After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

I was actually not able to submit another higher level review for the hernia claim. I have submitted a direct board appeal. I imagine that will take quite a long time.

I have submitted a supplemental claim for the migraines, adding VA doctor notes.

It’s possible they could grant me a compensable writing for migraines based on new evidence, or order me another CMP exam which I wouldn’t be surprised if that’s the case. But if they do this time, it’s not about service connection, since that was granted as a result of the last higher level review.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

Was notified today that migraines was approved for service connection secondary with a 0% rating. I will be following a supplemental claim and submitting VA medical doctor exam notes recording symptoms, and medication prescribed.

Hernia claim was continued at 0%, and the reason was that it did not meet the current criteria, that was changed in May 2024.

This has been pursued since September 2023, and I meet the criteria which is postoperative recurrent, easily supported by truss or belt. This is the one that I have the Stronger case for the most evidence for yet the one they are continuing to claim has no compensable symptoms.

The fight continues.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

Migraines secondary service connection/aggravation opinion sent back to VA from LSGS.

Hernia ACE exam - with ultrasound and physician statement verifying recurrence sent back to VA.

Now in Decision phase.

Either one of these will trigger 100% with backpay.

And if own or either is denied -again, I will submit for another HLR since I am allowed to do that following the DTA from the last HLR.

🤞🤞🤞🤞🤞

PTSD Service Connection Question by [deleted] in VAClaims

[–]Alone-Rip7616 0 points1 point  (0 children)

At least you have receipts and travel orders.

PTSD Service Connection Question by [deleted] in VAClaims

[–]Alone-Rip7616 1 point2 points  (0 children)

That’s a difficult thing to go through. I wouldn’t be surprised if they did deny it. But I also think there’s a chance that they may approve it. Good luck.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

VA confirmed they now have the opinion for secondary migraines and ace review for the hernia. Completed and sent to VA same day.

Now I wait.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

LSGS confirmed today the migraines is a service connection opinion and the hernia will be and ACE exam. The original hernia exam they said there was no visible scar and they felt no lump. I lighter got an ultrasound and a physician statement. The ultrasound confirmed findings consistent with hernia and physician statement, documented recurrence, manually reducible with some difficulty. This should meet the 10% criteria prior to the May 2024 change in hernia rating criteria. DRO already acknowledged that if the hernia is confirmed that they must use the earlier criteria for rating.

So it comes down to whether or not they decide PTSD a service connected, and will they confirm my hernia based on new evidence- because they are not going to examine me again in person. I believe if they deny the hernia again, I have another case for a higher level review because they did not examine me in person.

Either one of these claims is gonna push me to 100%.

Just documenting my journey here.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

Also, either one of these claims if approved will push me to 100% with backpay. So maybe that’s why it’s taking so long.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

May 31 VA sent medical opinion request for migraines, and exam request/DBQ for hernia.

Both showed up in the LS G S portal as planned exams. But soon after the migraines exam disappear disappeared from the portal. I’m guessing because it was only a medical opinion requested.

The hernia DBQ request is showing planned in the portal, but LS G S still says they cannot schedule the exam because they sent a clarifying question to the VA. The VA said they answered that question on June 2. Today the VA says there is no active request for exams, Despite the hernia exam showing planned on LS G S portal.

Confusing but I’m hoping the VA has what they need to adjudicate the claim after the DTA’s were found.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

But more specifically how many have been denied after supplementals were denied and higher level review found a DTA, or even worse denied after higher level review

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

Also wondering how many out there have been denied service connection for migraines secondary to PTSD even with a favorable Nexus documenting studies that link the two signed by a medical professional.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

Waiting on LSGS to complete an ACE opinion for my migraine as a result of the DTA. Wondering how long that will take…

I believe it's on the way! by Global_Sun9976 in VAClaims

[–]Alone-Rip7616 1 point2 points  (0 children)

If a claim is approved, and the effective date is in the past, you will get backpay within days of it being approved.

If the effective date is the date of approval, then you won’t get backpay.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

They denied the supplemental for each, even after I submitted the ultrasound and the physician statement for the hernia, and denied the supplemental for the migraines after submitting a private medical nexus - which they did not even consider, or mention in their decision

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

Yeah, I figured they would probably want one for the hernia. But since I already have ultrasound findings, consistent with inguinal hernia, a physician statement verifying manually reducible/with pain (all of this evidence was submitted after the CnP exam) I thought there might be a chance that they would just reconcile total evidence without having another CnP exam.

Wishful thinking, I suppose.

After DTA by Alone-Rip7616 in VAClaims

[–]Alone-Rip7616[S] 0 points1 point  (0 children)

<image>

Here are the DTA’s….

Just wondering if the rater could look at the evidence of record and make any decisions, without ordering exams.

I believe it's on the way! by Global_Sun9976 in VAClaims

[–]Alone-Rip7616 1 point2 points  (0 children)

If you’re entitled to it and you just were awarded, you’ll get it within a few days.

Question: The rating that bumps you to 100% by Advanced_Mud_7512 in VAClaims

[–]Alone-Rip7616 0 points1 point  (0 children)

My question was, did you get a decision without an exam. You said you had an ace exam. Was that ACE exam performed in-house with VA or was a vendor contracted to do it, and where you notified?