|
| 1 | +{ |
| 2 | + "data": { |
| 3 | + "type": "supplementalClaim", |
| 4 | + "attributes": { |
| 5 | + "benefitType": "compensation", |
| 6 | + "claimantType": "other", |
| 7 | + "claimantTypeOtherValue": "Veteran Attorney", |
| 8 | + "homeless": true, |
| 9 | + "homelessLivingSituation": [ |
| 10 | + "I LIVE OR SLEEP IN A PLACE THAT IS NOT MEANT FOR REGULAR SLEEPING", |
| 11 | + "I LIVE IN A SHELTER", |
| 12 | + "I AM STAYING WITH A FRIEND OR FAMILY MEMBER, BECAUSE I AM UNABLE TO OWN A HOME RIGHT NOW", |
| 13 | + "IN THE NEXT 30 DAYS, I WILL HAVE TO LEAVE A FACILITY, LIKE A HOMELESS SHELTER", |
| 14 | + "IN THE NEXT 30 DAYS, I WILL LOSE MY HOME", |
| 15 | + "NONE OF THESE SITUATIONS APPLY TO ME", |
| 16 | + "OTHER" |
| 17 | + ], |
| 18 | + "homelessLivingSituationOther": "random words for other living situation ", |
| 19 | + "homelessPointOfContact": "Shawn Hobkens Veteran Care Network", |
| 20 | + |
| 21 | + "mstUpcomingEventDisclosure": "NOT APPLICABLE AND/OR NOT ENROLLED IN VHA HEALTHCARE", |
| 22 | + |
| 23 | + "homelessPointOfContactPhone": {"areaCode": "777", "phoneNumber": "9957023"}, |
| 24 | + "veteran": { |
| 25 | + "address": { |
| 26 | + "addressLine1": "123 Main St", |
| 27 | + "addressLine2": "Suite #1200", |
| 28 | + "addressLine3": "Box 4", |
| 29 | + "city": "New York", |
| 30 | + "countryCodeISO2": "US", |
| 31 | + "stateCode": "NY", |
| 32 | + "zipCode5": "30012" |
| 33 | + }, |
| 34 | + "phone": { |
| 35 | + "countryCode": "03", |
| 36 | + "areaCode": "555", |
| 37 | + "phoneNumber": "8001111" |
| 38 | + }, |
| 39 | + |
| 40 | + "timezone": "America/Chicago" |
| 41 | + }, |
| 42 | + "claimant": { |
| 43 | + "address": { |
| 44 | + "addressLine1": "456 First St", |
| 45 | + "addressLine2": "Apt 5", |
| 46 | + "addressLine3": "Box 1", |
| 47 | + "city": "Montreal", |
| 48 | + "countryCodeISO2": "CA", |
| 49 | + "zipCode5": "00000", |
| 50 | + "internationalPostalCode": "A9999AAA" |
| 51 | + }, |
| 52 | + "phone": { |
| 53 | + "countryCode": "1", |
| 54 | + "areaCode": "555", |
| 55 | + "phoneNumber": "8111100", |
| 56 | + "phoneNumberExt": "4" |
| 57 | + }, |
| 58 | + |
| 59 | + "timezone": "America/Detroit" |
| 60 | + }, |
| 61 | + "socOptIn": true, |
| 62 | + "form5103Acknowledged": true, |
| 63 | + "evidenceSubmission": { |
| 64 | + "treatmentLocations": ["PRIVATE HEALTH CARE PROVIDER", "VA VET CENTER", "COMMUNITY CARE", "VA MEDICAL CENTERS (VAMC) AND COMMUNITY-BASED OUTPATIENT CLINICS (CBOC)", "DEPARTMENT OF DEFENSE (DOD) MILITARY TREATMENT FACILITY(IES) (MTF)"], |
| 65 | + "treatmentLocationOther": "hospital that is not standard other more words more words hospital that is not standard other more words more words", |
| 66 | + "evidenceType": ["upload", "retrieval"], |
| 67 | + "retrieveFrom": [ |
| 68 | + { |
| 69 | + "type": "retrievalEvidence", |
| 70 | + "attributes": { |
| 71 | + "locationAndName": "X-Ray VAMC", |
| 72 | + "evidenceDates": [ |
| 73 | + { "startDate": "2020-04-10"}, |
| 74 | + { "startDate": "2020-01-02", "endDate": "2020-02-01" }, |
| 75 | + { "startDate": "2020-02-20", "endDate": "2020-02-22" }, |
| 76 | + { "startDate": "2019-02-02", "endDate": "2020-02-03" } |
| 77 | + ], |
| 78 | + "noTreatmentDates": true |
| 79 | + } |
| 80 | + }, |
| 81 | + { |
| 82 | + "type": "retrievalEvidence", |
| 83 | + "attributes": { |
| 84 | + "locationAndName": "Blood Lab VA Facility", |
| 85 | + "evidenceDates": [ |
| 86 | + { "startDate": "2020-02-20", "endDate": "2020-02-22" }, |
| 87 | + { "startDate": "2020-02-02", "endDate": "2020-02-07" } |
| 88 | + ], |
| 89 | + "noTreatmentDates": true |
| 90 | + } |
| 91 | + }, |
| 92 | + { |
| 93 | + "type": "retrievalEvidence", |
| 94 | + "attributes": { |
| 95 | + "locationAndName": "Doctor's Notes VAMC", |
| 96 | + "evidenceDates": [ |
| 97 | + { "startDate": "2020-04-10", "endDate": "2020-04-10" } |
| 98 | + ], |
| 99 | + "noTreatmentDates": true |
| 100 | + } |
| 101 | + }, |
| 102 | + { |
| 103 | + "type": "retrievalEvidence", |
| 104 | + "attributes": { |
| 105 | + "locationAndName": "CT scan VA Medical Facility", |
| 106 | + "evidenceDates": [ |
| 107 | + { "startDate": "2020-07-19", "endDate": "2020-07-19" }, |
| 108 | + { "startDate": "2018-03-06", "endDate": "2019-02-12" } |
| 109 | + ], |
| 110 | + "noTreatmentDates": true |
| 111 | + } |
| 112 | + }, |
| 113 | + { |
| 114 | + "type": "retrievalEvidence", |
| 115 | + "attributes": { |
| 116 | + "locationAndName": "Lab work VAMC", |
| 117 | + "evidenceDates": [ |
| 118 | + { "startDate": "2018-03-06", "endDate": "2018-03-06" }, |
| 119 | + { "startDate": "2018-01-15" } |
| 120 | + ], |
| 121 | + "noTreatmentDates": false |
| 122 | + } |
| 123 | + } |
| 124 | + ] |
| 125 | + } |
| 126 | + } |
| 127 | + }, |
| 128 | + "included": [ |
| 129 | + { |
| 130 | + "type": "contestableIssue", |
| 131 | + "attributes": { |
| 132 | + "issue": "right shoulder", |
| 133 | + "decisionDate": "2000-01-08", |
| 134 | + "socDate": "2020-04-30" |
| 135 | + } |
| 136 | + }, |
| 137 | + { |
| 138 | + "type": "contestableIssue", |
| 139 | + "attributes": { |
| 140 | + "issue": "lower back", |
| 141 | + "decisionDate": "1900-01-06", |
| 142 | + "socDate": "2021-02-24" |
| 143 | + } |
| 144 | + }, |
| 145 | + { |
| 146 | + "type": "contestableIssue", |
| 147 | + "attributes": { |
| 148 | + "issue": "torn rotator cuff", |
| 149 | + "decisionDate": "1989-03-07", |
| 150 | + "socDate": "2020-04-30" |
| 151 | + } |
| 152 | + }, |
| 153 | + { |
| 154 | + "type": "contestableIssue", |
| 155 | + "attributes": { |
| 156 | + "issue": "hearing loss", |
| 157 | + "decisionDate": "1930-10-20", |
| 158 | + "socDate": "2016-05-30" |
| 159 | + } |
| 160 | + }, |
| 161 | + { |
| 162 | + "type": "contestableIssue", |
| 163 | + "attributes": { |
| 164 | + "issue": "sciatica", |
| 165 | + "decisionDate": "2007-01-19", |
| 166 | + "socDate": "2012-01-02" |
| 167 | + } |
| 168 | + }, |
| 169 | + { |
| 170 | + "type": "contestableIssue", |
| 171 | + "attributes": { |
| 172 | + "issue": "bowel obstruction", |
| 173 | + "decisionDate": "1999-12-29", |
| 174 | + "socDate": "2019-08-13" |
| 175 | + } |
| 176 | + }, |
| 177 | + { |
| 178 | + "type": "contestableIssue", |
| 179 | + "attributes": { |
| 180 | + "issue": "right eye", |
| 181 | + "decisionDate": "1920-04-02", |
| 182 | + "socDate": "2019-11-19" |
| 183 | + } |
| 184 | + }, |
| 185 | + { |
| 186 | + "type": "contestableIssue", |
| 187 | + "attributes": { |
| 188 | + "issue": "left index finger", |
| 189 | + "decisionDate": "2018-08-17", |
| 190 | + "socDate": "2021-03-20" |
| 191 | + } |
| 192 | + }, |
| 193 | + { |
| 194 | + "type": "contestableIssue", |
| 195 | + "attributes": { |
| 196 | + "issue": "spinal compression", |
| 197 | + "decisionDate": "2013-09-11", |
| 198 | + "socDate": "2020-08-24" |
| 199 | + } |
| 200 | + } |
| 201 | + ] |
| 202 | +} |
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