Supplemental in AMA Timeline

[Miken2c74]

Original claim opened in Nov 2013 (Legacy)

Claimed Denied Dec 2014 (Legacy)

Submitted NOD in Jun 2015 (Legacy)

Opted into RAMP July 2018

Denied Ramp May 2019

Supplemental Claim open June 2019 ( In decision phase now per VA)

 

Flat feet (aggrivated due to ) From original claim date ( new DBQ, Medical opinion, Nexus, lay statement) On supplemental claim

Knee condition from original claim date  also supplemental claim (New DBQ, Medical opinion, Nexus , Lay statement) on supplemental claim

Back condition from original claim date rated 20%

Fibro Denied

Hip condition denied

I am waiting to see how this comes out (nerve racking)

[Miken2c74]

Greetings Hadit Family,

I had a very interesting week (last week). During the week I was gathering evidence for my Supplemental Claim. I had been email an DAV SVSR, and a VA Rep with explanations on why I wanted to do a Supplemental claim and their suggestions. I first wrote them a email explaining the situation and asked them to read the most recent decision letter. In which they both came back with the same question, " was this a examination performed at a VA medical Center ?" I answered no, and this was one of the reasons for writing a letter challenging the examination (Aug 2018). I emailed the letter, which explained why I had the IMO done (Dr. Stargardt),  why the examination was inadequate (Aug 2018) using 38 CFR, also responding to statements made by the rater that incorrect, and why more probative value should have been given to Dr. Stargardt's exam over the contracted exam (Aug 2018). I received a reply on the letter, the reception about the letter was very positive. I was advised instead of doing an HLR to instead opt for a Supplemental because of the formal review of the exam performed by Dr. Stargardt and the post service records that is a matter of fact the VA does not have and the abundance of information contained within the letter that leaves way for me to submit this information. It was also said that the letter was so well written that in a perfect scenario if I had done a HLR, the HLR could have asked for this information or I could have offered it. They thought it would be better for me to give them what they need to make the decision. I was tempted to see if they were actually reading the information but decided against it. Last Friday I had a sit down with a actual VA Rep face to face, which was a god sent. I gave her a backstory. She looked in the system, read the decision, and then she read the letter. She asked if I wrote the letter, I answered "Yes Mam, she said "this letter is very well written. I said to her "Thank you". She said to me add a 21-4138 with an additional statement, which I have done. Along with the medical evidence and wait and see what happens. So this weekend I submitted to VA, the 20-0995 Supplemental Claim, reviewed examination Dr. Stargardt, 21-4138 (my boss), lay statement from my wife, 21-4138 with additional information, post medical service records. I would like to give everyone a little information. If you have a C&P exam through a Contracted company and your examiner is contracted through this contract company. They do not have access to your c-file, I repeat they do not have access to your c-file. Per VA rep.

 

[Miken2c74]

Greeting Hadit Family,

Ok, here we go my HLR is open. I actually open two supplemntal claims and a new claim for migraines. I submitted the supplemental claims after I had submitted the HLR form for the same issue with relevant evidence. I honestly don't know how this is going to play out. The paperwork is on file ie my challenge letter, and evidence that was stated in my letter. I hope they do this right, it should be reasonably easy to grant these disabilities. I think they are looking at the retro though. Wish me luck

[Miken2c74]

I think I have figured out how to better formulate my evidence in letters. I use 38 CFR a lot for reference and use that information (per regulation ) to articulate the point I would like to make. If 38 CFR is suppose to be the guideline for VA to follow and they don't, this leaves a basis for CUE. The points you make in your letter should always make mention of a paragraph in 38 CFR.

[Miken2c74]

Happy New Hadit Family,

Hope everyone enjoyed the holidays and your loved ones I know I did. Now it is time to get back on the bike. So today I wrote an email to DAV in Pittsburgh and  explained a situation that VA has gotten their self in by not following a specific request that was submitted in a timely manner which also was time stamped. I will cut and paste the body of the email below for your enjoyment. Tell me what you think.

 

Greetings,

       First of all Happy New Year to all DAV personal and family.  This email is for the some information on the chain of events that have thrown my

claims in a disarray or out of chronological order according to received and processing dates as pertain to Veterans Affairs. On October 18, 2019, I

submitted a statement challenging the C&P examination dated August 28th 2019, because of it being inaccurate and administered incorrectly. Shortly

thereafter I submitted a Form 20-0996 (Higher level review submitted Oct 18,2019), hoping the new evidence would be asked for as referenced in my

correspondence (dated October 18, 2019) or the possibility for me to offer this information if the lay evidence was read. However, in the subsequent

weeks that followed I was advised against this approach and was urged to submit the VA 20-0995 along with my additional evidence because there would

not be a guarantee that the lay statement I submitted would be read. This information about me submitting the VA 20-0995, was also cited in my file. I

submitted the VA 20-0995 along with associated evidence on October 27, 2019, and was received on the same day. In the weeks following I was checking the

status of my claims on VA.gov and noticed that I had two appeals open for the same disabilities. I called the 1-800 number and was advised to submit a

written statement, signed, and dated to withdraw from the Higher Level Review and allow the Supplemental claim run its course. I submitted this

statement on November 8, 2019.  Five days later I noticed that the Supplemental claim was closed and the Higher Level Review was still open,

which is the direct opposite of what I had requested happen. I have called 1-800 number on numerous occasions to get this problem solved. As of 23

December 2019, the Higher Level review has been closed but the Supplemental is not open. Could you please look into this problem and have it fixed.

Also, I have submitted another Supplemental claim for Fibromyalgia could you please bring this to VA's attention also as it has not been opened either.

Thanks so Much

 

Wish me luck

[Miken2c74]

All righty I have a question. I have submitted a claim for sciatica secondary to my service connected lower back condition. I have sent in lay statements from my wife and my present boss to what they see on a day to day basis. Which leads me to my question, I submitted a claim in 2013 for a hip condition which was denied. My back condition was approved and back dated to Nov 2013. There is readily available knowledge that if you have problems with your sciatic nerve, that pain will go through the hips. There are also STRs and other documents that help with this claim of a hip condition/sciatic nerve. How should I approach this.

I know I have to wait on the decision and see what it says.

Tell me what you think.

[awgv001]

3 hours ago, Miken2c74 said:

 How should I approach this. I know I have to wait on the decision and see what it says. Tell me what you think.

Coming from a Spiney with Sciatica ( I feel for you ), get the DBQ for thoracolumbar (lower back problem, right???)This one is for Spine(lower) https://www.vba.va.gov/pubs/forms/VBA-21-0960M-14-ARE.pdf

There ya go, make the soonest appt with your PCP to get this filled out, be sure to discuss symptoms, and also do a Hip DBQ too....make as many appts as needed to get these doc'd and then utilize them as your weapons of evidence. This one is for Hip conditions as you will have at least painful motion with sciatica through the hip --- https://www.vba.va.gov/pubs/forms/VBA-21-0960M-8-ARE.pdf

I found that sticky notes are a veterans best friend when it comes to DBQ's - to arrange dates, write details (cause i forget at least 70% of my entire day), and assist the doctor so they spend less time searching, and more focus on me and the DBQ. ---- If your VA doctor refuses to do one, leave, and request another (VA)doctor who will...I have so many people telling me that their doc won't fill out DBQ's I wanna have them print out an article to carry with them...as to what the "professional reasons" are.....I got no clue, maybe if they felt they were being forced to lie or something. Didn't find much when googling "professional reasons to reject a medical exam" either.

Q: Who is authorized to complete a DBQ?

A: Providers with active medical licenses must sign and attest to a medical condition on completed DBQs.

    The DBQ can be completed either by:

• Veterans' private treatment providers, or
• Veterans Health Administration (VHA) clinicians.
  • Some providers may decline for professional reasons
  • Some specialty disciplines may decline for professional reasons