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

[Scottish_Knight]

A continuation of this thread, update and question.

I followed the advise provided here, but nothing ever became of it.  The 'rep' who offered to assist, it would seem, did nothing.  Regardless, I found a group of people who did assist and did a cracking job!

As stated originally, the VA did recognise my gunshot wound as SC, but rated at 0%.  Last year, I was examined by another doctor in Augsburg and had subsequent x-rays in Stuttgart.  This was forwarded to the VA and the gunshot was rated at 40%, I've been informed.  With the additional three injuries / illnesses, I have a total rated disability of 60%.  I was informed that DFAS now does an audit before any payments are made.

Around the end of December, I received an email stating my pay had changed.  I reviewed it and my end of month retiree LES was indeed different.  No VA disability take out.  At the beginning of this month, my retirement pay and my VA disability did increase.  Nice that!  My VA disability increased by $850. 

Not long after, roughly 10 days ago, I received CRDP from DFAS at $2250.  Does seem a bit light for 11.5 years, but am happy to have it.

To back-up a wee bit, the VA rating was mailed to me on 25 November 2020.  Based upon the fact that the VA do not air mail letters and that three letters last year took approximately 3 months to arrive, I assume I'll receive this rating determination around the end of February or beginning of March.  So I have nothing in writing.

I contacted the VA yesterday to ascertain the status on the backpay.  The VA employee knew nothing on that.  Odd, indeed.  He told me a letter had been sent to me on 15 January with details of the backpay.  So, I should receive that around the end of April.  Again, nothing to know until then.

So, on the VA backpay.  Does anyone have insight into this?  I have none.  How long does it take to receive backpay?  Is it a lump sum or monthly payments?  Does the retro pay have time limitations or will it go back to when I retired?  How does one know if it's the correct amount?

Any thoughts would be appreciated and am grateful for any input.  Thank you.

 

[broncovet]

First, a question:  Do you have a bank (especially an American Bank) where you get direct deposit?  That will be much much faster than mailing a letter to Germany. 

Since you have apparently retired, it always delays retro (backpay) because the do a DFAS audit for CRDP.  

To find out "what is going on" you have a couple choices:

1.  (Best) Find a VSO with VBMS access.  I have no idea if this is available outside the USA or not.  But it might be at the VSO's office.  

2.  Try calling Peggy (the VA 1-800 number.  

3.  Contact "IRIS" email to inquire the status.  

     Do you have an ebenefits account?  Is it PREMIUM ebenefits/va.gov?  Try there also, but much on ebenefits and va.gov is unreliable, with some exxceptions:  "the letters".  The VA does not want you running around with a official letter from ebenefits that says you are 100 percent, unless you are.  

     The letter may give an effective date, too (this determines back pay).  But, the letter may not be accurate, they often use "the last Cola" for an effective date but that wont help you much since our last cola was Dec. 1.  

[Scottish_Knight]

Thank you for responding @broncovet. 

Yes, I do have a bank in the US and my VA pay is the only thing that goes in.  My monthly pay.

DFAS paid the CRDP about 10 days ago.  Again, seem a bit light, but ok.  Have no real means to verify it.

By VSO are you referring to VFW and the like?  Never heard of VSO or VBMS....or IRIS for that matter.

I contacted Peggy yesterday.  See above.

I do have a ebenefits account.  I'd assume it's not Premium. 

I don't receive COLA.  It would seem that since the VA recognised the injury as SC back in 2009, the back pay would be fully retroactive.  Correct?

I'm merely trying to guess or assume how much I should expect and when.  The $850 difference from the November and December pay is interesting.  If I multiplied that by 139 months, it's near on $118K.  I'm sure that's not accurate and would likely be less.  If that were the case, is that paid in a lump sum or in small monthly increments?

Thanks again.

EDIT:  Had a wee look at the VA and eBenefits sites.  No information on backpay / retro compensation.  The updated rating is there, but short of that....nothing.

Edited January 20, 2021 by Scottish_Knight

[Berta]

This DFAS site might help:

https://www.dfas.mil/retiredmilitary/disability/payment/

 

There is a 800 number for help in the link.

Also this might help as well:

https://www.military.com/benefits/military-pay/concurrent-retirement-and-disability-pay-crdp-overview.html

The COVID situation has slowed down many VA offices here.

 

[Berta]

to add  there are only 10 cases at the BVA that are appeals involving CRDP retro-I used CUE as well in the search feature.

One was a Motion under CUE involving retro due to a  CRDP veteran but the VA denied the Motion as it was not propery prepared.

There was however, a successful CUE claim:

https://www.va.gov/vetapp20/files7/a20012464.txt  ------granted CUE

"The withholding of $2,146.21 due to concurrent receipt of military retired pay (MRP) and VA disability compensation for October and December 2017 was clearly and unmistakably erroneous; the appeal is granted."

and also an audit request by the BVA:

https://www.va.gov/vetapp11/files1/1104298.txt

remand for full VA CRDP audit.

When you get your decision, it will help if you can scan and attach it here (please cover your C file # and name, address, prior to scanning it)

We will need to see the Evidence list as well, and then we will need to see a redacted scan of this past rating decision:

"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%. "

There could be a 38 CFR 3.156 issue or a CUE issue in that past decision that we can help with

to help you garner the proper EED ( Earliest Effective Date) for the CRDP.

The winning CUE provides us with a great template.

8 BVA decision regarding CRDP and retro were denied.

One was a widow's claim.

I read them all and they all seemed to have been properly denied.

But NOTHING is impossible - yet I am only speculating on potential CUE and/or 3.156 and did not want to forget these decisions above, if in fact, your retro is incorrect.

 

 

[Scottish_Knight]

@Berta, thank you for replying to this thread.  I have more information today that sheds some light on my recent questions, but offers new ones now.

As no one here in Germany was able to assist me in arguing my rating, I was able to find a non-profit in the US who does and did.  But they did something without notifying me and I am slightly miffed.  Ok, truly miffed.

I was informed today, that my backpay and CRDP will go back to March 11, 2020.  Reason?  According to the group 'There was never a disagreement submitted on the description of the disability or the granted 0 percentage from the December 2009 decision'.  Had I been made aware of that, I would have argued it.  Whole-heartedly.

To have been shot in the leg, with a destroyed femur to which a rod is inserted and held together with screws, which broke later, and a 18mm leg length difference....to have been rated at 0%.  Unfathomable! 

Yes, this could be a CUE. 

I responded back to the group today that this was unacceptable and I wish to counter it.  I'll see how they respond and report back here.

Thank you again.