Just wondering how long it typically takes to get your call? I’ve been waiting 60 days without any movement. HLR on one claim, single aspect. What’s normal timeline wise?
Original claim filed August 2024, took 23 months to fully resolve, ended at 90% combined. For mental health I claimed PTSD, GAD, and panic disorder. Only had one C&P (PTSD) and the examiner produced an inadequate DBQ that VA kicked back for rework. Then I waited over two months for that rework to actually get done, which was its own nightmare.
In the meantime I was receiving PCMHI treatment at my VA. Sessions with a psychologist, medication management, PHQ-9 and GAD-7 maxed severe, PCL-5 above the PTSD threshold, and a positive C-SSRS for a lifetime attempt. I submitted a 21-4138 identifying my treatment records and asking VA to obtain and consider them. VA sent me a letter confirming they’d uploaded my mental health records from the VAMC to my eFolder about three weeks before the rating decision.
The rating decision granted “other specified stressor related disorder” at 30%, denied PTSD itself as “no current diagnosed disability,” and denied GAD and panic disorder on the same “no diagnosed disability,” and denied GAD and panic disorder on the same “no diagnosis” basis without ordering any C&P for those specifically. The evidence section lists no VAMC treatment records, which means the actual PCMHI records apparently weren’t considered even though VA had said they were in the file. The 30% reasoning cites anxiety, chronic sleep impairment, depressed mood, and suspiciousness, but doesn’t address the C-SSRS positive, doesn’t discuss my spouse’s buddy statement even though it’s listed in evidence, and doesn’t analyze whether documented symptoms meet the 50% criteria.
Given the 23 months and effective date preservation, I really don’t want to risk backpay. HLR would let me argue procedural error (evidence supposedly in the file wasn’t considered, symptom criteria not analyzed, buddy statement ignored, Clemons issue on the GAD/panic denials). Effective date preserved, no new evidence. Supplemental would let me actually submit the treatment records as new evidence plus continued care since June, effective date also preserved if filed within one year.
I keep seeing here that HLR is basically always a mistake and supplemental is the better path. Is that still the case where there’s a specific procedural error to argue records the VA said they had but apparently didn’t consider, or is that mostly for cases without clear error? Anyone been in a similar spot where treatment records were listed as pulled but not actually weighed? What worked?
Thanks.