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Higher Level Review - Rater Missed and Did Not List Evidence on Rating Decision
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Theopolis
Hello hadit Community. I submitted an initial claim for Claustrophobia in 2011 and my claim was denied in March 2015. I submitted my NOD and appealed the decision. I recently (March 19, 2020) received another rating decision on my claim for Claustrophobia and was denied again for service connection. The issue in 2015 was that I had no evidence of my account of being mistakenly locked in the Arms Room. My period of service in the US Army was from 1985 to 1994, where I was a Supply Sergeant/Unit Armorer and stationed primarily overseas. I submitted buddy statements and a description of my Unit Armorer duties which required me to work in a vault like setting for long periods of time.
In September 2019, I submitted an affidavit from Allstate Insurance Company, (on their company letterhead) along with the date and time of the accident to include the Allstate claim number (the accident took place in January 1988) to the Evidence Intake Center. I called the VA Call Center (1-800-827-1000) numerous times afterwards and they confirmed receipt of the document and stated it was in my C- file. I also hand delivered a copy of the Allstate Insurance Company affidavit to my Regional Office in October 2019 and have a stamped copy of the documentation as evidence of my submission.
In March 2020, I finally was scheduled for a C&P exam for Claustrophobia. My C&P exam took place on March 13, 2020 and I showed the C&P examiner the Allstate affidavit and discussed my automobile accident and my duties as a Unit Armorer as my stressor events for Claustrophobia. My case was decided on March 19, 2020. When I reviewed the March 19, 2020 Rating Decision, the Allstate affidavit was not listed in the evidence section. The author of the rating decision spoke vaguely about the evidence and on Page 3 of the three (3) page decision, made the following statement; “ There is simply no evidence to confirm that the reported incident(s) occurred, or that you sought treatment documented during service as a result.”
In the March 19, 2020 Rating Decision, the rater stated: “that the March 13, 2020 C&P examination reported a diagnosis of situational phobia (claustrophobia) and the examiner opined that the present diagnosis was at least as likely as not due to the event you subjectively reported.” The March 13, 2020 C&P examination is also listed as a Favorable Finding in the March 19, 2020 decision. What is troubling about the rater’s language is they reference the “event” but does not refer to what the “event” specifically is. In addition to the Allstate affidavit, I submitted a lay statement from my sister also confirming the accident. I also included in the evidence:
My question for my fellow Veterans is this Rating Decision a Clear Unmistakable Error or just clear incompetence?
I have been examined four (4) times and currently by Psychologists and all of them have diagnosed me with Claustrophobia. I also have evidence of the automobile accident that I was involved in (thanks to Allstate keeping records over 30 years).
I requested a Higher Level Review on April 13, 2020 and articulated all of the above on the VA form. I also requested that a different office conduct the HLR in addition to requesting the informal telephone conference.
Thanks!
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