VA Issues Statement of Case, Refuses BackPay. Thoughts?

moneyblind

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Alright, I got a bone to pick now! I just about got done with the appeals process. SOOO CLOSE to a flawless(big picture flawless) VA experience. I received my rating decision yesterday and I was happy to see the finalized 100% rating! What I was NOT happy with was to see the effective dates!

I exited the military on July 29th 2013, Filed for my first appeal with the DAV in August 2013......THE VA PUT THE EFFECTIVE DATES TO THE DATES OF THE C&P's.... The effective date was July 1, 2014..... That is INSANE! According to their rules, since I filed within a year (filed alot sooner) of discharge, the ratings should be effective the date of discharge. (Please correct me if I am wrong)

Not only did the effective date NOT get pushed back to date of discharge, it did not even get pushed back to date of appeal?! What is with that!? It blows my mind to be honest, that the VA blatently ignored 2 of their own rules and forced me to APPEAL AGAIN because the dates are jacked....ughhh.... Backpay is supposed to be about 13k, and I only got allowed 1300.....

Don't get me wrong, I am very thankful for the smooth sailing and the 100% up unto this point, but my god, I was almost out of the woods and done with everything...... Literally.... But the VA put an effective date to the dates of the new C&P's..which took a year to get...because of the VA and not me...instead of the correct date of discharge...

So to cap it off,

What are my options?
Am I forced to go through another year of appeals just to get the backpay?
Why would the VA even do that? I could see the VA accidentally putting the effective date to the date of appeal...that makes sense, but putting it to the date of the C&Ps...that makes no sense.

I would love if one of our legal experts chimed in as this is in depth of appeals and it seems Appeals information is lacking.
 

Jason Perry

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Seems like you have a meritorious case as to an earlier effective date. (Only question or potential issue I could see- though in my opinion, it should not change the outcome- is whether you were a reservist. Also, did you have a previous claim for VA compensation?).

Yes, you will have to do an appeal. File a Notice of Disagreement and, it would probably make sense to request Decision Review Officer (DRO) review.

My guess is that someone just made an error and this should be sorted out pretty quickly. I could be wrong, though.

Best of luck in getting this last issue sorted out.
 

FloridaInjuredInCombat

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Seems like you have a meritorious case as to an earlier effective date. (Only question or potential issue I could see- though in my opinion, it should not change the outcome- is whether you were a reservist. Also, did you have a previous claim for VA compensation?).

Yes, you will have to do an appeal. File a Notice of Disagreement and, it would probably make sense to request Decision Review Officer (DRO) review.

My guess is that someone just made an error and this should be sorted out pretty quickly. I could be wrong, though.

Best of luck in getting this last issue sorted out.

Jason,

Not to that point in my travels yet, but could you please expand on why the rules would be different for the National Guard or Reserves?

In my case, I filed initially for VA benefits for the injury in July 2013, was entered into the SSMRB/MEB/PEB process (as a drilling Guardsman) in September 2013, had my C&P exams in June/July of 2014, and I am starting the PEB portion of the Army IDES now. It (was) my understanding that my VA benefits, once rated, and most likely appealed (given their AFU'ed C&P exams the first time) I would (eventually) have my benefits retroactively paid back to July of 2013.

How does being a Guardsman affect that?

As always, thank you so much for the guidance,
SSG Florida Guard
 

Jason Perry

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Jason,

Not to that point in my travels yet, but could you please expand on why the rules would be different for the National Guard or Reserves?

In my case, I filed initially for VA benefits for the injury in July 2013, was entered into the SSMRB/MEB/PEB process (as a drilling Guardsman) in September 2013, had my C&P exams in June/July of 2014, and I am starting the PEB portion of the Army IDES now. It (was) my understanding that my VA benefits, once rated, and most likely appealed (given their AFU'ed C&P exams the first time) I would (eventually) have my benefits retroactively paid back to July of 2013.

How does being a Guardsman affect that?

As always, thank you so much for the guidance,
SSG Florida Guard

While I haven't looked closely at this issue (meaning that I will not state that I am unequivocally right- but I think I am) there is language in the M21-1MR, Part III, Subpart i, Chapter 2, Section D regulation that concerns me- especially about closing out cases previously filed and parts about effective dates and transfers of cases to Regional Offices of Jurisdiction. My concern is not with the substance of the date of entitlement under the regulations. It is, rather, that by closing out cases and/or transferring them, that RO's who are not "paying attention" may use an erroneous date- and perhaps consider claims as being "original claims" rather than claims that are considered made as of the date that would normally issue from the IDES process.

Two points- I was speculating about a "potential source of errors" in determining effective dates of entitlement, and without specific facts and circumstances from specific cases, it is pure conjecture about what "might happen." Still, I have my concerns about the case processing, especially for RC members- which from the M21-1MR, Part III, Subpart i, Chapter 2, Section D (and as pointed out in my "Jabberwocky" post) relies on many different systems working together, but that don't communicate with each other).
 

FloridaInjuredInCombat

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While I haven't looked closely at this issue (meaning that I will not state that I am unequivocally right- but I think I am) there is language in the M21-1MR, Part III, Subpart i, Chapter 2, Section D regulation that concerns me- especially about closing out cases previously filed and parts about effective dates and transfers of cases to Regional Offices of Jurisdiction. My concern is not with the substance of the date of entitlement under the regulations. It is, rather, that by closing out cases and/or transferring them, that RO's who are not "paying attention" may use an erroneous date- and perhaps consider claims as being "original claims" rather than claims that are considered made as of the date that would normally issue from the IDES process.

Two points- I was speculating about a "potential source of errors" in determining effective dates of entitlement, and without specific facts and circumstances from specific cases, it is pure conjecture about what "might happen." Still, I have my concerns about the case processing, especially for RC members- which from the M21-1MR, Part III, Subpart i, Chapter 2, Section D (and as pointed out in my "Jabberwocky" post) relies on many different systems working together, but that don't communicate with each other).

Jason,

Sounds clear as mud to me, but I'm guessing that there "might" be a problem in that my original claim filed with the VA (July 2013) was on a different track (for lack of a better term) than the one that was initiated (around March 2014) through the IDES system.

When first contacted by my PEBLO, she said the Army was initiating a "new" claim through the VA to be used for the Army's MEB/PEB process, and that two of the differences would be "it would travel 'faster' through the VA system" and "it would go to Washington State for the rating". My guess is that by starting the process over, that by not talking to or seeing the other claim already filed, the VA might erroneously enter a wrong claim start date. If that does happen, I have my VA letter showing my claim date to be July 2013, and will (eventually) be compensated accordingly.

Is that the gist of it?

Thanks again,
SSG Florida Guard
 

Jason Perry

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Jason,

Sounds clear as mud to me, but I'm guessing that there "might" be a problem in that my original claim filed with the VA (July 2013) was on a different track (for lack of a better term) than the one that was initiated (around March 2014) through the IDES system.

When first contacted by my PEBLO, she said the Army was initiating a "new" claim through the VA to be used for the Army's MEB/PEB process, and that two of the differences would be "it would travel 'faster' through the VA system" and "it would go to Washington State for the rating". My guess is that by starting the process over, that by not talking to or seeing the other claim already filed, the VA might erroneously enter a wrong claim start date. If that does happen, I have my VA letter showing my claim date to be July 2013, and will (eventually) be compensated accordingly.

Is that the gist of it?

Thanks again,
SSG Florida Guard
That is a possibility- what you described possibly happening- and that is my concern, that given the various "moving parts" (for want of a better term) that VA could make an error in assigning the correct date of entitlement. The good news is that the correct date of entitlement should be (fairly) easy to clear up.

Much of this is based on speculation. But, once you appeal/NOD, the facts should become much clearer.
 

moneyblind

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PEB Forum Veteran
Seems like you have a meritorious case as to an earlier effective date. (Only question or potential issue I could see- though in my opinion, it should not change the outcome- is whether you were a reservist. Also, did you have a previous claim for VA compensation?).

Yes, you will have to do an appeal. File a Notice of Disagreement and, it would probably make sense to request Decision Review Officer (DRO) review.

My guess is that someone just made an error and this should be sorted out pretty quickly. I could be wrong, though.

Best of luck in getting this last issue sorted out.

Jason,

I was not reservist, I was active duty; However, reading through your dialogue I must say that the case was transferred from Rhode Island RO to Muskogee RO to do this. I know it was probably a mistake, but frustrating mistake to say the least.

I have filed an NOD to that affect, another DRO with explicit instruction to set the date to date of discharge should know what to look for in regards to the situation, I hope at least. I filed a NOD with the DAV on the issues that received the rating decisions and caused all of this. However, I got with a local lawyer to give my case a once over to make sure its all correct and they filed a separate NOD in December (Attempting to get the back rated better, increasing likelyhood for P&T...at least that is my wish). This NOD apparently got combined with the first at the RO.

Do you believe it will be a full length appeal (The previous appeals took almost a year on the dot.) Or since it is a VA administrative error and not compensation based it could be put in another, shorter, pile? (I am trying to hammer out an expectation rather than the short/long time generalities.)

Thanks a bunch for your help sir!
 
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Jason Perry

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I wouldn't hazard a guess as to the timeline. Too many variables and too many folks who could impact timing based on various factors. Hope it goes quickly and accurately.
 

moneyblind

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I wouldn't hazard a guess as to the timeline. Too many variables and too many folks who could impact timing based on various factors. Hope it goes quickly and accurately.

Thanks sir!

E-benefits is officially showing the latest appeal...along with the second appeal still open and the first one in UNKNOWN status (SOC not an official status lol)
 

danieldresen

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If you were to go crazy you might get faster results... I got a really bad letter that nearly drove me over the edge so I made phone calls... left a message even to the white house. Needless to say, my claim to add my dependants to my previous claim while my current claim is still in the process went from Received (08/29/2012) to Complete. That is a decent chunk of back pay that will help my gap and brings a little ray of light again into this whole... in limbo phase. Voc Rehab, EDD, and SS need to get together and figure out what DISABLED is and ABLE TO WORK is... I have social security saying I am able to work while EDD and Voc Rehab say no.
 
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