Evidence gathering, review and decision

[KansasNavy]

Good Morning.  VA site says evidence gathering, review and decision.  Then it says we sent you a development letter.  What is a development letter?  is that the same as a denial letter?  Don't think I ever received something saying we are developing your claim.

[brokensoldier244th]

a development letter is a  Subsequent Development letter- basically a category of any of the many letters we generate and send that have to deal with either information a veteran of a status ("we are continuing to work on your claim.........") to asking for more information ("you forgot to include a stressor statement", "you need to complete Line X on your submitted 21-22 POA form", "Please submit form 21-4142/21-4142a so we can request your private medical records...."). A development letter does not look like "one" thing- it is a categorical term for any number of letters. You only quoted 1 section of one of the standard attachments that is sent. 

Edited April 19, 2021 by brokensoldier244th

[Buck52]

Roger that everyone!

[Lavish]

On 4/18/2021 at 5:13 PM, brokensoldier244th said:

No. Its a letter saying that your claim is in development. Exactly what it says. Thats what I do all day, I take your claims, dig through all your stuff, annotate whatever is relevant to your claim, along with anything else I see that might be a future claim for you later so that the next person can find it easily. When its all out together and Ive done as much as I can, including ordering exams if needed, then its hurry up and wait until the exams and then the results come in. Then I go back through it, annotate the medical findings, download any new VAMC stuff you might have from them, and then send it to ratings. 

Brokensoldier244th,  

When you say "annotate whatever is relevant to your claim, along with anything else I see that might be a future claim for you later so that the next person can find it easily" - what does this mean? 

I though if there was documentation/evidence of a potential SC condition, the claim handler was supposed to add it to the existing claims and process is accordingly.   Am I wrong?   

I ask because I have a supplemental claim pending for CFS.  The VBA sent me to a CFS exam, but closed out my claim without adjudicating it.   When I submitted the supplemental claim for the Chronic Fatigue (using the C&P exam that they didn't review, as New Evidence), they sent me to another C&P exam. 

When I called VES to schedule the appt, the rep said the exam was for "CFS exam for Compensation for Supplemental".  

When I called the VBA, the rep said the exam was for "Gulf War  Syndrome Multi Symptom Illness, CFS, Medical Opinion".  

The exam took 4 hours.   The VBA didn't receive the results until a few days ago (took about 6 weeks).   Based on what the American Legion rep told me, the dr. apparently did 22 DBQs.  The American Legion said she didn't have time to review the DBQs with me because there were too many, however, she did review the one for CFS with me.

I've had several previous claims denied (headaches, Gerd, chronic fatigue, and sleep apnea being the primary ones). 

My questions are:

1). What conditions is the VBA suppose to rate me for with this type exam? 

2). Do you think I will be rated just for CFS or will they rate the other conditions that DBQs were done on as well - even though the supplemental claim is for the CFS? 

3). Or, will they lump all of the conditions together and call it Gulf War Illness or something like that for MUCMI claims?

[brokensoldier244th]

Mucmi consists of the conditions listed in the CFR. 3.317, depending on where you served and when it manifested. 

Not every injury,ever, is an inferred claim. That hangnail you got at Victory Forge that got infected does not usually rise to the level of claimable, at least for inferring. An inferred claim needed to be an injury or illness with chronicity in and post service- it's still subject to Caluza. 

 

As a vsr I can't infer a claim because it involves creating a decision and that is outside my lane. I document things like " I sprained my ankle in basic...." Or I hit my head on X...". Usually it's acute injuries that have  no continuing symptoms but I document then as I come across them, because while they may not rise to the level of inferred claim because they are acute with the records on hand that doesn't mean that you can't claim it down the road or that a RVSR won't kick it back to me and say that there IS enough for an exam. They have more systemic medical terminology knowledge than we get at my level, though I read a lot on my own. 

 

https://helpdesk.newmobility.com/index.php?pg=kb.page&id=1779

[Lavish]

1 hour ago, brokensoldier244th said:

Mucmi consists of the conditions listed in the CFR. 3.317, depending on where you served and when it manifested. 

Oh, forgot to mention that I'm a Gulf War Veteran (served in Saudi Arabia 90-91). 

Do you think I will be rated just for CFS or will they rate the other conditions that DBQs were done on as well - even though the supplemental claim is for the CFS?

 

Edited October 12, 2021 by Lavish
left something out

[brokensoldier244th]

They will get a direct or secondary opinion on all of it and rate it. There isn't a single 'GWS' rating, so they will take all of them and rate them is usually what I see, whether they are primary or secondary to something else. 

 

Also, for our listeners out there, the 31DEC2021 deadline for filing GWS has been extended to I think 2026.