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    • Howdy all,

      The VA DRO denied my claim for an earlier effective date for my sleep apnea. They originally denied it in 2008 but granted it in Nov 2019 secondary to my GERD. I was rated for GERD in 2001. So I had it in 2008. I have attached the 2008 denial, 2018 approval, and the NOD SOC. All of my medical files and the medical articles and VA Citations referenced were in existence in or before Jan 2008. The only new items were the NEXUS letter from Dr Bash and a few extra buddy letters. The original denial states that my medical records show no diagnosis or treatment and only isolated complaints of symptoms. The denial does not even list my wife's or my lay statements as evidence reviewed. I have symptoms listed numerous times in my SMRs:

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1454th Solider

Claim granted or denied. Which seems to come quicker in the claim process?

Question

I was wondering if any of the vets out there can shed some light on a question I have about granted claims and denied claims (Fully Developed Claims). Does it seem as if your claim is moving fast under 90 days for completion, that you are or denied or granted the claim most of the time?

Does it seem as if your claim was delayed during the Gathering of Evidence but then completion over 120 days, your claim was denied or granted? Share your experiences and thoughts.

Does a speedy Gathering of Evidence phase (30 days or less) result in more grants or denials?

Does a delayed Gathering of Evidence phase mean the VA is trying to find a way to deny a FDC?

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Posted (edited)

There isn’t. Some things like sending off to NPrc for records take time, they may be mostly be electronic ( after the mid to late 90s at least) most of the time but they still have to be located in the system(s) and then converted. Other times there is waiting for private doctors that don’t always respond to records requests from VA (they are under no obligation to do so).  Some cases move fast because the vet or their service STRs are complete. Some don’t. It’s not a conspiracy to deny if it moves fast or slow. Every single vet’s circumstances are different. Literally.

 

It is what it is. Certain actions on a claim have mandatory period of time to wait until that action is either fulfilled or a negative response is received- not answering (whether it’s the vet, nprc, or the private doctor) is not a negative response by statute, so a second request has to be sent. It’s mandated that for service treatment records, NGR/reserve, Private records, veteran, etc that two attempts be made, at 30 days a piece. You can do the math. NGRmedical records are often kept by the unit. I don’t know why, not my monkeys. So if you were guard our reserve there are now two-three different places that have parts of your records-Records’s threat are mandated to be received before exams can be scheduled except for some special issues. See what I mean?

Edited by brokensoldier244th

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43 minutes ago, brokensoldier244th said:

There isn’t. Some things like sending off to NPrc for records take time, they may be mostly be electronic ( after the mid to late 90s at least) most of the time but they still have to be located in the system(s) and then converted. Other times there is waiting for private doctors that don’t always respond to records requests from VA (they are under no obligation to do so).  Some cases move fast because the vet or their service STRs are complete. Some don’t. It’s not a conspiracy to deny if it moves fast or slow. Every single vet’s circumstances are different. Literally.

 

It is what it is. Certain actions on a claim have mandatory period of time to wait until that action is either fulfilled or a negative response is received- not answering (whether it’s the vet, nprc, or the private doctor) is not a negative response by statute, so a second request has to be sent. It’s mandated that for service treatment records, NGR/reserve, Private records, veteran, etc that two attempts be made, at 30 days a piece. You can do the math. NGRmedical records are often kept by the unit. I don’t know why, not my monkeys. So if you were guard our reserve there are now two-three different places that have parts of your records-Records’s threat are mandated to be received before exams can be scheduled except for some special issues. See what I mean?

I didn’t understand the, “until a negative response is received part”, can you elaborate?

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An actual ‘no’ , or, no records found. Unless it’s screen shotable or in print, it’s not verifiable, so, persist until one comes back. That is then uploaded to the folder for the veteran as evidence that the searches were performed.

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9 minutes ago, brokensoldier244th said:

An actual ‘no’ , or, no records found. Unless it’s screen shotable or in print, it’s not verifiable, so, persist until one comes back. That is then uploaded to the folder for the veteran as evidence that the searches were performed.

Thanks for the clarification, it was a fully developed claim so all the treatment records, IMO diagnosis/nexus and in service records were supplied. That’s why I ask this question for fully developed claims.

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That doesn’t mean that things don’t still need to be found. That being said, if your claim was submitted with everything other than maybe an exam then of course it’s less time.

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    • Howdy all,

      The VA DRO denied my claim for an earlier effective date for my sleep apnea. They originally denied it in 2008 but granted it in Nov 2019 secondary to my GERD. I was rated for GERD in 2001. So I had it in 2008. I have attached the 2008 denial, 2018 approval, and the NOD SOC. All of my medical files and the medical articles and VA Citations referenced were in existence in or before Jan 2008. The only new items were the NEXUS letter from Dr Bash and a few extra buddy letters. The original denial states that my medical records show no diagnosis or treatment and only isolated complaints of symptoms. The denial does not even list my wife's or my lay statements as evidence reviewed. I have symptoms listed numerous times in my SMRs:

      a. Medical visit dated 24 Feb 76 for problem sleeping and depression.
      b. Physical exam dated 24 Jan 79 listed frequent/severe headaches" dizziness, and
      nervousness.
      c. Physical exam dated 07 Nov 83 listed frequent/severe headaches.
      d. Physical exam dated 16 Jan 85 listed frequent/severe headaches.
      e. Admitted to hospital 05 Aug 86 for chest pains and anxiety.
      f. Medical visit dated 14 Jul 87 for problem sleeping and morning confusion.
      g. Physical exam dated 25 Feb 88 listed dizziness.
      h. Physical exam dated 07 Oct 91 listed frequent/severe headaches
      i. Physical exam dated 25 Aug 93 listed headache.
      j. Hernia repair surgery dated 22 Ang 94 surgeon had to insert devices of some
      kind in each of my nostrils that went down into my throat to keep rny airway
      open and stop my disruptive snoring.
      k. Physical exam dated 29 Sep 99 listed frequent/severe headaches.

      So could you all take a look and let me know what you think.

      Redacted VA NOD SOC 04-09-2020.pdf
      VA 2008 Denial of OSA Redacted.pdf
      VA Claim Decision Ltr 08 Nov 2018 Redacted.PDF
      • 3 replies
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