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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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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
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    • Exams that were being sent strictly to contractors before, due to VAMCs not being open, are starting to be routed back to VAMCs. This is going forward from last Friday- not sure if prior scheduled exams will be re-created for VAMC vs vendor.
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    • Mere speculation in your VA C and P exam

      M21-1, Part III, Subpart iv, Chapter 3, Section D – Examination Reports III.iv.3.D.2.r. Examiner Statements that an Opinion Would be Speculative Pay careful attention to any conclusion by the examiner that an opinion could not be provided without resorting to mere speculation (or any similar language to that effect). VA may only accept a medical examiner’s … Continue reading
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JaeT.21

They said no to my increase, but gave me a decrease

Question

Welp, Just found out they closed my claim. Surprise surprise, nothing changed EXCEPT they reduced my GERD from 60% down to 10%! WHY and What the?! So apparently that random C&P without my knowledge played a significant part.

 

So my questions are the following:

1. Should I reopen my claims or file an appeal?

2. How do I go about getting ALL of my C&P claim notes, especially whatever was said from this C&P without my knowledge?

3. Should I even attempt to ask for the much qualified for increase on other areas of my body, that have gotten worse, or fight this last round of let downs?

 

I try to explain to everyone when you retire or get out and become a veteran, your own company (the VA) treat you like used tissue. Nobody has any use for used tissue...tossed to the side.

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If the VA used the ACE procedures to rate your gerd  you will need to get a copy of the examination and review it.  Once you do that you will need to prove the examination was not complete.  If you have medical evidence outside the VA then you can claim the ACE did not consider all of the available evidence., because an ACE  only includes review of the VA medical records. 

 

Either way you have to attack the examination as inconclusive , you should appeal the decision to preserve the effective date.

 

ALSO ADDED: its very usual for the va to lower a rating based on one C/P exam alone,  that itself is a reason to appeal, its been my understanding that the va cannot use one review for downgrading  a rating.

 

ACE Directive.pdf ACE News Release.docx

Edited by Richard1954
see above
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24 minutes ago, Richard1954 said:

If the VA used the ACE procedures to rate your gerd  you will need to get a copy of the examination and review it.  Once you do that you will need to prove the examination was not complete.  If you have medical evidence outside the VA then you can claim the ACE did not consider all of the available evidence., because an ACE  only includes review of the VA medical records. 

 

Either way you have to attack the examination as inconclusive , you should appeal the decision to preserve the effective date.

 

ALSO ADDED: its very usual for the va to lower a rating based on one C/P exam alone,  that itself is a reason to appeal, its been my understanding that the va cannot use one review for downgrading  a rating.

 

ACE Directive.pdf 55.37 kB · 3 downloads ACE News Release.docx 113.8 kB · 1 download

Yeah when I went to the VA clinic a week after I found out about the 'ace' c&p exam, they couldn't see it I. My files. The only thing they saw was my C&P exam from last year. 

This is the second time I've filed for an increase and some random VA C&P exam for something I wasn't claiming happened and they decreased my rating. Last time was me finally getting the best evidence to prove my 18 years of neck/nerve/hand damage. Coincidentally I got an appointment for a C&P for my plantar fasciitis. Next thing you know my 30% went to 10% as my neck and hand went up. Thus I stayed at 94% instead of going over to 96% aka 100%. Now they dropped me down to 87%. Still 90% but I know my migraines warrant more than 0% and that's what the increase was for. That and trying to servicE connect my sleep apnea. I guess statement in support of claim and a visit about my sleeping lack thereof, slightly over  year after I retired don't count....

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St. Pete RO is sooo dirty!!

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I would get a copy of all those exams,  file for any another increases and any other new conditions you haven't filed for in the past.  Also,  were any of those conditions you were proposed a reduction for "protected" because they were over a certain number of years old, in that, they need to show marked improvement over time?  The St. Pete RO pulled this on me, when I filed for A&A and had the nerve to go by the CP exam given by a quack GP contracted who spent less than 5 minutes with me for two conditions!! after my neuro filled out the paperwork for A&A,  I freaked.  It would have dropped my rating below 70% losing my IU PT, with kids in college using Chapter 35.  I was LIVID.  I had held that rating for 10years and it was documented very thoroughly in my VA records, anyway I said screw that and filed for every single thing I have never filed for before, I went from 70% IU PT to 100% schedular with SMCs after a year of so much stress and grief.  I was sent an actual apology but only because I raised hell. 

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@seminoles is correct. Reducing a rating is a very specific process and must be followed.

There are specific timing issues with a reduction in rating and you need to follow them to avoid problems.

The other questions are on point

are/were any of your ratings in place for more than 5 years? 10 years? 20 years?

are you over 55?

did you receive a letter "proposing" a reduction in rating? did it include your options to appeal that reduction?

You need to file for a new C-File immediately.

You need to start gathering evidence for your appeal

As for the notes. you will have to include in your C-file request a specific demand for that notes. They may try to avoid doing that, and if they do that is more evidence in your appeal. Make this request ASAP.

you NEED to challenge the Dr's credentials in your appeal. This preserves that challenge for future potential legal claims in higher courts and MUST be raised at the first possible moment which is your first appeal. Make no mistake, this is not hyperbole. You legally lose the right to raise that issue later if you don't claim it NOW.

What you are experiencing is the underlying reasoning over why VSO's are known to try and discourage vets from filing appeals or increases once they have been rated. Their famous don't rock the boat statements.

When you apply for anything, you open your entire claims file for review, even if you are 100% P&T.

This new review could, in theory, uncover older errors is granting awards. The application of this and our (the vets) perception is that this is punitive on the part of the VA.

There is a rule in the VA Manuals, and I don't know it off the top of my head, that amounts to saying that if one rating is reduced, but others are increased and the net value is the same amount of pay/rating to the veteran then no actual harm is incurred. That is false and needs to be challenged on grounds of it being a presumption not a  reality. Our ratings are cumulative in nature and conditions tend to get worse with age not better. 

There is even a possible Constitutional Property Right claim to your existing rating and future rating potential. Even though some might see this as a stretch, it is one I would make in a case of reduction of rating in conjunction with your other paths of attack. IMO raising at the lowest possible level is just another opportunity for the VA to make more errors which the board or higher courts would have to address on further appeal.

read these

https://www.bva.va.gov/docs/VLR_VOL3/4-DeutschAndBurriesci-DueProcessInTheWakePages220-262.pdf

https://www.veteranslawblog.org/grading-the-bva-on-constitutional-due-process/

There is a case that modifies the application of Due Process to Veterans. I don't remember if it is Cushman or one after Cushman. But it is effect says that Vets do have a Property Right to their SC but it only attaches after the SC has been granted. The first case just said we had a blanket Property Right to SC which implied that we had that right even before SC was granted.

Keep us informed and post the letters or orders they issue so we can help where possible.

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  • Similar Content

    • By Endgame Thor
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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

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      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

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      Fund HadIt.com Veteran to Veteran LLC


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