  IDK?

if it is correct and dated back in 2000  and I got the IU P&T AT A DRO hearing at my R.O.on MAY 7TH 2003  HE (the dro) BACK dated it to a IMO DATE   Dec 20-2002..so if i can find this IU APP DATED SOME TIMES IN 2000....then they own me a year or more of 100% minus any thing they had paid me before that date  which I was awared 50% in April of 2000  I have these records. ....be worth checking out!!!

My C-File is a total mess  back in 1974-78  I went to school on the G-I Bill and my C-File IS FULL OF THOSE RECORDS AD STUCK INBTWEEN MY OTHER RECORDS  ..I contacted a VA  Accredited Claims Agent near me  and had him look at my C-file HE SAID HE DIDN'T SEE ANYTHING IN IT TO PROVE MY CASE FOR EED.....BUT IF I CAN FIND THIS COMPLETED  IU App date in 2000   I may have something,  but not sure it would be worth his time if I don't get much retro?

Edited May 7, 2021 by Buck52

[Scottish_Knight]

Bucks52, to use your own words against you, ... never give up.

pacmanx1 has a great idea.  See to your Voc Rehab records.

On the matter of time limitations is utter bunk.  Aye, the VA states that all the time.  We all know too well the 'one year from the date of the rating decision'.  If that was locked in stone, than my ability to make a CUE claim 12 years after the fact would not even be possible.  Both 38 USC and 38 FAR both make mention to supplemental claims and appeals subsequent to the one year date.

So the VA had page and not page two.  That alone is going to be an debatable matter.  You're going to say they never informed you and they're going to say they did.  Neither can prove it.  You can't prove a negative (your end) and all the can say is they sent it per post.  Most like back then, no copies were kept of sent letters.  Thinking 'fraudulently' the only recourse they would have is to potentially prove they did would by regenerating a form letter.  I doubt they maintain a tracking system for when they sent out letters.

Never give up.

[Scottish_Knight]

4 minutes ago, Buck52 said:

HE SAID HE DIDN'T SEE ANYTHING IN IT TO PROVE MY CASE FOR EED....

Same words uttered by the DAV to me.  When I sent them the new rating decision, which we know is a gold mine, they refused to respond.  Egg on face.

No one cares more about this than you.  Do it on your own, as I have.  It's more of a hassle, as you well know, but the end result is 1000% better.

[Buck52]

5 minutes ago, Scottish_Knight said:

Bucks52, to use your own words against you, ... never give up.

pacmanx1 has a great idea.  See to your Voc Rehab records.

On the matter of time limitations is utter bunk.  Aye, the VA states that all the time.  We all know too well the 'one year from the date of the rating decision'.  If that was locked in stone, than my ability to make a CUE claim 12 years after the fact would not even be possible.  Both 38 USC and 38 FAR both make mention to supplemental claims and appeals subsequent to the one year date.

So the VA had page and not page two.  That alone is going to be an debatable matter.  You're going to say they never informed you and they're going to say they did.  Neither can prove it.  You can't prove a negative (your end) and all the can say is they sent it per post.  Most like back then, no copies were kept of sent letters.  Thinking 'fraudulently' the only recourse they would have is to potentially prove they did would by regenerating a form letter.  I doubt they maintain a tracking system for when they sent out letters.

Never give up.

ROGER AND 10-4  PACMANX1 IS A Diamond in the rut   he is full of a lot of Valuable Information  that's for sure.

I AM GOING THROUGH MY C-FILE (NOW) TO FIND THE 1ST PAGE OF THE iU APP...I HAD IT A COPY OF IT BUT SINCE I DECIDED NOT TO ADVANCE WITH THIS ,  I MUST DISCARD THAT  idk   I  can't seem to find it amist my files.

SO BACK TO THE OLD FAITHFUL C-FILE.