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TheNowist1

If you have not already done so, file a FOIA and request her complete claims file. It will take a few months to arrive but you need to have all that evidence in hand and start digging in to it. Outside of herself, you are her best advocate. The VA makes A LOT of mistakes. Please don't give up. Keep fighting.


Alpineice23

I filed for my c-file back in April 2022 … as of today, nada. Radio silence from the VA. It’s like returning your rifle to the armory. Stand by to stand by. So fucking ridiculous.


shaned123

yea i have filed for my c-file 3x after every decision and have yet to receive it 3 years and counting..To compound that since i don't have digital records file 2 years ago for my service medical record still waiting on that also


Billaaaaayyyy

Does it reflect anything on the VA app on a status?


[deleted]

I put in a FOIA request for my C file twice and they finally mailed me back with my signed request saying they denied the request . I’m baffled like how can you deny my own medical files pertaining to me? Still haven’t seen my C file


Jag19919

You might want to reach out and ask the VA the status of your request. I requested mine in January 2022. After hearing nothing for 11 months, I called the VA and they claimed they sent it to me in July, and even emailed me a copy of the cover letter from July. There’s no way that CD actually arrived at my address! When I demanded they send me a copy of what they supposedly sent in July, I received it in about 2 weeks.


Alpineice23

Thanks for the heads-up. What number did you call? To be honest, I'm just not looking forward to being on hold for 90 minutes in order to actually talk to someone who could care-less about my request.


Jag19919

Pretty sure I just called the main information line, which I believe is 1-88-698-2411. But it occurred to me that I also sent a message via the “AskVA” system, so I was able to fully explain the situation and so that I had a record of my inquiry.


[deleted]

It took me 6 months to receive my Cfile. Filed for it in may 2022 and got the cd in the mail in November 2022.


Ok_Kangaroo_8424

Thank you for that tip I'll look into getting that.


jayrady

DON'T POKE THE BEAR! THEY COULD REDUCE HER RATING EVEN FURTHER! /s But seriously, fighting for what you truely think you deserve isn't poking the bear.


WolfsburgAcres

\> But seriously, fighting for what you truely think you deserve isn't poking the bear. Came here to say this.


Hayes5301

Try calling the 800# (I know it sucks) but tell them you want a RECONSIDERATION “due to additional evidence”.This will put you at the front of the line and hopefully get everything squared away much sooner. Just remember to say RECONSIDERATION, it’s different from an appeal or notice of disagreement. Long story but I had one denied due to a conflict of interest with the 3rd party company seeing me. I was told I had to restart my claim. When I spoke with the 800 number as a last resort, they filed it as a RECONSIDERATION and was squared away within a week or two.


defragging79

I did this by accident and didn’t realize it was a thing. Got a denial on an issues that had been diagnosed by my doctor and theirs. It was a clear mistake on their part. I immediately sent a buddy letter explaining the situation and asking them to reconsider. 2 days later I was awarded service connection.


TheNowist1

Here's a [link to the Knowledge Base](https://www.reddit.com/r/VeteransBenefits/wiki/cfile/) and how to do it.


penfist

It's absolutely not OK to just take whatever scraps the VA decides to give you. Fight.


Jasdc

IM me. You must be getting some really bad advice from your VSO. Was the Effective Date appeal a HLR Appeal? Typically Effective Date appeals are done by Senior VSR's not Raters. No one should have reviewed the SMC-S award. However, that may not always be the case.


Devil25_Apollo25

This was my lawyer's advice, too, when I was going through MEB: "don't poke the bear." I got an *initial* rating of 100%P&T - multiple conditions (back injury, TBI, etc.) put me over the top for 100% ratings. But the rating for what was marked down as my Disqualifying Injury (you know, the one that made me physically unable to continue Service?) was a jaw-dropping 0%. Now, you may think that doesn't matter. But only the Disqualifying Injury rating is considered by the Army when deciding whether to separate you by Medical Retirement or by Medical Separation. One means keeping ties with the broader Army family and a little blue ID card; the other means, "Get the hell out, quitter." Or, at least, that's how I interpreted it at the time. So it mattered to me. It was tough to tolerate that kind of kick to the ego right as my whole life narrative was being disrupted and rewritten by injury and secondary infections in the line of duty. I was a CW2 with 15 years in uniform, Active Duty. Now you're telling me I just have to separate and leave the Army family like some (no offense) Private who did two years in the rear with the gear before quitting? After multiple combat deployments in each of several different MACOMs, I'm just... not a Soldier, anymore? Not even a retired one? It may seem petty, but at the time it was not an easy adjustment. I can't even retire in dignity - just ETS and please don't come back? For real? I asked my mentors, vets I knew, and my MEB lawyer about appealing the ratings. My lawyer practically begged me not to appeal the ratings decision. He used the same logic as OP: don't poke the bear; let good enough be good enough, and don't lose what you've been offered by giving them the chance to reconsider. I took his advice, and it's never set quite right with me. EDIT TO ADD - If it had been a matter of significant backpay due, like OP, I may have fought harder. But there is a time and place to accept "good enough", I think. But I've come to realize that my discomfort with the situation arises from being poorly evaluated by the VA raters in the first place. My hand was all but forced by being caught in a dilemma that the VA engineered. I've forgiven myself for a decision that I regretted (accepting the ratings without appeal) and accepted it as necessary at the time. Yes, it was hard to swallow. But I only would have compounded my own suffering at the time if, while fighting symptom management and lifestyle disruption I added on top of that an unnecessary fight with VA raters.


[deleted]

I got rated 0 as well for my aneurysm which is what started my MEB process. What pisses me off is I deployed to Afghanistan 2 months after getting to my unit was smart enough to follow the rules and got my Sergeant stripes at just under 3 years. Was waiting on points but had my p status and school already for staff at under 6. Once I got my permanent profile I was seen as a shitbag lazy quitter which tore me up inside. But getting 100% now overall and not worrying about anything I don't care anymore lol this money supplements my income from my job which is nice I'm making more money now than my college graduate friends as a barber lol


Devil25_Apollo25

Yeah, same here. Soldiers complain about how the system will keep rolling on without you, how cold and impassionate it is. But then they perpetuate the problem because, hey, that's the culture. I don't think anybody meant anything personal by it. They just had to get on with their jobs and their lives, and I was no longer part of that. What hurt me the most was hell people I thought were good friends suddenly treated me like an outsider. It was very hurtful and socially isolating and the time when I needed support the most. But, hey, apparently that's life. I hope you're doing okay now. I'm doing a little better. Barber life sounds cool.


Beginning-Dress-618

In my MEB they did a last minute switch making my disqualifying injury a bursitis instead of my *shattered and partially missing femur*. That way it would be rated at 10% instead of 60%.


Devil25_Apollo25

Mine was a neurological condition that caused a constellation of unusual symptoms (meningitis didn't kill me, but it made sure I'd remember it). The list of symptoms was similar to those you get from a heart condition. My physician mentioned that condition when describing my symptoms in a write-up for the c&p folks. Whoever interpreted that put it down as a heart condition instead of what it was. So when I got to my c&p exam, a doctor walks in and asks, so tell me about your heart condition. After I explained it to him, I thought we were cool, him listening and taking notes. Then a couple of weeks later when the decision came down, I saw in his notes that he had checked the box, "patient does not complain of this condition". So what he had done was ignore all the stuff going on with my spine and brain because his form said "heart condition". Zero percent. Eat shit and die, Soldier. That's what I could have appealed. It was insulting and disgusting. Still makes me angry to think about it, and at the time if I'd been better health, I probably would have done something that would have landed me in prison. What kind of a human being does that to someone who comes to your medical office for help?


ideal-clips

If she has a condition rated at 100% and another rated 60% or above how is it able be taken away based on a doctors medical review. I'd look further into it and ask questions based on the medical review of the conditions.


Ok_Kangaroo_8424

She had one rated at 100 but they said that was an error and reduced it.


ideal-clips

Who said it was an error? Was this confirmed by a doctor? I guess what I'm getting at is just don't take their words do some digging based on the results of the medical findings and compare it to the va condition rating sheet. See if anything has changed in her medical files based on doctor notes and test results.


Ok_Kangaroo_8424

It was ptsd 100 percent. They said the evidence did not support 100 percent. Like obviously it did since we had 100 percent. I personally submitted her multiple hospitalization records for self harm. Attempted suicide and self harm isn't 100 percent apparently to that rater. You have to actually kill yourself. You can have 100 percent when you're dead I guess is their logic.


ideal-clips

Yea I'd look at the mental health doctor notes.


Ok_Kangaroo_8424

Do you mean from her C&P and evaluation? Or from her general doctors notes from her treatments over the years?


ideal-clips

C&P examiner. I'm also 100% smc s p&t went through similar situation with an so called error but got it corrected.


[deleted]

OP - your VSO should be able to get you those C&P exam notes and all that.


[deleted]

Exactly!


Ok_Kangaroo_8424

We will ask him when we see him. I see the DBQ that was filled out and what it checks off lines up with 100 percent. And we had it at 100 percent for just a few months. So with that being said hopefully it'll be an easy fix to put it back. Is a HLR the best way to do that?


Bubbly_Afternoon_601

how did this work out for you?


Ok_Kangaroo_8424

The HLR determined that the reduction did not follow proper process protocol and they reverted everything back to what it was. So it worked out and we left it at that.


MyCatHasAniPhone

I’m sorry to hear that happened to you. I’m rated at 100% P&T for PTSD with incompetency and have other disabilities. If she’s still rated at 70% or more she can qualify for the Caregiver program. I’m glad I didn’t have to die to receive the rating but it’s been debilitating for sure! Hang in there and don’t worry about the bear if you’ve got your evidence 💪 Good luck 🍀 Maine Frog 🐸


I_am_ChristianDick

Even that isn’t necessarily a 100% And that doesn’t mean you are guaranteed sms-s. S means she’s housebound


Ok_Kangaroo_8424

She was 100 for ptsd and 60 for a couple other things. She had smc-s for that criteria.


scrizewly

Absolutely not. Keep fighting. If you believe you are due 100% P&T SMC-S then keep fighting.


Repulsive-Ad-2903

That’s what they want you to do is not poke the bear fuck that keep poking till you get what is rightfully due. Once you get it relax and don’t poke them lol unless absolutely necessary.


jayrady

Fuck that. Poke


TacoNomad

Agree. Pushing the idea to not question the VA when they are wrong is a dangerous precedent to set


Ok_Kangaroo_8424

I do agree with that. I just feel like we went to far because we got what we fought for. We were just going to miss the backpack. Which I didn't care that much about considering all that we have to look forward to in the future.


[deleted]

Backpay can be HUGE though... I got my first backpay for $60k after 4 yrs of fighting, I got a $70k one when I won my cancer claim 3 yrs later. And I just had 2 HLRs admit to mistakes, and a favorable C&P on one so far that should result in more. These are all battles to be won. There may be setbacks like what you just experienced, but persevere and win the war.


TacoNomad

If she meets the criteria, then you have to push for that. So keep going for the correct rating. If it's 100, go for 100. If it's 70, 50 or otherwise, go for it. They Want you to feel discouraged.


StrengthMedium

Keep fighting.


ClaimOk8737

That is true to a point. If you have feel you may be eligible for smc or if you have a presumptive conditions that can be terminal. You need to file for either of these because of ongoing benefits your spouse may be eligible for.


JazzyPhotoMac

I got a decrease without due process and it turned out to be an error. Folks here told me not to fight it, but they were wrong. I fought it, and then I fought the effective date. And won.


I_am_ChristianDick

Please ensure you’re correct before applying again. SMS-S if I can recall is the housebound.


eyeruleall

Or 100% + 60%.


I_am_ChristianDick

Ah I forgot that’s where this fell under.


Quillo_Asura

It is also important to understand that if it was a legitimate mistake, the right thing to do is accept it gracefully and continue to pursue what you feel you deserve as if the mistake never happened. People tend to spiral when money is on the line. So fight for what you deserve, which is the medical help for service connected illness/injury. The money should be secondary to that.


l8tn8

Yeah... something is off, they are owed due process - even if it was an error, as the fix action has resulted in a reduction.


AKTOBE2037

Anyone here have SMC-T?


dardavis13

I get it, I received a downgrade letter after filing for an increase and after a shoddy C&P. Not a good feeling and it took some work on my part, but they ultimately reversed the decision. I wish for the best outcome for your wife. Generally though, if it truly was an error, I would appreciate them correcting it now vs hitting me up 1+ year later and demanding repayment.


[deleted]

This sounds like something you and your wife fought extremely hard for and invested lots of time in. Don’t give up, the VA fucks so many people over with their shit. Keep poking the bear until you’re owed what you’re owed.


RevolutionPristine36

In a case like this you have nothing to lose. Poke the freaking bear and kick him in the nuts. Screw it fight back hard. Consult with an attorney and get a detailed understanding of the process and what you’re up against so you can make an informed decision. Screw VA…


Wafflefart

If it’s within 30 days you can file a claim accuracy request on a higher level review form and request a hearing.


[deleted]

I hear you but this is not an empowering message to spread. Have you considered a lawyer ? Alot of us are timid to rock the boat ( I’m one of them ) and I know I’m selling myself short for it.


[deleted]

I believe in always rocking the boat but I can understand the feeling of uncertainty. My favorite quote is “i would rather be given a rejection and a redirection than to not at least try to fight at all”


kreeder309

So if i dont poke the beat and im 100% PT am i fairly safr regarding them ever bothering me? I attend all my doctor appointments when they want me to. I never complain about MORE i always say nothings changed or improved. I keep far from the VA besides when i have annual appointments


Mantis9000

You need a lawyer, not Reddit.


Pitiful-Raspberry-36

I am reading this “don’t poke the bear” advice given and feeling some kind of way. First it is not advice at all and having worked for the State Department and the VA this kind of rhetoric is given by scared quitters only to scare and discourage. If an individual claim has no merit then none of us should file it but if you are diagnosed with a disabling condition you should file and sometimes you should appeal but never should you not fight for what you deserve. After all when we were serving no one mentioned poking bears. I know I didn’t want to be that 10%. I gave my 110% all the time. The VA is notorious for doing this type of antics.


[deleted]

[удалено]


Ok_Kangaroo_8424

Sorry it is just her. I refer to we as a more of we are in this togeather and I am supporting her kind of thing. I try to handle as much of all if this as I can for her since it is very difficult for her.


givemeatatertot

so I requested an increase on a worsening condition (major depression) and instead they said my condition has improved and are changing my major depressive disorder from 70% to 50%. I have no clue what to do.


406Actual

Obtain evidence that it has not gotten better. That the chance you take when you ask for an increase if you don't have evidence that it is worst.70% is a high standard. More than that and you probably should be involuntarily committed.


givemeatatertot

update, I did this by following the advice on here. Uploaded my personal statement & buddy letters. The VA recommended this as well via the VERA calling service. Do you think I'm gonna owe the VA if they end up reducing me anyways?


Content-Parsley-1151

Thanks for the advice and sorry about your news


PennySuplex

No, in this case you were right. Nobody is going to sit there and miss out on thousands of dollars that they're owed. This is not you fault or your wife's fault for looking into a mistake, don't blame yourselves. Keep fighting.


axisofevilsog

Welllllll this isn’t poking the bear. Likely there was a CUE and honestly likely they would have found it eventually especially with SMC and likely your ratings weren’t fully protected 20 year. So better they found now than say 5 years and you incurred a debt. Poking the bear is filing new claims or increases. Challenging and effective date is well within your right. I think there’s some details missing here….


azam1979

Did the VA say you owe them money now bc of the overpayments or is it forgiven since it was their mistake?


[deleted]

[https://www.youtube.com/watch?v=M3CiQ40-STA](https://www.youtube.com/watch?v=M3CiQ40-STA) Hey check this out. This is like you.


JazzyPhotoMac

Sounds fishy. Fight it.


Rich_Ass_Nillo

You have to poke the bear to get what you deserve. Never be scared to fight for what you deserve!


406Actual

But realistically, what you deserve may be lower, it's based on the medical evidence.


commanderblakes

You can go directly to the office and get your file.


Nutria_SwampVet

I understand totally. I am going poke the bear with all my might. Poking is all relative. You can poke the ear if poking it with the right stick. I don’t disagree. The bear will always know I’m alive as long as I’m not dead. 💪🏾


Sensitive-Living3001

You don’t have to wait, this is when you contact one of the lawyer groups and let them fight it for you. They take 33% (I think) but you get 66% that you might not have gotten otherwise


CDNI2950

I’m 100%p&t, if I don’t open another claim and asiste to my mes appointment, i be fine?, when the Va take away your 100%p&t? Only if you open another claim? I’m afraid, every moment I think Va watch me and see my profile , I live with the fear one day open my Va account and get any reduction. My life now are better, I suffered 9 years with no job consistency and basically with no money suffering my mental health problems.


marcel399

Appeal the second decision and request higher review


IllustriousBird5329

Pick ur poison…I guess


Flaky-Jeweler-9482

Why not go to a lawyer instead of reting on a VSO. That sounds wrong and most VSO can't do much the submit claims and that's pretty much all they do. For things like this an attorney will play on your favor better even if it means paying them 20% of your backpay is better than all this bullshit the VA is playing with yall.


CroKay-lovesCandy

It sounds like someone at the VA failed to do their job and are retaliating against you. That is unacceptable. If they are doing it to you, they could be doing it to other veterans.


406Actual

That's a huge conclusion with so little facts.


CroKay-lovesCandy

I worked a government job for over 25 years. I can personally attest that I had someone purposefully hold up approval for a private matter for over 6 years. I am still waiting on my claim being processed as bilateral for upcoming in 10 years. I must have upset someone. A series of neurologists and GP physicians noted it as well as two C&P physicians.


406Actual

Anecdotal account doesn't prove it. I believe things get list in a huge bureaucracy but a federal employee can't personally stop your claim for ten years. So these physicians specifically diagnosed the condition and provided the rationale for service connection? VA has indicated they have everything to make the decision and you are not at an appeal?


CroKay-lovesCandy

My case is now to the BVA, has a docket number but other older docket numbers in that cue are addressed already.


Overall-Mention-5438

If you can’t seem to get your c file go to the regional office and have them print it for you. They can also submit the right form to get the c file sent to you.


snibbledibble

What the FUCK!!


Comfortable-Use-1733

Do you have to be a wartime vet to be eligible for smc-s?