Pending HLR, Pending Supp Claim, Closed Supp Claim. Should I call or file IRIS

[JKWilliamsSr]

I am trying to decide if I should call the white house line of file an IRIS claim myself.   I am leaning towards filing the IRIS claim because my understanding is that is what happens when you call the white house line anyway.  So here are where my claims stand.

1.  In September my supplemental for Sleep Apnea and 1 other was closed.   I still have not received a letter or any other type of notification about this other than it is what shows on va.gov.   I am certain they are required to send me notification and by not doing so is a clear violation of 38 CFR 3.103

2. The remaining claims on that supplemental claim are still pending.  I have called them twice already on this for the status.  This is the exam where I had the bad C&P exam but there still should have been some kind of movement.  I had the C&P exam on November 5th and 30 days later I called to request the status and was told they were waiting for exam results.  Called them out on that and they said it was because of backlog.  I called a couple weeks later and they were not gave me any additional information.  Just stated it was still pending.    I personally believe this exam should be in the hands of a rater because it is not an appeal but reopened claims with new evidence.  Unlike new claims or increases I cannot request a decision because I do not have additional evidence like you can on ebenefits.

3. I also have an HLR pending for denials I received an October.   Right now the status is "A senior rater is taking a new look at your case".  It has been sitting in that phase for the last 3 weeks and since no evidence  can be submitted it should not take a rater this long to be looking at this.  I could be wrong but I have seen way too many HLR's being completed within a week or so of a senior rater looking at it.   Maybe it is a good sign maybe not.

Here is what I think is happening.  I have several different types of claims going and I think it is just being swept away.   The last time I called I asked about both my HLR and Supplemental claim and the person I spoke to was clueless and could not give me any information because in my opinion they did not know what the hell they were doing.  I think with an IRIS complaint I can detail all of my concerns and have it listed where it cannot be ignored.  Sure it may not make a difference but it will be on record and can be used in my appeal.

[JKWilliamsSr]

ANOTHER UPDATE:

So today when I get home I check the mail and it appears I may get screwed but we shall see.   I got a letter from the VA from R.S.V.P Scheduling today telling me a request was made for an evaluation or re-evaluation and that I had 10 calendar days from the date of the letter to call and schedule an appointment.    Well this letter is dated October 16th and I did not call in time to get scheduled today and will have to do it Monday and hope they will schedule me since Monday is the 11th Calendar day. I had no checked my mail in a couple days.  I know the letter was not there Tuesday because that is the last day I checked the mail.   I did not check it Wednesday or Thursday.

Has anyone heard of R.S.V.P. scheduling from the VA?  I am scratching my head saying WTF! This letter is not even on VA letterhead.  Is looks like a flyer and not an official letter.

Edited January 25, 2020 by JKWilliamsSr

[GBArmy]

JK I hope you did a typo; you have the letter dated Oct.16. You mean Jan. 16? I never heard of RSVP, but what do I know. I'd make two calls: one to them and ask why the back date on the letter? If they are legit you shouldn't have a problem with making the appointment scheduled. Second one, if needed is to Peggy IF you get a negative from RSVP. 

[JKWilliamsSr]

9 minutes ago, GBArmy said:

JK I hope you did a typo; you have the letter dated Oct.16. You mean Jan. 16? I never heard of RSVP, but what do I know. I'd make two calls: one to them and ask why the back date on the letter? If they are legit you shouldn't have a problem with making the appointment scheduled. Second one, if needed is to Peggy IF you get a negative from RSVP. 

My bad....it was typo.   The letter is dated Jan 16. 

The number on the letter is legit because I called and it was to the VA but the problem when I talked to them they had no idea what kind of appointment needed to be made and I had to wait until Monday during business hours so I could talk to someone in Comp and Pen because apparently no one put in the code for the appointment that needed to be scheduled.

[JKWilliamsSr]

I called the number on the letter this morning and have a C&P exam scheduled for tomorrow morning.   They did not specifically say what the the appointment was for but only that it was an Ortho appointment but would not tell me specifically what for.   I am going to assume it is for my foot because when I called 800-827-1000 I was told a request for a C&P exam for my foot was made on Jan 15.  Since the letter I received was dated Jan 16 I assume it was for that. 

But.......

I had a really bad C&P exam for my back back in November.  Called and filed a complaint and sent in a memorandum for record for a bad C&P exam with the issues with the exam.  Some of the issues with that exam include.

1. Examiner reported a history I never stated to him.  (Submitted personal lay statements are contradictory to the statement he claimed I made.)
2. Examiner reported no radicular symptoms (Not mentioned during examiniation)
3.Stated  I reported no flare ups. (Submitted personal lay statements are contradictory to the statement he claimed I made.)

On top of that the examiner put on the DBQ that he examined things he never did.   He reported finding for Ankle Plantar Flexion,  Ankle Dorsiflexion, Great Toe Extension, Deep Tendon Reflexes and Hip Flexion but did not do any examinations. 

With that said I am going to go into this appointment with the expectation that I am going to be examined for both my back and foot. 

[vetquest]

It sounds like the examiner either was fraudulent or mixed up your exam with someone else's.  Go into the examination with your statements again and also upload your statement through VA.gov and have your VSO send your statement in if you have one.  This way you are on record with your statement and if the doctor does not file the same information they have a statement from you.  That is my best advice. 

[JKWilliamsSr]

22 minutes ago, vetquest said:

It sounds like the examiner either was fraudulent or mixed up your exam with someone else's.  Go into the examination with your statements again and also upload your statement through VA.gov and have your VSO send your statement in if you have one.  This way you are on record with your statement and if the doctor does not file the same information they have a statement from you.  That is my best advice. 

The examiner I had is a clear case study for lazy C&P examiners.   Couple other things to point out. 

1.  He completed the DBQ while I was sitting at his desk.  It was already uploaded into the system before I even made it to my car.  I watched him complete it.  He did nothing but copy and past from previous statements. 

2.  He stated that my back issue were influenced by my weight.   This alone is laughable.  He did not state my weight was the cause of my back issues.  He stated it was "influenced"  Something I nailed him on when I sent my memorandum for record.  But he stated that my back issues were not service connected because they were influenced by my weight.  Never mind the fact that I submitted a nexus from a doctor stating that because of my back issues I could not exercise and that contributed to my weight gain. 

3. He stated there there were only 2 visists in my SMR's for back issues.  Like that even matters.  I only need one instance for service connection but he attempted to make it seem like because there were "only 2" instances it could not be service connected.   There is a problem with this though.....see #4

4.  There are actually 13 visits while i was on active duty for back issues.  When I filed my recently claim I only uploaded 2 of the visits because they were the records that had diagnosis.  When I filed in 2009 the VA acknowledged that I had back issues but denied my claim because I did not have any diagnosis while in service.  When I got my c-file I found 2 visits with actual diagnosis and uploaded them as new and material evidence to reopen the claim. 

Edited January 27, 2020 by JKWilliamsSr