Major Increase after 11+ Years Wait

[myrah]

Bottom Line Up Front: 80% effective 1 Dec 2019, 70% effective 1 Mar 2007.  Decision letter dated 26 Nov 2019.  Previously 40% VA & 20% CRSC.

 VA and CRDP retro will likely take quite some time to to make it to my checking account but just knowing that I will eventually receive it is good enough for now. 

I am an AD retiree and long time hadit lurker who has gleaned a wealth of knowledge from this site over the past years.  Thanks to all whose experiences and or comments have contributed to my VA claim education.

History:

Previously granted 40% (initial claim) effective 1 March 2007 / retirement date.

Second claim filed in late 2007 within one year of retirement: being employed in Iraq and Afghanistan for 9 years resulted in my claim getting stuck on the VA denial wheel. Eventually an appeal ended up at the BVA and on 22 Feb 2018 they issued a remand directing the RO to address all 14 issues in my second claim.

20 months later (late Oct 2019) VA notified me of C&Ps scheduled for 12 & 13 Nov 2019 - attended both.  On 25 Nov I noticed a cryptic note on the va.gov site stating that my C&Ps had closed and "Auth Referral - case sent to AAFC for potential fee review", and the ebenefits site reflected 80% under Disabilities.  I received my BWE on 10 December.  The decision letter only addressed 4 of 14 issues from the remand. All four were favorably actioned and the rater added in a secondary condition at 10% (left leg radiculopathy) that wasn't claimed.

So now I am left wondering what happened to the other 10 conditions not addressed in the rating decision and whether I should hold off for a month or so to see if I hear further from the RO or to send up the red star cluster now.

I will update my success or lack thereof upon resolution of the 10 conditions currently pending decision.

 

[broncovet]

I dont recommend waiting AFTER you got the decision.  Of course, that assumes you carefully read the decision and those issues were not "deferred" or other wise addressed.  

This is what I would do:

I would file a NOD on the decision disputing the "deemed denial" of issues 1-10, which were appearently "unaddressed" by the decision.  This should preserve your effective date, and force an answer.  

On that, a HLR may suffice.   Example:

I disagree with the decision dated 26 Nov. 2019 on the following issues:

1.  Condition "a" was not addressed by decision.  

2.  Condition "b" was not addressed by decision.  

etc. etc.  You can cite why you deserve benefits, such as your a medical exam where your doc diagnosed you and provided a nexus for that condition.  

 

[broncovet]

You can also Cue it, because its a violation of 38 CFR 3.103 which reads, in part:

 

Quote

 

3.103 Procedural due process and other rights.

(a) Statement of policy. Every claimant has the right to written notice of the decision made on his or her claim, the right to a hearing, and the right of representation.

 

However, I really dont recommend cue for this, even tho I believe its an obvious error.  Why?  You have to prove the error was "outcome determinative".  

Its easy for the VA to say, 

"Oh, yes, that was an error, but it wasnt outcome determinative.  Reason?  Oh we reviewed your claims and we are denying everything, so it didnt change the outcome."  

"Oh, yes, and here is your decision. Denied, denied, denied, denied, denied, and, oh, did I mention denied?"  

 

Edited December 12, 2019 by broncovet

[Vync]

Welcome to Hadit!

Congratulations on your win. I agree with @broncovet's suggestions.

When you get any rating decision, always double-check to see if they got it right. I recommend comparing the findings against your medical records and C&P exams. The VA has a reputation for getting things wrong and you may not catch the errors.

[myrah]

Broncovet & Vync - thanks for the post rating decision guidance.  I can't afford to get it wrong this time around as if I have to wait another 11+ years for the VA to get it right I might not remember what it was I was fighting for in the first place.

I will reread the decision multiple times to ensure that I haven't overlooked or misunderstood anything as well as relook all known evidence.  I don't have a copy of my c-file but do have copies of my SMR.  My 12 Nov 19 C&P for PTSD posted today so expect the 13 Nov 19 C&P (all other) to post tomorrow.  They awarded me 30% PTSD so I am very interested in the all other C&P as it should provide some insight towards the 10 conditions overlooked in the rating decision.

 

[vetquest]

If you do not get a good answer go to your VA release of information office and request to get the C&P's that were done on xx date.  They have to provide them to you.  They might have some interesting information.  I agree with the others about appealing.  Don't wait too long before doing this, it can take some time before an HLR is completed.