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]

@Berta   Good morning.

What is a C File and to which law or regulation is 3.156?

Thank you.

[broncovet]

Cfile...VAspeak for "claims file".  

38 CFR 3.156 is reopening due to new and material (relevant) evidence:

https://www.law.cornell.edu/cfr/text/38/3.156

[Berta]

This is the form you nee to request a copy of your C file, from the VA Regional Office you deal with.

Unfortunately it can take many months to get a copy of a C file.

 

https://www.va.gov/vaforms/va/pdf/va3288.pdf

[Scottish_Knight]

Thank you @Bertaand @broncovet.  I'll ge the form completed and sent.

Today, as recommended from a friend and retiree, I contacted the CCK law firm in the US (Rhode Island, I think).  I had a chat with them and provided as much detail as possible.  There is nothing the can do.   I was informed the only hope is a CUE appeal, as you've mentioned many times here Berta.  Sadly, the CCK do not do CUE appeals.  They recommended the DAV (actually, the recommended a few alternatives, but I'll stick with the DAV.

Berta, is there anything specific I need to tell the DAV?  Again, I have no new evidence or material.  I'd like to hpoe they know what they're doing.  They got me sorted with a new claim, at least, albeit not the route I wanted, but it's something.  Advise?

Thank you.

[pacmanx1]

2 hours ago, Scottish_Knight said:

I was informed the only hope is a CUE

The first thing you need to understand is I can see your SSN on your post. It is best to make a copy of it and then redact/white out it on the copy then scan it and post it. Next you must get familiar with 38 CFR Part 3 and part 4. These are the regulations that the VA use to govern veteran’s disability claims and rating percentages. The more you know the better chance you have in winning your claims.  Next, whenever VA makes a decision, the veteran has 365 days, one year to file an NOD (Notice of Disagreement).  Next, whenever VA makes a decision, after ten (10) working days, the veteran can call VA and have them email them a copy of that rating decision.  I hope you can follow all this.

The questions are when did VA make their decision?  When did VA mail you their decision?

To back-up a wee bit, the VA rating was mailed to me on 25 November 2020.

You have until November 2021 to file a NOD on this decision. You can call VA and ask them to email you this decision. In stead of filing a CUE claim you can simply file a NOD. Compare the evidence VA used to make their decision and the evidence you had in your records back in 2009 and if you can prove by medical evidence that you had the same evidence and symptoms you can file a timely NOD and ask for an EED( Earlier Effective Date) back to 2009. Filing a CUE claim and filing a timely NOD can result/warrant the veteran the exact same benefits except filing a NOD is a lot and I mean a lot easier. With filing a CUE claim the veteran loses the benefit of doubt and filing a timely NOD the veteran keeps his benefit of doubt. You post different dates, so I am not sure when VA made their decision but keep in mind that the NOD time frame begins when the VA mail the veteran their letter and not the effective date.

Edited January 25, 2021 by pacmanx1

[pacmanx1]

You may not have PTSD but if the symptoms you have with your leg and hip bothers you in any way, you may want to consider filing a claim for depression. Keep in mind that filing a claim for depression does not mean that you are crazy, it just means you may have some type of anxiety about your limitations.