HLR leading to reduction of benefits with ALL prior claims

[dbgrace1970]

I know this may have been discussed previously, but here’s another example.  I was service connected for heart conditions at ten percent. I appealed the percentage and also put in for IU.  I U was denied and the percentage was not addressed, so I submitted a HLR to address the percentage.  I got a message to contact LHI for a C&P.  Called them a moment ago.  Turns out VA is asking for an IMO on ALL my prior claims.  These claims are ten years old.  Seems kind of strange? Doesn’t it?   HLR updates say a decision was made on 10/15, then it says an error was found the same day and they are fixing it.  Not feeling too confident about this news. 

[pacmanx1]

50 minutes ago, dbgrace1970 said:

I know this may have been discussed previously, but here’s another example.  I was service connected for heart conditions at ten percent. I appealed the percentage and also put in for IU.  I U was denied and the percentage was not addressed, so I submitted a HLR to address the percentage.  I got a message to contact LHI for a C&P.  Called them a moment ago.  Turns out VA is asking for an IMO on ALL my prior claims.  These claims are ten years old.  Seems kind of strange? Doesn’t it?   HLR updates say a decision was made on 10/15, then it says an error was found the same day and they are fixing it.  Not feeling too confident about this news. 

I know that this may not be what you want to hear but this may not be bad news. Unfortunately, you are going to have to wait for your C & P exam and your new rating decision. Reason being is that when a veteran files for IU he/she is filing for an increase in his/her rating percentages. That simply means that you may still get your IU. Due to the fact that you are going to have a new C & P exam may mean that your disabilities may be increased but it is hard to say without knowing what is in your records. If your new LHI C & P exam says that you are IU then you win.

Side note: The BVA granted me a 1998 rating decision and the regional Office increased my rating and screwed up my effective date and when I requested a corrected rating percentage, the Regional Office decreased my rating and assigned me a new effective date. I appealed and got my rating percentage restored and my effective date corrected. I am just waiting for the BVA to correct my increased percentage to match my effective date. So, I know it is possible.  Keep in mind that the Regional Office can not just reduce your ratings based on one C & P exam. The Regional Office has to prove that your disabilities have improved.

Edited November 5, 2021 by pacmanx1

[pwrslm]

Not knowing what conditions this covers, it may be wise to submit all medical info that the VA does not have on all of the conditions that you are dealing with. Up to this point, it sounds like you were expecting action on a single issue but instead, the entire file is under review. If you have private medical records the RO does not have, get them in ASAP. These may show that your condition(s) progressively got worse and justify an increase. I used to like the EBenefits site because I could submit any document I wanted on my claim and verify what they have anytime. I think the VA.Gov website has a similar option, but is more restricted because you cannot download and verify what document you submitted. It is less transparent.
When ever I see the PCP at the VA, I always give them info on any changes in my SC conditions. This has resulted in MRI's and xrays, as well as ultrasounds and other tests, that they normally would not have done. This also documents the status quo in VHA records that cannot be ignored by the VBA/RO. If you go to private/non-VA providers it is a good idea to do the same thing. Documentation over months and years by any medical professional is a powerful tool for increases.

[broncovet]

Something is wrong somewhere.  You posted:

Quote

Turns out VA is asking for an IMO on ALL my prior claims.  These claims are ten years old.  Seems kind of strange? Doesn’t it?  

The VA does not "ask" for IMO's.  Instead, the VA sends you to their doctors, and only when Vets get frustrated with VA docs or their contractors, do the Vets hire their own IMO.  

If you mean they are asking for you to attend a new c and p exam, its not unreasonable that your conditions have changed in 10 years.  Its probably likely that some or all will increase, since most of the stuff we got in the service gets worse, not better.  

[Vync]

On 11/5/2021 at 1:38 PM, dbgrace1970 said:

I got a message to contact LHI for a C&P.

(facepalm) Some veterans have had good experiences with LHI, however every decision I received from them has been incorrect and reversed upon review. Be sure to request a copy of whatever C&P exams were performed by LHI. I had incorrect boxes checked, medical evidence and tests were ignored, and they even opined on a disability which was denied 10+ years earlier which was not even the subject of the C&P.

 

On 11/5/2021 at 2:25 PM, pacmanx1 said:

Keep in mind that the Regional Office can not just reduce your ratings based on one C & P exam. The Regional Office has to prove that your disabilities have improved.

You are so correct!

With his disabilities being 10 years+ old, the 5 year rule requires the VA to prove sustained improvement in order to propose reduction in a rating.

https://cck-law.com/blog/rating-reductions-what-va-can-and-cannot-do/

I have been improperly reduced by the VA before. They must send a letter in writing to the veteran explaining why they believe there was improvement and describe their proposal to reduce. I had 30 days (this happened years ago) to respond and explain why the VA erred. I wrote back and sent it certified/return receipt mail referencing medical evidence proving they were flat out wrong. The VA reduced me anyway. I examined the decision letter and found they claimed that I never responded. Another case of the VA completely ignoring evidence of record. I appealed and they reversed it.

 

 

[pwrslm]

I had LHI for an injury to my shoulder. My SC left leg gave out on me, and I fell. On the way down I reached out and tried to stop the fall, which caused the shoulder injury. LHI's "medical professional" said that my left leg could not cause a shoulder injury. Go figure. Its been in appeals for 17 months now. HLR also failed to recognize the obvious error because nobody mentioned the fall except me about a dozen times in VA medical records when they treated me for the shoulder injury. The RO and examiner ignored the fall completely.

Without common sense, they are about useless.