secondary claims Supplemental Claim IMO timeline

[flynsolo2]

**UPDATE**June 23, 2023

 

I had a virtual appointment with VERA yesterday. They told me that my claim was sent for RFD (they stated it stands for rate for decision) on June 13th and the check back in about 10 days or so. As of today, nothing has changed on the VA website, (or in the disability letters or payment history), but, I will keep checking, daily now, lol  and will keep everyone posted on how long this process has taken-for me, at least. Here's hoping they granted the 50% for cpap use (fingers crossed)

 

 

 

 

*****UPDATE******* MAY 9, 2023

It has now been just over 60 days, and there has been no movement or updates on my supplemental claim. I called the VERA line and they said they also see no updates or movement on their end. When I asked them on the steps to decision for a supplemental claim with new evidence, she said she did not know (such as claim received, claim being reviewed, gathering evidence, etc..)., or if it goes from claim received and is being reviewed to a decision? Does anyone know, because that is where my claim has been since they received it. Also, I don't know if this has anything with them getting ready to make a (favorable) decision or not, but, I did receive a dependent verification form; I have never received this form in my 20 years of benefits, but the agent on the phone told me they do this every 8 years? 

So, over 60 days later and still just waiting on a decision, for anyone wondering how long the supplemental claim process is currently. Also, if anyone happens to have any info on the steps/process until a decision, I would appreciate it. I tried looking online but cannot seem to find anything....

 

 

 

Okay Hadit Community,

So finally took the plunge and got an IMO letter from Dr. Anaise for my OSA secondary to PTSD (and he even included it secondary to GERD). I know there are a TON of factors, but looking to see, how long did it take the VA to make a decision once you submitted a secondary claim with an IMO? Additionally, when did the VA backdate your claim to? I looked it up on the VA website, but it sounds very confusing. So here is my claim: Submitted De. 2021. Denied Feb. 2022 (asked for extension for this claim because of how long a sleep study was going to take); sleep study given in July 2022. Secondary claim with IMO submitted March 2023.

I am assuming it will go from the March 2023 submittal date, but some have told me it's from the date shown of disability (sleep study)....I am just hoping for a ruling in my favor and to finally finish this uphill battle of 100%.....

 

 

Edited June 23, 2023 by flynsolo2

[brokensoldier244th]

I would have filed the OSA secondary to the PTSD only- GERD may cause sleep disturbance but it doesn't cause OSA, it's more a secondary symptom OF sleep apnea, so I don't know where he thought he was going with that. I see a lot of pro-veteran doctors write a lot of stuff every day, including Anaise, and quite frankly, many of them fill their rationale more with legalese than just getting to the point. It ends up being more spaghetti on a wall rather than 1 or 2 solid theories, and it takes a lot longer to read through, support with evidence from your file, and then rate later.

Timeline, it just depends on what RO it goes to first, and how backed up they are. PACT claims were fileable from August of 2022 but not workable or rateable until Jan 2023 because Congress and VA did not have a funding mechanism for it, yet, so all the ROs are backlogged on those, along with regular claims. OSA secondary to PTSD is generally pretty straightforward, though, so I wouldn't think more than a few months, tops, and that's on the long end. If your other evidence is in a row, you can send a 5103 and check the box that says " I have submitted all remaining evidence...." yadda yadda. That will waive the mandatory 30-day waiting period that the claim is held in suspense to allow for other late-flowing evidence before going to rating.

[flynsolo2]

@brokensoldier244th Thanks! I am hoping only a few months. My VSO submitted it, so I am not sure if he checked the box or not, and he is now off for medical reasons, so I guess I will have to wait and see. But, he did file it secondary to PTSD, it is what I have been fighting them (and they keep denying). I think Dr. Anaise just put the GERD claim as well to help solidify it, in case my PTSD % ever gets lowered maybe? But, I get what you're saying. 

I did not know that there is a backlog because of the PACT, so, I do hope it does not put my claim decision out too far. It is the only new evidence I submitted, and in the IMO letter, he included the most sleep study, so, hopefully they rate it sooner rather than later....I have a BVA appeal from April 2021 that I am STILL waiting on a date for, so, I know it can take a long time.....

[pacmanx1]

21 hours ago, flynsolo2 said:

So finally took the plunge and got an IMO letter from Dr. Anaise for my OSA secondary to PTSD (and he even included it secondary to GERD).

Hopefully, the good news is that your supplemental claim should be rated just in a few months. The problem is what type of consideration the VA will give your IMO. The sad and truth is that the VA does not care. A few years ago, I filed a fully developed claim to reopen a claim request of an already service-connected disability for an EED (Earlier Effective Date) and the VA reopened my claim, sent me to a C & P exam for a medical opinion. When the examiner pointed out the VAMC medical records that supported my EED, the VA overlooked and has not considered and or adjudicated it, the VA completely ignored the examiner’s opinion. I was told to file a Supplemental disagreement and the VA would catch it and award my EED, but the Supplemental was denied not even reviewing my request and or the new examiner’s opinion. I was told to file an HLR, but I filed a Direct Review Appeal and that is where my claim/appeal has been sitting for close to two years.

[brokensoldier244th]

21 hours ago, flynsolo2 said:

@brokensoldier244th Thanks! I am hoping only a few months. My VSO submitted it, so I am not sure if he checked the box or not, and he is now off for medical reasons, so I guess I will have to wait and see. But, he did file it secondary to PTSD, it is what I have been fighting them (and they keep denying). I think Dr. Anaise just put the GERD claim as well to help solidify it, in case my PTSD % ever gets lowered maybe? But, I get what you're saying. 

I did not know that there is a backlog because of the PACT, so, I do hope it does not put my claim decision out too far. It is the only new evidence I submitted, and in the IMO letter, he included the most sleep study, so, hopefully they rate it sooner rather than later....I have a BVA appeal from April 2021 that I am STILL waiting on a date for, so, I know it can take a long time.....

The PACT claims aren't taking priority over others or anything like that, we work whatever comes through. I just mentioned it because its an influx of claims that built up over 5 months before being released to be rated. We were working them during that time, we just couldn't do anything with them until January.

[flynsolo2]

@pacmanx1 I have had the same thing with so many claims. It is extremely frustrating. For several claims, I have submitted more and more evidence, for them to deny the claims, pretty quickly, This is where I think hiring a VA lawyer to help navigate through some of these claims. I did it awhile ago, and they were able to get some claims at a higher percentage, which moved me from a 80% rating to a 90% rating. But, (and I have heard this from many others), getting from 90 to 100 is the hardest jump. And it has been. Either claims are denied, or even with a higher percentage rating on some claims, because of the VA "whole body rating", the 90-100 rating schedule, it does not jump in overall percentages like it does in lower perecents......

I hope you get a decision soon. I feel your frustrations......I am hoping once they rate my OSA, I will also fight for an earlier rating, as I originally had a diagnosis YEARS ago, with a sleep study, and they denied it back then. But, first things first, is to get it rated for right now......

[flynsolo2]

@brokensoldier244th I understand. Well, hopefully the VA will rate my decision sooner rather than later, but honestly, just getting a rating in my favor for once, I will be happy, even if it's months from now.......