My Most Recent Claim Denied – For Want of VA Records

Typical VA Claims Result

My latest claim for various VA disabilities (not the Agent Orange-related ones) was denied last week, mostly because the VA regional office in Denver maintained I had no new information to submit against earlier denials, thus the original denials were final.

VBA was especially clever in this response: the adjudicator avoided addressing several elements of the claim (different injuries,) knowing that once the claim reaches the Board of Veterans Appeals they don't have jurisdiction, and the claim will be remanded. That will mean more time at the regional office, and then back in line for more years of waiting for BVA to decide.

They don't do this stuff without strategy, you know! What looks like an oversight is meant to provide VA with several more years of stalling, waiting for the vet to lose interest, or die.

For some reason, eBenefits has been accepting electronic documents for several months, at least since the end of April, but not showing them in the list of either requested or unrequested materials. Things get posted on eBenefits only if mailed or if a vet calls IRIS. Thus all my responses to VA inquiries for the last ten weeks have disappeared, so VA denied my claim.

That's one problem. The other is that the FOIA I submitted in April, which was acknowledged, still hasn't been fulfilled. That was where I'd expected to find the Air Force line-of-duty determinations for the specific injuries in the claim. Originally VA had somehow failed to even note the LODs and denied the claim because the LOD-specified injuries "did not occur during service nor in one year after." Heck, I was even hospitalized in Bethesda Naval Hospital on AD and they missed that.

I should have asked the Denver FOIA office about this earlier, because from their response letter I had no idea their current backlog is actually between six to nine months for a "C" file FOIA response. I'd gone in to see my files but they could only let me see a few pages on their computer, so a trip to Denver was wasted.

Yesterday, Denver FOIA offered to move my request for a copy of my records up and get them here in about a week because I'm so sick. Great. Now I can face two to five years in an appeal but that's way, way past my life expectancy.

Nice folks. Lousy system. Everybody at VA solves claim problems with a vet by telling us to "just appeal."

That's like a kiss of death. They know it. Perhaps their greeting at the 800-number should be "sorry for your loss" instead of "thanks for your service."

Veterans MUST Personally Review "C" File!

Your "C" file is the complete set of documents regarding your claim. This isn't your VA medical records although many or all of those records may be in the "C" file as evidence. Instead, the VA maintains at each Regional Office the veteran's initial claim, supporting documents, VA records relative to that claim, awards, denials...everything. Pretty much a complete legal gathering of your case.

The problem is, as I have found out in two recent incidents, you can't count on the accuracy of that "C" file unless YOU spend a couple hours turning pages and taking notes.

Yesterday I reviewed my notes from checking out my "C" file a week ago. Back then I thought I'd caught the significant mistakes made by the VA (failure to obtain correct information from the JSRRC, and other errors). But I missed a big one! A game changer that should have been working for me from the get-go.

The local office forwarded my case with a recommendation for approval by the DC folks, where my claim was denied, in part, for lack of medical nexus between Agent Orange and my Agent Orange-presumptive illnesses. Problem: The local office failed to forward my cardiac surgeon's letter establishing exactly that nexus!

I didn't catch this on my visit and only noticed it in passing looking over my notes and some of the VA's documents. This missing document can be critical to my claim and I'll notify my VARO to correct their oversight.