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Old closed claim injuries added to current claim and I didn't add them. Also what does appeal substitution review mean on claim status?
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ZBS
So we are curious...
Have been at 80% since 2011 but things have progressed with mental status and being able to keep a job and function like normal. I decided to apply for an increase in PTSD on Jan. 9, 2019. I had a very weird C&P exam where it lasted literally 20min and nothing was really asked much about anything. My previous exam for this was very traumatizing and it disrupted my life for weeks after. Every trigger they could hit, they did. This time was very different. I was very thrown off by it as I was so worked up thinking about the last one I didn't sleep for 2 weeks prior to this one. This time the doctor said "I will suggest you are put in for an increase, God Bless you, and thank you for your service". Less than a month later they moved my PTSD from 50% TO 70% which brought me to 90%. I saw this in my bank account before I saw it in Ebenefits and way before I got the notice in the mail. When the notice came in the mail it said "at 90% pending return of TDIU form". The VA then sent me a form for TDIU. I have never heard of them actually sending/requesting to fill out this form, have you? I figured maybe they wouldn't send it if they didn't plan on considering it? So I filled it out and sent it back in.
At about the same time i submitted the TDIU papers I saw on my claim that 5 of my old physical injuries that were previously rated were added to my claim (both knees, both legs, and back) and in parenthesis after the description it said "(INCREASE)". I didn't add these to this claim, they were previously rated and closed claims. What does this mean? Has anyone had this happen before? A week or so later they also sent a request to disclose medical records from outside providers. In the same letter it said they will wait 30 days to process my claim unless I am done submitting evidence. If I was done submitting please check box (or do it online) that you are ready for a claim decision and that I have submitted all evidence I have.
Because they added the extra things on my claim, and my physical pain has been increasing as I have gotten older, I went ahead and sent in records from my physical therapist and such that were all done outside the VA since 2011. Because I had nothing left to send in, I then clicked on the button "decide my claim, I have no additional evidence to submit" and after that, this is what showed up in my claim status "File: ClaimDecisionRequest.pdf Type: Appeal Substitution Review". What does Appeal Substitution Review mean? It seems kind of confusing. I don't want to assume anything!
I also just got an email that 2 days ago from VES where I got my C&P notifying me that the VA claims requested clairification from my medical records from them. Looking at my claim it shows "Exam Request - Request for Clarification No longer needed" I've also never had this happen. Maybe this is all positive things?
It is all really odd to me, as all my other experiences in the past years have not been like this. In the past it was a horrible process to deal with and very long and drawn out. It currently seems to be moving very fast this time around, which is a load off. I am hoping its all positive as I am currently not doing well and not able to work. It would be helpful to get my 100% to help support my family right now. I have been out of work since February. Just curious what your thoughts are on this and if anyone has had anything similar happen as described above?
There is nothing left to do but wait. Thanks in advance, I appreciate the input!
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GeekySquid
In general it looks like the VA rate builder triggered and they want to bump you to 100% under TDIU, which is good for you based on your description. The VA pay rate table shows this 70% -
GeekySquid
@ZBS I am not sure I see all the details in your posts to track you from 50-70-90 but for this thread it doesn't matter. The big problem with TDIU is that by law, you cannot earn more than t
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