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Can the DRO make a decision on an undecided claim? a veteran's claim

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acz3inbigd

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Posted (edited)
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Veteran files a NOD on RO  decision on original claim.  DRO is selected.  Veteran then files a new claim for TDIU.  Does DRO have jurisdiction to issue decision on new claim?

I would not put anything past the VA, the thing to keep in mind is if you get a decision that you disagree with you either have to file an appeal or try to file a new claim. I have seen and warned veterans to be very careful not to file claims for secondary conditions if there was no service-connected rating or not meeting the rating criteria. Example: Veteran has ratings of 30% + 10% + 10% and file for a new claim and TDIU. The problem is the veteran does not meet the criteria and if the VA denies the new claim, they can also deny the TDIU claim.  

Edited by pacmanx1

My intentions are to help, my advice maybe wrong, be your own advocate and know what is in your C-File and the 38 CFR that governs your disabilities and conditions.

Do your own homework. No one knows the veteran’s symptoms like the veteran. Never Give Up.

I do not give my consent for anyone to view my personal VA records.

 

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Maybe.  There is such a thing as an "inferred claim".   While those are mostly not allowed CURRENLTY, in the past inferred claims were common.  

A great example is:

   You apply for PTSD.  You speak with the doctor, AND you tell him you are unable to work because of your PTSD.  Your doctor docutments this.  This could be considered an INFORMAL or inferred claim for INCREASE for TDIU.  

   Many Veterans, especially those with PTSD or other mental health disorders dont know the difference between TDIU and an IOU.  The VA is supposed to have a Liberal interepretation of his claim for benefits, and its highly likely telling his doctor this, could be construed as a claim for tdiu.  

   In many instances, the VA would be required to send the Veteran a TDIU claim form.  But, what if they dont?  

    Chances are pretty good, the Veteran "eventually" runs into a competent VSO or someone else who may explain to him that he/she should apply for tdiu.  So, lets say he does.  He could well get an effective date much earlier, since his statment to the doctor could have been construed as a claim for tdiu.  

 

   There are other examples, too.  Many of those involve Veterans "not understanding" a diagnosis.  

A DRO "could" view a diagnosis on a medial report "you did not apply for" because, for one thing, you may not have known you had the disorder" and applied for you.  The vA has a duty to maximize benefits, and its presumed the Veteran, when applying for benefits is seeking the max.  

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Posted (edited)

Finally, still another example is your VSO or representative.  

Most Veterans sign "stacks of paperwork" and dont read every word, ever.  I did.  

Maybe your VSO was sharp and saw a medical report and said, "gee, that Vet has a diagnosis of tinnitus", I will include that also.  

He may or may not have explained that to you, and you may or may not have remembered his explanation that happened months or years ago.  

 

The same thing often happens when you buy insurance or a car, or whatever.  You may get tired of listening to his talking.  Insurance agents often include something called "waiver of premiiums".   Do they always tell  you?  No.  You may not want to hear it all!  You may get a headache when they start talking about double indeminty comprehnesive, other than collision, and a bunch of other stuff you dont know or care what it means.  So, you dont ask.

So, you bought waiver of premiums.  3 years later, you get in a car accident and are disabled.  Your agent calls, noticing you stopped paying the premiums.  You respond that you cant, you are disabled.   The agent informs you that he included "waiver of premiums" which means your premiums are paid by the insurance company when you become disabled!   You are happy!   You get to keep your insurance without paying!  And you did not know what waiver of premiums meant, but your agent did, and he included it.  

Edited by broncovet
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All complicated cases are supposed to be referred to the Director, Compensation Services.  The first step of that is to send it to a DRO in the Central Office.  (Where my TDIU claim was sent).  A DRO from the Central Office sent the review and recommendation to the Director who made the award.

A claim for TDIU does not specifically have to be made. 

If you have stated that your multiple conditions that make you unable to find work, for example, TBI that makes mental work, as in desk jobs not possible, and injury residuals that make physical work not possible.  While neither alone qualifies you for TDIU, in combination they do making the case complicated.  My case when I was 40% combined.  Awarded to the date of my last full time attempt at being employed on a desk job.  I did eventually get the "presumptive ratings" after the TBI law took effect in 2009.  But my award went back to 1985 when finished in 2020.

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The VA is required to maximize your benefits. For example, you file a claim for SC neuropathy on you right leg. In the process the VA find out that you have a back a SC back issue that is causing the neuropathy. The VA has a duty to maximize your benefits by seeing if you back condition is. 1. service connected.  2. If so, do the need to SC the condition as secondary to your back and rate the back.

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