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Fully Developed Claims & Disability Benefits Questionnaire Info


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Why doesn't the C&P Examiner, Individual making Rating Recommendation have the ability to "Flag" a claims file when their recommendation is for 100% and/or IU? This would be another way to move claims along and prevent/help backlog. Current claims are slowly moving into backlog status (I.e. 180 days). Depending on whose claim date you go by.

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The C&P Examiner is not allowed to say something is service-connected, as that's a legal call, just as we the raters are not allowed to make medical judgments as that's the doctor';s call. (i.e., even though i know there is no way in hell that your plantar warts are secondary to your service connected migraines, if you claim that I have to put in an exam for the warts becuz I can't make a medical determination, no matter how obvious...same thing with the docs).

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  • 2 weeks later...

Hey all, sorry for the long absence, been working 2.5 jobs.

Anyway, we just had a team meeting & I heard something that is going to make life interesting re claims. The VA judges have ruled that in addition to the change of all claims being put on the Form 526 EZ (whether it's FDC or not), that if a veteran does not SPELL OUT that claimed conditions are due to service, they can be denied. In other words, say you claim a back condition. Your service records indicate you had some treatment for you back, & you were in service about 10 yrs or more ago. You put down "back problems" on the form, nothing else. You do not submit medical evidence, or u might have some VA Med. Ctr treatment but neither the doc nor u ever said it was due to service. If there is nowhere in those records or ON THE CLAIMS FORM that you have had back problems SINCE SERVICE, we do not order an exam for u & it can be denied.

If you are filing a new claim, PLEASE write in there somewhere that your condition is since service...those 2 little magic words may mean the difference between getting service connected or not!

This is the most ridiculous thing that I've heard so far and if it is true, someone should go to jail! You can not disregard a veterans claim because they do nott put the words service connected on their condition. The entire application is for "Service Connected Disabilities", anyone attempting to deny that all conditions listed are intended to be claimed as service connected is acting in bad faith and should at the very ;east be fired and publicly shamed!!

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  • 2 weeks later...
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