HOW DO I GO FOWARD ON OLD DENIED CLAIM

[randylan2]

1988 injured low back on active duty.  2002 awarded SC for re-current low back sprain with chronic low back pain 20% Tinnitus 10%

2004 Applied for secondary SC for Anxiety Disorder and Depression with Insomnia and panic attack caused by low back chronic pain and tinnitus.

C@P Examiner instead diagnosed me for Pain Disorder with Phycological issues stating Veteran had no in service treatment records for Anxiety and claim denied.

Fast Foward- Been treated by V A for low back chronic pain with anxiety for 17 years with last two years being treated by V A Pain Clinic

Continue to be treated by V A doctors and Psychologist for mental health issues directly related to my chronic low back pain and tinnitus

They now cover Somatic System Disorder as disability in 2004 not covered,

few months ago, found copies of my Active-Duty chart notes showing veteran was treated for situational anxiety in service and was prescribed anxiety medications. Appears V A does not have this record.  Question is in 2024 how would I move forward with new material evidence if I claim, Somatic Symptom Disorder now?

 

[john999]

 I think you should file for depression as secondary to your back disability.  Do you see a psychiatrist at the VA?  You should for sure.  They will most likely prescribe an anti-depressant.  You did the right thing in filing for psychiatric disability as secondary.  Did you appeal the denial of your pain/anxiety claim?  Any vet with a moderate to severe physical disability should for depression as secondary.

[pacmanx1]

7 hours ago, randylan2 said:

few months ago, found copies of my Active-Duty chart notes showing veteran was treated for situational anxiety in service and was prescribed anxiety medications. Appears V A does not have this record.  Question is in 2024 how would I move forward with new material evidence if I claim, Somatic Symptom Disorder now?

 

 

You should file a reopen claim based on new and material or relevant evidence under 38 CFR 3.156. Once the VA grants your claim, if they don’t award the earlier effective date then file an appeal and request it. If the VA denies your claim, then file an appeal. Try to get the service connected first then go for the earlier effective date.

It is probably best to file for depression and let the VA (NAME) and determine if it should be primary or secondary service connected. Try not to limit your claim or shoot for the wrong diagnosis. The Caluza Elements are 1. An in-service accident, incident or event, 2. A current diagnosis, and 3. A nexus or link that connects 1. and 2. 

 eCFR :: 38 CFR 3.156 -- New evidence.

Edited August 28 by pacmanx1

[broncovet]

I agree with pacman.  File new and relevant evidence under 3.156.  If awarded, it will likely be at the incorrect effective date, but stranger things have happened (VA getting the effective date right), but its never happened to me.  I had to appeal every one of 4 effective dates.  Hearing loss, MDD, tdiu, and tinnitus.  Its the VA way, mostly in this order.  

1.  Delay the claim as long as possible, with as many glitches as possible.  If there are no glitches, there are people in the VA who create them, such as by losing/shredding key evidence as in your claim.  

2.  When the VA cant delay it any longer, then deny it.  

3.  When the Veteran goes to the BVA, and wins SC. then the next step is low ball you.  The VA lowballed me at 0 percent, and my VSO suggested not appealing, or I could lose my service connection.  That was a lie. 

4.  After you successfully  appeal the disability percentage, the next step is to grant the wrong effective date, requiring a 3rd appeal ON THE SAME ISSUE.  

5.  After the successful appeal of the effective date, begin with step 1, all over again, when you apply for tdiu, making sure they deny you for a 4.16A denial, and ignore TDIU for 4.16B.  A 4.16B will add several more years to your claim delays, because the VARO generally does not do 4.16B, and instead denies based on your lack of percentage requirements of 4.16A.   As Broken soldier indicated a few Veteran friendly raters actually forward your claim to VACO for 4.16B consideration sometimes even without The VA being told to do this by the BVA after another long appeal, like mine.  

6.  Next the VA often overlooks or ignores consideration for SMC.  Go back to step 1, with SMC, and experience the delays and denials of SMC also.  

7.  Finally after VA lowballs SMC, you have to go back and fight them for a higher level of SMC.  

8.  Once you reach higher levels of SMC, you have to go back and fight VA on the effective dates, especially when they use date of claim, instead of date your symptoms should have got you smc.  

9.  Next, of course, the VA fights you on your dependent pay.  Mine went to the CAVC and even with a cavc "stipulation" va still did not pay dependents benefits!  They told me it was too late, to apply again.  

10.  Next, at least twice, after you have successfully appealed all of the above, the VA sends you a proposed reduction accusing all Veterans of getting a divorce when we have not.  You must respond or lose some of your benefits.  

Now, repeat the above frustrations for each benefit sought, until the Veteran dies, or can no longer continue because of illness.  

11. After the Veteran dies, fight his widow, denying her benefits for DIC or accrued benefits.  

Its an 11 step process the VA uses over and over again, adding, there will almost always be multiple, multiple, glitches for each step.  

 

[Rattler]

I do not want to discourage you from getting EVERY BENEFIT YOU DESERVE.  But to support broncovet post above. this is how bad it can get when trying to get the VA to re-open an old claim. I will post what I think you should do in the next one.

The question is what VA form should he use? VBA-20-0995-ARE-DECISION REVIEW REQUEST  SUPPLEMENTAL CLAIM. Or VAB-21-526EZ-APPLICATION FOR DISABILITY COMPENSATION AND RELATED COMPENSATION BENEFITS.

So here is the problem I ran into last year. I re-opened a legacy claim due to the date of the first filing from 1981 in January 2023. I always file my claims as a packet with exhibits to make them a "fully developed claim." . I used form VBA-20-0995-ARE-DECISION REVIEW REQUEST SUPPLEMENTAL CLAIM. The VA keep rejecting the claim demanding that I use VBA 21-525EZ . (See Exhibit 1) If memory serves me right I got pissed and filed it 5 or 6 times just to screw with them. I got 5 letters like Exhibit 1.

I contacted the White House Hotline after the 4 letter. Their response and my response to the White House Hotline email are in Exhibit 2. (you should get a good laugh out of it.)

After that, the White House Hotline and the Office of Client Relations agreed with me and the VA accepted my claim on VBA-20-0995-ARE-DECISION REVIEW REQUEST SUPPLEMENTAL CLAIM. The reason for using form VBA-20-0995 is it protects the effective date of 1981. In my opinion, the 21-525EZ does not. (see Exhibit 3) 

 

Exhibit 1- 1-25-23 Ltr-029001 Refual to use Form 21-0995.pdf Exhibit 2- 1-19-23-Email Response to Email WH hotline, Closed claim- Wrong forms.pdf Exhibit 3-1-20-23 Email WH hotline, claim found 1981 -Pending claim.pdf

[Rattler]

On 8/27/2024 at 9:56 PM, randylan2 said:

1988 injured low back on active duty.  2002 awarded SC for re-current low back sprain with chronic low back pain 20% Tinnitus 10%

2004 Applied for secondary SC for Anxiety Disorder and Depression with Insomnia and panic attack caused by low back chronic pain and tinnitus.

C@P Examiner instead diagnosed me for Pain Disorder with Phycological issues stating Veteran had no in service treatment records for Anxiety and claim denied.

Fast Foward- Been treated by V A for low back chronic pain with anxiety for 17 years with last two years being treated by V A Pain Clinic

Continue to be treated by V A doctors and Psychologist for mental health issues directly related to my chronic low back pain and tinnitus

They now cover Somatic System Disorder as disability in 2004 not covered,

few months ago, found copies of my Active-Duty chart notes showing veteran was treated for situational anxiety in service and was prescribed anxiety medications. Appears V A does not have this record.  Question is in 2024 how would I move forward with new material evidence if I claim, Somatic Symptom Disorder now?

 

You will have to decide if you are reopening the old claim or starting a new one that hasn't been filed before.

As you are getting treated by the VA you will need to your VA Hospital to the records request section. The reason for this is because they can print each visit your visits in one document. Ie MH visits 8-29-24 one visit. If you go online to do it that way it will jumble them all into one document that will be hard to separate. 

What I do is go through them and pull out ONLY the records that state you have Anxiety Disorder and Depression. (This is an example to use with all your claims) The reason for this is if the VA wants to find a reason to deny you let them dig through the 500 pages of your records to find it. (They probably won't.) I then put a cover letter on the medical records like, "Exhibit 1 VA Mental Health records for Anxiety Disorder and Depression. From 1-1-24 to 5-1-24. I then fill out VA Form VBA-20-10208-ARE-DOCUMENT EVIDENCE SUBMISSION and put it on top of the evidence you are submitting. I always file mine via access.va.gov. You will get a prof that you filed it via email. I print the prof and keep a copy. 

If you do it this way it should get you a fully developed claim and a decision fairly quickly.