HLR for Barrett's and Hiatal Hernia

[Carl the Engineer]

Well,

I waited as long as practical, but I just submitted an online (all of 2 minutes) HLR for my denied Barrett's and Hiatal Hernia of Jun 4, 2021.  I was waiting for my C-File to come to see the exams etc., but it has not arrived yet.

Both were claimed by me as secondary to my medications for HBP, DDD and DJD of spine, etc.  I was denied because the Barrett's and Hiatal Hernia was not related to the conditions of HBP, DDD and DJD of spine, etc., etc.  

I am unsure if "conditions of" is the same or not the same as caused by medications.  And I will express that to the caller when I have my phone meeting.

That and the fact that I do not have access to my exams and evaluations (opinions) from the third pary examiners.

Wish me luck,

Carl

Then if denied, supplemental.  Hopefully I will have the C-File by then.

Edited May 3, 2022 by Carl Bacon
cause I can

[Carl the Engineer]

2 hours ago, Whodat said:

Did they provide you with your examiners name a credentials?

Not yet, in the mail.  I will keep checking the portal.  It showed the last time, so it should this time.

Carl 

 

[Phury & Rhage]

On 6/15/2022 at 6:34 PM, Carl Bacon said:

On MyVA, it says,

"Your Higher Level Review was closed"

This review is now closed.

 

Hi Carl,

That is GREAT news.  The DRO working your HLR decided that VA committed a Duty to Assist error in the processing of your claim.  The DRO told you that you needed an exam, but there is an internal document that accompanies an HLR decision where a DTA error is committed.  That document will tell the processors exactly what the DRO saw as an error and will often say the specific language/question they want the examiner to answer. 

About the HLR being closed:  each claim has a unique "End Product" (EP) assigned when a claim is initiated in VA's software program (VBMS).  The the EP for an HLR is 030.  When a DRO completes the decision and identifies a DTA error, that decision is published (to you and your file) and the EP is closed.  VBMS automatically creates a new EP for HLRs that identify DTA errors.  That EP is an 040 and it will have the label "HLR DTA Error".  Here is a link to the M21-5 that describes the process:  https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000141004/M21-5, Chapter 5 - Higher Level Review Procedures#5 .  Please don't quote me, but you could ask your VSO a very specific question and the answer will help you prepare properly.  The new EP will have a VA Form 20-0999 associated with it.  It will give specific details about what the DRO thought was done wrong previously.  Ask the VSO to give you a copy of it.  They might not want to....but as far as I know, they are allowed to... 

Holler if you need help 

Phury   

[Carl the Engineer]

Today in the mail,

I recieved a letter from LHI stating that they recieved a request from the VA for a Medical Opinion(s).  This request was for a Medical Opinion(s) where an examiner performs and evaluation using your medical records and history.  At this time, no action is required on your part.

It will be done by a NP out of Tennessee. 

Service(s) requested, see attached.

 

[Carl the Engineer]

Nothing for sure yet, but a call today to my CVSO revealed the four questionaires that were opined on on 4 July, are all "less than" likely.

Looks like they rubber stamped the referred opinion from the denial.

But, I was buying time until I could get my c-file from them.

Now on to the supplemental, and it looks like I will be getting a IMO for the first time.

I would like to find someone who would go over all of my (my work) previous claims and ratings, to include this one to see what I may have missed.  Not sure if anyone dose that, or not,

Carl

 

[Carl the Engineer]

Every thing is closed on the myVA site, so I'm pretty sure the denials are in the mail.

Yippie,

Carl

 

[blahsaysme2u]

im so sorry bud- but maybe they arent denials...keep your head up man...