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TRIPLE THREAT!


Ztmiller8
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Question

Hey everyone, 

Need some insight here... I filed a triple issue appeal with the VA some time ago, I lawyered up and everything was handled very professionally. I asked my lawyer this; however, he has told me that if it is not a “next day due” issue, it will have to wait. I get both sides of that, 1 being, okay i get it, stuff is hectic! Other side is, well I’m paying for this, why are you not getting right back to me...none the less that’s why I’m here.

Appeal Issues: 1. PTSD: increase from 50 to 70 

                           2. Back: Get service connected (We already ruled this out)

                           3. Iritis: Raise from 10 to 60

Our goal is 100% like many others. 

Story: Got word my case was to be expedited due to financial hardships, we’ll leave it at that. On 3/25/2020 I was told via the 1000 VA number that all 3 issues were denied and an SOC was sent out. Shit...a few days later I and checking my Ebenefits and I am at 90% overall...okay...lets call them back...Idiots on the other line tell me that all three issues were SOC’d and that a decision packet was being sent out on the 29th of march...okay lets back up...did you just hear yourself? This is where it gets confusing... So I call back the following day to try and get some solid word (I know, foolish me) and I ask simply if they worked on my final issue within my appeal, they said they were all SOC’d and the iritis is waiting on a decision, thats new.... (again)...call right back for someone different...guy was a dick, name was Larry...wouldn’t give me an inch after explaining everything. 

The iritis is maxed out at 60% when the individual has gone to 7 or more clinical appointments within one year, I presented a letter signed from my optometrist stating I went to one each month for one year, I’m not great at math but that sounds a few more than 7 times. So I go to my C&P exam and the guy remembered me as I was his only case or this issue and he wrote down the same thing on his paperwork. So with such hard evidence within and out of the VA system...why are they saying it is denied and not just waiting for a decision???

Fast forward to today, I’m left questioning this in a few routes:

Route #1: They are dicked up and are being lazy...

Route #2: I was actually denied the remaining two issues (back and iritis)

Route #3: They are handling each one individually and the telemarketers at the 1000 number just don’t have the correct or updated info in front of them. Since some still tell me all three are denied... while then proceeding to say I am getting a decision packet for the ptsd...

 

I hope someone can shed some light on this as it simply makes no sense, and yes I am well aware that the VA never makes sense, as you can see, this is just all messed up, thanks for any of the replies!

- Z

 

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17 hours ago, Ztmiller8 said:

Hey everyone, 

Need some insight here... I filed a triple issue appeal with the VA some time ago, I lawyered up and everything was handled very professionally. I asked my lawyer this; however, he has told me that if it is not a “next day due” issue, it will have to wait. I get both sides of that, 1 being, okay i get it, stuff is hectic! Other side is, well I’m paying for this, why are you not getting right back to me...none the less that’s why I’m here.

Appeal Issues: 1. PTSD: increase from 50 to 70 

                           2. Back: Get service connected (We already ruled this out)

                           3. Iritis: Raise from 10 to 60

Our goal is 100% like many others. 

Story: Got word my case was to be expedited due to financial hardships, we’ll leave it at that. On 3/25/2020 I was told via the 1000 VA number that all 3 issues were denied and an SOC was sent out. Shit...a few days later I and checking my Ebenefits and I am at 90% overall...okay...lets call them back...Idiots on the other line tell me that all three issues were SOC’d and that a decision packet was being sent out on the 29th of march...okay lets back up...did you just hear yourself? This is where it gets confusing... So I call back the following day to try and get some solid word (I know, foolish me) and I ask simply if they worked on my final issue within my appeal, they said they were all SOC’d and the iritis is waiting on a decision, thats new.... (again)...call right back for someone different...guy was a dick, name was Larry...wouldn’t give me an inch after explaining everything. 

The iritis is maxed out at 60% when the individual has gone to 7 or more clinical appointments within one year, I presented a letter signed from my optometrist stating I went to one each month for one year, I’m not great at math but that sounds a few more than 7 times. So I go to my C&P exam and the guy remembered me as I was his only case or this issue and he wrote down the same thing on his paperwork. So with such hard evidence within and out of the VA system...why are they saying it is denied and not just waiting for a decision???

Fast forward to today, I’m left questioning this in a few routes:

Route #1: They are dicked up and are being lazy...

Route #2: I was actually denied the remaining two issues (back and iritis)

Route #3: They are handling each one individually and the telemarketers at the 1000 number just don’t have the correct or updated info in front of them. Since some still tell me all three are denied... while then proceeding to say I am getting a decision packet for the ptsd...

 

I hope someone can shed some light on this as it simply makes no sense, and yes I am well aware that the VA never makes sense, as you can see, this is just all messed up, thanks for any of the replies!

- Z

 

Sad to say but you need to wait for your decision letter. In the mean time you can contact your lawyer and ask them what the heck is going on. Did you file a claim for TDIU?  Are you working? Can you work? You are rated as being 70 +60 = 90%  Your lawyer maybe trying to get you TDIU.

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Again, I agree with PETE.  Tatoo THIS on your arm so you remember:

Quote

You can not always trust what VA employees, VSO's, or ebenefits tell you.  

Now that you got that one straight, wait for the envelope.  Your lawyer "may" be able to see the letter before it arrives via snail mail in your VBMS file, which he should have access to.  

ONE exception:  Check your ebenefits "letters".  If there is a letter that says you are 90 percent, chances are great that you are 90 percent.  Reason:  VA does not want Veterans running around with "letters" that say they are 90 percent when they are not.  

 

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1 hour ago, pete992 said:

Sad to say but you need to wait for your decision letter. In the mean time you can contact your lawyer and ask them what the heck is going on. Did you file a claim for TDIU?  Are you working? Can you work? You are rated as being 70 +60 = 90%  Your lawyer maybe trying to get you TDIU.

Pete,

Thanks for the reply, I have other ratings I did not list that when added to these, would rate 100%, sorry for not adding that.

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1 hour ago, broncovet said:

Again, I agree with PETE.  Tatoo THIS on your arm so you remember:

Now that you got that one straight, wait for the envelope.  Your lawyer "may" be able to see the letter before it arrives via snail mail in your VBMS file, which he should have access to.  

ONE exception:  Check your ebenefits "letters".  If there is a letter that says you are 90 percent, chances are great that you are 90 percent.  Reason:  VA does not want Veterans running around with "letters" that say they are 90 percent when they are not.  

 

Broncovet, 

thanks for getting back to me, yeah I figured they had no clue, or at least can’t be trusted, my letter does say 90, that’s mainly how I found out about things moving around, biggest thing now is trying to understand what is still open and what is waiting for a decision still.

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This is why we call the 800# "Peggy" .

Traditionally VA 800# for many years was Not supposed to advise if the claim had succeeded or been denied.

I found years ago that if I called 800# three times in one day ,I would get three different status updates.

Ebenefits seems to be a more productive way to see what is what. ....some times..not always.

 

 

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