ptsd My Denovo Review Results...

[BoonDoc]

I had applied for a "De Novo Review" and was denied.

I went point for point as to their reasons for denial in the first place...they didn't even mention the original reasons they denied but came up with some new ones. Most of My evidence was not even listed on the SOC...they omited the secondary disabilities, and PTSD that I had asked for their consideration just 3 weeks ago...

I will appeal to the BVA...just have to figure how the best way to do it is

I will open a new claim for secondary conditions

I will open a new claim for PTSD. This way it can't get lost in the paperwork as it deems to have done.

It gets harder to stay sane the seeper I get down this rabbitt hole....maybe I'll come out better taking the "red" pill, or maynbe the "Blue" is better...go ask Alice when she's ten feet tall....

FTVA

BoonDoc

[john999]

Allan

My VARO includes a SOC when they make a decision on a claim. They don't wait for the NOD. They tend to funnel vets to the BVA. I always ask for the DRO Hearing. You need to go to the personal hearing and make your case.

[carlie]

<H4 style="MARGIN: 0in 0in 12pt; mso-list: skip">

QUESTIONS:

1) at a DRO Hearing, you are not allowed to have a Lawyer plead your case, right?

ANSWER: No you may not have a lawyer you may have a VSO.

2) from the VARO, who is at a DRO Hearing..... a VA Lawyer, a VA Doctor, a VA Service Rep, or all of the above? Who has the Lead at a DRO Hearing?

ANSWER: No VA lawyer - Rarely a VA doctor - No VA service rep. - the DRO is incharge and will take the lead posistion.

3) how much is in the Reason and Bases section of the Rating Decision? Will it be as detailed as the SOC?

ANSWER:

19. Preparing an SOC</H4>

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">Introduction</H5>Prepare the SOC prior to sending it to the appellant and his/her representative.

This topic contains information on

· the SOC format

· limiting SOC content

· the guidelines for disclosing evidence in an SOC

· the matters not to be disclosed in an SOC

· disclosing information to the appellant’s representative

· the submission of new and material evidence

· evidence that is not considered new and material, and

· the SOC printing and filing requirements.

<H5 style="MARGIN: 0in 0in 0pt">Change Date</H5>June 19, 2006

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">a. SOC Format</H5>The table below describes the sections of an SOC and the actions required when completing the form.

Section

Description

Action

Cover Letter to Applicant

Indicates the appellant’s name, address, claim number and representative.

If there is no representative, enter the word “None.”

Issue

Identifies the issue(s) covered by the SOC.

If there are multiple issues, state and number each issue.

Evidence

Summarizes all evidence relative to the issues being considered.

Example: Medical records, places and circumstances of service, service medical records.

Use short sentences, when appropriate, for clarity and accuracy.

Adjudicative Actions

Cites only those rating and authorization actions relevant to the issues raised.

List entries in chronological order.

Continued on next page

19. Preparing an SOC, Continued

a. SOC Format (continued)

Section

Description

Action

Pertinent Laws and Regulations

Summarize the provisions in the statute(s) or regulation(s) that govern the decision(s) rendered.

Quote verbatim only those relevant portions of all regulations and U.S.C. sections that are pertinent to the issues.

Decision

States the decision.

If there are multiple issues, number each to correspond to the number shown in the issue section of the SOC.

Reasons for Decision

· Includes the reasons for the decision

· explains how the evidence supports the underlying decision

· states the analysis of the evidence of record under the applicable legal principles governing the decision, and

· indicates why most of the evidence is against the claim.

· Discuss the laws and regulations cited and explain how they relate to the adverse decision

· address all the appellant’s contentions

· attempt to clarify and reduce the reasoning to simple terms so the reader will understand the precise basis for the decision, and

· number the Reasons for Decision to correspond with the issues and decisions.

Continued on next page

19. Preparing an SOC, Continued

a. SOC Format (continued)

Section

Description

Action

Signature and Review

The person who prepared the original SOC must sign it.

Note: At the discretion of the VSCM, a second person may review and approve the SOC.

Review and sign the SOC. This applies to any SOC, whether prepared by a

· RVSR

· VSR, or

· DRO.

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">b. Limiting SOC Content</H5>Limit an SOC to content relevant to the issue(s) with which the appellant expressly disagrees.

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">c. Guidelines for Disclosing Evidence in an SOC</H5>Due process requires that an SOC cite the evidence pertinent to the issues raised by the disagreement; however, an SOC cannot disclose matters contrary to 38 U.S.C. 5701 or to the public interest per 38 U.S.C. 7105(d)(2).

Reference: For more information on matters not to be disclosed in an SOC, see M21-1MR, Part I, 5.D.19.d.

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">d. Matters Not to Be Disclosed in an SOC</H5>Do not include matters in an SOC of a sensitive nature that would be injurious to the physical or mental health of the appellant, including

· matters considered by responsible medical authority to be injurious to the appellant’s health

· references to

- a prognosis of “poor” or “terminal,” or

- conditions of misconduct, unless the specific misconduct is relevant to the issue, or

· discussions of evidence in a way that might provoke feelings of hostility, resentment, or rejection on the part of the appellant or his/her family.

Continued on next page

19. Preparing an SOC, Continued

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">e. Disclosing Information to the Appellant’s Representative</H5>All matters can be disclosed to the appellant’s designated representative unless disclosure to the representative would be as harmful as if made to the appellant. Therefore, in some cases, two different versions of the SOC may be prepared when it is permissible to furnish full information to the representative.

Use the table below when disclosing information to the appellant’s representative.

If the appellant …

And the …

Then …

has a representative

matters omitted from the appellant’s SOC may be released to his/her representative

· prepare a separate SOC for the appellant and omit matters not to be disclosed

· furnish copies of the edited SOC to both the representative and the appellant, and

· annotate the representative’s copy and the original SOC (full statement) to show what portions were deleted from the copy sent to the appellant.

Note: Annotate the statements to the effect that the material omitted from the appellant’s SOC is not to be revealed to him/her.

Continued on next page

19. Preparing an SOC, Continued

e. Disclosing Information to the Appellant’s Representative (continued)

If the appellant …

And the …

Then …

has a representative

matters omitted from the appellant’s SOC may not be released to his/her representative, because the information might provoke feelings of hostility, resentment, or rejection on the part of the representative

· prepare a modified statement omitting these matters

· furnish copies of the edited SOC to the appellant and his/her representative, and

· annotate the original SOC to show that matters not to be disclosed to the appellant or his/her representative were omitted from their copies.

does not have a representative

SOC contains matters not to be disclosed to the appellant

· eliminate those specific references from the SOC that will be furnished to the appellant, and

· annotate the original SOC (full statement) to show what portions were deleted from the copy sent to the appellant.

Continued on next page

19. Preparing an SOC, Continued

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">f. Submission of New and Material Evidence</H5>If the evidence is considered both new and material, then the claim is successfully reopened and must be adjudicated on its merits.

However, if the evidence on the reopened claim does not change the prior decision based on that evidence, the issue in any SOC resulting from that decision is the continued denial of the benefit claimed. The evidence, pertinent laws, and regulations cited in the SOC must support the decision.

In this situation, the SOC includes the

· date of the original denial

· date of notification of that denial

· date that denial became final

· regulations covering new and material evidence and finality of decisions

· summary of the evidence pertinent to the merits and adjudication

· decision on the merits, and

· reasons for the decision.

This obviates the necessity of a remand if the Board of Veterans’ Appeals (BVA) determines the evidence was not new and material and bases its appellate decision on that determination.

Reference: For more information on the submission of new and material evidence, see

· 38 CFR 3.156, and

· 38 CFR 3.104.

Continued on next page

19. Preparing an SOC, Continued

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">g. Evidence Not New and Material</H5>If an appellant disagrees with the decision that the evidence submitted to reopen a claim is not new and material, the rating should explain why the evidence considered does not meet the new and material standard as defined in 38 CFR 3.156(a).

In this situation

· limit the SOC, based on that decision, to the issue of whether or not new and material evidence was submitted

· cite in the “Adjudicative Actions” section the

- date of the original denial

- date of notification of that denial

- identification and date of receipt of the evidence submitted to reopen the claim

- date of the finding that the evidence was not considered to be new and material, and

- date of notification of that decision, and

· cite the regulations

- covering new and material evidence, and

- pertaining to finality of decisions.

References: For more information on

· new and material evidence, see 38 CFR 3.156

· finality of decisions, see 38 CFR 3.104, and

· rating new and material evidence, see M21-1MR, Part III, Subpart iv, 2.B.5.

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">h. SOC Printing and Filing Requirements</H5>When preparing an SOC

· use plain bond paper to

- print an original, and

- make any copies, as necessary, and

· maintain the original as a file copy.

Note: The SOC may be printed on both sides of the paper, provided that the reverse side is printed head to foot.