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Can you appeal a DEC denial...

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Post by Guest Thu 07 Mar 2019, 12:47

45jim wrote:From my case manager, they have increased flexibility regarding DEC decisions prior to April 1st to enable veterans access to the CIA Supplement which will disappear after PFL is in place. If your case manager is supportive, apply. They usually have one day a week where the DEC decisions are debated and either approved or denied.  

Your case manager can verbally inform you of a decision but a formal letter will follow, instructions for appeal/review will be on the letter.

Anyone can apply for DEC while on a rehabilitation plan. However, if your case manager is advising against it I would suggest that it won't go very far as the decision is made (up to April 1st) at the Case manager, supervisor and VAC office medical staff level. Your case manger is your advocate there who presents your case and can give insight as they should have met you. After April 1st,  DEC decisions will move to a cell in Winnipeg. As no one will "present" your case it will be a paper review of documentation like most other benefits. My case manager also stated that once DEC moves to Winnipeg the two-year review will become a regular occurrence even for those over 100% disability.  
so much clouded information out there my CM told me the decision was totally out of their hands,I guess I should have lathered the CM up more because they obviously didnt present very well.my question is ,during my appeal, if my CM and a board denied it, who looks at it next, same Cm and same board taking a second look at the evidence or my cm presenting to a brand new board ( how many board members can there be?), or does some else look at it like the national 1st level of appeals ,or whatever it's called. I once saw a chart that showed the nature of your complaint and which branch handles it,but in the list DEC wasnt a choice

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Post by johnny211 Wed 06 Mar 2019, 06:20

Bruce72 - Well said Brother. It’s way beyond time our Gov in power stop jerking Vets around. Sadly I don’t see this happening. VVV
Johnny Out..
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Post by Guest Wed 06 Mar 2019, 03:56

I am sick and fucking tired of veterans needs being an issue.

There is zero reasons why this shit should be happening.

Veterans are not a political football. We have laid our lives on the line, for hotdog eating, beer drinking, TV watching motherfuckers.

Some of our friends have paid the ultimate price. They're fuckin dead, and nothing will bring them back.

This bullshit of changing benefits to suit the government coffers ends tonight.

Veterans should never have to worry about the the fucking government doing their part.

The conversation is over. The fuck tard of a federal government will meet its obligations to veterans.

I won't say it twice.

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Post by Guest Tue 05 Mar 2019, 21:34

bigrex wrote:OK , there you go. It doesn't say that the reassessment will happen every 2 years, just 2 years after the Veteran was initially deemed DEC. And that they may request a reassessment, under certain circumstances, such as evidence that the Veteran is earning more than acceptable, under the DEC guidelines.

As long as they don't interfere in our lives.

The road has been long, and I'm not paying anymore tolls.

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Post by bigrex Tue 05 Mar 2019, 17:13

OK , there you go. It doesn't say that the reassessment will happen every 2 years, just 2 years after the Veteran was initially deemed DEC. And that they may request a reassessment, under certain circumstances, such as evidence that the Veteran is earning more than acceptable, under the DEC guidelines.
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Post by 45jim Tue 05 Mar 2019, 16:37

I can only forward exactly what I was told, its a head's up. The fact that VAC is creating a new cell for DEC means they will have plenty of time on their hands to do reviews as lets face it, the number of DEC veterans is pretty small. As PFL is nothing but a cost reduction scheme it seems reasonable that they would kick people off DEC if they believe they no longer qualify, saves them money. How this will all roll out after April 1 2019 who knows, but the legislation provides for a review every two years and if VAC decides to do it Veterans have no choice but to comply. The current procedure of NOT reviewing veterans who are more than 100% disabled is an administrative choice, one they could change at any time.

DEC Status - Follow-up

39. In all cases, two years following the date the Veteran is determined to have met the criteria for DEC, the Veteran must be re-assessed to determine if he or she is still meets the criteria for DEC. A Veteran may have his or her EL or CIA benefits cancelled if he or she fails to comply with any request for reassessment, as indicated in paragraph 36.

40. A follow-up examination of a Veteran’s DEC status may be conducted at any other time, and should occur in any of the following circumstances:
              a. the Veteran shows potential for improvement;
              b. the Veteran requests a re-assessment and/or is interested in re-engaging in the Rehabilitation Program;
              c. statements of earnings indicate that the Veteran may be gainfully employed; or
              d. statements of earnings indicate that the Veteran is no longer considered “totally disabled” as defined by a third party compensation plan, such as CAF LTD (SISIP), Canada Pension Plan, or provincial or federal worker’s compensation plan.

41. If an examination or assessment is determined to be appropriate, the decision maker should consider the evidence and factors as required for any DEC determination as set out in paragraphs 13 to 20 above. If the Veteran is determined to have the capacity for suitable gainful employment, the DEC status should be terminated effective the date of the decision.


36. A Veteran who fails to undergo a required medical examination or assessment without reasonable excuse to do so may have his or her EL benefit cancelled, as per section 20(2) of the VWA, and his or her Career Impact Allowance, including the CIA Supplement cancelled, as per section 40(2) of the VWA.

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Post by bigrex Tue 05 Mar 2019, 15:49

I think that they would be hard pressed to tell veterans, that they need to undergo assessments again, every two years, if it was already deicded that they didn't need to keep doing them, several years ago. I've been TPI/DEC, with ELB and CIA/S since 2012, and I've only had one review since. At some point, even they, have to realize that reviews for severely disabled Veterans, are nothing but a waste of time and, more importantly, money.
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Post by Guest Tue 05 Mar 2019, 13:37

"My case manager also stated that once DEC moves to Winnipeg the two-year review will become a regular occurrence even for those over 100% disability".

If VAC thinks I'm going to allow them to interrupt my life every 2 years, they have another thing coming.

Bothering me with constant reviews will only make me angry and intensify my symptoms.

If that's what they want, they'll get it.

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Post by 45jim Tue 05 Mar 2019, 11:02

From my case manager, they have increased flexibility regarding DEC decisions prior to April 1st to enable veterans access to the CIA Supplement which will disappear after PFL is in place. If your case manager is supportive, apply. They usually have one day a week where the DEC decisions are debated and either approved or denied.

Your case manager can verbally inform you of a decision but a formal letter will follow, instructions for appeal/review will be on the letter.

Anyone can apply for DEC while on a rehabilitation plan. However, if your case manager is advising against it I would suggest that it won't go very far as the decision is made (up to April 1st) at the Case manager, supervisor and VAC office medical staff level. Your case manger is your advocate there who presents your case and can give insight as they should have met you. After April 1st, DEC decisions will move to a cell in Winnipeg. As no one will "present" your case it will be a paper review of documentation like most other benefits. My case manager also stated that once DEC moves to Winnipeg the two-year review will become a regular occurrence even for those over 100% disability.

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Post by Zodiac Tue 05 Mar 2019, 08:06

Hello again, a bit confused here. I have read the VAC policy on this but when I wanted my case manager to make the request she said no. Any comments?

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Post by Guest Mon 04 Mar 2019, 21:48

BinRat wrote:https://www.veterans.gc.ca/eng/about-vac/legislation-policies/policies/document/1971

Communication of Decisions

22. All DEC decisions, including reassessment decisions, must be communicated to the Veteran in writing, including the reason(s) for the decision, the effective date of the decision and the Veteran’s rights for review.
thanks, so then I guess I will “request a review.?”, I’m just wondering if anyone else here had to.? Personally I think they are just stalling to apr 1, then apr2 they will say “ we reconsidered, you are actually DEC”.

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Post by BinRat Mon 04 Mar 2019, 20:26

https://www.veterans.gc.ca/eng/about-vac/legislation-policies/policies/document/1971

Communication of Decisions

22. All DEC decisions, including reassessment decisions, must be communicated to the Veteran in writing, including the reason(s) for the decision, the effective date of the decision and the Veteran’s rights for review.

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Post by 45jim Mon 04 Mar 2019, 17:07

When it comes to PTSD I have no experience with the process.

However, from my own experience it was nurse assessments, Occupational therapy assessments, previous disability claims with attendant QOL assessments (Quality of Life) and my doctor completing the DEC documentation that provided enough supporting information.

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Post by Guest Mon 04 Mar 2019, 16:31

45jim wrote:You can "question" anything but not necessarily "appeal". All VAC decisions have an option for review but not all go through VRAB or a formal appeal process.
Your DEC process was a local one (your case manager, supervisor, VAC medical team) and if they did not rule in your favour there should have been a reason. If they want more information (Capacity assessment, Dr. report, other assessments) then hopefully they will tell you what you need and appointments can be made. If they came back and said "you're not broken enough" then it will be difficult to reverse the decision without further claims.

After April 1st 2019, all DEC decisions will be made by a group in Winnipeg. Looks like case managers will not be part of the process anymore.
In my case they are looking for even more physician, psychologist and psychiatrist information than provided, I don`t know what else I can give them, all the paper work was completed by professionals but they said they wanted "independent" assessments, which I don`t understand as it`s like saying that VAC feels that the previous Dr.`s are not competent? None were connected with the OSI, but if they recommend I go there, how is that "independent" when they are intertwinded with VAC. I find the whole thing bizarre.

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Post by 45jim Mon 04 Mar 2019, 15:07

You can "question" anything but not necessarily "appeal". All VAC decisions have an option for review but not all go through VRAB or a formal appeal process.
Your DEC process was a local one (your case manager, supervisor, VAC medical team) and if they did not rule in your favour there should have been a reason. If they want more information (Capacity assessment, Dr. report, other assessments) then hopefully they will tell you what you need and appointments can be made. If they came back and said "you're not broken enough" then it will be difficult to reverse the decision without further claims.

After April 1st 2019, all DEC decisions will be made by a group in Winnipeg. Looks like case managers will not be part of the process anymore.

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