VA Claim Deferred After C&P for IMO and Higher Evaluation?

[yanrogue]

Hi, new to the forum and thank you in advance if you can provide any insight.  

I talked to the VA today because I was confused about my claim, they approved part of my claim and deferred the other half of it. I searched a lot of post here and being deferred is normal for the va, but what confused me was why they deferred it. The reason they deferred my TBI was because they wanted a IMO (independent medical opinion) and also flagged my TBI and major depression for higher evaluation and entitlement. I had a C&P for both of these months ago, plus many pages from C file and from tricare to support my claim.  

    

My questions are:  

-  I though you had to appeal to have your case reviewed by the higher level evaluation. I submitted the claim, evidence, and C&P and they moved it to higher evaluation on their own.  

-They also requested their own IMO following the C&P for TBI, is this bad or normal?

 

The VA rep told me that the 0% rating is a place holder stating that it is service connected while it is undergoing higher evaluation and not to worry, but all I can do is worry.     

 

 

  

 

[pacmanx1]

15 hours ago, yanrogue said:

The VA rep told me that the 0% rating is a place holder stating that it is service connected while it is undergoing higher evaluation and not to worry, but all I can do is worry.     

 

There is quite a bit of information here, just because your claim is deferred it does not mean it is a bad thing, actually if you think about it, it is a lot better then VA granting your claim and leaving it at 0%.  Because your claim has been deferred, VA is asking for more information/evidence. This information/evidence does not necessarily have to come from you but a medical opinion and or a medical rationale. VA is supposed to rate the veterans’ claim with the highest rating possible.

There are no set standards with VA and what one VA will grant another may not, but it is common for VA to combine a TBI Rating with a Mental Health Rating, but these ratings can be rated separately. It all boils down to the facts that if and I say if the medical examiner is willing to separate the onset and description of how your symptoms began/developed.

By VA already granting you a 0 % service connection is a big hurdle to overcome, I would say that it is at least 75% percent of the battle. Now VA is trying to determine to either grant you a combined rating or separate your ratings and go from there. Either way if you disagree with their decision you can always file a timely appeal (NOD) NOTICE OF DISAGREEMENT.

[ShrekTheTank]

I would not worry yet.  This is normal for the VA.  Just need to wait and see what they say to do.  If there is need they will contact you, but just be honest in you C&P or IMO.  Too often we tend to suck things up and not share the truth.  Now is not the time to do this.  

It is hard to hurry up and wait, but that is what they do.

Just be patient and share what they give you so we can help navigate these waters.  We got your back!

[El Train]

This is normal.  They are trying to determine what symptoms of your tbi overlap with your mdd.  Or ptsd in my case.  I had two outside ime's, then the VA put me through the wringer with their own.  5 total c&p's for tbi and ptsd.  I had a bad c&p examiner for one of the ptsd.  She stated I was an unreliable reporter (in other words, a liar. Even with overwhelming evidence).  This set me back quite a few months.  When I got my C-file, they had two Psyc. Dr's (which I never saw) fighting it out over the bad c&p exam.  One Dr. sided with the unreliable reporter c&p exam, the other Dr. siding with the four favorable c&p exams.  In the end they determined the bad c&p examiner as being the unreliable reporter and not making any sense. I hope they fired her ass.

So you never know what they are trying to determine.  But I would say they are trying to get it right.  They got mine right.  100% P&T ptsd/tbi combined after the dust settled. 

[yanrogue]

Found out an update from QTC: They differed my mental health back to the first doctor that had a very long C&P session with me and she is going to also be the same one to write the IMO opinion for the VA. She was a really kind doctor and I'm hopeful and less stressed out knowing that she is also going to conduct the IMO for the report.  The TBI is deferred to the higher graders so it feels like they are taking the claim more seriously. Once it all gets resolved I'll write down my whole process for here for others to search for and use in the future if they run into these things. 

Thanks again guys 

   

 

[Bluntly]

On 12/5/2020 at 12:10 AM, yanrogue said:

Found out an update from QTC: They differed my mental health back to the first doctor that had a very long C&P session with me and she is going to also be the same one to write the IMO opinion for the VA. She was a really kind doctor and I'm hopeful and less stressed out knowing that she is also going to conduct the IMO for the report.  The TBI is deferred to the higher graders so it feels like they are taking the claim more seriously. Once it all gets resolved I'll write down my whole process for here for others to search for and use in the future if they run into these things. 

Thanks again guys 

   

 

Any updates on a decision? I’m in the same boat and was curious on how yours turned out….thanks in advance