Vsrs And Rvsrs

[Guest jangrin]

If anyone Knows,

The veteran goes to his doctors and the doctor then provides records and reports the the VA. The doctors examin the veteran and then forward their findings on to the VA. Then all the records go to the VA and the claims raters VSR and the RVSRs take the information and make an evaluation regarding the vets claim. The supposed to figure out a rating that fits within the rules of the VA compensation guidelines and laws and coincides with the veterans medical condition.

No Problem. The question is.... How are the claims assigned to the raters. Is it the luck of the draw or is a complex case assigned to an experienced claims rep. and less complex cases assigned to the new reps? Is there some sort of review process once a claim is rated, before it is sent to the veteran?

I hate to think of how many claims may be incorrectly rated because a new VA employee just passed his claims adjuster test at 74% and now the VA figures he's ready to tackle any claim that comes along and if it' has not been figured correctly, the VA figures the vet can always appeal the decision.

Just wondering if anyone knows how this works.

Thanks for the imput,

jangrin

[Guest jangrin]

Thanks Terry,

Your AO DMII and residuals and my husbands AO DMII residuals are very much alike. I have a feeling he will be low balled on this initial claim. There is no reason for them to do that but I just have a gut feeling about it. I am starting to prepare the appeal.

I think they will rate the DMII low. It should be at 40% because the PCP at VA wanted to start him on insulin and also told him to limit his activities because of his heart. My husband told the doctor that he did not want to start on insulin shots when we were in the process of loosing our home and trying to move. They agreed that after the move he would need to start on insulin. Unfortunately we did not know it would take my husband 5 months to get a doctors appt. at the his VA facility. I think they will rate the DMII as 20%.

I also don't think they will rate the PN correctly. He should be rated at least 30% one foot (foot drop)(has tripped and fallen many times) 20% other foot for edema loss of feeling change in circulation and color and then both hands should be rated at 20% each for pain when touching anything causing loss of use, unable to grasp, hold, carry loss of strength. His hands are the primary reason he was unable to work and then subsequently was award SSD. I think the VA is going to rate 20% 10% 0%0% for the PN.

The heart qualifies as a 30% according to the C&P report, I can't really argue with that but I think once he has an angio we will find multiple areas of blockage. Unfortunately stents will not work because the areas are large. It will require bypass. But the doctors/radiologists tell us one thing and then write their reports on the conservative side so people don't panic out. Also the ejection fraction is at 7mets (but that was just a quess by the NP that did the C&P exam.They don't know for sure because they thought he had a heart attack when doing the stress test so they stopped the test.). His heart calcium score was a 1700 average for his age is 110. He should be at the next level which is 40 or 60% I forgot what the CFRs say. This too will be rated at 30% low.

He also was DX with HTN- but it will be correctly rated 10%

He should get the K-award- that should not be contested

Unfortunately the PTSD/MMD depression will be turned down. The stressor(s) are provable but I am sure we will have to appeal to get the award. His MOS was not combat but his job was and there is documentation. But we will have to appeal I'm sure.

gastrointestinal-due to DMII and /or medications 0%-10%

So I think with all this secondary stuff going on if they "low-ball" the claim he will not have the needed (40%) on one illness or injury required for TDIU.[/

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If he was rated correctly he would be at... 90% - 95% TDIU

The way it looks because they do "low-ball" 64% NO award for TDIU

Anyway we are sure to hear something soon as his claim has been at the rating board now since the beginning of December. He has had his claim in now exactly 11 months. So we hope for at least some news. He was awarded SSDI for these conditions which should all be service connected. Maybe that will make a difference, we'll see. It would be nice to have the education benefits for our teenage son. It is not the end of the world if it doesn't happen. We also have the EXAMINATION and report done by Dr. Bash. He actually spent 2 hours doing the physical exam on my husband. So he did exam, reviewed records, and did a report. We'll see what happens with an exam instead of just an opinion.

As you know ..... were just anxious and tired of waiting. I have always worked and continue to work but it would take a lot of financial pressure off to see the DMII SC'd so my husband could get his meds paid for and so he could get his doctors appts scheduled when he needs them. Not having anything SC'd makes things a bit more difficult on him and our family.

By the way, thank you everyone for the prayers this past couple of months. We really needed the spiritual support for some very serious matters. Things are OK, and I know that God has a reason for everything, so we will just carry on with the answers we have been given. Thanks for holding us up in prayer, it makes a great difference.

Jangrin