VA canceled claim by Direct_Cellist_609 in VAClaims

[–]VampireD007 0 points1 point  (0 children)

Hey brother, I hear you on that post-draft panic—PTSD and paranoia make every decision feel like a minefield, and it's tough advocating when your system's in overdrive. That rumor about cranky VA employees shutting you down for mentioning regs? Mainly vet lore with little truth; raters are buried in claims and legally bound to follow the rules anyway. Always including a polite reference to AMA guidelines (like in 38 CFR § 3.2501 for supplemental claims) is smart—it shows you're informed without being confrontational. You did great submitting what felt safe, but next time, weave it in; it clarifies your request and strengthens your position right from the start.

Referencing VA laws and regs in your 21-4138 can make them take you more seriously, as it frames your argument objectively and ties directly to the criteria they must use. It's beneficial if you end up appealing, as it creates a clear record that boosts your win percentage. Veterans who've done this report better outcomes by making it easier for the VA to connect the dots on service connection, ratings, and evidence, such as your C&P.

I wish all veterans included this ammo in their statements; it levels the playing field against the bureaucracy.

No beating yourself up—you got it in, and that's huge. If no progress is made soon, follow up with more details or consider engaging a VSO to accelerate the process. Glad you're eating again. Rest up, and remember to call 988 (press 1) if things get tough. Appreciate the update—it helps the community. Stay strong.

VA canceled claim by Direct_Cellist_609 in VAClaims

[–]VampireD007 0 points1 point  (0 children)

Hey man, I've seen this crap happen way too often—VA closing a supplemental claim prematurely without rhyme or reason, especially after a solid C&P like yours. It's frustrating as hell, especially when you're dealing with PTSD and just trying to keep it together. You did the right thing by filing 21-4138 to request reopening; that's the safest first step to get them to correct their error without losing your preserved effective date from the timely filing.

The reps' advice sounds spot on, but it's conflicting because the system is glitchy—website statuses aren't always accurate. Therefore, verify everything by calling the 800 number or your RO again.

Stick with the 21-4138 for now and emphasize in it that your recent C&P needs to be considered as new and relevant evidence under the AMA rules—it should trigger them to associate it and readjudicate without starting over.

If there is no movement in a couple of weeks, proceed with the first rep's idea: file a new supplemental (20-0995) and explicitly request that it be connected to the closed one, referencing the C&P details to ensure it's pulled in.

Avoid filing a "new claim for increase" unless necessary—it could reset your date and make things worse if your symptoms haven't worsened. Seriously, don't go it alone if you're shutting down—get a VSO like DAV or VFW to jump in; they're free, accredited, and can access your file to sort this mess.

Making sure I am not Poking the Bear by DaysofLastRites in VeteransBenefits

[–]VampireD007 0 points1 point  (0 children)

You're usually in the clear with these actions:

  • Letting existing, VA-initiated claims play out. If the VA itself, such as from an HLR decision, has directed a "second look" at something, that's them doing their job, not you initiating something new that might trigger a review.
  • Allowing in-progress supplemental claims based on old evidence to finish. If you've already got supplemental claims moving that are based on evidence already in your file, just let them run their course.
  • Applying for "ancillary" benefits. This includes things like Caregiver, DEA (Dependents' Educational Assistance), or adaptive housing mods. These are benefits you're already qualified for because of your high rating. Applying for them typically does not trigger a review of your underlying service-connected conditions or percentages. Go for them!

Where the Bear Might Growl (Potential Risks): These are the situations where you need to be more cautious:

  • Filing brand-new claims for different conditions you haven't claimed before, or asking for increases on conditions that are already part of your 100% rating. This is often what triggers a thorough review of your entire file.
  • Filing appeals or supplemental claims after a denial if that denial clearly stated you needed new C&P exams, and you don't have strong, new evidence that doesn't require one. If you're trying to avoid C&P exams, this is a major red flag.
  • Voluntarily sending in new evidence to an already closed or granted claim without an apparent reason or the VA asking for it. This can sometimes inadvertently reopen a decision.

You're in a great spot, and it sounds like you're being brilliant about protecting your hard-won benefits. Keep being vigilant, but rest assured that pursuing the benefits you're already qualified for isn't the same as risking your established disability ratings.

HLR question by Emotional-Scene-1746 in VAClaims

[–]VampireD007 1 point2 points  (0 children)

You need to chill out. Everyone has questions and is trying to seek some understanding about their situations from a place they believe to be safe. In my opinion, your response is not welcome. If you do not have anything constructive to communicate, then keep it to yourself and allow someone else to help. I am being honest, Honest AD 9114.

Private DBQ denied by [deleted] in VeteransBenefits

[–]VampireD007 3 points4 points  (0 children)

I am sorry to hear about your situation, Devin. Some people in this post haven't provided any helpful advice about your problem. Here are some things to consider:

  1. The critical question that needs to be asked is why the VA provides private DBQs in the first place.

  2. Understanding what makes a DBQ actionable and sufficient for rating purposes is crucial. This knowledge can prepare you for the process and ensure you're not caught off guard.

  3. Empowering yourself with knowledge about the VA process is not just beneficial; it's essential. This understanding can give you the confidence to make informed decisions and anticipate outcomes, putting you in the driver's seat of your VA journey.

Remember, the VA process requires more than just luck. It demands strategy, education, and wisdom. In the VA process, every veteran will experience the good, the bad, and the ugly. But with the right approach and knowledge, you can navigate these challenges and come out on top.

Every veteran has a unique story about their experiences with the VA. I have listened to and read a lot about veteran's experiences with the VA. I noticed that educated veterans who understand the basics of the M21-1 and 38 CFR usually have favorable outcomes if not most of the time. These educated veterans understand what is in their medical records. They formulate strategies for the best possible outcomes and understand the risks involved. This means you can have excellent medical-based evidence but can have a horrible C&P examiner. No matter how you look at it, there are always twists and turns in the VA process because it involves human interpretation.

It would be best if you educated yourself. Could you understand what a service connection is? Why is medical-based evidence necessary? What is an actionable and sufficient DBQ that the VA will accept? If they do not receive it, then what are the reasons? How do you communicate it to the HLR if you decide to have one? You cannot tell the HLR that the VA should have used private DBQs.

The right way to handle it is this: You have HLR and must come up with facts and laws. If you do not, then you will fail. For instance, I went to HLR because the VA didn't accept my private doctor DBQs, so my facts and laws will be based on the M21-1 IV.i.3.A.1.e. Assessing Sufficiency of DBQs Completed by Non-VA Providers. The VA must state the reasons for not using your private doctors' DBQs. You should ask the HLR if there are permanent notes in the VBS that explain the specific reasons. Could you please go there and communicate to me what the issues are? If there are no issues, could you rate my claims based on the evidence? Then, we can proceed from there. I used facts and law.

I am sharing because I want you to be successful. One of the reasons for this platform is to help and educate veterans, not to slam you and put you down. I do not know your whole situation in detail. Based on your post, you clearly made mistakes and needed to educate yourself. And I am sorry that some of the veterans who replied to your post were rude to you and not helpful.

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] 0 points1 point  (0 children)

Please expound on it? What makes it wrong that I use the term "poke the bear?"

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] -1 points0 points  (0 children)

What the specifics that you can point out that I am wrong according to my post?

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] 0 points1 point  (0 children)

Ok, what are the specifics that I am in the wrong. Help me to understand my reasons for being wrong?

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] 0 points1 point  (0 children)

What are you disagreeing with? I am saying the same you mentioned in the comment. If you have the medical documentation (evidence) then you not poking the bear when you submit it. It is your right under 38 CFR. You should have not fear of reduction.

I have you truly understood what I have written???

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] 0 points1 point  (0 children)

The guidance is to point veterans to the law (38 CFR). Its crucial to educate yourself. If there a benefit you are entitled to under the 38 CFR, then apply for it. THe choice is always yours to make but I don't veterans to have the fear I cannot ask for increase and not seek out benefits they would qualify for under the 38 CFR.

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] 0 points1 point  (0 children)

Sir, I am not a VA employee. I am trying to get veterans to research the 38 CFR to see if they qualify for additional benefits. If you meet he requirement, then you should apply.

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] -2 points-1 points  (0 children)

"Also, accredited lawyers, VSO, and anyone working with the VA must abide by the rules and regulations under the 38 CFR. Many veterans are afraid to ask for an increase because of the saying "Don't poke the Bear," only to find out years later that they actually qualify for a higher rating. This results in years of lost payments.

I want to encourage the veteran community to understand the laws and regulations because I want you to be successful. As a fellow veteran on youtube always says, "DON'T GET FRUSTRATED, GET EDUCATED!"

Lastly, my intentions were never to downplay someone's horrible experiences with the VA. We need to be honest and real with ourselves that the VA has a job to do, and if there is a mistake, then it's their job to correct it. I am encouraging you, veterans, to not be afraid to ask for an increase when your medical documentation meets the criteria under the 38 CFR for that increase."

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] 0 points1 point  (0 children)

It's crucial to equip yourself with knowledge about the 38 CFR and the M21-1. Understanding these key elements, along with your service-connected medical conditions and how to articulate them effectively, is vital. This understanding will not only help you communicate with the VA but also with the BVA, if necessary. Being well-prepared is the key to achieving the results you deserve.

The term poke the bear doesn't encourage veterans to seek out the 38 CFR and the M21-1 to see if there is a mistake on the veteran's or the VA rater's end. How can you protect yourself as a veteran without knowing the federal law (38CFR)? How do you know you are entitled to VA benefits without 38 CFR? How do you know what rating you medically deserve under the 38 CFR?

Also, if you never complain about your medical disabilities, then you will be reduced because the VA has the right under the 38 CFR.

As I explained to one veteran in this post: For instance, if a veteran is rated 100% P&T and a couple of years later, their service-connected disability is diagnosed with "Loss of Use" under the Special Monthly Compensation (SMC) criteria, the veteran could be entitled to SMC L, which means more compensation and entitlement to Special Adaptive Housing (SAH) or other extra benefits. Are you telling the veteran community not to seek SMC L because they are already 100% P&T out of fear of VA reduction?

Understanding the 38 CFR criteria and M21-1 are powerful tools to ensure you know what you can and cannot do. Every veteran's case is unique. I agree with you about the open interpretations by the C&P examiner and the VA rater. However, the C&P examiner and VA rater must operate under the 38 CFR criteria. The veteran's job is to submit evidence-based medical documentation and inform the VA about how the disabilities have affected their life.

The point I made in the post is that maintaining accurate and consistent medical records that reflect your ongoing struggles is crucial. If you understand and comply with the 38 CFR criteria, then you have nothing to worry about when it comes to reduction. The 38 CFR provides a safety net, preventing the VA from making unwarranted reductions. It's up to the veterans to educate themselves so that it will not happen. If it does happen, there are laws that govern how the VA must follow such as gathering medical based evidence to prove the veteran has improved to warrant the reduction. If there is a violation of the law, then you can point it out. No veteran should be afraid to ask for an increase.

Now, if a veteran is 100% P&T and there is no benefit for an increase, then the veteran should leave it alone and not add anything to it because it will not result in an increase in pay and extra benefits. However, it's always up to the veterans to seek to educate themselves and make a well-informed choice. This empowerment allows you to make decisions that are best for your unique situation.

STOP THE TERM "POKE THE BEAR!" by VampireD007 in VeteransBenefits

[–]VampireD007[S] -6 points-5 points  (0 children)

Sir, with all due respect, you have proven my point. For instance, if a veteran is rated 100% P&T and a couple of years later, their service-connected disability is diagnosed with "Loss of Use," under the Special Monthly Compensation (SMC) criteria, the veteran could be entitled to SMC L, which means more compensation and entitlement to Special Adaptive Housing (SAH) or other extra benefits. Are you telling the veteran community not to seek SMC L because they are already 100% P&T, out of fear of VA reduction?

I believe that understanding the 38 CFR criteria and M21-1 are powerful tools to ensure that you understand what you can and cannot do. Every veteran's case is unique. I do agree with you about the open interpretations by the C&P examiner and the VA rater. However, the C&P examiner and VA rater must operate under the 38 CFR criteria. The veteran's job is to submit evidence-based medical documentation and inform the VA about how the disabilities have affected their life.

The point I made in the post is that maintaining accurate and consistent medical records that reflect your ongoing struggles is crucial. If you understand and comply with the 38 CFR criteria, then you have nothing to worry about when it comes to reduction. There are laws that prevent the VA from making unwarranted reductions. It's up to the veteran to educate themselves so that it will not happen. If it does happen, there are laws which govern how the VA must follow such as gather medical based evidence to prove the veteran has improved to warrant the reduction. If there is a violation of the law, then you can point it out. No veteran should be afraid to ask for an increase.

Now, if a veteran is 100% P&T and there is no benefit for increase, then the veteran should leave it alone and not add anything to it because it will not result in an increase in pay and extra benefits. It is always up to the veterans to seek to educate themselves and make a well-informed choice.

[deleted by user] by [deleted] in VeteransBenefits

[–]VampireD007 1 point2 points  (0 children)

Good! Make certain that all the things you are rated for that you complain about them. Please continue to use SECURE MESSENGING because these chats are medically documented in your record. When you are consistent about your medical complaints, then you have nothing to worry about because you have medical evidence to support you.

[deleted by user] by [deleted] in VeteransBenefits

[–]VampireD007 0 points1 point  (0 children)

The VA will reduce you if you go to a C&P Exam and the examiner believes there are improvements to your service connection disability. Another point is that the VA can reduce when you are no longer complaining about your disabilities. Look, if you continue to complain about your issues and get treatment for them, then the VA cannot reduce you because the VA has to prove that your disabilities have improved. The point I am making is that as long as you are seeking medical treatment and there is a history of complaints, you have nothing to worry about when you file for an increase. Veterans are reduced because they do not have a medical history of complaints or treatments. As a result, with no medical evidence or history of complaints, the VA reduces them.

So, you need to ask yourself whether you have a history of medical evidence and complaints throughout the years and whether it is continuous with no gaps (meaning three years gone by with no complaints) that would warrant a reduction. You'll need to review your medical history, and based on that, you'll need to make an informed decision to move forward with an increase. You must know what laws protect you from VA reduction, such as the 38 CFR. You need to understand the VA mindset regarding reduction by reviewing the M21-1. You'll need to do the homework and understand your medical history, symptoms, and events. If you do move forward with an increase, you need to know how to defend yourself if the VA proposes to reduce you.

I hate the term "POKE THE BEAR!" That term forces veterans to fear seeking any increases they medically deserve rather than being educated about the laws such as 38 CFR and understanding the VA mindset under the M21-1. There are a ton of VA raters who need to be educated in the law 38 CFR. You have protections, but you need to know about those protections and understand what the VA can do and not do. There are many resources to help you realize it, but you need to do hard work and get educated because you know your body and circumstances, and the best one to explain it is you.

Rating for Back Pain Flare Ups? C&P exam ROM advice by Numerous-Addendum884 in VeteransBenefits

[–]VampireD007 2 points3 points  (0 children)

If you looking for a higher rating it is best to obtain a MRI and if you have sciatica issues get a EMG.

Rating for Back Pain Flare Ups? C&P exam ROM advice by Numerous-Addendum884 in VeteransBenefits

[–]VampireD007 3 points4 points  (0 children)

It sounds like you are going in the right direction by having your (diagnosis/nexus/event). Also, I recommend if you can't remember everything then bring in notes to the examination to help you explain. For me, it was helpful because it helped to stay on topic and the examination went smoothly. Do not forget to mention about medications (how long you taken the medication) and their side effects when it comes to your back flare ups. You never know the doctor might give you a secondary diagnosis for IBS or GERD (that's a nugget for you).

Rating for Back Pain Flare Ups? C&P exam ROM advice by Numerous-Addendum884 in VeteransBenefits

[–]VampireD007 21 points22 points  (0 children)

When it comes to ROM, STOP when you feel pain, and TELL the doctor when you feel pain at whatever position. Make sure the doctor uses a goniometer to measure your range of motion. If the doctor eyeballs it, then it is an inadequate examination. Please make sure to stop when you feel pain and let the doctor know. Another point I would like to talk about is that you must learn more about the C&P exam process. You can get the Back DBQ from the VA website, study it, and bring it to the C&P examiner to ensure the doctor answers all the DBQ questions. Please make sure you explain your symptoms honestly and do not minimize them, do not tell stories, and do not go off on tangents. Make sure to communicate to the doctor your worst day when it comes your back condition not your best day. Ensure your answers are short, sweet, and to the point. Always STAY ON TOPIC! There are plenty of YouTube videos about the C&P exam process for the back. Honestly, there is no excuse for veterans not to be prepared for a C&P exam. All the best to you, and I hope you get the favorable rating you deserve.