Higher level Review phone CALL

[USMCNEVERFORGET]

I just had my phone call from HLR person last week (not the same office who did the denial) .  I'm seeking service connection for sleep apnea as a secondary condition. I have everything documented EVERYTHING I mean EVERYTHING. My question is about the phone call experience. I was suppose to have it with my representative present but this wasn't the case due to DAV office being in-operational.  So I had it and was asked for the reason of my seeking  service connection. I explained my side and the person conducting the call agreed and also pointed out evidence that was over looked and not written in the denials.  My question is about what was said afterwards. "I'm going to channel this claim to the right place and you may or may not have someone call you or need another exam not sure how they are doing things now, during places being closed up."  Does this mean they made a mistake and need to correct it? Does this mean another C&P exam for sleep apnea?  Has anyone ever experienced the HLR phone call with the caller saying what was said to me?  What does this mean to you???

Below is what transpired since July 2018.

Filed fully developed claim July 9, 2018

Had C&P exam October 1,2019

Denial October 7,2019

NOD/Supplemental Claim filed on October 25,2019 with more evidence. More evidence filed on October 26,2019.

Denial November 6,2019 

Higher Level Review (requested informal call ) Submitted November 15,2019

HLR call June 4,2020

 

[USMCNEVERFORGET]

13 hours ago, Buck52 said:

FYI

What should I expect if I request a call with a senior reviewer?

If you request an informal conference with a senior reviewer on the Higher-Level Review option, they’ll call the phone number that you or your representative provided on the Higher-Level Review form to schedule a time to discuss your case with you. The senior reviewer will try to reach you or your representative by phone twice. If no one answers, they’ll leave a voice mail.

During the call, you and/or your representative can talk about why you think the decision should be changed and identify errors. There won’t be transcripts of this call.

What should I expect if I request a hearing with a Veterans Law Judge?

You have the option to request a hearing with a judge. A video conference hearing will take place at a VA location near you.

At your hearing, you and the judge will have a conversation. The judge will listen to your testimony. The judge may ask you a few questions. Your representative, if you have one, may help you at the hearing.

The hearing will be transcribed and added to your appeal file. You can add new and relevant evidence within 90 days after the hearing, but it isn’t required.

What if I want to choose a different review option after I’ve already submitted a form?

If you’ve submitted a form and want to change your review option, you can send in a new decision review request form within 1 year from the date on your VA decision. You must include a letter that says you want to withdraw your existing review and switch to a different option.

If you requested a Board Appeal and want to switch to a different appeal option, you can send in a new Board Appeal form with a different option selected. You can switch appeal options within 1 year from the date on your VA decision or 60 days from the date you submitted your original form. You can’t select a different appeal option if you’ve already submitted evidence or had a hearing.

How do I opt in if I want my legacy claim or appeal to be considered in the modernized system?

You may be able to opt in to the modernized review system after receiving a VA Statement of the Case (SOC) or Supplemental Statement of the Case (SSOC).

For an SOC dated before February 19, 2019, you must continue with the legacy appeals process.
Return VA Form 9 (PDF) to the VA regional office within 60 days from the date on the Statement of the Case to continue your appeal.  

For an SOC dated on or after February 19, 2019, you have 2 options:

• You can continue the legacy appeals process.
  Return VA Form 9 (PDF) to the VA regional office within 60 days from the date on the Statement of the Case. 
• Or opt in to the new decision review process.
  You have 60 days from the date on the Statement of the Case to opt in to the new decision review process. 

For an SSOC dated on or after February 19, 2019, you have 2 options:

• You can continue the legacy appeals process.
• Or opt in to the new decision review process.
  You have 60 days from the date on the Supplemental Statement of the Case to opt in to the new decision review process.

That surely explains the options leading up to the call. Now the call is over and now I have to wait it out.  

[Buck52]

Roger That!!!

[USMCNEVERFORGET]

I called the VA today and person told me VA made a decision yesterday and will be mailing a decision to you soon. VA.gov is unchanged and so is Ebenefits. Higher level review is different from other appeals person told me.

[USMCNEVERFORGET]

I just received a letter from the decision review operation center. What does it really mean? Service connected or not?

Decision: A duty to assist error has been identified during the Higher Level Review for sleep apnea.

Reasons for Decision: The issue of sleep apnea was returned for correction of a duty to assist error in the prior decision.

We failed to get an examinations and or medical opinions. We will develop for new medical opinions.

The claimed primary disabilities are service connected disabilities. 

The evidence shows that a qualifying event injury or disease had its onset during your service. 

 

[broncovet]

It means more waiting.  You will probably be scheduled for a c and p exam, like it said.  

[deedub75]

Sounds like they realized they screwed you over and are about to correct it.