How do I approach the appeal or reevaluation process for denied claims?

Posted on: Thursday, May 03, 2018
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How do I approach the appeal or reevaluation process for denied claims?

Question

Thanks for your hugely informational blog.

I have a question regarding reevaluations. My overall rating was recently upgraded but there are a few disabilities that I plan to appeal since they were not upgraded to the level of where my symptoms warranted per CFR.

Once such instance is my back. I was discharged in 2001 and rated 10% with a back condition (with an effective date of 2001). With my recent ratings increase, they changed by back condition to a "new" diagnosis, kept it at 10%, and then changed my effective date to 2017.

I plan on requesting a reevaluation of that rating since a) I made a claim of worsening conditions and the new diagnosis is a much worse condition than what was levied in 2001, and b) since I ALREADY had a back condition of which I was rated, I should have been awarded an increase (right?). Either way, I look at it as either there was a clear and unmistakable error in my initial diagnosis and I should receive back pay OR this new condition is a WORSE condition than the original diagnosis and an increase is warranted.

I have other issues that I plan to appeal/reevaluate and will be hiring an attorney to assist. Another one is TBI. I had several concussive episodes during active duty and they are CLEARLY marked in my record, but I was never rated for it and no service connection was assigned. I've been suffering from the effects for years and was finally given a 10% rating (though not 40% according to what my symptoms warrant). But since it was missed when I was discharged, shouldn't the effective date be back then instead of when I filed my recent claim for it? It's CLEARLY marked in my record, it's a clear and unmistakable error. (I understand with new regulations the effective date will be 10/2008, but should that not have been where they set if for in the first place?)

So, my larger question for you is how should I approach the reevaluation requests? Should I go ahead with the re-eval requests now OR wait until the full appeal process when they're going to ask for a reevaluation anyway? Which one offers a higher success rate of getting the rating increased to where it should be?

Thanks again for your time and help!

Jim's Reply

Thank you for your kind words. We're glad to know our publications are helping to sort out the hugely complex VA system. You point out that you have challenging medical conditions. An appeal of each and the addition of other rated conditions will be a bit of a maze and you'll benefit from professional guidance. I'd urge you to speak with an accredited veterans law attorney before you make any moves. Keep in mind that you don't want or need an attorney nearby, you need the best attorney for your case and that person can be located anywhere. We'd urge you to look around and speak to one or more lawyers for a case assessment and then partner with the one you're most comfortable with.

Good luck!

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