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GeekySquid

Question

So on my threads about my first claim under AMA I stated I put this here to track time and the AMA process.

My claim for Voiding Dysfunction was filed on May 8 2019  and closed June 16th 2019 (according to VA.GOV)

so basically 36 days.

I was denied, and will start writing my NOD.

What is new besides the speed, is that on Ebenefits yesterday I noticed a new entry under my listed Disabilities.

It will be good for others to start tracking this to see if this remains the standard.

It was marked Pending Claims.

Today after visiting VA.Gov and seeing my claim closed I went to Ebennies and looked under Disabilities and the DENIED claims are already showing.

This is a change in process. It used to take some time to get Ebennies updated. usually at least 10 days.

today however, the day after VA.gov says the claim closed, I see the following

It will be good for others to start tracking this to see if this remains the standard

I am tagging in a few people who I know are active here and may have recent claims under AMA.

@paulstrgn

@vetquest

@shrekthetank1

@Buck52

@jamesriley1990

@richard1234

@Oceanbound

@Richard1954

@Amazing Becky

hopefully you all will help track this change. It can alleviate some of the "wait time" stress as we look for the BBE in the mail. If you all see someone asking about processing time for a claim please ask them to track for this notification under Ebenefits Disability link.

Rated Disabilities

Disability Rating Decision Related To Effective Date
bilateral hearing loss 0% Service Connected   08/20/2018
tinnitus 10% Service Connected   11/30/2012
post traumatic stress disorder with bipolar II disorder (previously rated with major depressive disorder, psychotic features ) 100% Service Connected

PTSD

08/16/2018

benign prostate hypertrophy

  Not Service Connected    

urinary incontinence

  Not Service Connected    

erectile dysfunction

0% Service Connected   08/20/2018

benign paroxysmal positional vertigo

30% Service Connected   08/20/2018
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2 minutes ago, GeekySquid said:

Voiding Dysfunction itself is NOT a category that Ebenefits /VA.gov claim form default to allowing.

If you have a rated GenitoUrinary Condition it would be secondary to that condition.

You can type it in as voiding dysfunction but as my display shows the VA put it as secondary to my PTSD which is beyond me why.

If you you have BPH I would be interested in you responding if the C&P includes an attempt to SC your BPH too. For some reason the VA letter to the C&P asked them to SC BPH and I cannot imagine how you would do that.

I only put in this claim because my claim for ED awarded SMC(k) and the VA wrote in that decision that I might have a claim for Voiding dysfunction. Otherwise I never would have thought of filing for it.

This was NOT a supplemental claim. It was an original claim via Ebenefits.

If you have already been denied for Voiding Dysfunction then you would put in the Supplemental Claim.

 

 

Got it. I did not know that initial claims also fell under AMA. Assumed it was an appeal only method.

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1 minute ago, Mrpdbo said:

Got it. I did not know that initial claims also fell under AMA. Assumed it was an appeal only method.

yeah this whole change over to AMA has a bunch of things confused and changed. Particularly since RAMP was definitely only appeal.

The logic as far as I can tell is that now with AMA there is NO OTHER appeal process available to enter into. Folks in legacy or RAMP processes are supposed to get a chance to opt into AMA when they get an SOC or SSOC.

So with that logic all claims filed after Feb 19, 2019 are in AMA, even Initial Claims.

For example now we have the National Work Queue which is an offshoot of the AMA change. all new claims are in that NWQ.

There are going to be more weirdnesses that are uncovered as AMA matures and as I mention in other posts, I personally believe that the new target time frames and rabid hiring attempts by VA contract C&P providers will just produce more denials in shorter times.

That will put lipstick on the pig of VA initial claims processing times and shift that burden to the NOD process, DRO and or BVA processes.

There are many things I don't like about AMA so far so we will see.

On this note please please please track your times once you submit that claim.

Time to C&P, Time until it appears on Ebennies/VA.gov

Time until Ebennies / Disability Page shows "pending claim" under your other listed disabilities.

Est. Time to Complete, how often that changes, and the actual time to complete.

Please check ebennies the day VA.GOV says complete to see if your Disabilities page has an update to any pending disability entry (which is what prompted this particular thread for me).

The more data points we get on those things under AMA the better informed we all are about the AMA process versus what VA claims in their press releases.

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My attorney recently opted me into the AMA after I  received multiple Statement of Case/SSOC denying service connection for several disabilities.

We are taking the path to the BVA with submission of new evidence(Nexus Letters).

I'll try to post updates on progress.

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20 minutes ago, 63Charlie said:

I'll try to post updates on progress.

please do ! that is another of the very important paths we need to get a better handle on under the AMA.

There is so much to learn about the new process steps and out comes and we all have a stake in getting a handle on every aspect of the changes.

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I did notice that ebenefits was updating fairly quick, I noticed this over a month ago when my new  left knee claim ( secondary to right knee) rating showed up on ebenifits before I got  the letter. Last week I noticed that the va rated me 0% for scars on my right knee from a 1986 surgery... I didn't ask for this rating, it just appeared because I had a reevaluation of my right knee which had not been reevaluated for C/P purposes since 1986.  I still have not received a rating letter, but Saturday I did receive a letter telling me I could file for veterans disability life insurance ... this was mailed apparently in response to the new 0% evaluation. My right knee ratings haven't change or increased, so it looks like my request was denied.... I also requested service connected for Chronic Laryngitis & Dysphagia which was diagnosed by a va ENT doctor who said the problem is a result of the  steroids used for my lung disease.  Ebenfits shows it deferred, today I received a letter for a c/p exam to be done at the VA Hospital ( not contractors)  Ironically, they did the C/P exam on my Knee in May. why they did not order a c/p for my throat then is beyond me....  Anyway.. I agree Ebenefits is updating quicker... and it also has show at the bottom of the disabilities page any pending claims... See what I mean below:

 

Rated Disabilities

Disability Rating Decision Related To Effective Date
bilateral hearing loss 0% Service Connected   06/02/2005
low back strain with degenerative disc disease with left foot drop (previously rated as 5295-5293) 60% Service Connected   09/18/1998
tinnitus 10% Service Connected   06/02/2005
dysphonia   Deferred    
abnormal heart   Not Service Connected    
right knee sprain with torn medial meniscus, with instability 10% Service Connected   02/27/2001

left knee torn medial meniscus 

10% Service Connected   09/28/2016
residuals of traumatic brain injury, to include memory loss and encephalomalcia involving left frontal pole 40% Service Connected   09/20/2016
right knee sprain with torn medial meniscus, with limited motion 10% Service Connected   02/27/2001

scars, right knee 

0% Service Connected   05/17/2018
bronchial asthma with chronic obstructive pulmonary disease and obstructive apnea 100% Service Connected   01/31/2007
chronic laryngitis with dysphonia   Deferred    
status post cataract extraction surgery left eye with pigmentary glaucoma, pigmentary dispersion syndrome, and optic nerve damage with moderate posterior subscapular cataract, right eye 30% Service Connected   04/18/2008
claimed anal impairment and loss of sphincter control as related to hemorrhoids   Not Service Connected    
hemorrhoids 10% Service Connected   11/14/2000
chronic obstructive pulmonary disease 30% Service Connected   05/03/2005
epididymitis 0% Service Connected   11/14/2000
sinusitis 10% Service Connected   01/27/2004
allergic rhinitis 10% Service Connected   06/10/1986
chronic right knee sprain with torn medical meniscus 10% Service Connected   06/10/1986

Pending Disabilities

Disability Submitted Type Actions
Chronic Laryngitis With Dysphonia 2nd To S/c Copd 05/10/2019 SEC View Pending Claim
5260 Right Knee Currently Rated 10 04/29/2019 INC View Pending Claim
5257 Right Knee Currently Rated 10 04/29/2019 INC View Pending Claim
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5 minutes ago, Richard1954 said:

did notice that ebenefits was updating fairly quick,

Thank you for posting that info.

The data points I am trying to keep an eye on  w/ these rapid notifications and the rapid rate of vets getting C&Ps is if there a correlation to an increase in denials on initial claims and also on claims the VA "infers" ?

This may be the paranoid part of my mind, tiny though that is, but I suspect we will see an increase in denials on initial claims. I think we will see an increase in inferred claims but they will be denied.

As I don't really subscribe to conspiracy theories in general, a business case can be made considering the push from the top to reduce hospital funding (moving it from mandatory to discretionary spending), pushing choice rollout even though the systems are not in-place and QA'd, the rapid hiring of Contractor Docs to perform C&P exams, and the massive number of Medical Positions that the VA is doing next to nothing to fill.

I think we will hear that the VA is inferring more claims in an attempt to say they are being more efficient. That the denials will be cast aside as improper or unsupported claims despite being inferred and initiated by the VA. And the increase in NOD's to the various levels including to the BVA will buried in any public facing statements by the current VA officials.

please keep posting data points and encouraging others to do so.

The pending claims item on Ebenefits is a really good time-identification point. It did not use to be there in Legacy or RAMP. While i appreciate it, I feel we need to a handle on when it appears.

In my case it was not there from the day I filed the claim. Then recently I had a 10 stint where I could not get into Ebennies, then yesterday I saw the Pending, and today Ebennies shows the denials.

With a little collective tracking we can get a good idea of when vets need to start hawking Ebennies and VA.gov to see if our claims have been decided and if the C&P's should be available from the RO's.

 

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