HLR since pandemic

[flynsolo2]

******UPDATE---4-13-2021*******

 

I received my decision letter for my duty to assist (although I never did receive a full explanation on why a duty to assist was flagged or what basis and I think I never will)...they note that from my C&P exam, my symptoms are:  pyrosis (heatburn and/or reflux), regurgitation, substernal pain and vomiting, and the decision is to continue my GERD rating at 10%. I don't know what else to do here. Shouldn't I be rated at least 30%, if not 60%? I mean, there are times, (as I told the C&P examiner), that I have had to come home from work to take medicine or reschedule a meeting during a flare-up because, ya know, belching etc., isn't professional. My examiner wanted to hear none of it. Did not even look at my file when I tried to show him all the documentation that this has been going on for such a long time. Now, a week later, I get a decision letter that it is to be continued at 10%....Any suggestions? Should I do a CUE at this point?.... 

 

 

***NEW UPDATE-April 3, 2021

Okay, so I received a letter about the duty to assist for my GERD claim, and scheduled a C&P. My file online for disability claims also updated to show the GERD claim. I went to my C&P exam this past Wednesday, where the claims guy went over the whole sheet about my symptoms and whatever for my GERD. Then, on Thursday, it updated on my disabilities page-except now it says PTSD claim? Same thing yesterday, it says, "what you've claimed-PSTD, claim received March 31st (when I had my C&P exam". Who do I contact about this error? OR do I wait for them to catch it? It still says it today (obviously, since the VA is closed). But, all the way up to this point, it HAD said GERD. It also has listed my GERD files stuff under the files section of the claim.......

 

 

 

*****NEW EDIT AS OF FEB. 14th....

 

Okay, it says that the HLR review was completed on Jan. 28th. I STILL have not received a letter, and on Monday, the 15th, it will be three weeks. The rating looks to be the same on my e-file, but, when I called the VSO on Friday to see if he could see anything on his end of what the VA said about the HLR, he said that my file showed nothing-not the claim or my disability percent(s), or the HLR. Anyone else run into issues with HLR decisions and taking longer than the 10 days to receive your decision letter? I would like to know why I was denied (I am assuming I was, since the percent is the same)...

Thanks everyone!!

 

 

Good Afternoon,

 

I know the time frame for a HLR is normally about 4 months (they state on their website 125 days), however, I am wondering if anyone has filed a HLR since they opened up the VA more in August? Just wondering if there is a huge backlog now. I have mine just sitting there since September, and no status change, even though I was thinking it would be until January, but, as most others have said, still checking often to see if there has been any updates!

Thanks!!!

Edited April 13, 2021 by flynsolo2

[pacmanx1]

13 minutes ago, flynsolo2 said:

This is so frustrating.........

I am not saying you will have to have another endoscope; I am saying that they ordered another C & P exam, which could be a simple medical opinion of your records or yes, another endoscope.  I won a 1998 CUE/Unadjudicated claim and the VA sent me to a new, recent C & P exam. The medical records and evidence have always been in my files and a new C & P exam was just a waste of time, but the VA still sent me to a new exam, it is what they do. Keep in mind that you are asking VA to pay you retro pay from the time of your original claim and they want to make sure they do not overpay you. It is way too soon to know what your rating will be. The VA can grant you a rating over the entire rating period or they can grant you a Fenderson Rating which is starting you out at a low rating and increasing it over the last few years. Way too soon to tell. 

[flynsolo2]

@pacmanx1 I have never heard of a Fenderson Rating. But, this sounds more what I was actually wanting to do. I was talking with my VSO, and he said I should have been rated at at least 10% (if not the 30% , since that is the rating schedule from the VA for GERD, 10, then 30%) back in 2006, and then in 2019 rated higher with new evidence showing worsening of conditions. However, instead I was rated at 0% for GERD and then only 10% in 2019. I am going to look into the Fenderson rating some more!....Thank you!

P.S....yes, I think it is ridiculous that they have YEARS of evidence and VA doctor statements on how a disability is worsening in severity, yet choose to ignore ALL the visits and exams previously and instead send you for a recent C&P exam. Such a waste.....I really do not understand how they can ignore/discount all the other evidence, procedures, treatments and failed treatments and just say, okay, another C&P exam.....stupid.

[pacmanx1]

 Staged Ratings

VA has the authority to grant staged ratings, which are "separate ratings . . . for separate periods of time based on facts found."  Fenderson v. West, 12 Vet. App. 119, 126 (1999).  In cases where staged ratings are appropriate, the Secretary must consider all of "the evidence of record from the time of the veteran's application."  Id. at 127.  Staged ratings apply for both initial ratings and claims for increased disability ratings.  Hart v. Mansfield, 21 Vet. App. 505, 209 (2007).  The Board's determination of the appropriate degree of disability under the rating code is a finding of fact subject to the "clearly erroneous" standard of review.  38 U.S.C. § 7261(a)(4); see Smallwood v. Brown, 10 Vet. App. 93, 97 (1997).

Staged Ratings (vetsfirst.org)

[flow1972]

Just FYI, I've been to two C&P exams for GERD in the last year.  Both were just an in-person visit with one of the Dr.'s from VES.  They are literally just going over the medical records they have in your file related to the condition then asking you the questions they need to, to check the boxes the VA needs checked in order to rate.  The second one was a review of the first because I claimed Esophageal Spasm after I was already connected at 30% for GERD and IBS.  They left my rating at 30% just adding in my spasms as "symptoms of the existing condition", I probably could have argued for it to be rated separately (spasms themselves are a minimum rating of 30%), but I didn't really need to in order to hit 100%.  I just left it alone.  Too much hassle for no real gain in that situation.

[flynsolo2]

 

Sooooo, just got ANOTHER email from the VA....lol....I think it is basically saying the same thing. I guess my question is-a duty to assist error is usually a good thing though, correct? ....hopefully this still means that they would be giving a higher rating either way......

[flow1972]

It's basically just them CYA'ing themselves no matter what.  Somebody up the chain noticed they skipped something, and they're forcing them to go back and check all of their boxes.  Hopefully, it turns out to be a good thing for you.