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  • 14 Questions about VA Disability Compensation Benefits Claims

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

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    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

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Linda Jordan

Confusing Rating Decision From 1990

Question

Posted (edited)

Being involved with trying to get an earlier effective date for a claim I filed within one year of separation, I was going over my c-file with a fine tooth comb. When I looked at my Rating Decision, I got very confused. In the Narrative section the first line says "Original", the second line says " SC for left knee injury and obsessive-compulsive neurosis with depression and anxiety. ". Then it lists the evidence and proceeds to debunk or put forth reasons I don't qualify for the conditions listed as SC along with some other conditions in my claim. I'm so confused! 

 Did they service connect me in one section then un-service connect me later on in the narrative?

 Here's the actual text under the Narrative section with some personal stuff blanked out. I've underlined the SC part and the blanked out parts don't have anything to do with the SC conditions listed. Could the SC line only be a reiteration of parts of what I was claiming or is it a statement of service connection for those conditions? If there's a contradiction, should I get the benefit of the doubt?

23. NARRATIVE 
J. Original claim. 
I. SC for left knee injury and obsessive-compulsive neurosis with depression and anxiety. 
E. SMR’s, January, 82, to January, 90. DVA exam, 5/8/90, and 6/5/90, VANC, Loma Linda. Medical report, 4/22/81, ___________________ M.D. 
F. SMR’s show on entrance physical history of treatment for adjustment problems pre-service. Medical report of Dr. _________, shows veteran treated May 30, 80, to December 8, 80, ior adjustment disorder with mixed emotional features. 
During service veteran had pre-existing mole removed from upper left inner thigh. Veteran struck in face by hammer in November, 86. No fracture or dislocations by X-ray. Veteran landed on knees 12/2/89, knees cleaned and hibiclens scrub brush and bacitialim ointment applied. DVA exam shows no limitation of motion, no structural lumbosacral abnormalities. No residuals of facial or knee trauma. No evidence of ear infection or conjunctivitis. Veteran gives history of ovarian cyst. 
Mental status exam shows speech is slightly increased in rate normal tone. Affect is full and appropriate somewhat anxious. Mood is dysphoric. Veteran denies auditory and visual hallucinations, delusions, and suicidal or homicidal ideation. 

Thought processes are goal directed. Impression was dysthymia rule out organic mood disorder depressed secondary to ______________, generalized anxiety disorder and ___________________________Rule out panic disorder, rule out obsessive-compulsive disorder. Remainder of exam unremarkable. 
D. Veteran’s knee and facial trauma, ear infection and conjunctivitis were all acute and transitory with no residuals shown on DVA examination. Ovarian cyst is developmental. Back pain not ratable in absence of objective symptomatology. The removal of the mole, left thigh was remedial, no aggravation shown. The veteran’s generalized anxiety, depression pre-existed service. Aggravation not shown. ________________________________No basis for service-connection for any of the above conditions. 
8. NSC (PTE) 
5299- Bilateral knee condition ( acute and trans) 5299   Back condition (not incurred) 6099 Conjunctivitis -(acute and trans)  6299 Ear infection (acute and trans) - 7699 Ovarian cyst (can't read what they wrote) 9499. Obsessive-compulsive disorder with anxiety and depression (EPTS) 

14. Disability result of veteran’s ____________________________ 

Edited by Linda Jordan

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Never mind. I figured it out. Not in my favor but my claim was put into deferred status at one point. How would I know if it was taken out of deferred? It was denied but the medical examiner didn't have my c-file. Any chance my claim could still be ruled pending because of that? There was only one mental examination done and it's noted at the top that "c-file was not available". I was service connected 28 years later. They don't want to back date me. 

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So it looks like they went over the possible disabilities and then gave their reasoning for denial.  Go onto Ebenefits and see what you a SC for and check back with us.  They should have at least given a 0% rating for each condition, and you were seen for them.  

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Posted (edited)

Deferred claims are aggravating to say the least  it means BVA Usually sends the claim back to your RO AND SAY FIX THIS AND R.O. just sits on it  until the veteran wrinkels someones feathers.

You may want to file a new claim or reopen this old one for possible EED if you have new and meterail evidence   then you should be able to go for the EED.(EARLIER EFFECTIVE DATES)

Also you may want to check with a good experienced VSO /or VA Accredited Claims Agent to look for Possible  CUE???

Edited by Buck52

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Sounds like this examiner didn't do you any favors.

Do you have a service connected rating? for depression /anxiety  or PTSD?

What all are you S.C. For?

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A claim remains pending until finally adjuticated.  

Have you gotten a final decision on issues not yet adjuticated?  (Especially issues that were never addressed but claimed, or those deferred).  

If you did get a final decision on the above issues, then you have a one year window to appeal the effective date.  

There are at least two ways to attack the older decisions:

1.  File to reopen due to new and relevant evidence under either 38 cfr 3.156 B or 3.156 C.   Of course, this would mean you had new evidence that was not considered.  

   If you have new "service records", under 3.156 c, that VA did not consider, then you should get an earlier effective date. 

   However, under 3.156 b, "pending claim" it will only net you an effective date of the date you filed new evidence UNLESS you filed new evidence BEFORE one year post decision.  

 2.  File CUE on the decision(s).  

      My advice is to take your file to an attorney.  See if he sees an earlier effective date, and why.  You can then decide whether or not to hire him, or to try it alone.  

     Its my opinion that large retros dont happen without an attorney except in rare cases (or if your name is Berta).  There are reasons for this.  GS 7 rating specialists are pretty much not permitted to award 100,000 plus retro checks.  This only happens by a judge at the BVA or higher.  

     The bottom line is do you want 100 percent of nothing or 80 percent of, say, 200,000 dollars??  

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