Jump to content
  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Ads

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

  • 0
SgtE5

Can I add Additional Denial Rebuttable While In NOD?

Question

Posted (edited)

Filed for ankle and knee problems that both are documented in my SMR. I was denied with a reason stating that both were acute problems. I filed a NOD. I requested my c-file, received it on Monday. Had a c&p from a contracted VA doctor so was not in my medical file as it was a contractor. The c&p doctor that did the ankle and knee exam opined the claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness. Her rationale: Veteran had no issues related to the claimed CONDITION prior to military service. Onset of the condition was during service, documented in the Service Medical Records. There is evidence of current, chronic and continuous treatment and care. A nexus has been established.

I don't understand why I was denied if the c&p doctor opined claimed conditions was related to service and I have met all 3 elements.

Even though her opinion is in the record, can I add a statment arguing the c&p doctor provided nexus? Or just wait for the SOC as I know it will be denied again and argure to the BVA?


SECTION III – MEDICAL OPINION FOR DIRECT SERVICE CONNECTION
Choose the statement that most closely approximates the etiology of this claimed condition.
X 3a. The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury,
event, or illness.
3b. The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event,
or illness.
3c. Provide rationale:
Veteran had no issues related to the claimed CONDITION prior to military service. Onset of the condition was during service, documented in the
Service Medical Records. There is evidence of current, chronic and continuous treatment and care. A nexus has been established.

Edited by SgtE5

Share this post


Link to post
Share on other sites

Recommended Posts

  • 0
Posted (edited)

 Unless you received your claims file after September 2018 when you received the denial, then the VA's IMO reasoning is what you posted in #4 when you copied and pasted the info after being asked by my fellow moderator. You pasted:

1)Service connection for left ankle condition is denied since this condition neither occurred in nor
was caused by service. We did not find a link between your medical condition and military
service. 

2) Service connection for left knee condition is denied since this condition neither occurred in nor
was caused by service.

3) Service connection for right knee condition is denied since this condition neither occurred in nor
was caused by service. 

That decision, or VA nexus if you will, with the VA seal on the first pages is called the "narrative". It may or may not have come with what we call a confirmed rating decision listing all your SC and NSC conditions. If you received your claims file before they issued the narrative, then it would not be in the claims file you now have.

 As I tried to explain to any who will listen, VA has their own in-house VA examiner. S/he is a medical doctor or ARPN/PA-C etc. S/he is the one who made the nexus (IMO) finding of fact that denied you. I cannot seem to impress on folks that a LHI nexus isn't worth the paper it is printed on. You can fight it with a CUE. You might win it saying it's CUE but you are in for a NOD and appeal. File a NOD and allege CUE. Cite to M21-1, pt. III, subpt. iv, ch. 7, sec. B(3)(a);  see also sec. B(3)(b) (requiring correction of errors on the rating codesheet, including disability evaluations, effective dates, and diagnostic codes); id., sec. B(3)(c) (requiring referral of an erroneous decision "to a decision maker to issue a new decision" once an error has been identified). Hell, claim §4.6 was ignored. 

In sixteen months, VA will probably send you a SOC. At that time you can opt in to the BVA with VA form 10182. Shoot. I don't have any more advice to offer without stepping on someone else's toes around here. 

 

 

Edited by asknod

Share this post


Link to post
Share on other sites
  • 0

My appeal was recently remanded by the BVA for a "new medical opinion". I proved to the BVA that the C&P exam i received at a VAMC was inadequate and so they ruled. If i had a proper IMO in my file they would have granted my appeal. I wanted one but could not afford one. So what will i do now? I must find a way to get one now that i have a second chance. Maybe the new medical opinion ordered in the remand will turn the tide in my favor. Maybe it will result in denial. Maybe it will be remanded once again. However,if i get my own proper IMO i am certain i will prevail. Your situation is not the same as mine but while you are finding out why those clowns didn't consider the LHI doctors opinion you should be looking into getting your own IMO. You have lots of time. I am personally convinced,after reading many posts and forums,that a proper IMO is essential in most cases. I'm just a clueless numb nuts handling my own claim without an attorney or VSO but thats my two cents.

Share this post


Link to post
Share on other sites
  • 0

Thank you sir. I was actually wrong on the decision date. Got my claims confused. This was decided June 28, 2018. I just recieved my c-file this week. Oddly enough, reading further into the c-file, the LHI opinion was signed off on June 8, 2018 and decision was June 28, 2018. Wonder if that was enough time to have LHI entered in the record.

Share this post


Link to post
Share on other sites
  • 0

There's the problem. I doubt it would have been uploaded to VBMS before the 6/28 rating decision. Call 800 827-1000 and explain what happened. You may not even have to file a CUE for it. The 800 folks just got VBMS in it's most primitive form but they may be able to see it. Use the M 21 cite above. M21-1, pt. III, subpt. iv, ch. 7, sec. B(3)(a),(b).  VA pukes don't speak 38 CFR. The LHI/QTC/VES  run about 30 days out on most of the subcontractor submittals on the c&ps unless it's flashed RFN. If June 28th is the day they confirmed it, I'd guess they "promulgated" it about three to five days before that. Welcome to the new VA National Work Queue (NWQ), Sgt. Evidence? We don't need no stinkin' evidence. 

Share this post


Link to post
Share on other sites
  • 0
Posted (edited)

Letter is dated 6/28 with date of decision is 6/26

Edited by SgtE5

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Answer this question...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Our picks

    • Type 1 Diabetes recent onset!
      I was diagnosed with Type 1 diabetes in September 2017 OUT OF NOWHERE.

      i am a Navy Reservist and deployed in later 2009 to mid 2010 and again later 2014 to mid 2015; had a 2 year recall between those deployments.  

      Only healthcare received since commissioning in 2008 was from the Navy and no issues EVER.

      insulin dependent and have dietary restrictions and in a non deployable status.

      VA denied initial claim due to Type 1 not showing on active duty and now appealing.

      Anyone with successful experience getting a rating with my circumstances?  I live in Upstate New York.
      • 9 replies
    • Agent Orange Kadena Afb Okinawa
      I am looking for anyone who was on Kadena AFB, Okinawa or .Chanute AFB, IL. My dad was there from Oct. 68-April 70. He has ichemic heart disease, diabetes which has resulted in the amputation of his right leg below the knee and peripheral neuropathy. We were denied in 2002 AMVETS filed a claim on his behalf for heart condition, diabetes and back problems. I refiled in December 2011 and have just received the claim statements and medical release forms. I am familiar with filling out this paper work because my husband is a combat veteran of Iraqi Freedom. I have been reading articles from the Japan times and I am a member of the Agent Orange Okinawa facebook page. Another thing that helps make my dad's case is that he was on Chanute AFB, IL and it is on the EPA Superfund list and has PCBs/Pesticides and Dioxins/Furans listed as ground and water contaminants. I welcome any advice, tips or articles that I may have missed in my own research.
        • Like
      • 15 replies
    • CBO Options for Reducing the Deficit: 2019 to 2028 Published Dec 2018
      CBO Options for Reducing the Deficit: 2019 to 2028 - This CBO Report has been making the news. This post includes parts relevant to veterans. Nothing has been decided as of yet and some seem very unlikely but you never know. Forewarned is Forearmed.

       

      https://www.hadit.com/cbo-options-for-reducing-the-deficit-2019-to-2028-published-dec-2018/
      • 10 replies
    • 2019 Veterans Benefits
      State Benefits, Space A and More ... https://www.hadit.com/2019-changes-to-veterans-benefits-state-and-federal/
      • 2 replies
    • Appeal granted and closed.
      My appeal was granted and closed on November 9.  I got an unofficial notification from the DAV on November 15 stating "appeal granted with an evaluation of 30%" which is great!  My question is this:  How long until I get the official notification from the va? Nothing on ebennies has updated since the appeal closed. Appeal is now in historical and just says complete and at originating va office. I understand no one knows va timelines to a tee but a general timeline would be great.  Thank you all! Hope you have a Merry Christmas!

       

      Edit:  This was my first time appealing and it was a VBA grant. 
        • Like
      • 6 replies
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines