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Old 05-12-2014, 07:09 PM
 
Location: St. Louis, MO
4,009 posts, read 5,170,189 times
Reputation: 4524

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Hi Everyone,

My husband just received a letter from VES (Veterans Evaluation Services) regarding his Disability Claim. We are completely shocked! The VES has listed everything as 'Normal' based on their findings...

HOWEVER- DH has seen private specialists within the last year and a half since getting out (because he is in SO much pain from his knee and back especially- he actually ended up in the ER one day because it was so bad) and MRI scans have shown that he has floating fragments of bone in his knee, caused by a non-combat related knee injury while on deployment, and several herniated discs.

The VES ordered X-Rays but no MRI's. We have copies of the medical reports from the private specialists that he saw- but last time we offered to give them to the VA they said they couldn't take them, that they would have their own specialists evaluate him.

Another thing we are confused about- when DH had the VES eye and hearing exams, the doctors who evaluated him agreed with him that he had deteriorating eyesight (he sees 'floaters' constantly) and the doctor who evaluated his hearing told him that he definitely had a hearing problem. Now the report says these factors are normal as well.

It's too late to call the VA right now- so we'll be calling in the morning. But has anybody else had experience with this? The VES having a completely conflicting report to what private doctors / specialists have found?

We are well and truly shocked to say the least!
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Old 05-13-2014, 02:12 AM
 
Location: Northern VA
370 posts, read 511,619 times
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You can appeal the decision and you have a right to submit your medical documentation. Did one of the veteran's organizations (VFW, American Legion, etc.) help your husband submit his claim? If not I would contact one of them immediately. They can help you with the appeals process.

Does your husband have an eBenefits account? He can check his claim status, make an appeal, submit supporting documentation, etc.

https://eauth.va.gov/ebenefits/

good luck
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Old 05-13-2014, 06:56 AM
 
Location: San Antonio
3,182 posts, read 9,221,015 times
Reputation: 4716
I do think that you may have some trouble because you saw the specialists AFTER he got out, but good luck!!
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Old 05-13-2014, 08:13 AM
 
Location: St. Louis, MO
4,009 posts, read 5,170,189 times
Reputation: 4524
Thank you!

He had the injuries documented while he was in the Marine Corps, and was treated for his knee injury in particular (Sports Med, not that it did much good) but because he was having ongoing problems immediately after getting out, that's why he saw specialists once we relocated to St. Louis. It was also noted on his medical when he got out, that he had dislocated discs in his back, that his eyesight and hearing had worsened since he got in. That's another reason why it's so insane that they're now saying everything is 'normal' as it not only opposes what the specialists said, but what his medical evaluation upon discharge said.

He did the initial claim himself directly at the VA- he since saw a local VFW rep but they told him there was nothing they could do?

Anyway he went down to the VA this morning- and just now called me to say they told him there was nothing they could do. I suggested going to see the VFW rep again while he's downtown but he doesn't see the point.

We do have eBenefits- I'll look into the appeals process immediately.
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Old 05-13-2014, 08:55 AM
 
286 posts, read 182,406 times
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Quote:
Originally Posted by glamatomic View Post
Thank you!

He had the injuries documented while he was in the Marine Corps, and was treated for his knee injury in particular (Sports Med, not that it did much good) but because he was having ongoing problems immediately after getting out, that's why he saw specialists once we relocated to St. Louis. It was also noted on his medical when he got out, that he had dislocated discs in his back, that his eyesight and hearing had worsened since he got in. That's another reason why it's so insane that they're now saying everything is 'normal' as it not only opposes what the specialists said, but what his medical evaluation upon discharge said.

He did the initial claim himself directly at the VA- he since saw a local VFW rep but they told him there was nothing they could do?

Anyway he went down to the VA this morning- and just now called me to say they told him there was nothing they could do. I suggested going to see the VFW rep again while he's downtown but he doesn't see the point.

We do have eBenefits- I'll look into the appeals process immediately.
Talk to a lawyer for your appeal. Most will see you free of charge and decide whether to take your case or not, i.e. does it have merit. It may be that they will tell you that under the current law you are unlikely to get anything with what documentation you have. Unfortunately that can be a fact that is really unfair with how the process works. However, if they take it, most take 33% of whatever you increase in disability claim for the length of time of the appeal. Mine went over a year so I paid 13 months of what my increase was. Still, now I have the proper rating for the rest of my life.

The VA Disability system is broken for a number of reasons. Most of the disabling conditions were established during the Civil war and have only been revised during the Korean and Vietnam war. People used to die that now survive with life altering disabilities that are not covered under current law. A lawyer can phrase it in the proper way such that you get the disability you are entitled to.

I am not encouraging people to fake injuries or to freeload, but it sounds like he served his country honorably, may have some disability, and if he does, by law, he should be compensated.

I do want to mention though that most ratings are well below what you would expect. Things like eyesight floaters, needing glasses, hearing loss, generally will fall into the "normal" category even though it is worse than the general public. For example, loosing a leg below the knee with a prosthetic is only 40%. They are confusing, often unfair, and seem abitrary, but the ratings are listed at: 38 CFR Book C, Schedule for Rating Disabilities - Web Automated Reference Material System

Good luck. I know this can be difficult and frustrating, but there is help available. Do a search for veterans lawyers in your area and find one you are comfortable with. No one else is going to fight for his rights. Thank your husband for his service from a fellow veteran.
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Old 05-13-2014, 09:29 AM
 
Location: St. Louis, MO
4,009 posts, read 5,170,189 times
Reputation: 4524
Thank you both!

I decided to call the VFW rep myself, and he told me that the VA has to accept / look at the doctor's reports from the specialists that DH saw. DH is on his way now to pick up copies of the reports from the specialists to give to the VA (we have copies at home but don't want to part with the originals just in case).

I have contemplated speaking to a lawyer about it- I think it's probably worth it.

We are a year and a half into this process, and DH was told by the specialist that he's going to need knee surgery sooner rather than later. It just blows my mind that it could be suddenly 'healed' and 'normal' from the point of view of the VES?
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Old 05-22-2014, 10:21 AM
 
Location: Newport Beach, California
31,385 posts, read 18,420,530 times
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Quote:
Originally Posted by glamatomic View Post
Thank you both!

I decided to call the VFW rep myself, and he told me that the VA has to accept / look at the doctor's reports from the specialists that DH saw. DH is on his way now to pick up copies of the reports from the specialists to give to the VA (we have copies at home but don't want to part with the originals just in case).

I have contemplated speaking to a lawyer about it- I think it's probably worth it.

We are a year and a half into this process, and DH was told by the specialist that he's going to need knee surgery sooner rather than later. It just blows my mind that it could be suddenly 'healed' and 'normal' from the point of view of the VES?
One of my friends is currently dealing with the similar situation. I talked to an attorney about your case, and this is the answer she gave me.

Since the VA has denied benefits to your friend because their examination found him to be "normal", he has two options, but there are several things which must be done first.

The first step in your friend appealing the decision is to send a "Notice of Disagreement ("NOD") to the VA Regional office. There is no official NOD form, but he can use VA Form 21-4138 (Statement in Support of Claim), or he can write a letter. I believe that the letter is more effective. In the letter, he must state the following,

1. The date of the decision (that would be the date of the letter he received)
2. That he disagrees with the decision and state the reasons why he disagrees - For this purpose, he should refer to the MRI's taken by his physician's and the fact that the Veteran's Evaluation Services ("VES") did not order any MRI's and refused to look at those that had already been taken
3. State which issues he disagrees with and
4. State that he intends to appeal those issues

He has one year from the date of the VA's notice of its decision to file his NOD with the VA Regional office. Your friend should do this as soon as possible so that he does not miss the deadline. If he misses the deadline, it will be very difficult to reopen his case.

When the VA receives his NOD, he will receive a letter that acknowledges his NOD. He will be asked whether he wants to have his appeal sent to the Board of Veterans' Appeals ("BVA") in Washington, D.C., or if he wants to have his claim reviewed on a de novo basis by the Decision Review Officer ("DRO") Program. This is an informal appellate process within the regional office. The DRO has the authority to reverse or modify a VA rating board decision. It is best to ask for a DRO review before he asks for a BVA Appeal.

The DRO process is often successful and is generally faster than going straight to the BVA
. And, if he does not receive a better decision from the DRO, he can still file an Appeal with the BVA. So, he loses nothing by going to the DRO first.

Once the DRO has made a decision or has received your request to go directly to the BVA for consideration of his Appeal, the VA will issue a "Statement of the Case" ("SOC"). This document will explain the VA's decision in detail.

He will then have 60 days from the date of the SOC to file his substantive appeal to the BVA on VA Form 9. This form can be downloaded from the VA's "Compensation" website. His Appeal will then be certified and forwarded to the BVA for consideration.

However, please talk to an attorney.

good luck to you.
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Old 05-22-2014, 10:29 AM
 
8,768 posts, read 10,329,110 times
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I am astonished the VFW rep wasn;t all over this with an appeal and having him gather outside medical records. I hate to say this but dump the VFW reps and locate another service organization. You may want to try the DAV (Disabled Amercian Veteran's) as they have one of the best records for obtaining VA benefits.
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Old 10-13-2014, 12:07 PM
 
1 posts, read 11,801 times
Reputation: 11
I know how you feel Glamatomic. The medical findings should coincide with the decision, however that is not the case. You may appeal the decision and submit the necessary documents. If ever you will be needing blank VA forms, I was able to get the form through Pdffiller, Fillable Online vba va VA Form 21-4138 (Rev. Aug 2011) - vba Fax Email Print - PDFfiller. On-line PDF form Filler, Editor, Type on PDF ; Fill, Print, Email, Fax and Export
It has a PDF search engine with wide array of fillable Tax forms and it allows you to sign it electronically.
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Old 10-17-2014, 04:09 AM
 
286 posts, read 182,406 times
Reputation: 737
This is very standard unfortunately. The entire VA disability system needs to be scrapped and rebuilt. It is based on a model that started with the Civil war and has been adjusted during WW1,2, Korea and Vietnam. Back then they did not have the diagnosis that we have today, nor did they expect people to live from some of the injuries we recover from today.

Most of the VA people are very caring and try to help, but they are so behind, understaffed, and being told by congress that the most important thing to do is catch up instead of making sure each case gets the proper attention it deserves.

Here is what I did and I am so glad that I did it. You can not use a lawyer (or have the lawyer file) your initial VA paperwork. However, for your appeals, you can.

My lawyer took 30% of my award up to that point with a max of $6K. The VA lawyers know how to word the appeals exactly so that the VA people looking at your record can easily connect the dots. If you win your appeal, you are retroactively paid back from the point that they deemed it began (most of the time it is exit from the service).

It is a very slow process. My appeal wasn't complete for 3 years from my exit from the service, however it was a couple hundred dollars a month x 39 months. I absolutely don't believe I would have won my appeal even though I was very good at documenting what was in my records. Simply by using one word incorrectly can doom that part of your appeal.

Google VA lawyers in your area. You can find out their fees, their appeal win/loss rate, etc.

I hope this helps.
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