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"Secondary action required" "Stage 1 Development" What does it all mean?

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Spink88

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Spink88 Newbie

Spink88

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Hi all,

I was hoping someone more in the know than I am could possibly help me understand what is going on with my claim. 

I filed for an increase back in June of last year, after my migraines a mental health issues really took a dive for the worse. Around the middle of March, I was awarded a "patrial decision" and an initial increase, and my migraines capped out at 50%. The VA also started an inferred TDIU claim. I submitted my 21-4192 from the only full time empoloyer I've had in the last six years, as well as the 21-8940. 

The claim, after adding the IU claim, then had an estimated completion date of December... then January... March... May... June... and now late December.

 

There are seven requests in the "needed from you section." Request 2 was for medical evidence, which now says "<VA Medical Facility>". That request was initially for medical records, which they then said were no longer needed after being informed that all of my care had been at the VA. When I called the 800 number, all they could say was that it was now a request for an appointment.

Request 5 says "Secondary Action Required," but has no info on what it is. The person I spoke to at the 800 number wa sunable to tell me what the request was actually for.

Request 6 says "Stage 1 Development," but other than that status is the same story as request 5... no info from the 800 number.

 

Request 7 is interesting. It says "Exam Request - Processing." It was opened, and closed, on March 26th, according to the person who spoke on the 800 number. He could not give me any information other than that. I had C&P exams for all of my claims back in July, which prompted increases for my migraines and PTSD ratings. I don't know if already having C&P exams available so recently would have impacted a new exam request.

 

 

Any help is really appreciated. I don't fault the people I've talked to at the 800 number. They were extremely patient and friendly, they just weren't able to look and see what was going on with all of this. I'm just at my wits end after seeing my claim date jump literally over a year, and I just want some idea about what all of this means.

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broncovet Grand Master

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The short answer is that you can not rely upon ebenefits or the 800 number.   I simply suggest you not worry about "rating specialist" terms such as "stage 1 development", unless you plan on going to work for VA.  

Instead, focus on the basics.  Do you have your current cfile?  If not, you should order it.  To get an increase, you need to show that your symptoms worsened since the c and p exam which awarded them the first time.  

If you are seeking an increase for mental health issues, then compare your symptoms which are documented with the criteria.  While I wont be reposting the criteria for mental health disorders, I can tell you that it revolves around your degree of "occutpational and social impairment".  

I am somewhat "troubled" with your increase taking since June, however.  But..it kinda sounds like they forgot about you for 6 months or so, and now your claim is moving forward.  

What do you mean by a "partial" decision?  Each issue should be denied, awarded, or deferred.  If the VA does not address an issue "at all" in your decision it normally means its "deemed denied" and the appeal period begins to run.  However, some new case law says that the Veteran needs to know that his deemed denial was denied...which makes zero sense.  How would you know it was denied, if Va does not address the issue??

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Spink88 Newbie

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2 hours ago, broncovet said:

The short answer is that you can not rely upon ebenefits or the 800 number.   I simply suggest you not worry about "rating specialist" terms such as "stage 1 development", unless you plan on going to work for VA.  

Instead, focus on the basics.  Do you have your current cfile?  If not, you should order it.  To get an increase, you need to show that your symptoms worsened since the c and p exam which awarded them the first time.  

If you are seeking an increase for mental health issues, then compare your symptoms which are documented with the criteria.  While I wont be reposting the criteria for mental health disorders, I can tell you that it revolves around your degree of "occutpational and social impairment".  

I am somewhat "troubled" with your increase taking since June, however.  But..it kinda sounds like they forgot about you for 6 months or so, and now your claim is moving forward.  

What do you mean by a "partial" decision?  Each issue should be denied, awarded, or deferred.  If the VA does not address an issue "at all" in your decision it normally means its "deemed denied" and the appeal period begins to run.  However, some new case law says that the Veteran needs to know that his deemed denial was denied...which makes zero sense.  How would you know it was denied, if Va does not address the issue??

Thanks for replying.

 

I submitted a claim for an increase for migraines, and an increase for PTSD + depression. They approved and awarded increases to both, complete with the big envelope, but kept the claim open. Nothing had been denied. I called the VA after I saw that my percentages had gone up, and Peggy said that it was a "partial decision" because they had initiated an inferred TDIU. How it was explained to me was that they had approved, and immediately awarded, increases for those claims but that they wanted to keep the claim open because the TDIU claim had only just been added.

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vetquest Veteran

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6 hours ago, Spink88 said:

Thanks for replying.

 

I submitted a claim for an increase for migraines, and an increase for PTSD + depression. They approved and awarded increases to both, complete with the big envelope, but kept the claim open. Nothing had been denied. I called the VA after I saw that my percentages had gone up, and Peggy said that it was a "partial decision" because they had initiated an inferred TDIU. How it was explained to me was that they had approved, and immediately awarded, increases for those claims but that they wanted to keep the claim open because the TDIU claim had only just been added.

In this case you are in a waiting game.  The VA will take their time and get back to you only when they are ready.

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