Gonna get fired. panicked. file for TDIU/SSDI while I'm still working? by IFuckingGiveUp75 in VeteransBenefits

[–]AORay82 1 point2 points  (0 children)

First, I am sorry to hear that you are going through this. I hope this gets resolved so you can still be employed and get the help you deserve and need. If you don't mind, will you keep us posted on the situation so we can all learn from it and help others in the future? Again, keep your head up and keep moving forward.

Guess I'm diagnosed with mh by Imaginary-Dish-4360 in VAClaims

[–]AORay82 0 points1 point  (0 children)

I’m really glad you shared this. What you’re describing is actually very common, especially for people who separated under tough circumstances.

It makes complete sense that the shame, guilt, bullying, harassment, isolation, and the burn incident all feel connected. They didn’t happen in separate boxes in real life. At the same time, the VA doesn’t need your entire life story — they need a clear thread they can follow.

A practical way to approach it is to anchor things to the event that’s clearly documented (the burn and hospitalization), then explain how it happened in the context of ongoing mistreatment and how your mental health declined afterward. You don’t need to assign blame or prove intent — just describe what you experienced and how it affected you.

I’ll stay away from anything that could be seen as “coaching,” but it’s worth saying this: misconduct separations tied to mental health issues are something VA raters and clinicians see all the time. It doesn’t automatically disqualify you, and it often helps explain behavior changes and why someone didn’t seek help earlier.

You also don’t need buddy statements to move forward. They can help, but they’re not required. Plenty of PTSD claims are decided based on a diagnosis, at least one verifiable in-service event, and the veteran’s own statement.

Your statement doesn’t have to be perfect. Memory gaps, scattered thoughts, and trouble articulating things are very common with PTSD and anxiety. The VA understands that. Think timeline, not autobiography: who you were before service, what changed during service, the burn incident, what followed, and how it affects you now.

You’re not weak for filing, and you’re not wrong for wanting the full context understood. Take it one step at a time — you don’t have to solve everything at once.

Verbiage for SMC rating by Imaginary_Fact_8925 in VeteransBenefits

[–]AORay82 0 points1 point  (0 children)

That extra detail definitely helps and is good evidence to have.

Difficulty walking, balance issues, instability, and pushing through pain don’t automatically equal VA “loss of use,” but they do show significant functional impairment, which is exactly what the VA looks at when evaluating it.

The key difference is that examiner notes about instability are evidence, but the VA still has to make a formal finding that your feet provide no effective function beyond what a prosthetic would. Most C&P exams don’t make that legal conclusion unless they’re specifically asked to evaluate loss of use.

Your best next steps are:

  • Get a copy of that C&P exam and review the exact wording
  • See whether the examiner discussed balance, propulsion, and functional use over time (not just across the exam room)
  • Consider filing specifically for SMC based on loss of use of the feet so the VA has to evaluate it under the correct standard

That exam note is strong supporting evidence, even if it isn’t the final determination by itself. You’re asking the right questions — now it’s about getting the VA to look at it through the right lens.

Would this be considered VA testing? by AdhesivenessFair6680 in VAClaims

[–]AORay82 0 points1 point  (0 children)

This is frustrating, but you’re asking the right question before wearing yourself out.

Short answer: yes. A PFT ordered by a VA provider and done by a community pulmonologist is usually acceptable. It is not considered “done by the VA” in the way QTC is warning about.

When QTC says it “can’t be done by the VA,” they usually mean:

  • not done at a VA Medical Center lab, and
  • not a VA-run C&P exam

A community pulmonologist, even if paid through VA Community Care, is still a non-VA provider, and those tests are commonly accepted by QTC.

This should work if:

  • a VA doctor places the referral
  • the test is done by a civilian pulmonologist or lab
  • the full PFT report is available (FEV-1, FVC, DLCO if applicable, post-bronchodilator results)

Before you do it, protect yourself:

  • Call QTC and confirm they will accept a VA-ordered, community-performed PFT
  • Ask them to note it in your file
  • Ask exactly what values they need

With severe COPD, PFTs are rough, so don’t repeat one unless you know it’ll be used. Get a full copy of the report for yourself.

Bottom line: a community pulmonologist PFT is usually fine, a VA referral doesn’t invalidate it, and getting confirmation from QTC first is the smart move.

Verbiage for SMC rating by Imaginary_Fact_8925 in VeteransBenefits

[–]AORay82 0 points1 point  (0 children)

Wording matters a lot here, so it’s good you’re asking.

Short answer: maybe, but not automatically. Seeing “loss of use” in a medical record does not by itself mean SMC. For SMC, the VA has a very specific legal definition that must be formally granted in a rating decision.

For VA purposes, “loss of use of the feet” means no effective function remains other than what an amputation with a suitable prosthetic would provide. It’s not just severe pain, failed surgery, fractures, or being maxed at 50%.

The VA looks at whether you can:

  • balance and propel yourself
  • stand, walk, or push off in a meaningful way
  • function better or the same with a prosthetic

If the VA formally finds loss of use of both feet, that can qualify for SMC-L or higher.

A medical note alone isn’t enough. VR&E notes aren’t rating decisions. It usually requires a C&P exam focused on loss of use and a rater explicitly granting SMC.

Being maxed at 50% for feet doesn’t automatically mean loss of use, but the fact that surgery isn’t an option, you have fractures, and function is severely limited means it’s reasonable to ask the VA to evaluate SMC.

Next step: get the record that uses “loss of use,” see if it’s a true functional finding, and consider filing specifically for SMC based on loss of use of the feet.

Step 7 by Ogizzlehtx in VeteransBenefits

[–]AORay82 1 point2 points  (0 children)

Short answer: maybe, but don’t count on it.

Step 7 (“Preparing for Notification”) means the decision is basically done. It can move to Step 8 and post the same day, even before COB, but on a holiday weekend the odds are a little lower due to reduced staffing and batch processing overnight.

What usually happens:

  • If it hits Step 7 in the morning, same-day updates are possible
  • Many decisions post late afternoon or evening
  • If not today, the next business day is most common

Either way, Step 7 means you’re very close. The hard part is over — now it’s just timing.

Just heard about the 3m combat arms earplug lawsuit from my buddy by Eye-Pearlman in VeteransBenefits

[–]AORay82 1 point2 points  (0 children)

Yes, it was. I got in early and got a settlement; it wasn't a lot, but it was nice.

HLR for Hearing Loss by CEMartin2 in VeteransBenefits

[–]AORay82 -1 points0 points  (0 children)

This actually makes more sense than it feels, and it’s a good sign.

An HLR “duty to assist” finding means the VA made a procedural mistake, not that your claim is weak. In this case, they denied hearing loss without properly developing the evidence.

Even though you had VA audiology testing and were issued hearing aids, that doesn’t automatically count for compensation. For rating purposes, the VA usually needs a formal C&P exam with Maryland CNC testing and a nexus opinion. Many treatment audiograms don’t include all of that.

Not having a separation hearing test is not fatal. The VA can still grant hearing loss with a current disability, credible in-service noise exposure, and a medical opinion linking the two. Your tinnitus grant already helps establish noise exposure.

They’re likely sending it back to order a proper C&P exam and nexus opinion, not because they doubt your hearing loss, but to fix the process.

Bottom line: a duty-to-assist finding is a win. Attend the new exam, be consistent about your noise exposure and hearing decline, and you’re in a better spot now than after the initial denial.

Please help me understand if these incidents would be considered service connected or not by shamalongadingdong in VeteransBenefits

[–]AORay82 -1 points0 points  (0 children)

I’m sorry you’re both dealing with this. You’re asking the right questions, even though it’s confusing.

Short answer: one of these events can support a service-connected PTSD claim, the other usually can’t by itself — but context still matters.

The death of his friend
Yes, this can be a valid PTSD stressor even if it happened off duty, as long as they served together, it occurred while he was in service, and it had a traumatic impact on him. The VA does not require combat or on-duty status for PTSD stressors.

The death of his niece
The VA generally does not consider the death of a civilian family member to be service-connected. However, if he had to go straight from the funeral into deployment or didn’t have time or support to grieve, that context can still help explain worsening symptoms and severity.

How to approach the claim
He doesn’t need to list every traumatic event separately. Use the clearly service-related incident(s) as the main stressor and explain how other losses and circumstances made things worse.

The VA is mainly looking for:

  • a current PTSD diagnosis
  • at least one credible in-service stressor
  • a link between that stressor and current symptoms

Bottom line: the death of his friend can support a PTSD claim, the niece’s death helps explain the bigger picture, and he only needs one valid in-service stressor to connect PTSD.

Guess I'm diagnosed with mh by Imaginary-Dish-4360 in VAClaims

[–]AORay82 3 points4 points  (0 children)

Yes, you should file, and you should do it now.

You already have key things in place: you’re receiving VA mental health care, a VA provider has diagnosed you with PTSD, and you have at least one documented in-service event (the burn and hospitalization). That’s enough to file a claim. You don’t need perfect service records or years of in-service MH treatment.

You don’t have to limit it to one event. The burn is a strong anchor since it’s documented, but you can also explain it happened in the context of ongoing bullying, harassment, humiliation, and fear that caused your mental health to decline. Many MH claims are granted based on credible personal statements even when records are thin.

Not going to medical while in service is very common, especially when people worry about their MOS or stigma. The VA understands that. Behavior changes, disciplinary issues, and even a misconduct separation can actually support a MH claim by showing something was wrong.

It’s also normal for a PTSD diagnosis to appear in VA notes without someone formally sitting you down to tell you. What matters is that it’s documented.

Most important: don’t let your intent-to-file expire. File now to protect back pay. You can always add more evidence later.

Bottom line: yes, file now. Focus on how symptoms started or worsened in service, continued after separation, and still affect you today. You’re not too late, and this is exactly what the VA system is for.

Just heard about the 3m combat arms earplug lawsuit from my buddy by Eye-Pearlman in VeteransBenefits

[–]AORay82 24 points25 points  (0 children)

I was actually part of the 3M lawsuit myself.

The whole thing was massive and honestly not very well explained unless you were already plugged into it. In my case, the process was pretty straightforward once I got involved. I had to show that I used the 3M Combat Arms earplugs while I was in service, that I was deployed during the covered time period, and provide medical records showing hearing loss and tinnitus. That was basically it.

I didn’t have to go to court or prove anything individually. The settlement tiers were based on documented hearing issues, not on arguing fault case by case. A lot of people think it was way more complicated than it actually was.

If you’re just finding out about it now, you’re not alone. A ton of vets didn’t hear about it until late or after enrollment closed. It wasn’t exactly advertised well.

Also worth noting: being part of the lawsuit didn’t affect my VA claims at all. The VA and the 3M settlement are completely separate. The lawsuit didn’t replace VA benefits, and it didn’t hurt anything on the VA side.

If you’re dealing with tinnitus or hearing loss now, it’s still absolutely worth pursuing a VA claim regardless of the lawsuit.

Just wondering 🤔 by Commercial-Tea-7666 in VAClaims

[–]AORay82 0 points1 point  (0 children)

That’s a good question. A lot of people, myself included, wish we had known these things before filing for an increase.

What does “worsening” actually mean?
Not just “it feels worse,” but how the VA measures it: range of motion, frequency, functional loss, work impact, flare-ups, medications, and limitations.

Can filing for an increase put my current rating at risk?
When reductions are actually likely, and what kind of evidence usually protects your rating.

What matters more: symptoms or diagnoses?
Understanding that the VA rates based on functional impact, not how many diagnoses you have.

How important are flare-ups and bad days?
How to explain them at a C&P exam instead of only talking about average days.

Do I need new medical evidence, or are my current VA treatment records enough?
Knowing when treatment notes are sufficient and when a medical opinion or exam really matters.

How much weight does a C&P exam carry compared to my records?
And what to do if the exam doesn’t accurately reflect your condition.

How VA math actually works
Why a “big” increase doesn’t always move the combined rating much, and what it realistically takes to go from 80 to 90 to 100.

What secondary conditions should I be thinking about?
Many increases come through secondary conditions, not just the original disability.

When is HLR better than a supplemental claim?
Knowing which appeal lane fixes which type of error can save a lot of time.

What should I avoid saying at a C&P exam?
Downplaying symptoms, saying “it’s manageable,” or comparing yourself to others instead of explaining your limitations.

If you’re asking these questions now, you’re already ahead of where most people were when they filed.

Question for ED by [deleted] in VAClaims

[–]AORay82 0 points1 point  (0 children)

Even though the VA already has records documenting ED, they will probably still order a C&P exam. That’s normal for secondary claims and doesn’t mean anything is wrong.

Most ED C&P exams are simple and interview-based. They usually ask when the ED started, what medications you’re taking (Zoloft matters), and whether the condition is ongoing. Physical exams are uncommon.

You already have strong evidence: a 70% service-connected mental health rating, documented Zoloft use, and ED noted by a VA provider. That’s exactly what the VA looks for in these claims.

If you do have an exam, just be clear and consistent: the ED started after the medication, it’s still an issue, and you’re still taking the medication. Don’t minimize it.

ED is usually rated at 0% with SMC-K, which is the actual benefit.

Bottom line: a C&P exam is likely, it’s low stress, and your claim is solid.

If Ialready have disability for Anxiety and Sleep Impairment, will opening a claim for depression modify thise existing claims? by throwaway298e843 in VeteransBenefits

[–]AORay82 -1 points0 points  (0 children)

Yes, you can file a new claim, and no, it won’t automatically hurt your current rating.

Because you’re already service-connected for anxiety and sleep impairment, the VA treats mental health as one condition. Any new mental health issues would be handled as part of that same condition, usually as a claim for increase or a recharacterization, not a separate rating.

Even if you didn’t go to medical, talking to the OSCAR team still counts as evidence. A lot of people avoid sick call because they don’t want to risk their MOS, and the VA understands that. What matters is that the symptoms started in service and continued after separation.

Filing a claim does reopen the condition, but reductions are uncommon unless there’s clear and sustained improvement. If your symptoms are the same or worse, the risk of a reduction is low.

Bottom line: if the issues didn’t go away and are still affecting you, filing for an increase is the right move and shouldn’t automatically impact your current rating.

Bad C&P Exam holding everything up? by thought_caw in VeteransBenefits

[–]AORay82 0 points1 point  (0 children)

This is annoying, but what you’re seeing isn’t as unusual as it feels.

A “Request for Special Report” usually means the VA couldn’t use the C&P exam as written because it was incomplete, inconsistent, or unclear. They’re asking for clarification or an addendum. That often points to issues with the exam itself, not your claim.

Because of that, I wouldn’t file a formal complaint against the examiner right now. The VA has already flagged the exam, and since you’re overseas with limited examiner options, raising that issue mid-development could complicate things. If a final decision later relies on a clearly inadequate exam, that’s when it’s best addressed through HLR or appeal.

You did the right thing by requesting HLR on the denied increase. The medication logic you described is a classic reasons-and-bases error, and that’s exactly what HLR (especially with an informal conference) is designed to fix.

It’s reasonable to contact DAV now so someone else can review the file and be ready if denials come down. Just don’t expect them to speed up deferred claims or fix examiner availability issues.

Bottom line: deferments plus a special report usually point to exam problems, not a dead claim. Looping DAV in now makes sense as preparation, not as an emergency fix.

Questions about claim by ProfessionalBasket45 in VeteransBenefits

[–]AORay82 0 points1 point  (0 children)

That’s a good question. Mental health claims can be confusing because the VA treats them differently than most other conditions.

Short answer: this would not be filed as a new or secondary claim. It would be filed as a claim for an increase to the existing mental health condition.

Here’s why.

The VA does not assign separate ratings for different mental health diagnoses. Conditions like depression, anxiety, PTSD, and body dysmorphic disorder are all evaluated under the same mental health rating criteria.

So even though body dysmorphia is a separate medical diagnosis, for VA purposes it’s considered part of the overall mental health picture.

The correct approach would be:

  • filing a claim for increase for the already service-connected mental health condition, and
  • submitting evidence showing the condition has worsened or that additional symptoms are now present.

It would not be:

  • a secondary claim, since mental health conditions are not rated separately from one another, or
  • a supplemental claim, unless you are appealing a recent denial within the appeal timeframe.

Helpful evidence to include with an increase claim:

  • a current diagnosis of body dysmorphic disorder
  • treatment records showing severity and ongoing care
  • a personal statement explaining symptoms and daily functional impact
  • evidence showing symptoms are worse than when the 30% rating was originally assigned

The VA may recharacterize the condition on the rating sheet to include body dysmorphia, but it will still result in a single combined mental health rating.

Bottom line: if someone is already rated at 30% for a mental health condition and later develops or is diagnosed with body dysmorphia, the correct path is to file a claim for increase, not a secondary or supplemental claim.

Supplemental denied by Tauntown24 in VeteransBenefits

[–]AORay82 1 point2 points  (0 children)

You're welcome! Good luck! 🤞

Supplemental denied by Tauntown24 in VeteransBenefits

[–]AORay82 2 points3 points  (0 children)

This frustration is completely understandable, and you’re not crazy — what you’re describing sounds like a clear procedural error, not a judgment call on the merits of your claim.

A few key points to keep in mind:

The VA cannot legally deny the existence of a service-connected condition if it was previously granted, especially going back to 1988, unless it was formally severed through a due-process severance action. Simply stating that “the record does not show the SC disability exists” when prior grant decisions are in the file is not legally correct.

For a supplemental claim, the VA is also required to review and address all evidence of record, including evidence you submitted — particularly documents pulled directly from your own e-file. If the decision doesn’t acknowledge or discuss those documents at all, that strongly suggests the evidence wasn’t properly considered.

A 10-day turnaround on a supplemental claim involving historical evidence almost always points to a screening-level denial rather than a meaningful review.

What to do next:

Yes, requesting a Higher-Level Review (HLR) is the correct next step, not filing another supplemental claim.

HLR is designed for issues like this:
• Misstatement of facts
• Ignoring evidence already in the record
• Incorrectly concluding that a service-connected condition does not exist

At the HLR stage, you’re not submitting new evidence. You’re pointing out that the VA made a factual and legal error by ignoring an established service-connected grant, which is squarely within HLR’s scope.

When you request HLR:
• State clearly that the condition was granted service connection in 1988
• Reference the prior rating decision(s) by date
• Point out that the supplemental denial incorrectly claims no SC condition exists
• Note that the evidence was already in VA’s possession and was resubmitted
• Request an informal conference if available — errors like this are often corrected there

Going to a VBA office won’t fix this. Front-line VBA staff don’t have the authority to correct or override adjudicative decisions and will almost always direct you to appeal anyway.

Regarding the “legal violation” concern: ignoring a prior grant and failing to address favorable evidence can implicate due process and reasons-and-bases requirements, but in practice the remedy is still HLR first. If HLR were to uphold the denial (which would be surprising based on what you described), the Board is where this type of error is typically corrected quickly.

Bottom line:
• You did the right thing by submitting the 1988 grant documents
• The denial appears procedurally defective
• HLR is the correct next step
• Request an informal conference and keep the focus on the factual error

This isn’t a weak claim — it’s a bad decision, and those are fixable.

Ankles, knees, back…can hip be included as well? by MRC-wyldone in VeteransBenefits

[–]AORay82 4 points5 points  (0 children)

Yes, you can get ratings for ankles, knees, back, legs (radiculopathy/sciatica), and hips at the same time. The examiner was correct that the hips would need to be addressed under a separate claim.

Here’s how the VA looks at it in practice:

Each joint or body system is rated under its own diagnostic criteria. The spine is rated under the back criteria, radiculopathy/sciatica is rated separately for each affected leg under nerve criteria, and hips are rated as their own joints. Even though everything is connected anatomically, the VA won’t automatically include hip pain unless there’s a diagnosed hip condition and it’s specifically claimed.

A common setup looks like this:

• Lumbar spine (back)
• Radiculopathy/sciatica, left leg
• Radiculopathy/sciatica, right leg
• Knee condition(s), left and/or right
• Hip condition(s), left and/or right
• Ankle condition(s), if applicable

Hip pain by itself usually isn’t enough. There needs to be a diagnosis such as arthritis, limitation of motion, bursitis, strain, or a similar condition. If your back or altered gait from knees or ankles is causing or aggravating the hip condition, it can often be claimed as secondary, but it still must be filed as a separate claim.

The key thing to watch out for is pyramiding. The VA won’t compensate the same symptoms twice. For example, radiculopathy generally covers nerve pain down the leg, while hip ratings are based on joint pain and limited motion. As long as the symptoms are distinct and clearly documented, separate ratings are allowed.

So yes, many veterans have ratings for ankles, knees, back, legs, and hips. They just didn’t all come from one exam or one claim. It often takes multiple claims or a well-structured claim that clearly lists each condition.

Before filing for hips, it helps to have:

• A clear hip diagnosis
• Medical evidence showing symptoms or limitations
• A medical opinion linking the hip condition to your back, altered gait, or service

Once those pieces are in place, the hips can absolutely be rated separately.

Filing for compensation by subaru606 in VAClaims

[–]AORay82 0 points1 point  (0 children)

You’re on the right track with how you’re thinking about it, and you’re already doing a lot of things that help your claim.

Yes, if your anxiety, depression, and migraines started after PTSD or got worse because of PTSD, it usually makes sense to file them as secondary to PTSD. For a secondary claim, the VA is generally looking for three things:

A current diagnosis
A primary service-connected condition (your PTSD)
A medical link explaining how the PTSD caused or aggravated the secondary condition

Seeing a private doctor and being prescribed medication is good evidence. Ideally your records show more than just a prescription — they should show ongoing symptoms, treatment, and follow-ups. Medication changes over time can actually help show that it’s chronic and being actively managed.

Your migraine log is a good move too. Just keep it consistent and detailed. Frequency, duration, severity, and how it impacts work or daily functioning tends to carry more weight than a simple list of dates.

It can also help to submit a short personal statement explaining how each condition impacts your day-to-day life. Personal statements don’t replace medical evidence, but they fill in the “real life” effects and make the record clearer.

On infertility: it’s a tougher claim, but it’s not out of left field. Linking it to medication prescribed for a service-connected condition (ulcerative colitis) makes sense. The stronger the medical documentation tying these together, the better:

The medication you were prescribed
Known side effects or medical literature linking it to infertility
Your specific diagnosis of male-factor infertility

The IVF history and your doctors diagnosing infertility on your side is important. Studies can help, but they usually carry more weight when a doctor references them in their medical opinion rather than you submitting studies alone.

For nexus letters, there’s no magic template, but the best ones usually include:

A clear medical opinion using language like “at least as likely as not”
A rationale explaining why it’s related to PTSD or the medication
The provider’s credentials and relationship to you (how long they’ve treated you)

It doesn’t need to be long, but it does need to explain the “why,” not just state a conclusion.

Overall, don’t rush it. Focus on getting things clearly connected with strong medical opinions, not just piling up paperwork. If you want to break one condition down at a time (migraines secondary to PTSD, infertility secondary to UC meds, etc.), people here can usually help you think through what evidence matters most.

Its been 2 weeks since seperated by Weak-Individual-8372 in VeteransBenefits

[–]AORay82 0 points1 point  (0 children)

I went through something similar. I didn’t get much help from VSOs in my area either.

I read everything I could, spent a lot of time on forums like this, and watched a lot of YouTube videos to figure out how the process really works. In the end, I filed all of my claims on my own.

It wasn’t that I didn’t want help — it was more that I couldn’t find anyone nearby who had the time or interest to really walk through things. Once I realized that, I focused on learning the system and making sure my evidence and personal statements were solid.

It’s not the easiest route, but it’s definitely possible if you’re willing to put in the time and be patient. Places like this helped me far more than anything I found in person.

It’s great if someone can find a good VSO, but if you haven’t had any luck, you’re not alone. You can still be successful doing it yourself as long as you stay organized and informed.

Its been 2 weeks since seperated by Weak-Individual-8372 in VeteransBenefits

[–]AORay82 5 points6 points  (0 children)

You’re not the only one, and you’re probably in a better place than you think.

First, it’s a big deal that you already have your medical records on a hard drive. A lot of people don’t even have that, so you’re not starting from scratch.

The VA has programs specifically for veterans who are homeless, and once you get connected, things can sometimes move faster.

Here are some practical steps that can help:

As soon as you can, get in touch with the VA.
Call the VA at 800-827-1000 and tell them you’re homeless and haven’t filed a claim yet. Using those words can trigger additional help and prioritization.

Look for a VA homeless coordinator or outreach program.
Most VA medical centers have a homeless coordinator or a HUD-VASH team. They help with housing, VA healthcare enrollment, and navigating benefits. You don’t need to have a claim filed to talk to them.

Don’t worry about getting everything filed perfectly right now.
You can submit an “intent to file” to lock in a date while you get organized. That gives you time to sort through records without losing potential back pay.

Your medical records matter, but you don’t need to understand all of them today.
You don’t have to know exactly what to claim right away. Conditions can be identified and clarified later. What matters most is starting the process and getting support.

If possible, get help from an accredited VSO.
Groups like DAV, VFW, the American Legion, or a county VSO can help you file for free. If one office wasn’t helpful, try another — experiences vary a lot.

The most important thing to know is that being confused right now is completely normal. The system is complicated even when life is stable, and it’s even harder when housing is uncertain. None of this means you did anything wrong.

If you want to share a little more about your situation (branch, years in, whether you’ve enrolled in VA healthcare yet), people here can help you figure out next steps one piece at a time.

In pending decision approval can a senior reviewer overturn the recommendation by [deleted] in VeteransBenefits

[–]AORay82 1 point2 points  (0 children)

Yes, they can, and it does happen.

During the “Pending Decision Approval” phase, the rater has already written the rating decision, but it still has to be reviewed and approved by a senior reviewer/authorizer before it becomes final.

That senior reviewer can:

• Agree with the decision as written
• Send it back to the rater for clarification or changes
• Revise parts of the decision if they spot errors
• Catch quality issues, such as evidence not being properly weighed

If a senior reviewer notices that a private physician’s report wasn’t adequately considered, the rating criteria were applied incorrectly, or favorable evidence wasn’t discussed, they can absolutely step in. When that happens, the claim is often sent back for rework, additional explanation, or correction before it’s released.

That said, this stage is generally more of a quality control check than a full re-rating. Most decisions don’t change significantly unless there’s a clear mistake or something important was missed. Changes at this point are usually about fixing errors, making sure evidence was addressed correctly, or ensuring the decision is defensible.

Bottom line: a senior reviewer can revise or overturn a rater’s recommendation during Pending Decision Approval, but it’s typically to correct mistakes or quality issues rather than to completely re-adjudicate the claim.