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Back pay timeframe after winning appeal?


Backpay
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Question

Hello,

Dec 5th I won 2 parts to my appeal and had 1 remanded. 1 of the disabilities awarded is tinnitus. On the VA.gov website it says that it should take 1 to 2 months for the new disability rating to be reflected. It's been over 2 months and nothing. I called the national number and they could only say it was at my RO (that was a month ago) , I contacted my VSO who didn't know anything either. How long does it normally take? I'm going to be out of work for 4 to 6 weeks because of surgery that I have next week.

 

Thanks

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Call Peggy again. It is possible that the remand is holding everything up. You haven't provided any facts; have you explored getting workman's comp? If your surgery is for a s-c disability, sometimes you are eligible for temp disability comp. For example, if you have s-c prostrate cancer, you can be paid 100% rate for recovery time and then your ar re-evaluated.

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17 hours ago, GBArmy said:

Call Peggy again. It is possible that the remand is holding everything up. You haven't provided any facts; have you explored getting workman's comp? If your surgery is for a s-c disability, sometimes you are eligible for temp disability comp. For example, if you have s-c prostrate cancer, you can be paid 100% rate for recovery time and then your ar re-evaluated.

My surgery is unrelated. I'm having section of colon removed because of recurrent diverticulitis and gallbladder removed at same time for polyps to rule out / prevent cancer.

I'm going to be on short term disability during my recovery time so Ill be making less money during the time I'm out.

Currently rated at 10% and judge ruled in my favor for tinnitus and range of motion for right arm because tenosynovitis and surgery that occurred in service. Remanded issue is for increase in rating for scar from said surgery.

I've called a few times. I've been told that the remanded issue has an order in and that the RO has my file and that it takes time to figure out backpay. They also don't have any estimates on timeframe.

Called back again after almost 3 month mark because the VA website specifically says if the decision resulted in increase in disability rating it should take 1 to 2 months. This time agent I spoke with said that he never even heard about estimates on their website but it would be just that an estimate. So I asked if it would be crazy for it to take 4 months which would be double estimate and he said no. 

In the past when I filed for increase I had it within weeks after exam.

I also asked the person if I could talk to anyone else about the issue and they suggested the BVA but I said it's with RO right and they said yes so the BVA would be no help then they gave me the claims fax number which I don't think will be helpful at all either. 

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19 hours ago, GBArmy said:

C disability, sometimes you are eligible for temp disability comp. For example, if you have s-c prostrate cancer, you can be paid 100% rate for recovery time and then your ar re-evaluated.

 

So I called again.... I was told that the 1 to 2 months timeframe is always listed and essentially means absolutely nothing. Won't lie kind of upsetting especially considering the scandals with VA and wait times for medical care so it seems like they care about appearances vs actually following through of time frames. Was also told the Dec 5th date was the date someone at the RO got my file back from BVA and updated the status. He said it's been in the ready for decision status since Dec 5th and that they need to determine effective dates and percentages and basically go through everything again and there is no way to know if it's actually being worked on or not. 

Edited by Backpay
Trying to delete quote
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Backpay You are between a rock and a hard place for sure. Not that it is of any help, but when the remand comes down and they are figuring out back pay, the VA has a real tendency to string you along for a while. Kind of holding up your money, which is no longer the VA's. But that really isn't unusual; they do it to most. The only thing I could think of is to call your congressman's office and see if they can issue a letter of inquirey. Have all the facts, dates, and play upon the fact you will bee out of work with no income for several weeks and the resulting hardship it will bring.. Pick a Congressman who cares about veterans if you can; it would have more clout. I don't know of anything else to tell you. It's their process, they were directed by BVA, and now tey are going to take as long as they want to pay you. Good Luck.

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48 minutes ago, GBArmy said:

Backpay You are between a rock and a hard place for sure. Not that it is of any help, but when the remand comes down and they are figuring out back pay, the VA has a real tendency to string you along for a while. Kind of holding up your money, which is no longer the VA's. But that really isn't unusual; they do it to most. The only thing I could think of is to call your congressman's office and see if they can issue a letter of inquirey. Have all the facts, dates, and play upon the fact you will bee out of work with no income for several weeks and the resulting hardship it will bring.. Pick a Congressman who cares about veterans if you can; it would have more clout. I don't know of anything else to tell you. It's their process, they were directed by BVA, and now tey are going to take as long as they want to pay you. Good Luck.

Thanks for your reply I really appreciate it. The remand was because the examiner didn't get all relevant information needed to determine a proper rating since I disagreed with 0% rating. They also apparently didn't look at more medical records over 2 year period that were related. 

I think your right about congressman. I might try the Whitehouse hotline number first for veteran issues then if that doesn't seem promising reach out to congressman. 

Are there any regulations your aware of for timelines in which VA has to respond to BVA or anything else like that so I can use it to hold feet to fire?

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I am not aware of any time limits on remand decisions but if you go to their web site, https://www.bva.va.gov/ , there is a tab to contact and also to ask questions. If you find out anything, I'm sure we would like to hear it.Good luck.

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8 hours ago, GBArmy said:

I am not aware of any time limits on remand decisions but if you go to their web site, https://www.bva.va.gov/ , there is a tab to contact and also to ask questions. If you find out anything, I'm sure we would like to hear it.Good luck.

If I find out anything good I'll definitely update everyone here. Personally I found the following interesting.

Let's break down my situation to basic terms. I was granted service connection for 2 disabilities. 1 for tinnitus which is 10% rating no matter what. The other for tenosynovitis which would require them to look at the evidence they already have in their possession.

The remanded issue is because the examiner didn't get all the info they were supposed (this is for an increase in an established SC disability because I disagreed with initial rating) and the judge said the RO didn't bother to look at relevant medical records from a 2 year period.

These are some interesting facts though when considering the above.

According to the VA in December the average time for a decision on a new claim was 82.4 days. That includes getting all the evidence, reviewing it, deciding if it's service connected, and at what rating. 

https://www.va.gov/disability/after-you-file-claim/

Personally I'm inclined to believe that it's so fast for new claims because like my remanded issue they don't do what their supposed to and deny claims to make those wait times look better. But let's say they are doing things properly for the sake of everything.

83 days after RO received order from BVA to grant me 2 SC disabilities will be February 26th. So why when most of the work is already done is it taking that long to get my rating? Again VA website said I should expect it in 1 to 2 months.

 

The VA also claims to decide claims for increases in disability if you file decision ready claim and work with veteran service organization within 30 days. 

I have a VSO representing me and essentially the BVA gave me service connection so the VA is just processing an increase and according to person I spoke with on phone my case has been in decision ready status since December 5th.

I definitely feel like I'm finding more and more information to use to speed this up especially if I call congressman.

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The AMA implementation has speeded up "average" claims considerably, but I am no so sure about the approval rates improving. But we are so used to delays in the process for so many reasons that most of us are not surprised it takes 3 months for a remand to be implemented. Getting a congressman involved may work because they can cause a lot of unneeded attention to a VA RO which is not desirable for the head honcho and just might grease the skids a little. Hope it work for you.

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As for how long it takes, it is a crapshoot.  I had a ED fully developed claim under the AMA that took 13 months.  It depends on the complexity, RO, work que, and how the rater is feeling on a given day.  If it is a BVA remand they are most likely holding up backpay until the remand is done, they are not supposed to but they get away with it so they do.  The VA is not your friend and cares only about their appearances.  Yes, if you can find a congressman interested it might help but not always.

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26 minutes ago, vetquest said:

As for how long it takes, it is a crapshoot.  I had a ED fully developed claim under the AMA that took 13 months.  It depends on the complexity, RO, work que, and how the rater is feeling on a given day.  If it is a BVA remand they are most likely holding up backpay until the remand is done, they are not supposed to but they get away with it so they do.  The VA is not your friend and cares only about their appearances.  Yes, if you can find a congressman interested it might help but not always.

Like I said I'll keep updating this thread throughout my journey so that it may help someone else. 

I sent the about info last night to my VSO and they called me this morning but I was sleeping. Waiting on another call back from them.

But here is a new question. So if the DRC takes 30 days if I filed it today would that mean they would deny it because they would see my file and have to approve the grant from BVA so my fast track claim would be moot? 

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So I'm finding more and more info that I feel will help.

See the following which is found in federal regulations regarding adjudication of claims.

https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=549cda86648188a6a068def5530850c9&rgn=div5&view=text&node=38:1.0.1.1.4&idno=38

§3.2502   Return by higher-level adjudicator or remand by the Board of Veterans' Appeals.

Upon receipt of a returned claim from a higher-level adjudicator or remand by the Board of Veterans' Appeals, the agency of original jurisdiction will expeditiously readjudicate the claim in accordance with 38 U.S.C. 5109B. The agency of original jurisdiction retains jurisdiction of the claim. In readjudicating the claim, the agency of original jurisidction will correct all identified duty to assist errors, complete a new decision and issue notice to the claimant and or his or her legal representative in accordance with 3.103(f). The effective date of any evaluation and award of pension, compensation or dependency and indemnity compensation will be determined in accordance with the date of receipt of the initial claim as prescribed under §3.2500(g).

 

[84 FR 172, Jan. 18, 2019]

 

i then searched all of the sections under adjudication and found that the word expeditiously is only used twice. Both times regarding how the VA must handle claims sent back to them from a higher authority.

why is that important? It shows that regulations require they be handled faster then a standard claim. So I definitely should have received my rating and back pay by now.

 

so I guess I could also go the route of inspector general now since I have reason to believe federal regulations are not being followed.

Edited by Backpay
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Called Peggy with questions on regulations who said I had to escalate it and suggested white house hotline. Called them and got conflicting information. 

Basically I was told they don't give estimates but estimates given on website are based data such as claims, information they have, workload etc. But they are just estimates. He couldn't help me but I also mentioned that if they have data they use to give those estimates on website then it would be crazy to think it should take double the higher estimated timeframe.

 

Also said that appeal grants are treated totally different and in seperate pile for handling then new claims which again seems crazy if appeals once given back to the RO are supposed to be handled expeditiously. He said I may have different interpretation of expeditiously and I just said to me expeditiously should mean faster then the standard claims. 

 

So to me personally it seems like the VA is playing games with optics and timeframes to make themselves look better. 

So the fight continues, at this point since I tried handling it on the lower levels I'm going to prepare letter for my congressman and for the office of inspector general as well as see if there is an investigative reporter who would like to do a story not on me but on these "estimated timelines" and possible regulation violations.

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Some more relevant issue regarding word expeditiously.

https://www.federalregister.gov/documents/2019/01/18/2018-28350/va-claims-and-appeals-modernization

N. Comments Concerning § 3.2502—Returns by Higher-Level Adjudicator or Remand by the Board of Veterans' Appeals

 

 

Several commenters expressed confusion over the inclusion of the term “adjudication activity.” VA agrees that our use of this term in the proposed rule was confusing. Accordingly, VA revises § 3.2502 to use the term “agency of original jurisdiction” throughout the final rule. Similarly, commenters requested further clarity on what it means to “take immediate action to expedite readjudication.” The AMA amended 38 U.S.C. 5109B to state, “The Secretary shall take such actions as may be necessary to provide for the expeditious treatment by the Veterans Benefits Administration of any claim that is returned by a higher-level adjudicator under section 5104B of this title or remanded by the Board of Veterans' Appeals.” VA agrees that clarification is necessary and revises § 3.2502 to more closely mirror the statutory language. The statute does not further define what is meant by Start Printed Page 147“expeditious,” leaving timely treatment of claims to the Secretary. Clearly, Congress intended that VA would process these claims as expeditiously as possible depending upon available resources. VA will similarly not further define “expeditious” in the rule to provide the Secretary the discretion to direct expeditious processing of actions through allocation of available resources, appropriate prioritization of workload, and issuance of procedures.

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I have been giving this more thought. Monday I am going to my congressmans office since I have surgery Tuesday and will be out of commission awhile. 

The more I think about this and research it the more I realize how wrong veterans are being treated by the VA and how they don't even try and hide it.

Aside from my grants which should be super easy for VA to do, the VA website says remands typically take the veterans benefits administration (agency of original jurisdiction) 16 to 29 months to complete. So if a new claim takes 82.4 days to receive a decision and federal regulation requires claims going back to VBA from BVA to be handled expeditiously this clearly shows a violation of regulation and our due process rights. 

I've been trying to reach out to a lot of people over last day or so, hopefully something comes of this so all Veterans will have their claims handled properly and in a timely manner.

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4 hours ago, Backpay said:

I have been giving this more thought. Monday I am going to my congressmans office since I have surgery Tuesday and will be out of commission awhile. 

The more I think about this and research it the more I realize how wrong veterans are being treated by the VA and how they don't even try and hide it.

Aside from my grants which should be super easy for VA to do, the VA website says remands typically take the veterans benefits administration (agency of original jurisdiction) 16 to 29 months to complete. So if a new claim takes 82.4 days to receive a decision and federal regulation requires claims going back to VBA from BVA to be handled expeditiously this clearly shows a violation of regulation and our due process rights. 

I've been trying to reach out to a lot of people over last day or so, hopefully something comes of this so all Veterans will have their claims handled properly and in a timely manner.

Expeditiously: Merriam-Webster Definition marked by or acting with prompt efficiency.

Expeditiously: Veterans-Administration Definition marked by whenever VA can get to it.  With all the mandates of processing new claims and any other special claims you are looking at a very short time.  Some of us got granted BVA claims and it has been a lot and I mean a lot longer than five months with no retro pay, no Iris response, no nothing from our VARO and Peggy,  she/he is as helpful as the commercial Peggy.

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Its all about a "general disrepect" for Veterans by VA employees.  

When it comes to VA employee checks, now those are handled expiditiously.  If there is a mistake in your VA employee check, expect it to be resolved by the following payday..or else.  

However, when Vets checks are late, inaccurate, or missing, the VA posits, "Who cares? We will get to it when we get to it and not one second sooner".  

They must have some good, fast efficient and detail oriented employees who process VA employee paychecks.  

Those that process Veterans checks are lazy, inefficient, uncommunitave, incoherent, and bitter.  

We need to force congress to link "VA exec bonus" so that ZERO are paid until all Veterans are paid.  

Lets put those great employees who process employee pay to work on Veterans payments, and the lazy, inefficient, bitter and uncommunitave employees should work VA employee checks.  Watch Veterans backlog disappear when VA exec bonuses are linked to Veterans speed of payment.  

In the "real world" (non VA), that is what happens.  If you want a bonus, then give excellent customer service.  In VA, if you want a bonus, do favors for those who decide bonuses, or "have something" on them, such as know that he is "taking from the till".  

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Yes it's totally rediculous. I read another thing that I can try as well. I plan on faxing over a demand for action letter on my claim.

We really shouldn't just give up and on this and we should keep calling Peggy and our representatives bringing up this violation of our due process. If I have to follow the law a Federal regulations why doesn't the VA? Is it's excuse they are understaffed? Well maybe I'm to busy to pay my VA co payments? Definitely a double standard.

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