Re: CIA appeal

by Guest Wed 13 Feb 2019, 16:54

Newfie wrote:Sleepingdog. I was denied CIA and again denied at 1st Level appeal. I appealed to 2nd level appeal and I provided additional medication information to support my appeal. I won my the appeal at 2nd level. Took over a year. As for DEC I was granted DEC and CIAS and stayed level 3 CIA as I served past 20 year mark

thanks, a few people here posted about being denied initial CIA and appealing that, but what about already having CIA , applying for a higher grade and having that appeal denied. Can you add new evidence and contest the negative appeal result?

by Newfie Wed 13 Feb 2019, 16:24

Sleepingdog. I was denied CIA and again denied at 1st Level appeal. I appealed to 2nd level appeal and I provided additional medication information to support my appeal. I won my the appeal at 2nd level. Took over a year. As for DEC I was granted DEC and CIAS and stayed level 3 CIA as I served past 20 year mark

by **bigrex** Wed 13 Feb 2019, 15:06

Right now, it would depend on how many years you served, before being medically released, AND at what level of DEC you have . If you served more than 10 but less than 20, and are limited to earning less than 66.6% of military income, you would get grade 2. If you served less than 10 years, AND were unable to earn more than 33.3% of your military income, then you could get grade 1.

These criteria re being eliminated in April, so any increases to your grade, will require that your medical conditions meet the requirements.

by Guest Wed 13 Feb 2019, 14:17

45jim wrote:My appeal was denied using the same wording as the denial of the original submission. I am now in the DEC process so that may change the outcome and perhaps a new application will be required rather than appeal the old decision. That is if I am declared DEC.

I thought I read here that if you are declared DEC, that you automatically go to grade level 2 of CIA as well, though I could be wrong. I am wondering if someone was CIA grade level 2 and then declared DEC would they yet again go up a grade?

by 45jim Wed 13 Feb 2019, 12:12

My appeal was denied using the same wording as the denial of the original submission. I am now in the DEC process so that may change the outcome and perhaps a new application will be required rather than appeal the old decision. That is if I am declared DEC.

by Guest Wed 13 Feb 2019, 12:06

45jim wrote:Just had CIA denied (first application) and I am going to appeal. The appeal process for this benefit is through the National First Level Appeal Unit, which appears to be another name for a departmental review, so no VRAB assistance. My application was based on physical disabilities and not having appealed any decision before I am looking for some guidance in how to draw up and word my appeal. I have already read their decision in detail and notice the "form letter" type of content. So i think it was just the general first kick-at-the-can denial.

So, has anyone successfully appealed and would they be prepared to provide the "jist" of their appeal so that I can use it as a template. Obviously, I can fill in the blanks with regards to disabilities and quote VAC scripture but I am really looking for a letter format that can remain here so it becomes a resource for all that need it.

Once I submit my appeal and I get (hopefully) a positive response I will post my letter as at least one example that may be of assistance to someone else.

Any takers?

how did this work out for you.?l applied for a CIA upgrade but was denied, so I appealed. The appeal was denied. BPA doesn’t get involved in these matters so l don’t even know if you can appeal an appeal denial, ?lol.

by AirLog Sat 06 Oct 2018, 12:53

Thanks to all. I appreciate the input and will let you know how it turns out.

AirLog

by By the Bay Sat 06 Oct 2018, 12:06

AirLog wrote:Good morning,

By the Bay, did you visit your Doctor to assist in filling out the medical questionnaire? My CM has recently sent my Doctor a medical questionnaire to fill out for my CM initiated DEC and I was wondering if I should make an appointment to see my Doctor to assist him in filling out this questionnaire?

AirLog

Yes I made a doctor's appointment. What I did was tell the receptionist that the Doctor will be receiving Medical Questionnaire from VAC and that I would like to be there to assist her with filling it out. So she booked me into a 45 minute slot. VAC also paid for the doctor to fill it out my forms. I was not charged anything.
It worked out nicely.

Cheers,
By the Bay

by Guest Sat 06 Oct 2018, 11:38

AirLog wrote:Good morning,

By the Bay, did you visit your Doctor to assist in filling out the medical questionnaire? My CM has recently sent my Doctor a medical questionnaire to fill out for my CM initiated DEC and I was wondering if I should make an appointment to see my Doctor to assist him in filling out this questionnaire?

AirLog

Yes make the appointment.

by Teager Sat 06 Oct 2018, 11:06

I made an appointment for the medical questionnaire just in case the doctor had any questions or needed clairfication. The questionnaire was pretty lengthy and he wasn't able to complete it in enough time. He told me he would finish it that week and if he had any questions he would call me. My doctor also has my med records from the military so he was able to refer to those.

by AirLog Sat 06 Oct 2018, 09:54

Good morning,

By the Bay, did you visit your Doctor to assist in filling out the medical questionnaire? My CM has recently sent my Doctor a medical questionnaire to fill out for my CM initiated DEC and I was wondering if I should make an appointment to see my Doctor to assist him in filling out this questionnaire?

AirLog

by Guest Sat 06 Oct 2018, 07:40

By the Bay wrote:I can answer a few questions regarding DEC process since I have been through it and I was approved with no issues.

My CM kept me informed on the process of my DEC application. She sent the DEC Medical Questionnaire to my doctor, and request my doctor to fill out the questionnaire and send it back to VAC ASAP.
After my CM received the doctor Medical Questionnaire, my CM sent it along with other supporting evidence to the VAC local Doctor for DEC approval. The VAC doctor is the decision maker when it comes to DEC applications.
Hope this helps.
Cheers,
By the Bay

Awesome info Bay, thank you. I have a DEC application in at VAC initiated by my case manager and your info gives me some relief from the stress of wondering how it works.

by By the Bay Sat 06 Oct 2018, 03:37

I can answer a few questions regarding DEC process since I have been through it and I was approved with no issues.

My CM kept me informed on the process of my DEC application. She sent the DEC Medical Questionnaire to my doctor, and request my doctor to fill out the questionnaire and send it back to VAC ASAP.
After my CM received the doctor Medical Questionnaire, my CM sent it along with other supporting evidence to the VAC local Doctor for DEC approval. The VAC doctor is the decision maker when it comes to DEC applications.
Hope this helps.
Cheers,
By the Bay

by Guest Sat 06 Oct 2018, 00:36

bigrex wrote:For DEC, I think that it's a small group of VAC workers, but not a board per say. Just your CM, maybe a regional manager, a medical advisor, etc, who discuss your file and reports, to come up with a decision, or make a recommendation to Charlottetown, for the final approval. See physical disabilities are easier to prove DEC, because they send you to a 3rd party OT, to do an assessment. They have no skin in the game, so therefor their assessments are free from bias, and based purely on how you performed during their examination. Psychological conditions on the other hand, are more subjective. with the report written by the same doctor, who has been treating the Veteran for months, or years, and have to base their report, strictly on what the Veteran tells them during their sessions. And VAC being VAC, they will deny or reduce anything, if they have the slightest doubt.

and what if a Vet was put on Cppd while VAC was mulling things over, you would think that would help swing the vote? Less money out of their pocket as isnt cppd subtracted from any ELB/DEC payment due?

by **bigrex** Fri 05 Oct 2018, 23:58

For DEC, I think that it's a small group of VAC workers, but not a board per say. Just your CM, maybe a regional manager, a medical advisor, etc, who discuss your file and reports, to come up with a decision, or make a recommendation to Charlottetown, for the final approval. See physical disabilities are easier to prove DEC, because they send you to a 3rd party OT, to do an assessment. They have no skin in the game, so therefor their assessments are free from bias, and based purely on how you performed during their examination. Psychological conditions on the other hand, are more subjective. with the report written by the same doctor, who has been treating the Veteran for months, or years, and have to base their report, strictly on what the Veteran tells them during their sessions. And VAC being VAC, they will deny or reduce anything, if they have the slightest doubt.

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