VA Regional Office Claims Question

[jm0365]

I filed a claim for TDIU 2/14/23. Already have combined rating of 80% (70/30/10). Initially the VSO told me that it wouldn't be too long of a process. Went to PFD 3/22/23. I spoke with my VSO again on Friday and he said to expect a decision in a few days. My last claim took 5-6 months, but the C&P examiner took over 8 weeks to submit the exam.

I see stories on here of people in PFD for 3-4 months. Is a lot of this based on the VA Regional Office that is processing the claim or is it based on the claim itself?

[broncovet]

You asked:

Quote

Initially the VSO told me that it wouldn't be too long of a process. Went to PFD 3/22/23. I spoke with my VSO again on Friday and he said to expect a decision in a few days. 

Sometimes, I wish VSO's and VA employees were held accountable to promises like this.  

While "optimism" is good, false optimism is not so good.  Im more than a little skeptical that your claim "will be completed (favorably)" in a few days.  

Possible Exceptions:  If you have great documentation.  This means "not only" did your doctor state you are unable to work due to SC conditions, "but also" you are unable to do ANY job, an assessment normally made not by a doctor, but by a voc rehab counselor.  

You see, your doc can opine you are unable to do your job, but it takes a voc rehab assessment to determine if you are a good candidate for retraining to another career.  VA often refers to this a "sedentary" employment.  The idea is, you worked in a warehouse, injured your back and the doc says you cant lift over 15 pounds, but your employer says you have to be able to lift 60 pounds to do your job..  So you cant work, right?  Not so fast.  

    Theoretically, you could go to school and take computer classes and learn to be a programmmer and the heaviest thing you need to lift is a book or a pencil.  

     If you do get a grant of tdiu (denial is different), "in a few days", then I will post an apology to your VSO.  

    But retraining eligibility, is not made by the doctor.  This is not his area of expertise.  

   Unless you had a favorable voc rehab assessment, along with a favorable nexus from your doctor, as well as history of unemployment, I would guess you have very long odds to get approved in a few days.  Much more likely you will have to appeal and that would be in 6 months after the decision.  

    Therefore:  My odds are that, without a favorable doc and voc rehab assessment, your odds are 1 in 10,000 of getting IU in "a few days".  

    If you have a favorable voc rehab assessment and favorable doctor nexus, your odds of getting tdiu "in a few days" are 1 in 10.  You should get it, but it always takes longer than you think.  

    In other words, there is "at least" a 90% chance your VSO is either not being honest, or vastly underestimated the time involved.  

Edited March 27, 2023 by broncovet

[brokensoldier244th]

To be somewhat fair, VSOs may say this but no RVSR or public contact person I've worked with or talked to (in my office or others) has ever told a veteran an estimated date of decision, for the reason you bring up. It depends on the claim, if the records/exams come back quickly or not, if they need to be sent back because the examiner didn't answer all the questions or if something is brought up in an exam that now needs an exam or clarification of its own. 

[jm0365]

7 hours ago, broncovet said:

You asked:

Sometimes, I wish VSO's and VA employees were held accountable to promises like this.  

While "optimism" is good, false optimism is not so good.  Im more than a little skeptical that your claim "will be completed (favorably)" in a few days.  

Possible Exceptions:  If you have great documentation.  This means "not only" did your doctor state you are unable to work due to SC conditions, "but also" you are unable to do ANY job, an assessment normally made not by a doctor, but by a voc rehab counselor.  

You see, your doc can opine you are unable to do your job, but it takes a voc rehab assessment to determine if you are a good candidate for retraining to another career.  VA often refers to this a "sedentary" employment.  The idea is, you worked in a warehouse, injured your back and the doc says you cant lift over 15 pounds, but your employer says you have to be able to lift 60 pounds to do your job..  So you cant work, right?  Not so fast.  

    Theoretically, you could go to school and take computer classes and learn to be a programmmer and the heaviest thing you need to lift is a book or a pencil.  

     If you do get a grant of tdiu (denial is different), "in a few days", then I will post an apology to your VSO.  

    But retraining eligibility, is not made by the doctor.  This is not his area of expertise.  

   Unless you had a favorable voc rehab assessment, along with a favorable nexus from your doctor, as well as history of unemployment, I would guess you have very long odds to get approved in a few days.  Much more likely you will have to appeal and that would be in 6 months after the decision.  

    Therefore:  My odds are that, without a favorable doc and voc rehab assessment, your odds are 1 in 10,000 of getting IU in "a few days".  

    If you have a favorable voc rehab assessment and favorable doctor nexus, your odds of getting tdiu "in a few days" are 1 in 10.  You should get it, but it always takes longer than you think.  

    In other words, there is "at least" a 90% chance your VSO is either not being honest, or vastly underestimated the time involved.  

Thanks for the in-depth response. For my specific claim my doctor wrote a detailed letter stating how my individual symptoms impacted my ability to work and stated at the end "his ability to work in any setting can be profoundly diminished or non-existent as he would require intense interventions..............because of his current medical conditions, he is unable to secure and hold any substantially gainful employment." One my C&P examiners for this claim also marked "Total Social and Occupational Impairment" in the DBQ.

So hopefully that puts my claim in the great documentation bucket. But I get your larger point. For what it's worth I called the VSO office again and spoke to someone else who told me that it's been in the National Queue waiting since 3/23/23. So longer than a few days.......

[broncovet]

You posted:

Quote

because of his current medical conditions, he is unable to secure and hold any substantially gainful employment." 

Unfortunaly, if this is the doctors opinion, VA does not like this.  The voc rehab specialist can opine if you are able to be retrained or not, but the doctor normally does not do voc rehabilition, and the voc rehab guys dont practice medicine.  I hope it works for you, and it may.  

[Stayfocus]

On 3/27/2023 at 7:29 AM, jm0365 said:

I filed a claim for TDIU 2/14/23. Already have combined rating of 80% (70/30/10). Initially the VSO told me that it wouldn't be too long of a process. Went to PFD 3/22/23. I spoke with my VSO again on Friday and he said to expect a decision in a few days. My last claim took 5-6 months, but the C&P examiner took over 8 weeks to submit the exam.

I see stories on here of people in PFD for 3-4 months. Is a lot of this based on the VA Regional Office that is processing the claim or is it based on the claim itself?

Regional office has a lot to do with this yes.

[Stayfocus]

On 3/27/2023 at 3:20 PM, jm0365 said:

Thanks for the in-depth response. For my specific claim my doctor wrote a detailed letter stating how my individual symptoms impacted my ability to work and stated at the end "his ability to work in any setting can be profoundly diminished or non-existent as he would require intense interventions..............because of his current medical conditions, he is unable to secure and hold any substantially gainful employment." One my C&P examiners for this claim also marked "Total Social and Occupational Impairment" in the DBQ.

So hopefully that puts my claim in the great documentation bucket. But I get your larger point. For what it's worth I called the VSO office again and spoke to someone else who told me that it's been in the National Queue waiting since 3/23/23. So longer than a few days.......

The VSO doesn’t make the decision.