Case sent back to VA from PEB?

Good afternoon,

I was curious if anyone has experienced their case being sent back to the VA? My case closed March 12th with the VA and now it's been over a month, and I haven't received results still. I spoke to Jeff over at the PEB and he stated that my case was sent back to the VA while it was in the QA Phase. He wouldn't tell me why.

Has anyone experienced something like this before?

 

[Provis]

Good afternoon,

I was curious if anyone has experienced their case being sent back to the VA? My case closed March 12th with the VA and now it's been over a month, and I haven't received results still. I spoke to Jeff over at the PEB and he stated that my case was sent back to the VA while it was in the QA Phase. He wouldn't tell me why.

Has anyone experienced something like this before?

Its pretty common. Cases get randomly chosen to have checked over. If there are issues then they have to fix them. Sometimes the VA will have you do another C&P exam if the needed data wasn't obtained. Its nothing to worry about. The issue could even be administrative. It just means your case will take longer than others because not only was it randomly checked by QC but there was an issue that needed to fixed before your proposed ratings could be determined. Its usually one thing and it may not even be related to your referred unfit conditions.

 

[navyseadaddy]

Its pretty common. Cases get randomly chosen to have checked over. If there are issues then they have to fix them. Sometimes the VA will have you do another C&P exam if the needed data wasn't obtained. Its nothing to worry about. The issue could even be administrative. It just means your case will take longer than others because not only was it randomly checked by QC but there was an issue that needed to fixed before your proposed ratings could be determined. Its usually one thing and it may not even be related to your referred unfit conditions.

I’m sure it’s random for every issue, however, is it an extra timeline? I kinda have been going off the timeline that is posted online for the IDES process.

 

[chaplaincharlie]

The publish timeline is aspirational, not a standard to which anyone is held.

 

[navyseadaddy]

The publish timeline is aspirational, not a standard to which anyone is held.

Understood, I’m just learning new things as it goes, however, things like the QA phase aren’t on there so I figured it was worth asking.

 

[Almostthere86]

Understood, I’m just learning new things as it goes, however, things like the QA phase aren’t on there so I figured it was worth asking.

Would be nice if the timeline worked haha. Don’t think I have had one block line up since the start of this ride.

 

[navyseadaddy]

Would be nice if the timeline worked haha. Don’t think I have had one block line up since the start of this ride.

Yeah. Honestly me either. I was just referring to it to kinda show me at what stage I was in the whole time, not necessarily looking at dates.

 

[Almostthere86]

Yeah. Honestly me either. I was just referring to it to kinda show me at what stage I was in the whole time, not necessarily looking at dates.

I understand completely and the hard part is that it’s not very descriptive, in that certain pieces are sub sets inside a specific section. Like my exams got stuck in QA for two months after they were completed. That blows that 31 day window out of the water. Makes all those years of hurry up and wait make sense.

 

[navyseadaddy]

I understand completely and the hard part is that it’s not very descriptive, in that certain pieces are sub sets inside a specific section. Like my exams got stuck in QA for two months after they were completed. That blows that 31 day window out of the water. Makes all those years of hurry up and wait make sense.

So you experienced something similar? It also dumb founds me with the lack of explanation that occurs through this whole process.

 

[Almostthere86]

So you experienced something similar? It also dumb founds me with the lack of explanation that occurs through this whole process.

If it wasn't for this forum and the people here keeping one another informed and sane, I imagine everything on fire. I had the same experience and even now I am stuck in a weird loop with the VA and the company (VES) who did my ratings over some clarifications before ratings can be assigned. Neither side can give me info on who owns what at this point other than the VA will say you are in IDES and VES saying yep we see nothing.

 

[chaplaincharlie]

QA is part of the rating process. Some cases are QA'd twice. The VA is not perfect, but they do have checks and balances intended to ensure the Vet gets a fair shake.

 

[navyseadaddy]

If it wasn't for this forum and the people here keeping one another informed and sane, I imagine everything on fire. I had the same experience and even now I am stuck in a weird loop with the VA and the company (VES) who did my ratings over some clarifications before ratings can be assigned. Neither side can give me info on who owns what at this point other than the VA will say you are in IDES and VES saying yep we see nothing.

That’s brutal. I’m sorry you have to go through all that.

 

[navyseadaddy]

QA is part of the rating process. Some cases are QA'd twice. The VA is not perfect, but they do have checks and balances intended to ensure the Vet gets a fair shake.

Also, thank you for clarifying. I appreciate all you guys do!

 

[johnbgately]

Good afternoon,

I was curious if anyone has experienced their case being sent back to the VA? My case closed March 12th with the VA and now it's been over a month, and I haven't received results still. I spoke to Jeff over at the PEB and he stated that my case was sent back to the VA while it was in the QA Phase. He wouldn't tell me why.

Has anyone experienced something like this before?

This is called a PEB-directed Rating Review ("PDRR") and typically occurs when the rating assigned by the VA to an unfitting condition is clearly incorrect and is usually to the member's benefit. Examples: 1. When either the DBQ or the evidence of record clearly shows that an individual is prescribed immunosuppressant therapy for an autoimmune disorder, but the VA rating decision indicates that a higher rating could not be considered because there was no evidence that the member was on immunosuppressant therapy. 2. When a member has been diagnosed with an eye condition with several specialty visits for treatment, either by ophthalmic procedures or medication adjustment, but the VA discounts some of those visits by characterizing them as being for diagnostic as opposed to treatment purposes- thus dramatically lowering the rating.

Are there times when the PEB sends back a rating decision for review that can adversely impact a member? Yes, it occasionally occurs- typically when the PEB tries to carve out multiaxial ratings and only finds particular aspects of the condition unfitting. Example: When a member receives a relatively high rating for a TBI that is rated in combination with headaches and obstructive sleep apnea, but the PEB does not wish to find the OSA unfitting. If that OSA component to the multiaxial rating resulted in a higher rating than would be merited by the TBI on its own or in conjunction with the headaches. However, this type of PDRR request is rare- most of these requests by the Navy PEB tend to be for the benefit of the member.