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1. Filed for increase on mental health condition (Depression 2nd to Tinnitus)
2. VES exam, didnt go well, got reduced. Examiner said I had another condition, it wasn't service related, etc, etc.
3. Filed a supplemental with a DBQ from a private psychologist (looked like 50-70 percent)
4. New exam from QTC, went well, probably around 70 percent
5. VSO told me a few weeks ago they sent it back to examiner for medical opinion. I know the QTC examiner had mentioned that they did not ask for one in which he thought was odd during my exam in August.
6. VSO told me today that they sent it back to the VES examiner from May, and the examiner basically regurgitated the same thing he already said. He already provided a medical opinion previously in May. Examiner said I had OCD (never been diagnosed by anyone in 5 years).
I am confused to why they sent it back to the VES examiner and not my most recent examiner? Could this be a mistake? Thanks. Not sure how this will pan out.
Which came first, the chicken or the egg? Or the claim request or the right form? Or when is a claim considered officially open?
This is a case of my VSO helping me submit a new claim in April 2019 right after the AMA changes went into effect. At the time, neither of us knew we needed to submit it as a supplemental claim instead of a new claim. Years earlier, I had filed a heart claim for Afib, but I forgot about it. I have medical treatment records and a "more likely than not" IMO from a neurologist that I would like to provide to the VA. Just need to get an idea of the actual status of my claim and how I should submit the records.
I never received a formal decision letter granting or denying my claim for heart condition. Instead, on July 29, 2019, the VA sends me a decision letter denying Cushing's (separate claim), but it says this about my heart claim:
The VA claims "no action on this issue was taken", despite taking action on this issue (i.e. C&P exam). The rating narrative pages for the Cushing's claim make zero mention of heart issues.
The VA's stance on supplemental claims appears to be that if you previously filed for any claim regarding an organ, then all future claims regarding the same organ would be supplemental, regardless of the actual diagnosis.
I checked on va.gov and found the claim they received on May 3, 2019, for Cushing's and heart condition was closed. I called Peggy and they are as baffled as I am that the VA can claim to take no action, despite having taken action.
Is my heart claim legally considered open? How can they take action on a claim request and not consider it open?
Should I submit the IMO with a supplemental statement of claim or as a supplemental claim?
My claim is being denied over and over again since 2009 and the VA states it is due to my OTH Discharge . Here is a rundown of the claim,
Bars to benefits per the VA:
1. AWOL more than 180 days
2. Acceptance of OTH discharge in-lieu of General Court Martial.
VA states no records indicate insanity at time of offense, nor compelling circumstances. I recently was made aware my mental health records from Fort Bragg do exist but for 12 years I was told they don't. Someone eventually informed me after countless calls that they do exist and cannot be released to me because of the sensitive information within and might me attempt suicide?
I filled the supplemental claim October 28, 2019 with 4 "buddy statements", gave specific locations of these "clinical inpatient records from Fort Bragg", listed my current mental health treatment records from 2012 to 2019 and I am now seeing a VA psychiatrist at the mental health clinic in Tampa, FL 2019 to 2020. VA closed the supplemental claim Novemeber 20, 2019 after 23 days.
Called and requested a informal hearing via telephone with ST. Petersburg Florida RO, called 800-827-1000 and a represenative filled out VA Form 27-0820 on my behalf. Mysteriously the same supplemental claim "reopened" on VA.GOV Website and after speaking with a "Assistant Coach" as the man claimed he literally said my claim had no hope and to just give up cause your service is dishonorable. VA closed supplemental claim again December 13, 2019.
Fast forward to February 2020 and behold my long awaited clinical inpatient records from Fort Bragg arrive, My period of treatment was from August 1998 to February 1999, the records I got covered only November 1998 to February 1999. I was excited because I finally had the silver bullet and my records proved I had 9 different diagnoses, 52 days in the WOMAC Psych ward at Fort Bragg. Plus I was awaiting for a bed at medical holdover for a Physical Evaluation Board to wrap up my medical discharge.
Filed Supplemental claim March 10, 2020 with a clear and concise case that I was insane at the time of offense and 13 days later on March 23, 2020 claim closed again but here is the kicker they once again reopened the October 28, 2019 claim and as of yesterday March 31, 2020 they closed it again.
After speaking with a VSO who called on my behalf to inquire the reason, and no surprise it was the character of my service and once again they denied me even though I provided a legal brief that I learned how to write so they could understand every statue and regulation that applies to my claim.
Lastly, here is one more point I applied for a VA home Loan certificate and was denied which I knew I would be but wanted the character of service determination and I got the letter stating my character of service is sufficient for VA purposes, so go figure?
If anyone can please help me here I would greatly appreciate it, I am exhausted from staying up every night reading statues and VA regulations, I am about at the end of my rope.
I received me letter today, and I was denied. This time the error is clear. The Doctor who preformed my ACE examine said my initial diagnoses was Epilepsy then proven to be pseudo seizures. Initially at the ER (and my week long hospitalization after) and for about one month after I was diagnosed with PNES and not epilepsy. However since I kept experience both petite mal and grand mal episodes and then Epileptic medication treatment began to WORK, I was diagnosed with Epilepsy. My doctor in my civilian record's back dated the diagnoses to the May when the first event occurred. I've attached my letter; you'll see that they received my Neurologists note about my treatment since may and then confirmed my Diagnoses on 04DEC2019. Pseudo seizures are only mentioned in my records between May2019-June2019. I think this VES contracted doctor saw the diagnoses labeled in may but didn't review(or care) to look at the LETTER AND NOTE DATED BY MY DOCTOR ON 05DEC2019 WITH MY CONFIMRED DIGNOSES AND THEN UPLOADED TO THE VA ON 24DEC2019. Opinions? HLR or do I wait 3 months to see my VA Neurologist, as I no longer have Tricare to see my UCHealth DR., and have him confirm the diagnoses... I'm only 5 months away from all this stuff lasting a year and getting really fed up with the VA. My first denial was also because of the phraseology used by my ER and Hospital doctors after the first event in may. Hint that's why I had my specialty neurologist who had been seeing my since June confirm my Epilepsy diagnosis... uuuhhhggg.
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.
Ztmiller8 posted a question in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC,Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!
My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.
Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
Joey Ross posted an answer to a question,I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and nothing about stressor,
Picked ByJoey Ross,
This is the latest Compensation & Pension (C&P) Clinicians Guide dated 20180719. The only other one I've seen is dated 2002, including the one on this website and the VA website. I got this from my claims agent, who got it from the VA.
VA Compensation & Pension (C&P) Clinicians Guide 2 Final Corrected 20180719.pdf
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