Furious and Completely Done
Posted on
I've had my claim deferred for almost two months, requesting a SECOND clarification from the same provider at LHI that could have been done a month ago. My claim was submitted in January as a fully-developed claim.
On June 3 after my claim was flagged for hardship, the VA sent a request for clarification to LHI in regards to my GERD claim and LHI scheduled it by June 11 to be completed on June 21. The clarification was sent back the same day and the VA pushed the claim to PFN awaiting the senior rater's signature.
It was then pushed back on June 23 to Gathering of Evidence and another request for clarification was sent to LHI for Chronic Fatigue Syndrome (CFS), as the nurse practitioner who conducted my C&P Exam in February said that it is not service connected and later said that it is. I called LHI five times over the next week and finally was told on July 1 that it is scheduled on July 5. I reiterated numerous times that my claim is flagged for hardship.
July 6 rolls around and I call to see the status. They only said it was in progress. I call again on July 9 and get the same answer. I call again on July 13 and they say they're waiting for further documentation from the VA. I call again on July 15 when my twins are born and get the same answer. I had enough. I then called the VA, as my suspense date was July 15. They said they're going to figure out what is going on. I call the VA on July 18 and am told that they're still waiting on LHI.
I call LHI again on July 19 and they say it's in progress. I was furious. I escalated to a customer service lead and was told they can escalate it. I said they damn well better because this was flagged for hardship two months ago and it's been two weeks since the appointment has passed. I know all the documentation that is available on me for CFS and it doesn't take two weeks to clarify one detail and then pass it around for certainty. I told the lead that if this isn't done in two days, then it's over their head.
I call this morning and get the same runaround, and I get an unsatisfactory, scripted answer from the team lead. I said I need to speak to your boss, now. I get the manager and explain everything that has happened and that I'm done with this. He said he'll contact the regional manager that would be the liason between the VA and LHI to figure out what is going on and that this needs to be prioritized.
The backlog from VA claims has decreased month-over-month this entire year, and assuming that the VA is balancing out workload between all third-party medical professionals performing services for C&P claims, there is zero excuse this is not done, other than pure negligence or not giving a fuck about hardship claims. Either way, all my documentation available on CFS does not take nearly three weeks to go over and verify with other medical professionals. The C&P exam was entirely unnecessary as I submitted a lengthy Independent Medical Opinion from a long-time doctor and expert on CFS, while also submitting a DBQ from my primary care doctor who has taken care of me over the last decade.
Tl;dr: The dumbass nurse practitioner who conducted my C&P Exam in February from LHI wrote that CFS is not service connected and later said it is service connected. This nurse practitioner is the reason I've been waiting for the last two months. This egregious error was not caught by the VA after my claim went from PFN to GoE numerous times, and after nearly three weeks from LHI's start date for the clarification, it's still not done. My claim is flagged for hardship and LHI is not treating it like it is. I've escalated this so it's going to be discussed at a regional level. Fuck this shit.
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