Tracking my claim - Timeline of claim with HLR involvement

[Foxhound6]

I am posting my timeline of my claim in hopes it helps others along with theirs in some way. I believe others have done this, including @broncovet and I always felt it was helpful. Here we go..

 

ITF on 9SEPT2018 for back and neck issues.

FDC filed 4SEPT2019 for back and neck issues.

First Denial of claim for back and neck issues on 13SEPT2019 - Denial based on the lack of nexus to service connection but did have DX.

Supplemental Claim filed 16OCT2019 for the back and neck claim denial. Filed my own statement plus multiple buddy statements to support an event in service and my current limitations from former SM's and family.

                       (Joined Hadit 19OCT2019)

                         **Secondary Claim filed for Mental Health 1NOV2019** - Separate from the back and neck claim. I also began speaking to the attorney firm The Rep for Vets at this time where they began an evaluation of my case.

Supplemental Claim denial 23JAN2020 - Denial cited the same as last denial, stating that the examiner opined that my issues were "less likely than not" due to my service and in-service event. However, I found the rater made a mistake in reading the examiners notes in the C&P exam as well as inconsistencies in the examiners opinion.  **Secondary Mental Health Claim filed 1NOV2019 was approved on this rating decision as well.**

Second Supplemental Claim filed 19FEB2020 - Explaining the inconsistencies in the examiners opinion as well as the misinterpretation of information by the rater in the previous denial.

                  **Around this time, the attorney firm who had been evaluating my case had called me back and was "very interested" in my case as the rep felt I had a "very strong" case. I held off until I could provide an an opportunity for myself to get my last supplemental try on record.

Supplemental Claim denial 13MAR2020 - Decision cited continuation of denial due to my supplemental claim submitted 19FEB2020 was not "new and relevant" evidence. (This baffled me to some degree).

At this time, I fully gave control of my case over to The Rep for Vets firm out of Tampa Florida. (I will refer to this firm going forward as RFV)

RFV submits HLR of back and neck claim as well as my approved mental health claim 8JUL2020. The HLR covers a bit of a blanket of issues but they specifically stated that I was arguing not only my denials but the denial of an award greater than 70% for my mental health including "the effective date awarded and all claims and issues that were reasonably raised by the evidence which the VA failed to adjudicate." It also goes on to request that "a total disability evaluation based on individual unemployability be considered part and parcel with the current appeal."

VA initiates TDIU claim 21SEPT2020 based on HLR submission above.

VA closes HLR and places it back into Supplemental lane 25NOV2020 due to a DTA error that needs to be corrected. TDIU was denied around this time as well.

As of now, I am waiting to see what happens with the duty to assist error. I only know its a DTA as that what was told to me via rep on Peggy line. So I am hoping its favorable for me. I am also expecting a possible change to my mental health EED as there was a possible claim that wasn't adjudicated or was left "open" back in 2013 for my mental health. I will update this post as it develops.

UPDATE** 12/4/2020 - Missed a call from QTC regarding a C&P Exam for my back and neck issue. This, I would assume, was the error they are fixing, something with the previous exam made it erroneous and now they want a new exam. I call QTC back and they say they are all booked up and are putting me on a list so when they "get more providers in my area they will call me". I guess I should have expected that considering the pandemic and all. But this would be my first QTC exam whilst having 4 VES exams in the last year. Seems odd they'd swap contractors now. In any case, I'm now on some "waiting list" until they find some more "providers in my area". I called Peggy to have the rep send a note or message that due to the indeterminable amount of time to wait for this exam, I am wiling to try VES or another contractor. See if that helps at all. Couldn't hurt.

UPDATE** 12/12/2020 - Got HLR decision regarding error specifics - Seems like it may be presumptive (See attached document HLR Decision - Error Correction)

UPDATE** 3/23/2021 - Finally had my C&P Exam for the HLR on my back and neck today. Felt it went well and I even had new xrays that provided great details of my issue. Possible that I may be scheduled for another exam or EMG test since my knees and ankles had absent reflex (maybe radiculopathy), but not sure on that yet. Since it was with QTC I will have to wait until QTC processes it and the VA gets it and finishes my HLR. I am hoping not too long and based on the HLR decision I already have from when they sent it for another exam, it seems like it will be presumptive as long as this examiner opined in my favor. Will update once something else changes.

UPDATE** 3/30/2021 - Did a check of Ebennies and noticed I was awarded a 20% rating for DDD with arthritis lumbar as well as 10% Radiculopathy left side sciatica with my Cervical being deferred. The EED for the awarded was 2018. The last HLR decision I received explaining the DTA and new exam inferred that they could likely be presumptive.

UPDATE** 4/28/2021 - Got BBE for my neck claim. Continued denied. However, this rating decision is likely even more confusing than the last one. I will update if my attorney makes an action on this or not. For now, it was confusingly denied. Have a look at the 4.28 denial below.

UPDATE** 6/15/2021 - RFV sent a supplemental for multiple claims to include my neck, back, and UI claims. So far, only the neck claim has come back denied. The status stated that all had been completed but I have only received my BBE for the neck claim which was continued denied because they stated there was no medical lit to back up my neck injury as secondary to my knee as well as stating that its "reasonable to assume that leisure activities could have contributed to the neck problem due to normal wear and tear" or something along those lines. Still awaiting more BBE. Have appointment with VARO on 7/6 to try and get copies of CP exams for SSA attorney. While there, Ill ask about those BBE packets for other claims.

UPDATE**---Due to length of time since last update, I will be posting the important bits in the best order I can recall.

6/15/2021 - 07/2022 - Since my last update (apologies for the time gap), I was awarded 100% TDIU P&T (90% Overall). After the last update, RFV continued to hammer on the TDIU and updating my medical records with them. I also switched oer to VA mental health due to the lack there-of in my area on civ side. Perhaps this helped? Unsure. But was my only real option. That was back around January 2022. My neck claim was continued denied and still is. However, RSV has since sent that and a few other of my issues to the BVA for Service connection (neck) and EED for others. I had a couple more CP Exams for back, knees and mental health I believe. After those, I was granted the TDIU with retro back to when RSV first filed it which was July of 2020 I believe?. It took time and lots of leg work but it'll happen. Just gotta keep pushing. Now just awaiting result of my second full attempt thru SSDI.

 

HLR Decision - Error Correction_Redacted.pdf

4.28 denial_Redacted.pdf

Edited December 19, 2022 by Foxhound6
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