How long does the authorization process take?

[smithmary614]

I have had an appeal in for over four years now. In January I was put on financial hardship to expedite my file. I was sent an SOC April 10th detailing why they couldn't fully grant my appeal. I did get two things increased but three other things denied. Also in the SOC they said that they newly granted me service connection for fibromyalgia, mental disorder and sciatica. But they had no rating in the SOC just a note saying "an award letter would come under a separate cover". The 1-800 number says that there has been a rating assigned to the new service connected conditions but they can't tell me what they are because they haven't been finalized yet. They are being reviewed and authorized. So my question is how long will that take to finish usually? And why did they do them separately? 

[ShrekTheTank]

We would have to see the letter to see what is going on but it sounds like you don’t have one?  Have you checked ebenefits?  Or va.gov?  

Are you at the BVA?  

[GeekySquid]

@smithmary614

your post is titled How long does the authorization process take?

sadly the answer is no one can really say.

As @shrekthetank1 asked do you have access to Ebenefits? and are you at the BVA or RO ? I suspect BVA but please verify.

The reason for Ebenefits access is that under the Disabilities section your changes will show up long before the BBE. Under the Letters section if you receive a 100% rating (TDIU or Schedular) a Commissary Letter will be generated and a ChampVA letter.

The Commissary letter has no financial information so it generates very quickly. In it will be authorization for a 100% SC vet to use a base commissary and to do that you need a base ID. A vet who is 100% P&T will have no expiration / renewal date on that ID in the letter. A TDIU vet will have a date that corresponds to their next review C&P.

As for authorizations and time, there are many factors. Is there an Earlier Effective Date (EDD) involved? Back Pay? if so then depending on the amount of pay more signatures are required. I think the number 25K is the trigger for more signatures.

Are there SMC's involved like Aid and Attendance? that needs other authorizations.

Did you get an increase on your May 1 check? any deposits your were not expecting? those often happen before the BBE arrives and with very little math you can identify your rating level increase, but not the specifics or reasoning, only the BBE will tell you that.

Since you know you were denied a couple things, order your C-file now. by the time it processes these documents will be at the imaging center. I am supposing you will want to know what evidence was used and what the Codesheet and DBQ say so you can form your appeal of the denials.

I wish there were more definite answers but at this point everything is just speculation.

Good luck and let us know what happens.

 

 

Edited May 10, 2019 by GeekySquid

[smithmary614]

@shrekthetank1 and @GeekySquid sorry it took so long to respond. I had to scan cooies of my SOC to post here and show you both. On page 1 of my SOC the issues section outlines five of the seven issues I was appealing. And then below it is has a note that states that I was granted service connection for the other two issues I was appealing plus a third that I didn't claim but I'm told comes with having back issues. But they don't have a rating assigned to them. The 1-800 number and my VA appeals coordinator said that they are rated but they can't tell me what they are because they haven't been finalized yet. Then on page 34 is the decision. I was granted increased rating for my back and my knee. My sleep apnea stayed the same and then they denied the other two. The increase on my back and my knee alone will increase my overall rating and give me a back pay. I was told by one VA rep that I wouldn't have to wait until the new service connected issues were finalized to get my back pay for the increases. But then I was told by another VA rep that I would have to wait until the newly service connected issues were finalized before I would get any back pay so it's done all together. So if that's the case how long should it take for the new service connected issues to finalize? Its been over a month now. 

Also, I appealed the effective dates of my back and knee that was in the SOC and I was told that wouldn't affect the back pay from that but then I had another VA rep tell me that since I appealed those effective dates that I could potentially have to wait until that goes to the BVA before I get back pay. So I'm just really confused. Why did they not finalize everything together in the first place? 

SOC.pdf

[GeekySquid]

40 minutes ago, smithmary614 said:

The 1-800 number and my VA appeals coordinator said that they are rated but they can't tell me what they are because they haven't been finalized yet.

@smithmary614

Did you look on Ebenefits under the Disabilities link? As a matter of policy Peggy will never tell you squat about a rating decision that is not finalized or that you have not yet received a BBE on.

Based on your SOC this was an appeal to the RO.

 

42 minutes ago, smithmary614 said:

. I was told by one VA rep that I wouldn't have to wait until the new service connected issues were finalized to get my back pay for the increases. But then I was told by another VA rep that I would have to wait until the newly service connected issues were finalized before I would get any back pay so it's done all together.

This is another area that is swampy and it should be concrete.

Depending on the claims and the reasons that issues are deferred, split off, or new ones attached to a claim, and I suspect on how bad a day the rater is having, they could do any of them.

back pay gets even trickier than just getting rating decisions. Depending on the amount there are multiple levels of approvals that have to sign off on for the VA to authorize a check to you. I think that 25k or higher in back pay triggers the next level of authorization needed, but don't hold me to that number.

In a structural sense it does flow that everything before them should be finalized and only one back pay authorization cut.

For example if you are rated 50% ptsd, 30 % lungs, 30% knees, and you appeal all three for EED and increase.

If they decide that your PTSD is really 70%, lungs 60%, and knees 40% then if they first paid you for the PTSD backpay (from 50 to 70) then figured out that you also have 60% from the same date, that means you should be paid at 80% instead of 70 and they would have to got through all the hoops for that increase. Then they find out about your knees and that 40% which would jump your 88 to 93 which is paid at 90%...more hoops. 

It gets worse, in this example you might be eligible for TDIU based on the PTSD jump to 70% alone. If that is awarded you are 100% at that time of your original claim, more backpay. Then if they later found out the 60% you are immediately eligible for SMC(s)....and all hoops start over again because that would be paid back to the ED of the original claim you were appealing....

As you can see, there is a structural reason to holding off back pay until all claims are finalized.

My best suggestion is to monitor you bank account. Check the Disabilities link in Ebenefits, and get a hobby that prevents you from obsessing over when the BBE will show up. I understand you have a financial hardship, but the stress will kill you so don't add too it. About once a week call Peggy about the BBE.

[vetquest]

The good news is that you have been SC'ed, the bad news is that you must now wait for the two new conditions to be rated.  It is most likely that all awards will be held until the new conditions are rated.

As far as appealing your service connection that should not affect the payment of back pay.  Will it, there seem to be no hard and fast rules with the payment of back pay.  For instance if you win a BVA appeal and another condition is remanded they are supposed to pay for the awarded condition while your other condition is being rated.  Does the VA do this, no they have been holding back pay until all actions are finalized.  They VA will do as the VA has always done, delay, delay, delay.

[GBArmy]

I also understand that if you are in financial hardship, you can apply for an expedited payment, on at least any new s-c condition that was found and awarded while the other(s) are being worked on.