Interesting little blip under AMA (maybe?)

[GeekySquid]

Interesting little blip I discovered today and am wondering if anyone else has seen these same things under the AMA process.

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The situation:

I just applied for a rating for Voiding Dysfunction as the VA said I had a possible claim when they granted my ED claim.

The whole C&P was a joke and I suspect I will  have to appeal based on the fact the Dr was not qualified among other reasons.

However, the blip is that today I went to VA.gov to check the status. I do this to track how many days it takes to get to each stage.

In the file today I noticed it had two closed requests so I went looking around. Both requests are marked closed

Documents filed

Request 2

Exam Request - Request for Clarification  ---Now who they sent this too and if it means the VA has the C&P is up in the air. I will call peggy on monday to find out.

No longer needed

Request 1

Exam Request - Processing

No longer needed

 

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One the files tab under additional evidence was this line

Additional evidence

File:
Type: VA 21-4192 Request for Employment Information in Connection with Claim for Disability

 

Now the blip is that I own my own company, and nowhere in the claim application, C&P, or my VA files is the name and address of my company. Nowhere is there a reference to the fact that I own a company. This is intentional on my part.  The Dr who did this C&P did not ask who I worked for or what type of work I did. He only asked how my BPH was service connected and how having to pee a lot impacted my work.

I have not received that request form and of course the VA does not show dates sent.

But VA.gov does show that 2 requests were made and both were closed on May 15th and 17th respectively.

I am 100% P&T and generally work at my office or home.

In none of my claims has there ever been a letter from the VA asking about my employment and I don't remember ever seeing that Form Name or Number on any of my previous claims in Ebenefits. I searched my existing C-File copy and that form is not in there at all.

I am wondering if this is a new thing under AMA and who they sent that form too. It is aimed at an Employer not at the SSA.

I am also wondering if I will be able to get the form and who they sent it too from the VARO office when I go get the C&P once I know it has been brought into the VA system.

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There is also this under additional evidence

Additional evidence

File:
Type: VA 21-8940 Veterans Application for Increased Compensation Based on Unemployability

 

I did not file an IU request. I am 100% already. IU would be moot.  I searched my C-File for this one too and that form has never been recorded into the C-file.

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 I don't know if the presence of these files is some automatic thing under AMA. I will have to look and see if they are just new form names and numbers under AMA, but either way they were never sent to me or filled out by me in any of my claims.

 

 

[paulstrgn]

That is interesting. Did they file this under the wrong person? I am assuming you make income from your business (not a hobby), so why would the VA think you need IU? This is all under the voiding dysfunction claim?

Hopefully someone will give you a real answer instead of one off of a script.

[Buck52]

Geeky

Do you use a VSO? OR Anyone at the VBA? (Veterans Benefit Administration)

They can look in the VBMS and see what all is going on?

Alex (Asknod ) is about the only one I know that can tell you what all this means  he has trained and study for all this but the AMA is New to everyone!!..most of us would be guessing  and could possibly tell you wrong.

I'd say give it more time to develop they seem to changes things every day...back and forth  ect,,,ect,,,.AMA still needs some work , thats obvious.

[GeekySquid]

5 minutes ago, paulstrgn said:

That is interesting.

 

Thanks Paul, it is interesting. I don't know why the VA would need/do this and who they sent that form too.

I know you just did a C&P (and were on the Rocket Docket, congrats!) did you happen to see something similar in your Claim documents on VA.gov?

Once I am sure that VES has submitted the forms to VA I will be heading to the RO to get it. I just got the last pin out of my foot and in a couple days will be able to move about more freely without the wheel chair.

Dr said I have 6 more weeks where I cannot really put pressure on the foot. So that is one of my current limiters to getting to the RO. The area is all hills and there in not a lot of seating in the RO entrance area so having to hang out and wait presents a barrier.

The whole IU thing is what is so strange. I own a tech consulting firm, but even if I did not, the fact I am at 100% already would moot any IU claim. Which raises the question what the heck is that all about?

The conspiracy theorist part of my brain is saying they might be trying to develop evidence to reduce, but my awarded 100% has nothing to do with my bladder or the ED.

All of my conditions except  tinnitus 10% and Hearing Loss 0% are service connected as secondaries to my 100%.

I don't have a claim in for BPH, but the VA letter to the C&P Dr. asked for an opinion on how it would be service connected. I have no idea how that could be SC'd or what condition it would be secondary too for SC. What would the nexus be? BPH is a normal result of aging as far as I know.

the one new piece of medical evidence outside the bladder that I told him about was my issue with Partially Empty Sella which is Empty Sella Syndrome. Since this involves the Pituitary Gland, which is the Master Gland, there is a hormonal tie in towards bladder function through a series of medical connections around how hormones affect different body systems like the adrenal glands, Hypothalmus, Thyroid, etc

ESS can rarely be a genetic thing...very very rare. Usually it is connected to a TBI which can be as slight as  car crash marked by a mild concussion with disorientation for a few days, short term memory confusion etc. Stuff that would not send the average person for an MRI. Even tripping and banging your head can cause such a mild TBI and even an edema of the brain. Millions of people experience this every year and don't run out for an MRI.

In the pure speculation mode, there COULD be a chance that now seeing the ESS the VA rater is exploring the connection to that for some of my other conditions to maximize my rating to get Statutory SMC (s). If they decide that the ESS is the more likely cause of things like my depression and anxiety and weight issues, or they tripped over my sleep study they have ignored for 6-7 years, they might be rejiggering my claims decision to put those under ESS.

If (and I really don't believe they are doing that rejiggering for my benefit), they moved those items to be secondary to ESS from TBI, then I would end up with a single 100%, plus 60% (or more) in a separate category and that would take me to SMC (s). 

That is a big "if" and I have very little belief that this is what they are doing and it still does not explain why they sent a request for a former employer (and who do they think that is?) for IU.

I hope others chime in and I will update when I know more.

[GeekySquid]

11 minutes ago, Buck52 said:

Do you use a VSO?

@Buck52

My VSO on file is the American Legion. The local ones seem to be as useless as nipples on a mannequin.

The last time I called them, April 2019, I was informed 1st that their computers were "down". Then a 2nd person got on the phone and snidely informed me that they just did not Access Cards to get into the system and they did not know when they would get them. This group is in the VA office itself downtown.

Prior to this, back in 2018 I contact 3 different AL offices here and the only one to respond said he had no idea that as my VSO he could look into the VBMS....DERP DERP DERP.

15 minutes ago, Buck52 said:

AMA still needs some work , thats obvious.

so true! That is why I asked TBird to start this particular forum so we could track AMA specific stuff.

If you read my response to @paulstrgn you will see my current speculations.

In reality I just don't know and will have to wait.

I hope others who have processed a claim, or filed one, under AMA chime in.

Honestly, if I had not been just lazily drinking my morning coffee when I check VA.gov, I would not have even looked at the file requests. Under the Legacy system where I did all my other claims, I knew what all the requests were so it never blipped on me that there might be something amiss under AMA......Until I saw those requests and that they were "closed"

In human speak (as in other than VA speak) when you close a request for something it is completed and done. But I doubt that applies to what VA means in that status message.

There is a newbie on here who has stated they work for VA in prepping files to go to the raters. I am going to try and find him and tag him into this conversation.

I know Alex a.k.a. @asknod is busy and I hate to ping him on every little thing. If he runs across this I will gladly appreciate his input.

[FormerMember]

AMA is a work in progress. Most raters are not well-versed in this yet and may never figure it out. As for the VA sending out a 4192 and a 8940, they generally travel in pairs. If you file an 8940 for IU, you will automatically get a 4192 to give to your prior employer to ascertain why you are no longer employed there (in their opinion). 

As for 100% P&T, let me illuminate you. A lot of you think an IU rating is 100%. Some insist it's P&T forever. A rating is not substantially protected until you've had it for 5 years. It is not permanently protected until 20 years and even then subject to revocation if it was obtained fraudulently. I had clients at 19 yrs and 4 months get the revocation notice. They reduced one rating and upped another. The net effect, in their eyes, reset the 20-year clock as well as entitlement to DIC (the ten-year clock). I fought it and won but that isn't the point. IU is technically never truly protected. If you began delivering newspapers 20 yrs after you got IU w/ P&T and any income showed up on SSA records, your P&T would be gone with the wind. IU is not 100% except for pay purposes. VA is fond of slamming you with a reduction and knocking you below 40%+ others to get to 70% or reducing a 60% downwards resulting in revocation of IU. Always remember who you're dealing with. In VA's eyes, we all get better someday and are targets for reduction. If you do not appeal a unlawful denial, it becomes part of the 98% of claims they did correctly. When you take into account all legal decisions done on appeal, the error rate mushrooms to 75%. So much for VA's statistics.

As I mentioned last Thursday in the Radio show, in January VA 86'd a 20% rating on one of my clients that was 26-year protected. They dropped it to 0% but simultaneously gave him another 30% for some other nitnoy crap. Net result? He was still at 80% and no IU. VA's logic was it wasn't a "reduction" but rather a "rearrangement with no net loss to incur a §3.344 reduction proposal". If they had done it correctly, he would have been 100% combined or at the very  least IU. Half my work is running around fixing the VA's errors with NODs. With the AMA permitting us to skate to the BVA with our NODs now, it will be far better. Shoot, if you lose there, there's no need to go up to the CAVC. You just run back to the RO and file your 20-0995 within  120 days and start over.You keep your filing date. In this reduction case, I even called up the DRO in Houston and informed her it was illegal to reduce the protected rating. She gasped and agreed it would be very illegal. I can see her note in the VBMS from that conversation. Three days later one of her gomers punched print and made it official. The only fixer is filing the NOD and claiming CUE on that in addition to all the other errors.  And VA wonders why 20 or more of you folks commit suicide every day? Helloooooooooooo?

This isn't a conspiracy. It's ignorance. If you had a computer hooked up to your car and it told you the fuel injection was toast, would you question it? Hell, no. You'd throw a new injection pump on there and presume that was the repair order. Could be it was nothing more than a vacuum leak. The same applies to the M 21 computer. If it tells a rater to do it, he does it without question. He doesn't even need a second signature! The last time the M 21 was officially revised was 2006. Ever since then they've just been racing around behind CAVC precedence to input that and little else. The fact is, the M 21 is so wrong in so many respects on 38 CFR and the raters swear by it's dictum like it was the Oracle at Delphi. Boy howdy, try quoting M 21 to a Veterans Law Judge. You'll get the legal smackdown of your life. Judge Cherry Crawford did it to me last year and I will never pull that stunt again. You can refer to it but do not quote it as stare decisis. 

Any time a c&p reveals additional "contentions", VA will investigate them to see if they should be SC. You do not even need to file for them. This is the implied or inferred claim. See Moody v Principi to grasp the concept. 

[GeekySquid]

30 minutes ago, asknod said:

AMA is a work in progress.

@asknod

Thank you for chiming in. Just for clarity I am 100% Schedular P&T. That upgrade occurred in 2018 from 70% schedular. I have never been IU.

I assume my 5 year protected status is on the70% and it won't be until 2013 that I garner any protection (beyond being over 55) to the 100% Schedular rating. This is what trips my tiny conspiracy theorist thinking that they might be trying to reduce.

On the issue of contentions I wonder if you have seen this.

My claim was for Voiding Dysfunction. It came from my C&P for ED which was granted for SMC(k) and appeared in the rating decision that I might have a claim for it. Not a word about BPH in that decision letter.

The letter to the VES C&P Examiners asked them to see if my BPH was service connected. Not only did I not make that claim, I don't know how you could service connect BPH. The VES examiner did not know what BPH was (I am not joking) I had to tell him. Then he tried five times to say it out full and then complained he hated it when other people used acronyms he did not understand. DOH.

39 minutes ago, asknod said:

As for the VA sending out a 4192 and a 8940, they generally travel in pairs. If you file an 8940 for IU, you will automatically get a 4192 to give to your prior employer to ascertain why you are no longer employed there (in their opinion). 

That is kinda my point.  I am 100% Schedular, filing for IU would be moot and I did not do it. Another thing that is tweaking my inner conspiracy theorist monologue.

Have you seen that exact sequence? are the raters so inexperienced that they don't realize if a veteran is 100% Schedular that IU is moot?

Further who would they have sent them too? I own the company and if anything like that had been received my HR person and my executive assistant would be sent into gales of laughter and the whole company would be teasing me about it forever!.

45 minutes ago, asknod said:

Any time a c&p reveals additional "contentions", VA will investigate them to see if they should be SC. You do not even need to file for them. This is the implied or inferred claim. See Moody v Principi to grasp the concept. 

Does Moody only apply to inferred/implied claims if a C&P exam does so? or are there other places it applies? I will go read it again, but was curious if you knew and if there was a primer on how to evaluate if Moody applies.

BTW the Seattle RO is ignoring me left and right. I gotta figure out how to get their attention.. any suggestions? I even had someone in the Director of IT in Washington call them to get their attention and was promised someone name "rona" (sic?) would contact me. That was 3 weeks ago. I feel warm wind blowing up my skirt.

Thanks A lot.