PEB submission to fit/unfit

USAF90210

PEB Forum Veteran
Registered Member
Joined
Dec 9, 2016
Messages
59
Likes
11
#21
Mine did this when the PEB requested clarification on the ratings they had provided. Took about a week for the VA to answer the question and return it to the PEB. Only time I saw a "needed from others" show up.
Thanks for the insight. I'm thinking one of the higher approving authorities at the VA is doing the same (requesting clarification) on something an initial rater or reviewer did.
 

1942

Registered Member
Joined
Apr 18, 2017
Messages
13
Likes
2
#22
My PEBLO was able to tell me why mine changed. The fact it was sent back for clarification, not what they needed clarified though.
 

USAF90210

PEB Forum Veteran
Registered Member
Joined
Dec 9, 2016
Messages
59
Likes
11
#23
So I've been sticking with the be patient and let the VA do its thing, since I retired. However, today I got an email from the VA saying I had been scheduled for exams or I had made a new C&P claim. No further info; you know, where, when, why I have an appointment? So I decided to call and find out what this means.

The very nice and helpful person who answered was able to figure it out. The VA has pushed my package forward to the final review process, but have "deferred" decision on 4 smaller conditions that as of now were rated at 0%, and I never expected much anyway. What he said this means is the VA will give me final ratings based on all my conditions except those 4 which they have deferred. They'll at some point want me to come in to essentially finish C&P exams for those 4 conditions they deferred, and then after that reevaluate my ratings with those 4 included in the total. Essentially, someone looking at my ratings thinks the VA med facility who did my C&P didn't evaluate me fully for those 4 conditions.

I was amazed, as I had not heard of this deferral process. He said he's been seeing it more and more. The goal being, they get people through the process and provide them final ratings, rather then have the entire process stopped to wait on what they've had to defer. In my case this is very beneficial, as all the deferred conditions are currently 0%, so it's not like my final ratings would be lower than proposed based on these 4 conditions being removed.

Hopefully that made sense. And hopefully it helps other vets in the future speed through the process like I did.
 

AFLady4

PEB Forum Veteran
Registered Member
Joined
Nov 18, 2015
Messages
166
Likes
28
#24
So I've been sticking with the be patient and let the VA do its thing, since I retired. However, today I got an email from the VA saying I had been scheduled for exams or I had made a new C&P claim. No further info; you know, where, when, why I have an appointment? So I decided to call and find out what this means.

The very nice and helpful person who answered was able to figure it out. The VA has pushed my package forward to the final review process, but have "deferred" decision on 4 smaller conditions that as of now were rated at 0%, and I never expected much anyway. What he said this means is the VA will give me final ratings based on all my conditions except those 4 which they have deferred. They'll at some point want me to come in to essentially finish C&P exams for those 4 conditions they deferred, and then after that reevaluate my ratings with those 4 included in the total. Essentially, someone looking at my ratings thinks the VA med facility who did my C&P didn't evaluate me fully for those 4 conditions.

I was amazed, as I had not heard of this deferral process. He said he's been seeing it more and more. The goal being, they get people through the process and provide them final ratings, rather then have the entire process stopped to wait on what they've had to defer. In my case this is very beneficial, as all the deferred conditions are currently 0%, so it's not like my final ratings would be lower than proposed based on these 4 conditions being removed.

Hopefully that made sense. And hopefully it helps other vets in the future speed through the process like I did.
That's great information. Thanks for sharing!
 

USAF90210

PEB Forum Veteran
Registered Member
Joined
Dec 9, 2016
Messages
59
Likes
11
#25
This morning Ebenefits switched to "Gathering of Evidence" again, but now states "Decision notification sent". So I went to the disabilities section, and there it is, my final ratings.

"Good" news:
They did look at my additional evidence provided to MSC after initial ratings. They appear to have only considered evidence for very specific claims I made; in this case I provided test results for sleep apnea. That is to say, I also provided evidence of a partial blindness in 1 eye, but did not claim blindness on my disability claim, so they did not rate it. Other good news, my final rating increased to 90% from the 80% proposed.

"Bad" news:
They reduced my MH claim from the proposed 50% to a final of 30%. That's obviously a huge disappointment. It's also a roadblock to getting to 100% VA, which is obviously the end goal. I was slightly surprised when the initial was rated at 50%, but then saw the DBQ and understood. Now I'm surprised they reduced it.

I will appeal. In the very records they already have, there are a few things they overlooked, and 1-2 things they didn't rate due to a lack of evidence that I now possess. HOWEVER, unless the MH rating is raised back to 50%, there is no path to 100%, even with all the other evidence.

At the end of the day, 90% is more than many people get, and will help my family greatly; so if that's where it ends I'm content. I am certainly annoyed that they were able to overlook the results of tests that they (the VA) actually conducted themselves at my C&P, which VASRD states are compensable. Additionally, in their final decision they removed some things from service connected to non-service connected, such as Tuberculosis, which I contracted in Iraq.
 

Warrior644

PEB Forum Veteran
Registered Member
Joined
Mar 4, 2013
Messages
6,330
Likes
822
#26
This morning Ebenefits switched to "Gathering of Evidence" again, but now states "Decision notification sent". So I went to the disabilities section, and there it is, my final ratings.

"Good" news:
They did look at my additional evidence provided to MSC after initial ratings. They appear to have only considered evidence for very specific claims I made; in this case I provided test results for sleep apnea. That is to say, I also provided evidence of a partial blindness in 1 eye, but did not claim blindness on my disability claim, so they did not rate it. Other good news, my final rating increased to 90% from the 80% proposed.

"Bad" news:
They reduced my MH claim from the proposed 50% to a final of 30%. That's obviously a huge disappointment. It's also a roadblock to getting to 100% VA, which is obviously the end goal. I was slightly surprised when the initial was rated at 50%, but then saw the DBQ and understood. Now I'm surprised they reduced it.

I will appeal. In the very records they already have, there are a few things they overlooked, and 1-2 things they didn't rate due to a lack of evidence that I now possess. HOWEVER, unless the MH rating is raised back to 50%, there is no path to 100%, even with all the other evidence.

At the end of the day, 90% is more than many people get, and will help my family greatly; so if that's where it ends I'm content. I am certainly annoyed that they were able to overlook the results of tests that they (the VA) actually conducted themselves at my C&P, which VASRD states are compensable. Additionally, in their final decision they removed some things from service connected to non-service connected, such as Tuberculosis, which I contracted in Iraq.
Indeed, it's good to read that you finally have your DoVA official ratings albeit not to your expectations.

If I may offer any additional insight on your specific situation, it's best to request a DoVA reconsideration (with the new medical evidence) at this particular point in time than going straight to the DoVA NOD appeal. Why? Because the DoVA reconsideration only takes a couple of months to complete versus a DoVA NOD which shall definitely take more than a couple of years to render a final decision. But, no matter what your finally decide, please ensure that you submit your request for a DoVA NOD within one year of the date on the DoVA official ratings documentation letter; that's highly imperative! Hope this helps and take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

TundraX_SA

Registered Member
Joined
Aug 16, 2017
Messages
11
Likes
0
#27
Good to see you got a rating and thanks for the in=depth status updates. The way the VA claims work boggles my mind. One of my contractors just retired and received 90% VA, but mainly due to Obstructive sleep apnea and Anxiety. Which are legitimate medical problems, but he was diagnosed with them during his final retirement appointments. Just crazy to think he went 20 years with no problems and goes to the doctor a week before his retirement ceremony and walks out with 90%.
 

USAF90210

PEB Forum Veteran
Registered Member
Joined
Dec 9, 2016
Messages
59
Likes
11
#28
Indeed, it's good to read that you finally have your DoVA official ratings albeit not to your expectations.

If I may offer any additional insight on your specific situation, it's best to request a DoVA reconsideration (with the new medical evidence) at this particular point in time than going straight to the DoVA NOD appeal. Why? Because the DoVA reconsideration only takes a couple of months to complete versus a DoVA NOD which shall definitely take more than a couple of years to render a final decision. But, no matter what your finally decide, please ensure that you submit your request for a DoVA NOD within one year of the date on the DoVA official ratings documentation letter; that's highly imperative! Hope this helps and take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
That is, in fact, very useful information. I was under the impression that a reconsideration was only a process available during IDES, and that after retirement NOD was the only option. I will definitely look into that process.

Separately, but related, do you know off hand what the limits of the reconsideration are relative to NOD or a new claim? I believe 1-2 conditions that the VA already has evidence for were not rated simply because I did not claim them. I'm assuming a reconsideration cannot take these into account, though that would be optimal if it did. With all that said, I think I could reasonably argue I did claim them; I claimed bilateral eye condition- so they should have looked at my evidence for blindness in one eye; I also claimed tuberculosis - their very own test due to this claim revealed a diagnosis of "interstitial lung condition", so it should have been rated secondary to TB. That's just this guy's opinion though, and I might be biased...
 

Warrior644

PEB Forum Veteran
Registered Member
Joined
Mar 4, 2013
Messages
6,330
Likes
822
#29
That is, in fact, very useful information. I was under the impression that a reconsideration was only a process available during IDES, and that after retirement NOD was the only option. I will definitely look into that process.

Separately, but related, do you know off hand what the limits of the reconsideration are relative to NOD or a new claim? I believe 1-2 conditions that the VA already has evidence for were not rated simply because I did not claim them. I'm assuming a reconsideration cannot take these into account, though that would be optimal if it did. With all that said, I think I could reasonably argue I did claim them; I claimed bilateral eye condition- so they should have looked at my evidence for blindness in one eye; I also claimed tuberculosis - their very own test due to this claim revealed a diagnosis of "interstitial lung condition", so it should have been rated secondary to TB. That's just this guy's opinion though, and I might be biased...
Well, I would think that the DoVA reconsideration shall review all available medical evidence and/or medical documentation that's already within the current DoVA disability claim; at least that's what was done in my particular case many months ago.

Indeed, I would mention all of what you stated above for the DoVA reconsideration and let the process proceed to whatever decision it shall render. If you don't receive the decision you expect, than it would be time to file the DoVA NOD and let that particular process proceed until completed; that's at least my opinion of how to proceed in your specific situation. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

USAF90210

PEB Forum Veteran
Registered Member
Joined
Dec 9, 2016
Messages
59
Likes
11
#30
So, the "good" news is, my ratings are 100% done now. Rather than expect you to remember my whole story, the VA gave me final ratings for the majority of my claims, and DEFERRED decision on a few of them until later when they could get more evidence.

Here's what's odd, to me. I got a letter from a civilian contractor the VA must use, completely out of the blue. It was for an exam for those deferred conditions. The date/time they assigned me did not work for my schedule so I called and canceled. Due to authorization timelines, they had to cancel the order and send back to VA to process again. Like 2 days later, the VA sends me a letter that they finalized my deferred ratings, the ones I haven't been seen for since my original C&P. So in the same week, I canceled an exam for the deferred conditions and the VA made a decision on them. Very odd!

So I believe I'm at a good point now to start an appeal/reconsideration. If you don't remember, from my proposed ratings the VA did and gave the USAF, to my final ratings, I had a significant number of them be reduced or completely eliminated to 0% and non-service connected. I've read on this forum it's pretty rare for a proposed rating to be lower in final ratings, since a tie usually goes to the service-member and obviously someone already thought it should rate higher. Their reduction/removal of so many of my claims, not just 1, makes my rating 90% right now instead of 100%; an obvious huge difference.

I have my first PCM appointment with the VA clinic this month, so I'm going to address any medical concerns that the VA didn't rate correctly (in my mind) so there is more evidence on file, before I go and file an appeal.