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Mantana

Question

I'll try to be brief.

 

Va claim filed April 2019 for sleep disturbances, jaw condition, scar in mouth, painful scar. In June my scar was rated 0% and pain 10%. Jaw condition was deferred and sleep disturbances ignored.

 

In July I filed somatic symptom disorder and mood condition secondary to all my denied disabilities and current ones. I received a letter saying I did this incorrect and ebenefits updated accordingly deleting the claims. Then in August I filed somatic symptom disorder and mood condition secondary to jaw condition and scar pain. I also filed hearing loss primary. Ebenefits updated accurately showing what i claimed. 

In October I get a call from the regional office wanting to clarify what I was trying to claim. They then attached my somatic symptom disorder and mood condition to my sleep disturbances claim. The person told me I would retain my original effective date of the April claim. 

I attended c and p for jaw condition and hearing loss. I submitted a dbq from a board certified psychologist. The October called said I had plenty of information to get it rated.

 

I looked at ebenefits December 14th and have now been rated 20% combined due to my scar pain and TMJ. Claim CLOSED.

I called VA 1800 number and they tell me the somatic symptom disorder and mood condition, as well as hearing loss are attached as secondary to tinnitus which is pending appeal (and nothing else).

What I did from there this week was submit a 21-4138 explaining I claimed those secondary to tmj and scar pain, not tinnitus. Also hearing loss as primary. I then called the VA and they took a statement to send to the regional office. 

 

Has anyone had experience with this and should I be worried?

Will I still retain my effective date with my original claim? 

 

Edited by Mantana
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1 hour ago, Dustoff 11 said:

As a follow up the VA will not recognize a secondary service connected condition you are claiming that is due to a NON SERVICE CONNECTED condition (there may be a rare exception I am not aware of).  If your denied primary medical conditions are still not service connected then you won't be granted secondary SC due to these denied SC conditions.

You really need to find an experienced full time and MOTIVATED (high energy) professional VSO located at a VA regional office to assist you with your many contentions of medical conditions and claim filing. Good luck.

The above info is not legal advice as I am not an attorney, paralegal or VSO.  

I forgot to tell you it was a VSO that claimed secondary to conditions I was not service connected for AND the ones I am. That's the strange part they addressed the not service connected part in a decision letter but never addressed my secondary claim to my service connected disabilities. They disregarded it 

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Robinson says the VA has a responsibility to maximize your benefits to the extent the law allows.  Its not your job to figure out whether your conditions are secondary to tinitus, primary, secondary to something else, or presumptive.  Its the VA's job to figure that out, based on the evidence.  

Did you read your VSO's application?  Did it really say that "I apply for benefits secondary to ( a condition to which you are not sc for)?  If it did, well the problem is with your VSO.  Of course, that is now your problem also.  

But, its more likely that your VSO asked for benefits "both primary or secondary".  Its crazy to limit your benefits like that.  Its like winning a million in the lottery, then saying, "oh, I dont need a million dollars, I only want 45,000 to pay off my house".  

A review of your file is needed to see what was actually applied for, rather than speculation on what you think (some VSO) applied for.  

Its all about documentation.  

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  • HadIt.com Elder

Not sure this would apply here  I have not read all about this thread. 

but if you didn't know this  this is worth reading about.

VA Has the duty to maximize veterans benefits

see attorney Chris Attig VLB (Veterans Law Blog)

https://www.veteranslawblog.org/va-duty-to-maximize-benefits/?ck_subscriber_id=187219681

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On 12/27/2019 at 5:41 AM, Buck52 said:

Not sure this would apply here  I have not read all about this thread. 

but if you didn't know this  this is worth reading about.

VA Has the duty to maximize veterans benefits

see attorney Chris Attig VLB (Veterans Law Blog)

https://www.veteranslawblog.org/va-duty-to-maximize-benefits/?ck_subscriber_id=187219681

Chris Attig has some great stuff online.

Just to give an update, after submitting the 21 4138 and calling the VA 2 times a week for the last month, they have admitted to making an error and reopened my claim. 

 

 

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