Retroactive Pay on Open Claim

[USMCScorpio]

Hi Hadit community,

I am looking to see if anyone has had payments for a claim that is still open, gathering evidence, and still has physicals and appointments yet to complete?

I received a VACP deposit this morning a little over 2k,

Submitted claim 11/2019 - 

Completed the 1st physical appt for hearing loss in early Feb 2021.

Still have a lot of items open which have yet to be addressed on this claim.

Did see the Retro Claim payment info on the va government site and waiting on the explanation letter.

But I am at a loss because I thought you didn't get payments until a final decision was made on your claim?

Just wondering if they've just started paying what they've ruled so far while scheduling the other appointments? Or just shut it down with what looks to be 10% and not schedule any other appointments, while the site updates from open gathering evidence to 'closed and final decision'? 

Which would be odd because there are clearly items that need to be addressed with appointments yet scheduled.

Thanks all.

[USMCScorpio]

22 minutes ago, Hamslice said:

To the OP and the original question,

I have had received payments while one or two of my conditions were referred for further work.  Actually, I received a little retro, then regular payments, and then after the deferred issues came back, a bump.

This was when they first started the process of farming out claims to the next rater in line, unlike before when your claims stayed with the same rater all the way through the process, so that might have had something to do with it.  I had one condition that I claimed go to three different raters in three different States with each question opined and answered only to go to a different rater, who hadn't asked the question in the first place.  

Fun with the VA,

Hamslice

 

Different VA raters?

Wow lol thats really a thing?? I'm learning something new every day. 

[USMCScorpio]

4 hours ago, Buck52 said:

If you put the reasons they denied your claims on here we can better help you and advise on your Appeals  because you need to appeal these claims within 1 year from the denial date.

just post a redacted copy of the denial  cover/black out all personal information  name & claim # address ect,,ect,,

If we know why you were denied from what they mention we can better help you.

I sure will, thanks Buck52! 

[Carl the Engineer]

1 hour ago, USMCScorpio said:

Different VA raters?

Wow lol thats really a thing?? I'm learning something new every day. 

The way it works now, is if the RO (Rating Officer), which I will call, rater, needs further clarification from the examiner, they will return the exam to the examiner and ask him/her to opine and return.  The examiner will opine and return, however, it goes to the "que" and the next rater available (remember, everything is digit's now, so they could be a million miles away) will take it and finish the claim or further develop.  In my case it went to the "que' twice, so I had three "different raters" all working on my claim, one after another. 

My issue with this process is that the rater asking the question is not the rater that gets the answer, etc.  A very inefficient way of doing things, when different personalities ask different questions for different reasons.  I may ask a question that you would not ask etc.

Before the change to the que, ones claim stayed with the same rater till it was approved or denied.

FWIW,

Hamslice

 

[USMCScorpio]

*UPDATE*

Hey Good Morning Hadit,

I just received two separate QTC exam request. They both state 'An in person evaluation will not be performed by this QTC provider '  (They'll review your medical evidence to complete the VA's disability questionnaire.)

1. From Psychology

1. From Internal Medicine 

Why are these necessary? And why did they send them to me if I don't need to do anything?

Thanks!

[brokensoldier244th]

Because we are legally required to tell you that we are doing it. As for why, it depends on what issues you have out. Your most recent decision letter should tell you about deferred issues- either for increase, SC, or if they need clarified, etc. 

 

[USMCScorpio]

1 minute ago, brokensoldier244th said:

Because we are legally required to tell you that we are doing it. As for why, it depends on what issues you have out. Your most recent decision letter should tell you about deferred issues- either for increase, SC, or if they need clarified, etc. 

 

brokensoldier244th

Thank you,

I will keep an eye out for the letters of explanation (they may already be in my ebenefits.va.gov account) I'll have to check.

I also needed to be sure there was no action needed on my end for these two requirements. 

Appreciate the clarification.