The Fine Tooth Comb Approach To Disability Claims
Over the past week, I’ve been revisiting my own disability claims to be sure VA did it properly.
No matter how many years that go by, and how many issues they miss, I am still able to find new issues VA skipped, or omitted, or manipulated to fit their denial.
Here is what this means to you, and I’ll explain what happened to my own claim later. When you read your own file, read both your initial claim to VA and VA’s actual response to you.
What you may notice is that VA will fail to adjudicate all conditions you write down. This seems to be especially true with older claims.
Let’s not forget that VA has been caught intentionally lowballing veterans at least once a decade. So, if you happened to be one of the unfortunate majority of veterans who got screwed, you need to be ready to read your own claim very carefully.
The first step is getting a copy of your file through a Privacy Act request or a Freedom of Information Act request.
Once you get your file, start to read it through, end to end. Be sure VA examiners properly noted conditions. Be sure, if the condition or symptom was noted, that VA’s adjudicator actually included the data in their decision.
Case in point.
In my situation, I have an adjudicated Form 9 in my file from 2003. VA cannot seem to figure out what to do with it. In addition to the Form 9, there are many symptoms of conditions in my claims that VA also did not adjudicate.
Specifically, I noted to VA that I was suffering from fatigue in a Statement in Support of Claim. I thought the fatigue was related to Sleep Apnea, which is a condition VA denied in 2003 and again in 2012. While fatigue could be related to Sleep Apnea, it can also be connected to many other things, such as TBI.
As chance would have it, I do have a current diagnosis for TBI in 2009.
Here’s what this means. When a claim is unadjudicated, it could result in VA being on the hook for an earlier effective date. Now get ready for the dip and hook.
Instead of VA connecting fatigue to TBI, they connected it to Sleep Apnea. And since I don’t have a service connection for Sleep Apnea, VA is off the hook for the earlier effective date.
And, best of all, the VA adjudicator did this without consulting a doctor. Instead, the nonmedically trained VA employee rendered a medical decision when they could not do so based on medical training.
This kind of decision is contrary to many decisions from the US Court of Appeals for Veterans Claims. Regardless, VA continues to defy logic and law to deny veterans benefits.
Of course, in my situation, I won’t stop until I win. And you shouldn’t either.
The sad fact is that the American people need to be accountable for their decision to fight many wars across the country. If we let VA get away with scamming veterans out of their benefits, the American public will not know how much war really costs when it comes to cleaning up the mess.
Without a full understand of the cost and impact of war, many more “Chicken Hawks” in Congress will be able to lead us into senseless wars.
So, my charge to all of you is to be sure to read your claims file very carefully. Be sure to not let VA off the hook without fairly adjudicating all of your claims.
Look for any instance where a VA adjudicator dimwit rendered a medical opinion with no medical proof or sound reasoning.
I can assure you that VA probably does this in at least half of the claims they deny. In fact, I believe 60 percent of all claims that are denied are denied on unsound reasoning last I checked.
After I’m done with the MN State Bar, I’ll be breaking down my own claim and the process I go through to fight for my own justice. Check back in from time to time to see if you can gain some insight.
Most importantly, if you can, never give up.
I walked into a VA Regional Office and was told to have a seat. The VA employee pulled out a form and with the help of my discharge physical proceeded to fill it out. I mentioned my head injury and was asked if it was in my record. I told him the Navy lost my record. He said…… “Can’t prove it, don’t waste my time”.
Just out of service, intimidated and suffering from undiagnosed brain injury, I signed the form slid across to me.
After I diagnosed myself with a TBI over 2 decades later , I started to get benefits. Injury 1985, Discharge 1990, informed VA 1991 and stated to get benefits 2014.
I was going to let this go having been told I had no chance without a written claim. No, not gonna do that. I’ll fight them on the steps of the Supreme court if I must…….. Because this is just plain Wrong!
As an clarification to the comments I just submitted, my husband is rated for diabetes which the doctors say his kidney failure was caused from, so the relationship between the two conditions does mean the kidney condition would have been an acceptable rated condition if he hadn’t been already 100% when it occurred.
I plan to read my husband’s paperwork. He is 100% now for the past 7 or 8 years, but it took 4 or 5 years to get there with gradual increases as we submitted more claims. However, I’m sure they underrated his heart condition in earlier years as they later awarded the rest of the 100% based on the same heart condition we reported earlier. My question is what about the year time frame for appeal? We’ve long since passed all the deadlines for appeals so what can we do when we find errors (judgement or otherwise)? Also, my husband has developed some other conditions (not rated specifically) ie:kidney failure-has done dialysis for 4 years now. If he passes away due to that it’s my understanding it doesn’t qualify for having died of a rated condition. And that then prohibits any of his disability coming to me as the widow. He also was denied for PTSD because we couldn’t find any buddies to agree the incidents happened. So they agreed he has it but not necessarily from being in Viet Nam. Then a few years later, they removed the requirement for witnesses but never notified us so that it could be re-evaluated. Now it’s also not a part of the rated conditions. Can anyone help me with any of these issues?
there are people within the veterans administration that are using their job positions to process claims for themselves and friends and getting paid for things like getting water up their nose when jumping in water ,while swimming. also for their feet hurting because they where made to march. I was up in northern Michigan on the 4th of July in a bar with friends and a man named Mike Wise, who said he works for the V.A. Adminastration Office in Cheboygan. He said he was a V.A. Concellor, Rep. and he was laughing about my friend who was talking about not being able to get his V.A. benefits after 5 years. he told him if he moved up to northern Michigan area that he would get my friend claim processed and approved for a fee, with no troubles at all. he said he had gotting benefits for himself and other officials and friend he knows up there, with no trouble at all because of his opposition at the V.A.. He said he,( Mike Wise) was collecting 876.00 dollars a month for jumping in the water while he was drunk and off duty at a party. He jumps in the water and gets water up his nose and gets benefits, can you believe that? Soldiers are wounded and have mental issues and where in combat and they are denied benefits, but his guy Mike Wise of Cheboygan ,MI. who is a V.A. Reprasentative At the V.A. in Cheboygan,MI. get a disability check for all most 900.00 dollar a month for getting water up his nose. then sits in a bar and laughs and braggs about it. Unbelievable!
I stumbled upon this article when I was searching for information on lost medical records. I just submitted an application to reopen a claim because the VA’s decision to deny me was based on my diagnosis. What I mean by my diagnosis is that they reviewed my file and noticed that I had complained of tinnitus during allergy season. My tinnitus is continuous and was caused by chemotherapy. During allergy season I am congested and the ringing is “louder” or more pronounced. Perhaps I worded it incorrectly in my claim and/or didn’t know how to explain myself to the ENT doctor. My biggest mistake is waiting three years to re-open this claim.
Also, my Army medical records were lost and I attempted to put in a claim for some issues I had to have physical therapy for. Of course they denied me for insufficient evidence. It’s impossible to find these records – they disappeared into thin air. I only have the medical records that were created in my last duty station. From basic training on, no medical records exist. Very frustrating to say the least
*I meant based on self-diagnosis not a doctor’s.
This is a very motivational article. I too will use this insight to educate the american people on the cost of war.
Well-written. Best of luck on the EED. If they give you the “I can’t hear you” treatment, don’t continue pro se. I finally got a law dog when i approached the Court. VA had their ears plugged up and refused to even acknowledge what was in the C-file.
VA is a past master of the “deemed denied” claims philosophy. You report. We ignore. I filed in 1994. Denied (of course). I sent in new evidence and they foolishly said “Roger, we got it. Will get back to you soon”. They never did. I won in 2008 and they refused the earlier date until we got to the CAVC. Nineteen years later, on the courthouse steps five minutes before showtime they expressed their mea culpas. Remember, Vets. If you do not appeal it, they will consider the decision correct. Win or die trying. Mr. Krause is entirely correct. VA can’t take the trash out without spilling it. On the older stuff, the errors are even more egregious. When you’re the only insurance company in town, it breeds contempt for Vets. Considering they’ve been doing this since 1789, you’d think they could figure it out by now. Read my book for more trick on how to unravel this enigma at asknod.org.
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