LOD issued and VA denied claim

tarain

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I am a reserve member and I was told I'm getting a letter denying a claim for a mental health issue that I have an approved LOD issued for. The reason I am being told its being denied is because I was hospitalized while on active duty for training orders and not on actual active duty orders at the time. I don't understand how they are able to make this claim if the army issued me an LOD.

I am also being processed through IDES and was told to not reply to the letter as its from the local VA office. My MEB has been pending for about 3 yrs and along the way I was told to go to the local va and file a claim because this was going to be the part of my MEB that would take the longest. Well there were two claims one 4/14 and another 8/14 and then my MEB was placed into the system 12/14. This is a total mess. :mad:

What do I do?
 

Ed Mercanti

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The Army operates under Title 10 US Code. The VA operates under Title 38 US Code. Different laws, different rules.
 

scoutCC

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But pretty much the same standard. They have the requirement to make their own determination, but if they didn't receive the same information, they will come to different conclusions. If you can identify when the military decided when the condition first manifested, which is different from the time you were in the hospital, that is the info the VA needs.
 

tarain

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The Army operates under Title 10 US Code. The VA operates under Title 38 US Code. Different laws, different rules.

Ok so what you are saying is the army recognized the issue as service connected but the va does not have to. Go figure
 

Jason Perry

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HALT.....I have written about this before and the law is very clear on this:

"(m) In line of duty means an injury or disease incurred or aggravated during a period of active military, naval, or air service unless such injury or disease was the result of the veteran's own willful misconduct or, for claims filed after October 31, 1990, was a result of his or her abuse of alcohol or drugs. A service department finding that injury, disease or death occurred in line of duty will be binding on the Department of Veterans Affairs unless it is patently inconsistent with the requirements of laws administered by the Department of Veterans Affairs. Requirements as to line of duty are not met if at the time the injury was suffered or disease contracted the veteran was:
  • (1) Avoiding duty by desertion, or was absent without leave which materially interfered with the performance of military duty.
  • (2) Confined under a sentence of court-martial involving an unremitted dishonorable discharge.
  • (3) Confined under sentence of a civil court for a felony as determined under the laws of the jurisdiction where the person was convicted by such court.
    (Authority: 38 U.S.C. 105)"
38 CFR 3.1

They made a HUGE error in your case. Your condition is compensable. PERIOD. You may have to fight it out, but, you will win in the end. They are wrong; you are right.
 

Jason Perry

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PLEASE, PLEASE, PLEASE, Folks who are trying to help (and the vast majority of the time, do help), do not go with your "gut instinct" on replying to posts. Do research, cite bases for your opinions, or don't just state things without support. If you aren't sure (or at least have a basis for your posts, don't post....the stakes are too high here. Consider the basis for comments, if you are not sure, caveat them; it worries me greatly that people post based on instinct with an "authoritative tone" and give erroneous input).
 

tarain

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HALT.....I have written about this before and the law is very clear on this:

"(m) In line of duty means an injury or disease incurred or aggravated during a period of active military, naval, or air service unless such injury or disease was the result of the veteran's own willful misconduct or, for claims filed after October 31, 1990, was a result of his or her abuse of alcohol or drugs. A service department finding that injury, disease or death occurred in line of duty will be binding on the Department of Veterans Affairs unless it is patently inconsistent with the requirements of laws administered by the Department of Veterans Affairs. Requirements as to line of duty are not met if at the time the injury was suffered or disease contracted the veteran was:
  • (1) Avoiding duty by desertion, or was absent without leave which materially interfered with the performance of military duty.
  • (2) Confined under a sentence of court-martial involving an unremitted dishonorable discharge.
  • (3) Confined under sentence of a civil court for a felony as determined under the laws of the jurisdiction where the person was convicted by such court.
    (Authority: 38 U.S.C. 105)"
38 CFR 3.1

They made a HUGE error in your case. Your condition is compensable. PERIOD. You may have to fight it out, but, you will win in the end. They are wrong; you are right.
Jason,

Thank you for taking the time to address my post. I will get back with my DVA rep and press forward with this item.
 

Ed Mercanti

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Sorry Jason. I was in a hurry. You're right. I know that there are times that an approved LOD will not get you certain benefits. Say, for example, a veteran who has an approved LOD and has a dishonorable (or discharge that is considered dishonorable for VA purposes) discharge. The veteran will receive treatment for the condition but not compensation. Or in some cases a disease incurred on less than 30 days of active duty will bestow limited benefits regardless of LOD finding.
 

tarain

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Sorry Jason. I was in a hurry. You're right. I know that there are times that an approved LOD will not get you certain benefits. Say, for example, a veteran who has an approved LOD and has a dishonorable (or discharge that is considered dishonorable for VA purposes) discharge. The veteran will receive treatment for the condition but not compensation. Or in some cases a disease incurred on less than 30 days of active duty will bestow limited benefits regardless of LOD finding.

Ok I am confused now so the reason the VA has declined my claim is because when I was hospitalized For 4 days I was on Active duty for training no title 10 orders. Once the hospital released me my commander amended my AT orders and sent me home. The unit refused to process an LOD until an MEB attorney made contact with them. It was a formal LOD investigation that dreamed the issue is services connected though and yes I was not on title 10 orders for 30 plus days. The medical records from my stay steed that the issue was related to and directly agrivated by my service.
 

Hawkeye99

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In my own case, I was med boarded for a condition that occurred while on training orders and the VA didn't deny me. Who is telling you that is the reason?
 

scoutCC

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Ok I am confused now so the reason the VA has declined my claim is because when I was hospitalized For 4 days I was on Active duty for training no title 10 orders. Once the hospital released me my commander amended my AT orders and sent me home. The unit refused to process an LOD until an MEB attorney made contact with them. It was a formal LOD investigation that dreamed the issue is services connected though and yes I was not on title 10 orders for 30 plus days. The medical records from my stay steed that the issue was related to and directly agrivated by my service.
So the VA has to determine service connection for benefits. You can't be compensated for things that have nothing to do with your service. They clearly did not use the right rules to determine it, same as the military didn't the first time. You have to respond to them and say no, no, this is service connected, and why. The simplest way would be to reference 38 CFR 3.1 and say the Army LOD is binding. Its not that uncommon to have to educate decision makers on a rule by referencing the correct rule. CFR 3.1 gives them only 3 outs to say the Army was just plainly wrong, which obviously won't apply. A simple letter through certified mail would be the route I would take. Me, I'd also walk them through the logic they used in the correct LOD as well, i.e. that the condition didn't start at the hospital, it started during my period of active duty.
 

tarain

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In my own case, I was med boarded for a condition that occurred while on training orders and the VA didn't deny me. Who is telling you that is the reason?
Hawkeye99,

Thank you for your reply.. I was told by the DAV that my claim was denied. The letter should be in the mail decision was made Monday of this week.
 

Drew35

New Member
Registered Member
HALT.....I have written about this before and the law is very clear on this:

"(m) In line of duty means an injury or disease incurred or aggravated during a period of active military, naval, or air service unless such injury or disease was the result of the veteran's own willful misconduct or, for claims filed after October 31, 1990, was a result of his or her abuse of alcohol or drugs. A service department finding that injury, disease or death occurred in line of duty will be binding on the Department of Veterans Affairs unless it is patently inconsistent with the requirements of laws administered by the Department of Veterans Affairs. Requirements as to line of duty are not met if at the time the injury was suffered or disease contracted the veteran was:
  • (1) Avoiding duty by desertion, or was absent without leave which materially interfered with the performance of military duty.

  • (2) Confined under a sentence of court-martial involving an unremitted dishonorable discharge.

  • (3) Confined under sentence of a civil court for a felony as determined under the laws of the jurisdiction where the person was convicted by such court.
    (Authority: 38 U.S.C. 105)"
38 CFR 3.1

They made a HUGE error in your case. Your condition is compensable. PERIOD. You may have to fight it out, but, you will win in the end. They are wrong; you are right.
Jason I was injured 26 years ago in an active duty training accident in the middle of the night. I was with the Army National Guard training with the U.S. Army in Hohenfels, Germany. Our foxhole was run over by a Humvee and logs, dirt and sod buried me alive. I was knocked out for a short time and when I woke up it was pitch black and I couldn't breathe because sod was covering my mouth. I thought I was going to die, but I was able to move one leg which dislodged a log and enabled me to wiggle out. I sustained a head, back and neck injury. A U.S. Army Captain was driving the Humvee and admitted he wasn't using his night vision and did not want to report the accident. I limped to an armored vehicle behind our position and had them call in the accident. When our superiors got there they told us to clean up as best we could and "hold" our position. The next morning I turned in my damaged M16 and was told that a report wasn't necessary and to keep my mouth shut about the accident or it could hurt my chance for promotions are get me an early discharge. So no report was ever written up or medical aid ever given.

I dealt with the back/neck pain and headaches as best as I could over the years, but my symptoms got progressively worse. Due to my injuries I haven't been able to work for the past 5 years. My wife told me to file a VA Claim and see if I could get some assistance.

I did track down the other soldier that was in the foxhole with me and he wrote written testimony that the accident happened, I was buried alive in the foxhole and I did sustain injuries.

I have already taken that letter to 3 treating doctors and they have all wrote Nexus Letters service connecting my injruies based on that written testimony.

Do you think that witness letter and Nexus letters will be enough to service connect me?
 
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