Wrong effective date?

[allansc2005]

Got a veteran who applied for and was granted SC for PTSD; applied in December 2020, granted March 2021.

Veteran was paid back pay to December 2020, however, the vet was already denied SC PTSD back in 2009.

So should he have gotten back pay to 2009, or was the VA right in granting him only 3 months of backpay?

 

Thanks,

Allan 2-2-0 HOOAH!!

 

 

 

 

 

[pacmanx1]

47 minutes ago, allansc2005 said:

What form needs to be filed that says the veteran disagrees with the effective date of the PTSD award?

Depending on how he wants to appeal, he would have to use one of the new appeal forms.  VA Form 0995, VA Form 0996 or VA Form 10182. Please see attached. Please note that if you take the Supplemental Claim or the HLR route and they deny your claim after the decision is made you will have to file an appeal to the BVA. That means the Supplemental Claim or the HLR would take around 125 days more or less then if he has to file an appeal it will take the BVA about 365 days more or less.

VA Form 20-0998

Edited May 16, 2021 by pacmanx1

[Carl the Engineer]

I just got a decision letter in the mail today.  They included VA Form 20-0998, which is a breakdown of the 3 avenues you have. 

Supplemental Claim, VA Form 20-0995 is out, because you are not adding new evidence. 

Higher-Level Review, VA Form 20-0996.

Board Appeal, VA Form 10182.  

My only other question would be did he get a PTSD specific exam when he was denied in '09 because he didn't have (according to VA) a stressor in his record?  If he didn't have the exam, that could be the/a issue.

FWIW, 

Hamslice

 

4 minutes ago, pacmanx1 said:

Depending on how he wants to appeal, he would have to use one of the new appeal forms.  VA Form 0995, VA Form 0996 or VA Form 10182. Please see attached.

VA Form 20-0998

Beat me by 4 minutes.  Trying to type and eat pizza at the same time, LOL..

Hamslice

 

[broncovet]

Allen...Ok, if you know the facts, what are the date(s) the Veteran's doctor said he had symptoms of PTSD consistent with 70%?  You have to look up doctor exams, and see what symptoms of PTSD he documented.  

Its not enough for the Veteran to say, "well I had PTSD since I served in the military."  Or, even a diagnosis.  

You see a diagnosis is required for SC, but your disability percentage is based upon symptoms.  

Instead, the doctor would have needed to document the applicable symptoms, and

when the symptoms occurred. 

Likely, this was done at some exam, but the doc did not give the "dates" the symptoms 

first appeared.  

If the doc gives no date, then the VA presumes the date of the exam.  

[Berta]

"Veteran was paid back pay to December 2020, however, the vet was already denied SC PTSD back in 2009."

"Veteran was paid back pay to December 2020, however, the vet was already denied SC PTSD back in 2009."

Allan you know it is not a CUE, I am sure- I remember this post you made in 2017:

"Just got that "big white envelope" yesterday, awarding me a CUE from 1990, and TPIU back to 2010. Combined will be 6 figures."

https://community.hadit.com/topic/69861-va-dfas-or-both/ 

It appears to me to be a basis for a  newly discovered service record ( a claim under 38 CFR 3.156 C)

"(c) Service department records.

 

(1) Notwithstanding any other section in this part, at any time after VA issues a decision on a claim, if VA receives or associates with the claims file relevant official service department records that existed and had not been associated with the claims file when VA first decided the claim, VA will reconsider the claim, notwithstanding paragraph (a) of this section. Such records include, but are not limited to:

 

(i) Service records that are related to a claimed in-service event, injury, or disease, regardless of whether such records mention the veteran by name, as long as the other requirements of paragraph (c) of this section are met;

 

(ii) Additional service records forwarded by the Department of Defense or the service department to VA any time after VA's original request for service records; and

 

(iii) Declassified records that could not have been obtained because the records were classified when VA decided the claim.

 

(2) Paragraph (c)(1) of this section does not apply to records that VA could not have obtained when it decided the claim because the records did not exist when VA decided the claim, or because the claimant failed to provide sufficient information for VA to identify and obtain the records from the respective service department or from any other official source.

 

(3) An award made based all or in part on the records identified by paragraph (c)(1) of this section is effective on the date entitlement arose or the date VA received the previously decided claim, whichever is later, or such other date as may be authorized by the provisions of this part applicable to the previously decided claim.

 

(4) A retroactive evaluation of disability resulting from disease or injury subsequently service connected on the basis of the new evidence from the service department must be supported adequately by medical evidence. Where such records clearly support the assignment of a specific rating over a part or the entire period of time involved, a retroactive evaluation will be assigned accordingly, except as it may be affected by the filing date of the original claim."

 

 

(Authority: 38 U.S.C. 501(a))

 

https://www.law.cornell.edu/cfr/text/38/3.156

 

This is obviously the stressor that the award was made on.

 

"On 27 August, 1978, Sgt__ was attempting to rescue a PFC__ who's raft overturned on the Imjin River in South Korea. Sgt__ was unsuccessful, and PFC was presumed drown and never located."

 

But did the VA have evidence of the stressor at time of the older denial?

Did the VA say JSRRC could not verify the stressor?

Maybe the VA did not even try to ( the C file should reveal if they did)

 

The above regulation is a powerful one- and this is why veterans have to do all they can sometimes, to verify a stressor themselves, with evidence, and/or strong buddy statements.

JSRRC needs the stressor narrowed down to date and place as best as the veteran can recall.

 

Broncovet is correct that this would need a Fenderson rating ( a staged rating) .

 

Does his C file reveal a NSC rating for PTSD  with a percentage on the older rating sheet?

[allansc2005]

Bronco, maybe I didn't put my question(s) in the right context.

Here are the facts:

1. The veteran was awarded SC for PTSD in March 2021(applied in December, 2020)@70%.

2. The veteran FIRST applied for SC PTSD back in January, 2009, but was DENIED.

3. The veteran got back pay for the SC PTSD for December, 2020, January 2021, February 2021 and March 2021.

Here are the questions:

1. Shouldn't the veteran gotten back pay back to the time he was initially denied SC for PTSD in 2010(or the time he applied for PTSD the FIRST time)?

2. How(what VA forms) do we object to the effective dates that were shown in the 2021 decision?

 

 

 

 

[allansc2005]

Berta, there is no doubt, this isn't a CUE situation.

This isn't my case by the way.

This veteran has extensive proof in the form of Buddy letters, Army investigations...., that his PTSD did in FACT result from an incident that happened in Korea in 1978.

He has his complete C file, ALL doctor's reports, all VA exams..the whole ball of wax.

 

In other words, it's WELL documented that this veteran has an active duty origin established for his PTSD..

So my questions are on my previous post.

Oh, and Berta, thank you so much for the information you provided back in 2017 that helped me win my case!

 

Allan 2-2-0 HOOAH!