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How to proceed? Supplemntal Claim from Grand Mal Epilepsy DENIED


Glenndawson100
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Question

Hi there,
Recently actually yesterday the 21st of February the VA gave me notice that my supplemental claim had been decided and that they had sent out the letter that morning as well (meaning the decision was actually made on the 20th). This of course prompted me to check Ebenefits, where I saw no change in my rating. I'm currently rated at 40% for other issues. And in the past Ebenefits updated almost instantly leading me to believe that this supplemental claim was denied.
I originally submitted my Epilepsy claim back in august, it was denied about 4 months later due to conflicting phraseology given by one of my doctors (mind you i still have a diagnoses of Epilepsy with 15 witnessed Grand Mal seizures at this point). Once i got the original decision letter I contacted my County VSO's office and set up an appointment. After they reviewed everything they we surprised that my claim was denied as it has a clear nexus and on top of that falls under the conditions; that if they manifest within a year its considered service connected (I separated 02/01/2019, first seizure onset was 05/25/2019). They did review the 112 pages of evidence from my civilian doctors and did see the conflicting phraseology. They told me that if I could get my Neurologist to just confirm my diagnoses and say i was and have been under treatment since 05/25/2019 that we could submit a supplemental claim since that's the fastest route. So that's what we did. That brings us to now.
Under the standards for Epilepsy I was looking at a single rating of anything between 80%-100%. An 80% from 40% would have resulted in something Close to 90%. While i'm holding out, since in either case the retro pay (if my claim was awarded) would be greater then 20K that the additional signatures required are slowing down Ebenefits from updating, but as in most cases if the letter has sent and Ebenfits doesn't updated, 90% of the time you Claim/Supplemental/Appeal is denied. ( I mean correct me if I'm wrong).
Whats the moral of the story? No matter how much evidence you have to support you the VA will be the VA. I'm lucky that I'm rated for other conditions so that I can at least have the VA help me cut down on the costs of treatment for Epilepsy, but it would have been nice to have it service connected so that I wouldn't have to wait months on months for Neurology appointments since I don't have priority.
If any one has any information for me that might help moving forward, I'm all ears as once my letter is received and upon reading of the denial ill be filling an appeal.
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First, wait for the decision.  Speculating on what ebenefits means is not productive.  I recently got favorable board decision AND a favorable VARO implementation (The VARO actually gave me more than the BVA required.  I was awarded eed for tdiu by the BVA, but the VARO ALSO awarded SMC S)

In both cases, ebenefits was inaccurate.  I knew this would happen and waited.  

About 3 weeks later, a deposit went to my account for retro.  

Moral:  Dont count on ebenefits, wait for the envelope.  At a minimum, they dont update ebenefits frequently, so its usually out of date.  

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Until you get the letter you don't know for sure. Ebenefits isn't an instant update. Did you try printing your new benefits letter? I've seen that update before the rest of the site a few times. Either way, you can't really decide how to proceed until you have the letter to say why (If) it was denied.

Edited by brokensoldier244th
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Welcome to Hadit!

Following, I go to neurology for TBI and secondary symptoms, wishing you the best when you get your packet/updates!

Edited by awgv001
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23 hours ago, broncovet said:

First, wait for the decision.  Speculating on what ebenefits means is not productive.  I recently got favorable board decision AND a favorable VARO implementation (The VARO actually gave me more than the BVA required.  I was awarded eed for tdiu by the BVA, but the VARO ALSO awarded SMC S)

In both cases, ebenefits was inaccurate.  I knew this would happen and waited.  

About 3 weeks later, a deposit went to my account for retro.  

Moral:  Dont count on ebenefits, wait for the envelope.  At a minimum, they dont update ebenefits frequently, so its usually out of date.  

Yeah, while I guess I really shouldn't put all my eggs into one basket but with all of my other ratings, after the VA said they sent the decision letter, Ebenefits reflected the new rating % on the same day, of course the pay out was a lot smaller so that could be the case. I'm by no means hopeful.

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About 1/4 down in this VA article, are the regulations regarding claims filed within one year of service.:

The regulation they cite is linked in the article and also available at hadit under a search

https://www.va.gov/disability/eligibility/illnesses-within-one-year-of-discharge/

https://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKB/PART3/S3_309.doc

If the disability is not a "chronic Presumptive" under those regulations you will need to try to find an inservice nexus in you SMR , and/or your  military 201 Personnel file, and/or with strong buddy statements and you might need a strong Independent medical Opinion based on review of your inservice records.

But you do not have a decision yet and if it is a denial and if you can scan and post the decision here when you get it ( to include the evidence list) we can help more.

cover your C file, name ,etc prior to scanning it.

 

 

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Wait a minute-----I just realised the epilepsies are on the Chronic Presumptive list!!!!!

I apologize to you!!!!!

It is a long list and I sure never remember them all: and it is Very hard to find here in the search feature:

https://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKB/PART3/S3_309.doc

Yousaid:

"They told me that if I could get my Neurologist to just confirm my diagnoses and say i was and have been under treatment since 05/25/2019 that we could submit a supplemental claim since that's the fastest route. So that's what we did. That brings us to now."

And you ARE falling under the Chronic presumptives!!!!!!

So as good as this sounds, some optimism is in order but we ll have learned how the VA 

can screw up anything.

Sorry I didnt check that list sooner for you. You did the leg work you needed to succeed!

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