Question:
Jim,
Last summer I corresponded with you about my personal problems with having a claim resolved at VA. Briefly – I served from 1966 to 1988 and volunteered for Desert Storm and most recently Iraqi Freedom (Casualty and Mortuary Affairs).
While on active duty I had a heart attack and stint placement. Within a year of my discharge I had a second heart attack and triple bypass – May 07. I filed for a claim for 1st MI in 2006. While waiting on the results I had my second MI and had a C&P that combined both MI’s and Coronary Artery Disease.
I was called back to have a SECOND C&P February 2008. The attending doctor stated the results of this C&P were the same. He also stated the nexus to Type 2 Diabetes was 50/50.
I was told I was denied Peripheral Neuropathy even though my medical records indicate lower extremity pain is a constant complaint. I went to a private specialist and had test performed and the results were SEVERE NEUROPATHY. VA told me I initiated my claim in November 2007! I wrote them a sprawling reply with documentation for the THIRD time and a VA Service Representative said she would take care of it.
I was told today that my claim is at the decision board. It has taken 19 months so far to get to this place. I submitted the paper work for this claim THREE times and had TWO C&P exams for the same complaint.
Sir, I am not a whiner and I would serve my country in a heart beat if called but doggone it I have limits. Do I have to start the process all over again with the Neuropathy and associated maladies of Agent Orange and MI disabilities? I would like to see about receiving CRSC but its difficult at best if a veteran can’t get a nexus for DMII/Neuropathy/MI/PTSD/Hypertension et al.
I don’t know what you could do and I only send you this to keep you posted to your offer for assistance. Thank you for letting me rant. (Signed) Your Brother In Arms.
Answer:
I hear you loud and clear. This is the most frustrating process most of us will ever have to confront. A lawyer recently told me that the VBA is making the Social Security disability claims system appear to be a smooth running machine. That's a shame.
Here's how I see your claim...
As a Vietnam veteran, your Type 2 Diabetes is presumptive. That you have diabetes and RVN service means that the service connection is automatically established (presumptive) and you do not have to prove a clinical cause. The only thing the VARO should do is assign a rating according to just how disabling the disease is. That's usually 10% to 40%.
Coronary artery disease or CAD is often seen as a disease that is secondary to diabetes. Thus, you should be able to establish that as you have Type 2 Diabetes, service connected, your CAD is more likely than not caused by or contributed to by the Diabetes. That is beyond a 50/50 estimate.
The hypertension isn't very likely to be rated unless it was diagnosed on active duty or within one year of discharge. The peripheral neuropathy should be claimed as secondary to the (established) service connected diabetes. The PTSD is another issue entirely and deserves its own attention in the claim for benefits.
The concepts above are no-brainers. However, you're dealing with the VBA. Today's VBA is a mess and it gets worse daily. That your claim has only been in the pipeline for 19 months makes it about average. I'm currently warning people that if they file a claim in March of 2008, it will be 2 years before they can hope for their first adjudication.
At the 2 year mark, 75% of those adjudicated cases will be blatantly and stunningly wrong. This means an appeal that will likely take another 2 years. Many of those will also be wrong and require an appeal of the appeal. Thus, I'm advising 2 years at minimum, maybe 5 years to reach a reasonable adjudication. Then, within 2 to 3 years VA will contact you for reexamination, even if you are "Permanent and Total" and they will attempt to lower your rating.
Were I you, the first thing I would do is sort out my dates of filings. I would want a reference that I could use to tell myself and the VBA the date I am sure I filed a claim for;
(1) Type 2 Diabetes
(2) CAD
(3) Peripheral neuropathy
(4) PTSD
I would then sort out my paperwork to provide evidence for future use that would prove those dates of submission. This is why I always recommend registered mail, return receipt requested. Once you have established that your claims are filed as above and you are satisfied that you have done your part, I'd do nothing more for 6 months, maybe more.
Even though you're told your plea is being adjudicated by "the decision board", I don't know what that means. Unless you have appealed to the Board of Veterans Appeals (BVA) there is no "decision board" that I'm familiar with.
The usual course of events is for your application and evidence to go to a room stacked floor to ceiling with the thousands of other files your VARO is behind on. A Veterans Service Representative (VSR) eventually gets your file, makes some initial notes and gets things rolling. Then it waits to get to a rater. That rater sees some 5 each day and makes his determination of awards and denials.
There is nothing to move your file through the pipe faster. There are maybe 400,000 claims waiting with yours and hundreds more are added each day. When the decision is made, you'll get a letter. That's when you may begin to appeal the flawed decision you'll undoubtedly get.
I'm not trying to be funny when I tell you that your wait time so far is less than the average today. You haven't reached a 2 year mark yet.
There are 2 traits that will get you through this to a successful award...(1) The patience of a saint and (2) The tenacity of a junkyard dog. Dealing with VBA is not an event or a series of events...it's a job for life. The reality is that there is no way to speed things up.