[Veterans Self Help Guide]

To file a VA disability claim and receive compensation, you must have all of the following:

• A current physical or mental disability. (List of disabilities rated by the VA 38CFR4 Schedule for Rating Disabilities) See Caluza Triangle
• An injury or disease in service that caused a disability or aggravated a disability that existed before service.
  • An important point to make here is that if the military said you were fit to serve and did not note any existing conditions, the veteran has the presumption of Soundness. Here is an excerpt from M21-1MR, Part IV, Subpart ii, Chapter 2, Section B.
• The presumption of soundness means that the Veteran will be considered to have been in sound condition when examined, accepted, and enrolled for service except for defects, infirmities, or disorders noted at entrance into service.
  • Notes: 
    • The presumption of soundness applies only when the Veteran underwent a physical examination at the time of entry into service on which the claim is based.
    • Only the conditions that are recorded in the examination report are to be considered as noted.
• When no pre-existing condition is noted at entrance into service, the burden falls on the VA to rebut the presumption of soundness by clear and unmistakable evidence showing that the disease or injury 
  • existed before service and
  • was not aggravated by service.

Reference: For more information on the presumption of soundness, see
38 U.S.C. 1111  - VAOPGCPREC 03-2003 - Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004).

There are two types of service-connection

• An in-service injury/disease means that, for the most part, it must be documented in the veteran's service medical records (SMRs). One thing to remember is that, generally, the in-service injury/disease must be shown to be “chronic” during in-service. If it is not shown to be a “chronic” condition while in service, then you'll more than likely need an Independent Medical Opinion (IMO) to substantiate the claim. If a veteran doesn't have either a documented “chronic” condition or an IMO, the VA will more than likely state that the claimed condition is “Acute and Transitory,” meaning that the injury/disease resolved itself and there are no residuals.
• A current condition with a medical diagnosis means that the claimed condition has to show current residuals from that in-service injury and must have a current diagnosis from a physician. A lot of times, the diagnosis can and will be obtained from the VA C&P exam. Suppose the VA sees that your condition was “chronic” while in the service or that you have medical documentation of continuity of treatment since discharge. In that case, they will often schedule the veteran for a C&P exam to obtain the needed diagnosis and the current disabling effects of the claimed disability.

Something connecting the two means either continuity of treatment of the claimed disability from discharge to the present or, if this is not the case, an IMO will be needed from a physician. A lot of times, an IMO is a critical part of the veteran's claim. An IMO can sway the benefit of the doubt in the veteran's favor if the claim is borderline, or it can flat-out prove service connection when one of the three components of establishing service connection isn't met! For example, by borderline, I mean that a veteran was seen for lower back pain once while on active duty over a five-year enlistment. Now, it is ten years since his discharge, and the veteran hasn't been seen for the lower back until recently or only had one episode of back pain within those ten years since getting out of the military. The veteran will need an IMO stating something to the effect that his current lower back condition is somehow related to the episode while on active duty. If the RVSR (Rating Veteran Service Representative or “Rating Specialist”) is very liberal in applying the regulation, he/she may award service connection without the (IMO) Independent Medical Opinion. However, if the RVSR is “by the book,” then he/she may deny service connection without a good IMO. An example of where an IMO can establish a service connection with which one or more of the three criteria listed above are absent would be, let's say, that a veteran was seen one time for a knee condition while on active duty. This incident is noted in his SMRs. Ten years later, the veteran is experiencing pain in that same knee but hasn't had any type of treatment since his discharge; he would need a really good IMO to establish that his current disability is somehow related to the in-service episode.

As far as presumptive service connection is concerned, a veteran needs to be able to show that a condition listed in §3.307, §3.308, and §3.309 has manifested itself within the prescribed time limits after separation from the service. A presumptive condition does not need to be noted in a veteran's SMR, or it's presumed that the said disability/disease occurred while in the service. Some presumptive disabilities do need to have manifested themselves within the first year after separation and to the degree of 10% disabling to warrant presumptive service connection. One common one is Arthritis.

Filing the Claim

Once you have determined that you have met three basic criteria of disability compensation, you should then file the claim with your local Regional Office.

There are two types of claims for initial service connection: an Intent to file a claim and a Formal claim. (There used to be something called informal claims, which was removed in March 2015)

Intent To File A Claim

A new intent-to-file process has been established for Veterans and Survivors who intend to file a claim for VA compensation, pension, or survivor benefits but need additional time to gather all of the information and evidence needed to support their claim. Intent To File A Claim FactSheet

A Formal Claim

A formal claim for disability compensation is the VA Form 21-526. You should fill this out to the best of your ability. You should attach any Service Medical Records, Private Treatment records relevant to your claimed disabilities, a certified copy of your DD 214, copies of marriage certificates, divorce decrees, and dependent birth certificates. By attaching these documents, you'll speed up the processing of your claim quite a bit. However, you do not need to attach those documents if you do not have them in your possession. If you do not have any of those medical records, the VA will assist you in obtaining those by asking you to fill out VA Form 21-4142 for each facility where those records are located. One important side note: make sure you sign the VA Form 21-526!!

Now, what will happen after I file my formal claim?

What Happens After You File Your Claim

After you send VA your Formal claim, several “teams” at your local, regional office process your application. Essentially, six "teams" at a Regional office make up the "process." When a veteran files a claim for benefits with VA, it is received at what is called a 'Triage Team.' This is where the incoming mail is sorted and routed to the different sections or other "teams" to be worked. Picture this as a Triage unit at a Hospital. There they decide who goes where according to the injury/condition involved. This is the way it works at VA too. The main function of the Triage Team is to screen all incoming mail. Within the Triage Team, there are other sub-components; the Mail Control Point, Mail Processing Point, and to a certain extent, supervision of the files activity. The mail control point is staffed with VSRs (Veteran Service Representatives) who are actually trained in claims processing. This is also where they receive and answer the IRIS inquiries. The mail processing point is where chapter 29/30 claims (a bit later on, these types of claims) are processed/awarded, and to a certain extent, dependency issues are resolved.

The next step is the "Pre-Determination Team." This is where your claim for benefits is sent to be developed, meaning verification of service from the Service Department if a certified copy of the DD 214 is not submitted by the veteran; SMRs are obtained from St. Louis if they weren't sent in already by the veteran, any CURR verifications are done for PTSD stressors, any private treatment records are obtained under the "Duty to Assist," and inferred issued are identified. Once the Pre-Determination Team figures out what you're claiming, they'll send you what's known as a “Duty to Assist” letter or the VCAA letter. This letter states what type of claim you are filing, what conditions you are claiming, and what the regulations say you must show to have your claim granted. It will also state the evidence needed by VA to support your claim and what VA is doing or has done. The letter will also explain VA's “Duty to Assist” you in obtaining the evidence to support your claim. There will also be a response form that you should fill out and return. If you do not return this form or mark the box that you have additional evidence to submit, the VA must wait 60 days to further process your claim. As your claim progresses further through the Pre-Determination Team, you may or may not receive other letters. Examples of those letters include follow-up letters to let you know VA requested something from a third party and there is a delay in their reply and letters requesting that you provide something to VA to support your claim. The Pre-Determination Team may also send you a computer-generated letter telling you they are still working on your claim. That letter is pretty interesting because it means a couple of things have happened with your claim; 1) your claim was reviewed by someone recently, or 2) your claim has aged where the computer system is telling the regional office that they must look at your claim. One thing to keep in mind is that every time VA sends you a letter, regardless if it's for the information you already sent them, you should always respond with a letter via Certified Mail with a return receipt. If you already sent something to VA that they previously requested, just send them a letter stating that you already submitted the information and when you sent it. Once all the developmental work has been done on a claim, it is then designated as "Ready to Rate" and sent to the Rating Activity.

The Rating Activity or “Rating Board” is where most veterans want to have their claim. This is where the claim for benefits is decided. The RVSR (Rating Veteran Service Representative, or “Rating Specialist”) is the person who rates a veteran's claim. They review the entire C-file to ensure it is ready to be rated and schedule any C&P exams that may be needed if not already done so by the Pre-Determination Team. If a C&P exam is needed, they do the paperwork to schedule this. Once the RVSR has all the needed paperwork to rate the claim, they make their decision. If the RVSR determines that there is something missing from the claim to make a decision, they send the claim back to the Pre-Determination Team for further development. Once they have reached their determination, they produce a rating decision with their decision and forward the C-file to the Post-Determination Team.

The Post-Determination Team is where the rating decision is promulgated. In other words, it is where the decision gets entered into the system and the rating decision is prepared and sent out to the veteran. If the veteran has a Power of Attorney (POA), they give them a heads up about the decision. If a claim has been granted and the retro involves over $25,000.00, it is sent to the VSCM (Veterans Service Center Manager) or their assistant for a third signature. The Post Determination Team may also do the following actions; accrued benefits claims not requiring a rating, apportionment decisions, competency issues not requiring a rating, original pension claims not requiring a rating, dependency issues, burials, death pension, and specially adapted housing and initial CHAMPVA eligibility determinations when a pertinent rating is already of record.

The Appeals Team handles appeals in which the veteran has elected the DRO review. They also handle any remands that have been sent back from the BVA and the Court. The Appeal Team is a self-contained unit within the Regional office. They make determinations on appeals, make rating decisions that are on appeal, do any developmental work on any issue that may be on appeal, and issue any SOCs and SSOCs in conjunction with their review.

The Public Contact Team's primary functions are to conduct personal interviews with and answer telephone calls from veterans and beneficiaries seeking information regarding benefits and claims. Depending on their workload, regional offices also handle IRIS inquiries and fiduciary issues.

As one can see, the VA claims process can be complex. In essence, a veteran's claim is continuously going from one team to another until it has been decided. This process can be rather lengthy depending on what regional office has jurisdiction over your claim and their pending workload. During this process, a veteran may want to find out the status of their claim. This should be done through the VA's IRIS website inquiry system. The veteran will get much more accurate information through this inquiry system than by calling the 1-800 number. The 1-800 will only connect you to the regional offices “Public Contact team.” These employees aren't really trained to deal with the different processing stages and so forth and aren't able to give very accurate information in that regard. The intention of the 1-800 number and the Public Contact team is really to give general benefits information and send out forms to claimants, not to try and track a veteran's claim. Furthermore, veterans' claims aren't like tracking a UPS package where it travels in a straight line to its end destination. Veterans' claims will end up bouncing from team to team at the regional office until all of the work required to make a decision is done.

Appealing an issue with VA

When you receive your rating decision from the VA, look over it carefully. Make sure all of the evidence you sent them is listed in the ‘evidence” section of the rating decision. The “Decision” section will be what VA decided. The “Reasons and Bases” section will be VA's rationale for its decision. If you disagree with VA's rating decision, you can appeal that decision.

In any type of appeal, the first step is submitting a Notice of Disagreement (NOD) with your regional office telling them what issue you disagree with and why you disagree with that decision made by them. You have one year from the date of the rating decision to submit your NOD. In the NOD, you should also specify which way you wanted your appeal handled, i.e., the traditional way (Board of Veterans Appeals, or “BVA”), or through a DRO review. If you don't tell the VA which one, they will send you a letter asking which route you want. You then have 60 days from the date of that letter to choose. If you don't answer the letter, the VA automatically processes the appeal through the traditional process. Also, in the NOD, you should state if you want a hearing or not.

NVLSP suggests adding this into the I-9 form- usually, there is enough space under the hearing questions on the I-9 form.
"I take exception to and preserve for appeal ALL errors the VARO may have made, or the Board hereafter might make in deciding this appeal. This includes all legal errors, all factual errors, failure to follow M21-1, all due process errors, and any failures to discharge the duty to assist as a violation of basic VA laws and regulations within 38 USCS and 38 CFR."

A DRO review is where a Decision Review Officer, hence DRO, who is a senior rater with many years of experience that works in the appeals Team, will completely review your claims folder and NOD and decide whether or not he/she can grant the benefit the claimant is seeking. If the DRO grants the appeal in full, he/she will produce a rating decision telling the claimant of the percentages, etc... just like the Rating activity would on a normal claim. If the DRO cannot grant the appeal in full, then he/she will issue a Statement of the Case (SOC) explaining the actual laws and rationale which pertain to the denial. Even if the DRO is able to grant a partial appeal, they still must send out a SOC. For example, let's say you are appealing a PTSD rating of 50%. The DRO grants an increase to 70%, but since the DRO didn't/couldn't grant the highest possible award pertaining to the disability, they must still produce a SOC. In this scenario, the DRO would send out a rating decision with the grant in an increase from 50% to 70%, and a SOC stating why he/she couldn't grant the full benefit allowable, i.e., the 100% rate. Once a claimant receives a SOC, they have 60 days from the date of the SOC to either "perfect' their appeal by submitting VA Form 9, which will prompt the RO to send the appeal to the BVA, or submit 'New" evidence that was not before the decision maker when he/she made their prior determination. When the claimant submits "new" evidence, the VA will evaluate the new evidence and either grant the benefit sought on an appeal or issue a Supplemental Statement of the Case (SSOC) outlining why the new evidence was unable to be used to grant the appeal. An SSOC will only address the new evidence the claimant submitted. From the date of the SSOC, the claimant again has 60 days to either "perfect" the appeal by submitting VA Form 9 or again submitting "new" evidence. If the claimant submits new evidence again, then the process of either a grant in benefits sought or an SSOC will repeat itself until the claimant "perfects" their appeal.

The traditional appeals process is where the claimant wants to skip the DRO review and appeal directly to the BVA. In this case, the claimant still must send a NOD to the VA. The VA, more specifically the rating activity that made the prior decision, will send out a SOC. Once the claimant receives the SOC, the process afterward is the same as when the DRO issues a SOC. You can either submit "new" evidence and have the Rating activity reconsider their previous decision, which will either prompt them to grant the benefit sought on appeal or send you an SSOC, or you can "perfect" your appeal by sending in VA Form 9. Once the VA Form 9 is sent in, the regional office then prepares your claims folder for the BVA, where it gets put on the docket. Remember you only have 60 days from the date of the SOC or SSOC to submit the VA Form 9!

Requesting a "Reconsideration" of a Prior Decision"

Another route that may be of some interest is the "reconsideration" route. This is where a claimant has received a rating decision and may disagree with that decision but has "new" evidence that the Rating activity was unaware of at the time of their decision and may think that the "new" evidence might result in a more favorable decision than the prior one. In this case, the claimant has the one-year appeals period to send in the "new" evidence and request that the Rating Activity "Reconsider" their previous decision. The claims folder would then go back to the Rating activity to be reconsidered, and the RVSR would send out a new rating decision where the "new" evidence is considered and a new decision rendered. One thing to keep in mind is one MUST submit "new" evidence in order for the VA to "reconsider" its previous decision. Another reason one might consider the "reconsideration" approach is simply because a request for reconsideration generally goes faster than an appeal because the claims folder goes back to the RVSR and is worked according to the date of the request for reconsideration. If the request for reconsideration warrants a favorable decision, the effective date may be the original claim's date, depending on what the evidence submitted dictates. A request for reconsideration is simply "re-opening" a claim within the one-year appeals period [(see 38 CFR, §3.400(q) for effective dates concerning reconsiderations) also see "Re-opening claims" for an explanation].

Another topic concerning "reconsideration" is whether or not one should file a Notice of Disagreement (NOD) if the VA hasn't yet rendered a decision before the one-year appeals period has expired. If one sends in "new" evidence within the one-year appeals period and requests a "reconsideration" of VA's prior decision, they better be 100% certain it will change VA's prior decision; If VA accepts it as a "Reconsideration" (which as stated before is a "Re-opened" claim), they must follow the rules and regulations for a reopened claim and render a formal decision unless one withdraw the claim prior to a decision being made. If they do render a formal decision, they must notify you of this decision which means that they cannot then turn around and accept the request to reopen as a Notice of Disagreement because it is dated and received prior to the latest decision on this issue. The NOD must be received AFTER you have been notified of the latest decision on that claim. Reopened claims and NODs are not worked by the same people nor by the same administrative procedures. 

If one requests a "reconsideration" with the one-year appeals period and then files a NOD before the one year elapses because VA hasn't made a decision on the "new" evidence, then one is asking that VA go through all the administrative procedures for a "reopened" claim up to and including a review by a Rating Specialist and then if the claim cannot be granted to just stop without a formal decision and send it back out to start reprocessing as a NOD. 

This would create an administrative nightmare and simply cannot be done. If, after requesting a "re-opening" of the claim, you then file a NOD, the "re-opened" claim is no longer valid, and whatever evidence you submitted with it will be considered as part of the NOD. As soon as the NOD is received on that particular issue, whatever it is, it MUST be worked under the appeal procedures. One cannot have both a reopened claim and a NOD on the same issue at the same time. In short, one must keep an eye on the expiration date for the appeal period so you can convert the "reopened" claim to a Notice of Disagreement (NOD) if a decision was not rendered before the appeal period expired. If you disagree with the decision and you aren't 100% certain that the new evidence will result in a grant, you cannot let that original appeal period run out. If the reopened claim is not granted and you don't submit a NOD within the appeal period for the first decision, you have lost the date of claim on that decision as a potential effective date. There are a limited number of situations where one should "re-open" the claim instead of filing a NOD, but these are few and far between, and one must really, really know what they're doing when they make the decision to do this. In the overwhelming majority of cases, a Notice of Disagreement is the best path to take.

Can one ask for reconsideration of a claim without submitting new evidence if one claims a clear and unmistakable error (CUE)?

Yes, but there has to be a clear and unmistakable error in the decision. It does no good to claim that there is if there isn't. The person looking at the claim of clear and unmistakable error can only change the prior decision by calling it CUE, and this must be signed off on by the Service Center Manager. He/she can't change the decision simply by substituting his/her judgment for the original decision maker. So consideration of CUE is not really a "reconsideration." They are looking to see if an error in the statement of fact or application of a law resulted in an erroneous decision (see also "Clear and Unmistakable errors").

Re-Opening Claims

Applying for an Increased Evaluation

Suppose you are already receiving service-connected compensation from VA for a disability and/or disease(s), and they have gotten worse since the last rating decision. In that case, you can request an increase in evaluation from VA. This is also known as a claim to Re-open. To do this, you just need to write the VA a simple letter with your claims number on it (usually your SSN) stating that you believe your service-connected disabilities have gotten worse and you would like an increase in evaluation. Along with this letter, you should attach any treatment records pertaining to your service-connected disabilities since your last C&P exam and rating decision. Once the VA receives your request for an increase, it will go to the Pre-Determination Team and go through the steps I previously mentioned in reference to an initial claim. In other words, you'll receive that “Duty to Assist” letter again and all the things surrounding it. After your claim is “Ready to Rate,” it will go to the rating activity for a decision, just like a normal claim would. Once the RVSR has made a decision, the rating goes to the Post-Determination team to be promulgated as would an initial rating does. If you disagree with the RVSR's decision, you can appeal that decision just as any other rating decision outlined in “Appealing an issue with VA.”

Previously Denied Claims

Suppose you have previously been denied a claim for disability compensation and that decision has become final, meaning the one-year appeals period has run out. In that case, you can request to have that claim to be Re-opened. In order to be able to re-open a previously denied claim, you must submit “New and Material” evidence. This means evidence that is “new," or was previously not before the decision maker, and “material,” which is evidence that bare directly on the fact as to why the previous claim was denied. Once you have submitted “new and material” evidence and VA re-opens your claim, they again have a “Duty to Assist,” and your claim will go to the pre-Determination Team for development, then to the Rating activity. Post Determination Team, just as a claim for increase or an initial claim would. Remember that submitting "new and Material" evidence doesn't mean your claim will actually be granted. It just means that there is enough prima facia evidence to warrant another look by the VA!

The Board of Veterans Appeals (BVA)

Suppose you have received a decision from VA and sent the Notice of Disagreement to your Regional Office and have either received a Statement of the Case or a Supplemental Statement of the Case from either a Decision Review Officer or the rating activity. In that case, you can further appeal the decision to the Board of Veterans Appeals by sending your Regional Office what is known as VA Form 9. By sending your regional office VA Form 9, you are what is called “perfecting” your appeal. Keep in mind that you only have 60 days from the date of the SOC or SSOC to submit this. Otherwise, the decision becomes final! Once the regional office receives your VA Form 9, they will certify your claim to be forwarded to the BVA, and you will be put on the docket. During the time the C-file is being certified to be sent to the BVA, the claimant can submit additional evidence to support their claim. Once the C-file leaves the regional office of jurisdiction to the BVA, the claimant has 90 days to submit any additional evidence.

Miscellaneous subjects concerning the VA

Clear and Unmistakable Errors (CUE)

The phrase "clear and unmistakable error" is a very misunderstood phrase by veterans when dealing with VA. When used by VA, it is a legal phrase that does not necessarily mean what a simple reading of the words would mean to the average layperson. When VA says there has not been a clear and unmistakable error committed, they aren't saying there was no error; there might have been. What it means is that there wasn't an error that rises to the level of the legal definition of this phrase as applied by VA in VA law. The phrase "clear and unmistakable error" means something entirely different in its legal context than simply saying whether or not VA made an error. Many veterans have the understanding that CUE is something that can appear to be erroneous and yet not be a CUE. To most people using logical thinking, an error is an error. However, to qualify as a CUE, the error must not involve judgment on the part of the decision maker (most decisions by RVSRs involve some type of judgment). That is the key element that confuses many veterans. 

In order to be a CUE, the decision maker must have reached a decision based on the incorrect application of a regulation or law without judgment being involved, or the decision must be based on an incorrect statement of the facts as they are known at the time. This doesn't mean that the decision-maker simply stated something that was not accurate, but that the decision itself turned on an erroneous statement of fact as was known at the time of the decision. A CUE must be based on the laws and regulations in effect at the time of the decision. A CUE is the means by which VA can go back and correct an error in a decision that would otherwise be considered final and not subject to correction. The VA has one of the most, if not the most, liberalizing appeals time frames there is in the disability compensation industry, so if there is an error in bad judgment, the veteran has every opportunity to appeal that decision.

Some other elements besides judgment by a decision maker that also aren't a basis for CUE are exam protocol and accuracy of the medical reports or completeness of the medical reports (A CUE is based on the accuracy of the decision made by the decision maker on the basis of whatever evidence is in front of him/her, not the accuracy of the content of that evidence, a doctor's opinion or statement), failure in the “Duty to Assist” except in the most extraordinary cases (where evidence available at the time of the decision were clearly shown that there was no doubt in any ones mind that the claim would have been decided differently if it had not been for the failure of the “Duty to Assist”), and changes in diagnosis (meaning a new medical diagnosis that “corrects” an earlier diagnosis), 

An example of a claim that would demonstrate a CUE; A veteran is awarded service-connection for IVDS and is awarded a 20% evaluation based on forward flexion of 20 degrees. The C&P exam and the whole medical record are silent for any duration of incapacitating episodes and any other measurements for range of motion. This would be a CUE because the rating criteria specifically states that “forward flexion of the thoracolumbar spine 30 degrees or less” would be assigned a 40% evaluation. Now, if there were some other forward flexion measurements noted in the rest of the medical records, then this would not necessarily be a basis for a CUE because the RVSR may have based his/her decision on the other forward flexion measurements, which may have more accurately portrayed the current overall limited range of motion.

CUEs are relatively rare, but most involve effective dates (EED) when they happen. The effective date is when VA determines when compensation payments begin. Generally, this is the date the veteran submits a claim.

Reduction in Benefits

Reduction in Current Awards

Suppose you are already receiving disability compensation from VA for a disability or disabilities, and the VA wants to reduce those awards. In that case, the VA will send you a “proposal to reduce” letter showing the proposed action (The proposed rating they want to assign and the effective date of the reduction). This is just a proposal and cannot be appealed. Once you receive a “proposal to reduce,” you have 60 days from the date of that proposal to submit any additional evidence to the Regional Office stating why you think your evaluation shouldn't be reduced. After the 60-day period is up, an RVSR will make a decision whether to actually reduce the award(s) or maintain the current rating as is. Once the RVSR makes a decision, they will send you a rating decision detailing their decision. If the RVSR decides to reduce the award(s), then the veteran has the one-year to submit a Notice of Disagreement (NOD) to start the appeals process outlined above.
If you want to make the VA hold off on reducing the monetary amount on the proposed date, you can file a request for a hearing. This must be done in writing within 30 days of receiving the “Proposal to Reduce.” Once you have submitted a request for a hearing (just a simple letter as there is no prescribed form), the VA cannot reduce the evaluation on the proposed date until the hearing is held, regardless of how long it takes to have that hearing.

Pyramiding

Pyramiding is the prohibition of assigning more than one evaluation per bodily etiology based on the same symptoms. CFR 38, §4.14 states;
“The evaluation of the same disability under various diagnoses is to be avoided. Disability from injuries to the muscles, nerves, and joints of an extremity may overlap to a great extent so that special rules are included in the appropriate bodily system for their evaluation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service-connected, others not. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation and the evaluation of the same manifestation under different diagnoses are to be avoided.”

The VA compensates a veteran for symptoms of residuals from injuries or diseases suffered to a body part while on active duty, not the number of injuries or diagnosis to a particular body area. For example, if a veteran has a lower back disability, let's say IVDS with scoliosis. Scoliosis would not be rated separately because it is also within the lower back. It would be “lumped” together in the rating with IVDS. Having said that, the lower spine (Lumbar and Thoracic) and upper spine (Cervical) can be rated separately because they are two separate moving parts of the spine. Another common one that veterans seem to misunderstand is mental disabilities. A veteran can only be compensated for one mental disability at a time. For example, if a veteran has PTSD and Depression, the VA would determine which of the two warrants the higher rating and “lump” the lesser one with the other.

One joint in the body can have more than one rating without pyramiding. That's the knee. The knee can obtain two ratings, such as limited range of motion and lateral instability, as long as the second one is compensable at the 10% rate or higher. For further reference, see VAOPGCPREC 23-97 and VAOPGCPREC 9-98.

Individual Unemployability

Individual Unemployability (IU) or also known as Total Disability due to Individual Unemployability (TDIU) is a rating that pays veterans at the 100% rate who do not meet the 100% criteria according to the 1945 Rating schedule because they are unable to secure and maintain a substantial gainful occupation due to their service-connected disabilities. The requirements needed to be considered for IU are spelled out in 38CFR4.16. There it states;
38CFR4.16 4.16 Total disability ratings for compensation based on unemployability of the individual.

(a) Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided That, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: 

1. Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, 
2. disabilities resulting from common etiology or a single accident, 
3. disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, 
4. multiple injuries incurred in action, or 
5. multiple disabilities incurred as a prisoner of war. It is provided further that the existence or degree of nonservice-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the veteran unemployable. Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination. 

(Authority: 38 U.S.C. 501)

(b) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue. 

[40 FR 42535, Sept. 15, 1975, as amended at 54 FR 4281, Jan. 30, 1989; 55 FR 31580, Aug. 3, 1990; 58 FR 39664, July 26, 1993; 61 FR 52700, Oct. 8, 1996; 79 FR 2100, Jan. 13, 2014]

One thing to keep in mind is that if a veteran doesn't meet the schedular requirements stated in subparagraph (a), there is still the possibility of obtaining IU under subparagraph (b). However, considerations under subparagraph (b) rarely happen because, first, the RVSR must think you are unable to obtain and maintain a substantial gainful occupation due to your service-connected disabilities, which becomes a judgmental call on their part and, second, if the RVSR thinks you can’t work because of your service-connected disabilities, he/she must submit the claim to the Director of Compensation and Pension in Washington, D.C. for extra scheduler approval.

Having said all of this, a veteran still should file the application for IU (VA Form 21-8940) if they are unable to work because of their service-connected disability, regardless of their rating percentages. I say this because when a veteran submits VA Form 21-8940, it also acts as a claim for an increase in evaluation. Suppose the veteran does not meet the schedular requirements stated in subparagraph (a) and submits the IU application. In that case, the VA will first see if the disabilities warrant an increase in evaluation. If so, they will determine whether the increase then meets the schedular requirement and if they do, then VA will address the issue of Individual Unemployability. By submitting VA Form 21-8940 when one is unable to secure and maintain a substantial gainful occupation due to their service-connected disabilities, regardless of their rating percentages, they protect the earliest effective date possible.

If you decide to apply for IU, you can do a few things to speed up the process. When sending in VA Form 21-8940, you should have each of your former employers from the last five years fill out and sign VA Form 21-4192 and then attach them to the IU application. Also, suppose any of your private physicians can write statements concerning you being unable to work because of your service-connected disabilities. In that case, they will help and should also be attached to the IU application.

Note: Your service-connected disabilities must be the sole reason for being unable to work. If there are any non-service-connected disabilities involved, then a physician will need to make a statement as to why the non-service-connected disabilities are a non-factor in you being unable to work.

Independent Medical Opinions by Your Private Physician

An Independent Medical Opinion (IMO) from a treating physician is, in many instances, a critical part of a veteran's disability compensation claim. An IMO may sway the “benefit of the doubt” in favor of a veteran's claim, or it may actually be the missing ‘link' or nexus in a claim. When a veteran asks his or her physician to compose an IMO, there are a couple of things that should be noted in it. One of the most important things that should be done and mentioned in the IMO is that the medical professional has reviewed the entire medical record, including the veteran's SMRs. The medical professional should also state his or her area of expertise and additional training. For example, if the doctor is board certified in radiology, they should state that, especially when rendering any comments regarding radiological film studies. Also, it is very important that the physician give their rationale as to why they have come to a certain conclusion. When giving his/her rationale, the physician should also cite any relevant medical literature that may support the findings. By doing all of this, the IMO becomes probative. There is also certain language the physician needs to use when opining whether or not the disabilities at hand is/are related to the veteran's service. 

The following phrases are from the Department of Veterans Affairs' “Clinician's Guide for Disability Examination;.”
"is due to" (100% sure)
"more likely than not" (greater than 50%)
"at least as likely as not" (equal to or greater than 50%)
"not at least as likely as not" (less than 50%)
"is not due to" (0%)

The phrase “at least as likely as not” is the legal phrase that is needed for the VA to award service connection for a particular disability based on the “Benefit of the Doubt” when an IMO should be the deciding factor in the evidence of record.

Note: You shouldn't send your regional office any medical articles printed from the internet. They only pertain to the general population and aren't afforded very much weight when they are being evaluated by the decision maker. The VA needs something from a doctor that states your disabilities are related to your service, not something meant for the general public.

Reasonable Doubt Rule

The Reasonable Doubt rule is one of the most important liberalizing rules that the VA uses to grant veterans benefits and is defined under 38 CFR, §3.102. The Reasonable Doubt rule means that when there is an equal balance of evidence for and against the claimant, the claimant is awarded their claim. This is just like in baseball as the "tie goes to the runner." Keep in mind this doesn't mean that just because there are ten pieces of evidence for your claim and ten against that, you will be granted your claim. It means that after consideration by the decision maker at VA, they have weighed the evidence, and there is an equal balance in their judgment. They must resolve reasonable doubt in the claimant's favor. It also doesn't mean that if, for example, there are five pieces of evidence in favor of a claim and only one against, a claim will automatically be granted because there is a preponderance of the evidence (meaning more evidence in favor of the claim than against) in your favor. The decision maker must still weigh the probative value of each piece of evidence and determine the weight of each piece in relationship to each other and the claim, and then reach a decision as to whether there is a balance of evidence for the claim and against the claim based on the weight given to each of that evidence.

38CFR3.102 Reasonable doubt.
It is the defined and consistently applied policy of the Department of Veterans Affairs to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. It is a substantial doubt and one within the range of probability as distinguished from pure speculation or remote possibility. It is not a means of reconciling actual conflict or a contradiction in the evidence. Mere suspicion or doubt as to the truth of any statements submitted, as distinguished from impeachment or contradiction by evidence or known facts, is not justifiable basis for denying the application of the reasonable doubt doctrine if the entire, complete record otherwise warrants invoking this doctrine. The reasonable doubt doctrine is also applicable even in the absence of official records, particularly if the basic incident allegedly arose under combat, or similarly strenuous conditions, and is consistent with the probable results of such known hardships.

Note: The resolution of the Reasonable Doubt doctrine can not be the basis for a Clear and Unmistakable Error (CUE). Since the Reasonable Doubt doctrine is based on Judgment made by a decision maker, it cannot be a basis for a CUE.

Obtaining a copy of your Claims Folder from VA

The best way to obtain a copy of your claims folder (your C-file) from the VA is to write a letter to your regional office citing the 1974 Privacy Act. When doing so under the 1974 Privacy Act, the VA has, according to federal law, 20 days to respond.

I hope this guide has been able to help you understand how the VA operates and why they need certain things to award disability compensation benefits. The key to being awarded service-connected disability compensation is evidence. You'll receive your deserved benefits if you have evidence of the three portions of a valid disability claim. 

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[14 Questions: VA Disability Benefits Claims]

When a Veteran starts considering whether or not to file a VA Disability Claim, they tend to ask many questions. Over the last ten years, the following are the 14 most common basic questions I am asked about when it comes to filing Veterans Affairs Disability Claims. [Reprinted here with permission from Veterans Law Blog] 

1. What benefits do you get from a VA Disability claim?

There are several major categories of VA benefits you can get when you file and win VA Disability claims. You should look at the VA’s “derivative benefits matrix” to see what other VA benefits you may be eligible for from the VA.

CATEGORY 1: Non-Service Connected Pension. These benefits are available to “wartime” veterans with no or low income due to non-servive connected disabilities. The calculation of the amount of the pension can be very difficult, so reach out to any attorney if you have been denied or feel like the VA didn’t calculate the pension correctly.

CATEGORY 2: Education Benefits. There is a wide array of VA educational benefits available to veterans seeking additional education, from the GI Bill to Dependents Educational Assistance and additional monthly compensation for dependents in college. Not only should you look at the VR&E benefit in Category 5, but you should also evaluate your eligibility fo

CATEGORY 3: Survivor benefits. The VA provides many programs to assist veterans' spouses, dependents, survivors, and caregivers. You can find a rather thorough list on the VA’s website.

CATEGORY 4: Health Care benefits. VA Healthcare is available to all veterans, with more disabled veterans (and veterans in special groups) getting higher priority access to care. You can learn more about what VA healthcare is and what it covers by clicking here. In some cases, your dependent, spouse, or survivor may be eligible for CHAMP-VA coverage.

CATEGORY 5: Employment Benefits. This category involves benefits such as access to the VA’s Vocational Rehabilitation program (now called VR&E, for Vocational Readiness & Employment) services to help with job training, employment accommodations, resume development and job-seeking skills coaching. You might also be eligible for help starting your own businesses or getting help with independent living services if you are severely disabled and unable to work in traditional employment. Veterans with a service-connected disability have access to a 10-point federal employment hiring preference.

CATEGORY 6: VA Disability claims for “Service Connected” compensation benefits. It is this sixth category of benefits that is the focus of this post – and the focus of the Veterans Law Blog since 2007. In this category of benefits, veterans receive monthly compensation for the impairment of earning capacity that results from diseases, conditions, and disabilities that had their origin in military service.

(Note that you do not need to show that military service CAUSED the disability – Congress long ago recognized that Veterans should get benefits even if a disease or disability that wasn’t caused BY service has its origins IN service.

When it comes to VA Disability claims for service-connected disabilities, the primary benefit is financial.

Once you prove to the VA that your current medical condition, disease, or disability is related to your military service, they will assign a percentage of disability to that condition – using a complicated table and formulas.   That percentage of disability translates to a monthly dollar amount.  10% equals one amount….20% another amount… and so on and so forth. You can see the 2021 VA disability ratings by clicking here.

You can take a look at the current VA Disability claim compensation amounts by clicking here.

In addition to the basic rates of compensation mentioned above, you can get additional compensation for different scenarios that you raise in your VA Disability claim. The VA, in fact, has a legal duty to maximize a veteran’s benefits in VA disability claims by broadly construing disability compensation claims and awarding as much compensation as the facts and evidence support.

The best place to begin a search for these benefits is to look at the VA Benefits Eligibility Matrix to see if you are eligible for what the VA calls “derivative benefits” — benefits that derive from VA disability compensation or even a non-compensable service-connected disability rating.

Here are just a few (you can read about even more by clicking here)

• A Veteran who has a certain percentage of disability ratings for multiple disabilities can be eligible for additional Special Monthly Compensation.  This Special Monthly Compensation is also available to Veterans with certain disabilities that limit the use of, or that resulted in the loss of, their extremities, their reproductive organs, and organs of special sense (vision, etc). Some of these benefits can be substantial – like SMC(t) for veterans with a TBI who have difficulty caring for themselves (or whose family has difficulty caring for them).
• Veterans who are unable to work because of their service-connected disabilities are entitled to a 100% total rating under a benefits program called Total Disability for Individual Unemployability, or TDIU.
• Veterans who need special aid and assistance with certain activities of daily living are entitled to an additional amount of compensation.
• And Veterans with a spouse or certain dependents are entitled to higher rates of compensation as well.
• There are certain vocational rehabilitation benefits available to Veterans with service-connected disabilities.
• The total percent rating of your  service connected disabilities can play a role in the ease you get VA Healthcare or the Priority Group you are assigned to.
• There are grants available for special adaptations to housing or automobiles that can grow out of your service-connected disabilities.
• Survivors of Veterans are entitled to non-service connected survivors’ pensions – also limited to the lowest-income survivors. These survivors are typically spouses or children, but in some cases, include parents and adult children who were permanently incapable of support before they turned 18.

2. How do I file a VA Disability claim?

 The VA’s answer to this question is found by clicking here. It used to be that you could file a VA Disability claim for a service connected condition, disease or disability just by writing your claim on a piece of paper – a famous anecdote that floats around the Veterans’ community is the veteran who  wrote his claim on a square of toilet paper while in prison.

This is no longer the case: filing a VA Disability claim has, like many other things in this world, become increasingly complicated.

Generally, filing a VA Disability claim requires a series of actions:

Step 1: Filing Phase

You can first file an informal claim for benefits using the required “intent to file” VA Form.  If you formalize your claim within one year of that informal claim, the VA treats your informal claim as a formal claim.

There are currently two claims & appeals processes. The legacy system covers cases where the veteran received a VA Ratings Decision before February 19, 2019 (and did not opt into AMA). The AMA Modernized Appeal system covers cases where the veteran received a VA rating decision dated after February 19, 2019. The system you are in primarily controls the process the VA uses, and, for the most part, the laws pertaining to service connecting a disability are largely the same.

Step 2: Development Phase

You can let the VA develop the evidence to support your claim – officially, they have a Duty to Assist the Veteran in this development of certain claims in limited situations.

Or, you can be more proactive and develop your OWN claim, using the three types of evidence common to VA disability claims and appeals.  Theoretically, these claims are supposed to be decided more quickly, and for the most part, they are.  But by developing your own claim and using the knowledge, information, and tools I share on the Veterans Law Blog, you can set your claim up for more thorough decisions, more proper decisions, quicker decisions, and….worst case scenario, if you have to appeal, a better chance at winning your claim on appeal.

Step 3: The Decision Phase

In this phase, the VA will decide that there is possible merit to your VA Disability claim for service connection of one or more conditions.

In most scenarios, they will send you to a C&P (Compensation & Pension) Examiner, who is, in theory, a medical doctor who will decide if your diagnosed condition is related to your military service and how bad your condition is, percentage-wise.

The VA might, before or after that review, issue a denial or a grant of benefits that is supposed to address a few questions, what I call the ‘4 Pillars’ of a VA Claim:

Pillar 1: Are you eligible to file a VA Disability claim for compensation benefits

Pillar 2: is the medical condition – or conditions – in your VA Disability claim related to your military service? (This pillar is often called the “service connection” or “nexus” element of your VA Disability claim)

Pillar 3: To what degree does your disability impair your ability to seek and hold work, or engage in average daily living activiites? I call this pillar the “Impairment Rating”.

Pillar 4: What effective date are you entitled to (it is the effective date that governs how far back in the past your benefits will be retroactive).  Some Veterans call this “back-pay” or “past-due benefits”, and depending on how long you have been battling the VA, they can often go back decades.  My colleague at another law firm won a case for a Veteran with a service connection granted all the way back to the 1950s, for example.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

Step 4: The Administrative Appeal Phase.

If you are not satisfied with the VA’s decision in step 3, you can appeal.

How you appeal has recently become very complicated. As of February 2019, the VA introduced a new appeal process called the Modernized Appeal system (or AMA), replacing the old “Legacy Appeal system.

You can read about the Legacy Appeals process by clicking here – there is a TON of information on the Veterans Law Blog® for those veterans who remain in the Legacy Appeals system.

You can read about the AMA appeals process by clicking here. As we learn more about this relatively new process, the Veterans Law Blog® will share what we learn.

Under the Legacy Appeals process, the goal was to get your denied VA disability claims reviewed by either or both a DRO (Decision  Review Officer), or to a Veterans Law Judge (VLJ) at the  BVA (Board of Veterans Appeals). To do the latter, you had to  “perfect your appeal” by filing several forms in a particular sequence and on a specific timeline. Under the Legacy system, you could then get a BVA hearing: an in-person hearing in DC, during a video conference hearing from a VA facility near you, or waive the hearing and submit a “brief” with “exhibits” and have the VLJ review your claim “on the record” before it. The BVA Judge could do one or more of the following – reverse, remand, grant, or any combination of those 3. By far, a combination of the 3 is most common. After that, these are the different things the BVA VLJ can do, in order of most to least common:

1. Remand the claim for the development of more evidence;
2. Deny your appeal (also known as affirming the VA denial of your VA Disability claim);
3. Grant your appeal (also known as reversing the VA Denial of your VA Disability claim).

The VA AMA modernized appeal process is much different. You can seek a Higher Level Review, file a supplemental claim, or appeal to the BVA. If you appeal to the BVA, you have to pick one of three “hearing” lanes. The BVA judge cannot remand except in incredibly limited scenarios.

Step 5: The Court Appeal Phase

If you are not satisfied with your BVA Decision, so long as it is not a remand, you can appeal to the Court of Appeals for Veterans Claims (aka, the “CAVC” or the “Veterans Court”).  That court only decides whether a BVA decision is proper under the law or properly applied law to fact….it cannot make factual findings.

On average, between 70-80% of BVA Decisions contain a reversible or remandable legal error, so if you have a BVA Decision, please talk to an attorney with experience at the Veterans Court to discuss appealing it.

Veterans do not pay out-of-pocket for lawyers at the CAVC…if the Veteran wins at the CAVC, the VA has to pay the lawyer out of IT’S own pocket and NOT out of the Veteran’s past-due benefits.

The CAVC can do any of the following: affirm (uphold) a BVA Decision, reverse (reject) a BVA decision, vacate (erase) a BVA decision, and remand (send a decision back to the BVA for repair of legal errors.  It can also combine 2 or more of those types of relief, depending on the case.

Step 6: Judicial Review phase

If you are not satisfied with your CAVC Decision, you have a limited opportunity for judicial review at the Federal Circuit Court of Appeals (Fed Circuit) and then the  Supreme Court of the United States.

The Federal Circuit only has the ability to decide PURE questions of law…I’d be willing to bet that 80-90% of Fed Circuit decisions in Board cases are “Rule 36’s”… decisions without a written opinion, typically because the Court does not have jurisdiction over the appeal.

Getting review at the Supreme Court is much harder, and appeals to both courts can be very expensive….filing fees alone at the Federal Circuit cost $500 and the cost of copying and filing the brief and the record of proceedings below costs between $2,000 and $5,000….so attorneys and Veterans tend to be more conservative about appeals to these courts.

3. When do I file a veterans benefits claim?

Ideally, you want to file your VA disability claim within a year after discharge from military service. (Learn about the one VA Program I like – the Benefits at Discharge Delivery, or BDD, Program)

However, most conditions do not get diagnosed for years or decades after service.  In those cases, if you are filing an original VA Disability claim (i.e., for the first time), you should file at least the intent to file a claim form mentioned above as soon as you have a suspicion that your condition is related to military service.

This protects the earliest possible effective date for your VA Disability benefits claims.

If you are filing claims for increased compensation, then you want to file the claim for increased rating as soon as you believe your condition is getting worse.

3. Where do I file my VA benefits claims?

Technically, your VA Disability claim is filed with the VA Regional Office for your geographic area.

However, you can file your VA Disability claim online through the eBenefits portal for Veterans, or, if you want to be sure that you create a paper trail for your claim to make sure it is not lost by the VA, you can file it by sending it to the Evidence Intake Center (also known as the VA’s EIC in Janesville, Wisconsin).

5. Who can help me file and appeal claims for service-connected VA disability compensation?

Anyone that you trust can help you with VA Disability claims.

However, nobody can charge you a fee for filing your VA Disability claim – attorneys and accredited agents are only allowed to charge a fee for filing or helping you in your VA Disability claim after the VA has denied the claim.

There are some fly-by-nighters who pretend to be VA claims insiders, telling you that they have the secrets that nobody else has. Those same self-proclaimed “VA disability claims insiders” will charge you fees that are illegal and, even when they are legal, are far higher than you should pay an unlicensed and unaccredited clown.  If someone tries to tell you that they are an insider with secrets that can help you with your VA disability claims, check to see if they are either or both an accredited agent, an attorney, or work for a VSO.  If not, the chances of getting cheated out of your benefits get pretty high.

Some national organizations, like the Disabled American Veterans (DAV), Veterans of Foreign Wars (VFW) and the American Legion (Legion or AL) have what are called “Veteran’s service representatives” or VSOs that volunteer to help with filing initial VA disability claims. The quality of work or help you get varies widely, and I’ve seen both extremes: I’ve seen VSOs that do amazing work for free, and I’ve seen VSOs that pull the rug out from under their “client” or “member.

Organizations like the Paralyzed Veterans Association (PVA) and the Vietnam Veterans of America (VVA) get consistently high marks for the work they do for their members.

6. How long does it take to receive compensation after filing VA Disability Claims?

The amount of time that it takes for the VA to decide a VA Disability claim can very greatly, and depends on a lot of variables: how difficult your claim is, how many conditions you include in the VA Disability claim, how well your claim is prepared, whether your claim is a Fully Developed Claim or not, how big your VA Regional Office is, etc.

Here are some general rules:

* If you click here, the VA provides its current time for processing claims (154 days as of the date of this writing). Keep in mind, appeals can take much, much longer, but for the most part, we are seeing most veterans get VA rating decisions on their original claims in under 6 months.

* If you are really bored, or like looking at really small numbers on mind-numbingly complicated spreadsheets, click here to see how long claims are currently taking in your geographic region.  Pour a scotch or glass of wine…these spreadsheets are consistent with everything the VA does….hard to understand, loaded with jargon, and obvious number juggling to hide problems in the system.

* Claims for VA disability benefits that are filed with smaller urban and rural VA Regional Offices are faster than VA Disability claims filed with larger metropolitan VA Regional Offices.

* Once you file an appeal, it can take 3-10 years to get a decision, again, depending on variables that are too numerous to list here

* Veterans can speed up the timeframe by filing well-developed and well-documented claims, like we teach here on the Veterans Law Blog®.

7. How do I check the status of my VA Disability claims?

That, right there, is the million dollar question.

The VA will tell you to call their VA toll-free number 1-800-827-1000 to get the status. Veterans that use this approach find that they are able to enjoy their favorite hobby while waiting to talk to someone at the VA: some Veterans relax and enjoy 2-3 hours of hold “muzack”, others read the week’s newspapers or a few magazines, and others have actually written a book while waiting on hold.  If you are among the patient and lucky few that get through to a human being on the 1-800 line, here are some tips and pointers how to get more value and information out of the call.

The VA also suggests that you check your status on eBenefits. eBenefits is a federal government site online which you log into and perform several claims-related actions, including file a claim.

Be forewarned, though – eBenefits is a glitchy and inaccurate tool.  For example, if you log into my eBenefits account, it shows that the VA held a hearing on my VA Disability Claim 2 years before I filed it.  That’s a true story, folks.  Now that is efficiency – maybe the VA will start a new pilot program: the pre-claim denial process.

Be careful what you see on eBenefits..it’s not always your claim status, and its not always accurate, and its rarely up to date.

8.How are VA service-connected compensation benefits calculated?

I wish that I could tell you that the VA simply added up your disability ratings from individual conditions to reach your total disability rating, and paid you according to that rating.

But the VA doesn’t do it that way. They use a unique system called “VA Math” to “combine” your individual disability ratings into a total, and then they award a monthly amount of compensation that corresponds to the resulting total impairment rating.

You can read more about impairment ratings here – Veterans have a lot more control over these ratings than they have been led to believe, however.  I teach Veterans how to improve or maximize their ratings for a TON of conditions – knee/arthritis, sleep apnea, PTSD, Tinnitus, Hearing Loss, Fibromyalgia and Chronic Fatigue, Gulf War, Migraines, Diabetes, Parkinson’s Disease and many more!

In my 5+ hour video training course, “How to Prove the 4 Pillars of a VA Claim“, I teach Veterans how to prove the 4 Pillars of a VA Claim, including a lot of specific ways to prove the degree of disability you experience and get the highest rating possible.

The only way to get access to this course is to become a subscriber of the Veterans Law Blog®….look at the other perks of subscribing, here.

9. Does the VA have to pay Veterans retroactive pay (back-pay)?

Yes, they are required by law to pay all past-due benefits.

The question is “how far do they go back”?

There is a whole set of rules that helps the VA decide how far back in time to go to pay retroactive benefits. These rules are called the effective date rules, and there are hundreds of them.

There are a few general guidelines….it’s not all the rules for every effective date for every type of VA Disability Claim, but it should give you an idea how much you have NOT been told about VA disability benefits over the years.

* In most VA disability claims, the effective date will be the LATER of the date you filed your claim and the date the entitlement arose. Click here to learn more about what that means.

* If you file your VA disability claim within 1 year of leaving service, your effective date will typically be your date of separation from military service.

* Claims for Increased compensation rates follow the general effective date rule, except that if you can show that the worsening of your condition started to occur BEFORE you filed your claim, you can get up to 1 year earlier.

* In some cases, if the law changes while you are trying to prove a claim, or after you’ve been denied a claim, and your claim is granted pursuant to that change in law that made it easier for you to win (in other words, the change in law is a “claim liberalizing rule”) you may be able to get up to 1 year prior to the date of your claim as your effective date

* If you reopen a previously denied claim by submitting New and Material Evidence, and you  win the reopened VA Disability claim based on military records, military service records, or military medical records that were previously unavailable to the VA or that the VA neglected to get in the prior claim, you can use the effective date rule in 38 CFR 3.156(c) to get an effective date of your original VA Disability claim date. (NOTE: REOPENED CLAIMS ARE ONLY AVAILABLE IN THE VA LEGACY APPEALS SYSTEM. In the AMA modernized appeals system you will need to file a supplemental claim with new and relevant evidence to revive a previously final claim.

* If you submit New and Material (under the Legacy System) or New and Relevant evidence (under the AMA Modernized Appeals system) within 1 year of the date your ratings decision denied your VA Disability claim, your claim is “open and pending” (Legacy) or “continuously pursued (AMA Modernized Appeal system) until the VA issues a new ratings decision, and if your benefits are granted based on that new and material evidence, your effective date could be the original date of your claim. This is a risky path to take, though, because if the VA denies your claim because the evidence wasn’t New and Material, then you may have lost your original effective date if you did not file an appeal within that same year after the VA Ratings Decision.

* If you are a “Nehmer Class Member”, meaning a veteran exposed to dioxin (aka, Agent Orange in Thailand, Vietnam, Korea, or other places), a whole set of effective date rules apply due to the VA’s settlement of a class action lawsuit in the 1980s. These are called the “Nehmer Rules”, and they can get pretty complicated pretty quick.

* A survivor who files a claim for survivor benefits (DIC, service connection of the cause of death and substitution, for example) will get survivor benefits retroactive to the date of the Veteran’s death if they filed their VA Form 21-534 within one (1) year of the Veteran’s death. If they file the claim for accrued benefits within that year, they may be able to get retroactive benefits paid to the date of any VA Disability claim or appeal pending on the date of the veteran’s death.

10.Are VA Disability benefits for life?

 I’ll answer this question along with #11.

11.Are VA Disability benefits permanent?

Generally speaking, they can be.

If a medical condition substantially improves, the VA can propose to reduce your disability compensation benefits to different levels.  The rules that they have to follow to do this can differ depending on certain factors, but here are a few considerations…you can click here to learn more about how the VA tries to pick Veterans’ pockets by reducing benefits, and get an idea how to stop it.

* The VA can only reduce “continuous ratings” (those that have been in effect for 20 years or more) after showing that they were awarded based on actual fraud by the veteran.

* There are 3 types of ratings in VA Disability claims that are considered “protected” ratings, which the VA cannot reduce without showing first a “substantial improvement” in your medical condition.

* If a VA Disability rating is considered “unprotected”, the VA can reduce it, but they have to send you notice of their intent to respond, give you an opportunity to respond and submit evidence and if you request it, provide a hearing.  The timelines on this type of reduction are pretty friendly to the VA, and pretty hard for the person filing the VA Disability claim to understand, no less follow, so be ready to move quick and do plenty of legwork to understand what is happening and how to stop it.

* If you are incarcerated for more than 60 days, on the 61st day, the VA can reduce your VA Disability compensation to no less than 10%, and must reinstate it after your release from jail. Click here to learn more about each time of rating and how long they stay in effect.

12.Are VA Disability benefits subject to child support?

Yes.

In every state that I am aware of, VA Disability benefits are considered income for the purposes of calculating child support.

Child support laws differ in each state, so there may be nuances from state to state how much is subject to child support, particularly when a portion of your VA Disability benefits is offset by military retirement payments.  The best thing to do is get out ahead of this situation by talking to a local family law attorney and making sure you do right by your kids, state  law, and federal law.

If you need a referral to a family law attorney in Texas or Arkansas, fill out a support ticket.  I know a lot of family law attorneys in both states and may be able to give you a couple referrals.

13.Are my VA disability compensation benefits taxable?

Nope.

At least not under Federal law.  Amounts paid to Veterans or their families for education, training, subsistence allowances, clothing allowances, disability compensation and/or pension payments are not taxable by the Feds.

As to whether these benefits are taxable at the State level, consult your state’s income tax agency, as the answer will vary state-by-state.

14. What are the most common medical conditions that Veterans seek to service connect?

The VA actually publishes a report of the conditions it service connects, the average ratings for each, and more. Click here to check out the report.

If you don’t have the stomach to read MORE VA propaganda – and honestly, who can blame you – here are the Top 10 conditions that the VA reports as being part of most original VA Disability Claims (click on the links to see information published on the Veterans Law Blog about these conditions common to VA Disability claims)

Tinnitus

Hearing loss

Lumbosacral or cervical strain

Limitation of flexion, knee

Scars, general

Post-traumatic stress disorder (PTSD)

Limitation of motion of the ankle

Migraine

Impairment of the knee, general

Bursitis

Here are some other conditions that I see very frequently in many a VA Disability Claim (click on the links to see information published on the Veterans Law Blog about these conditions common to VA Disability claims)

Sleep Apnea

Fibromyalgia

Peripheral Neuropathy

Diabetes

Parkinson’s Disease

Particulate Matter in the lungs

Gulf War Illness (aka, Chronic Multi Symptom Illnesses)

Traumatic Brain Injury

What other questions do you have?

If you have other questions about VA disability claims, the claims and appeals process, or other issues related to VA service-connected disability compensation, please type a comment below.

I do not publish all the comments, but I do read each one and use your questions to expand this post to have the most information possible about VA disability claims.

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[General VA Rating Formula for Mental Health Disorders]

How Does VA Rate Mental Health Conditions?

Aside from eating disorders, the VA rates all mental health conditions using the same diagnostic criteria. Mental health conditions are rated at 0%, 10%, 30%, 50%, 70%, or 100% using the VA’s General Rating Formula for Mental Disorders. These ratings are based on the social and occupational impairment level a condition presents. For example, a veteran experiencing mild symptoms or whose symptoms are well controlled by continuous medication may receive a disability rating of 10%. Veterans with more severe symptoms—such as an intermittent inability to perform the activities of daily living or suicidal ideation—may receive a 100% disability rating.

Veterans are not required to meet all, or even any, of the criteria in a rating level to qualify for that rating. Since mental health conditions can manifest differently per individual, the VA’s rating formula for mental health conditions is not binding. Symptoms listed in each level of the rating formula are examples of the types and levels of impairment commonly found at that assigned percentage rating.

Quote

 

The law is provided below as a reference.

Always click the links to see if the law has changed since this was written in 03/2024.

 

38 CFR 4.125 Diagnosis of Mental Disorders

 

(a) If the diagnosis of a mental disorder does not conform to DSM–5 or is not supported by the findings on the examination report, the rating agency shall return the report to the examiner to substantiate the diagnosis. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), American Psychiatric Association (2013), is incorporated by reference into this section with the approval of the Director of the Federal Register under 5 U.S.C. 552(a) and 1 CFR part 51. To enforce any edition other than that specified in this section, the Department of Veterans Affairs must publish notice of change in the Federal Register and the material must be available to the public. All approved material is available from the American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209–3901, 703–907–7300, http://www.dsm5.org. It is also available for inspection at the Office of Regulation Policy and Management, Department of Veterans Affairs, 810 Vermont Avenue NW., Room 1068, Washington, DC 20420. It is also available for inspection at the National Archives and Records Administration (NARA). For information on the availability of this information at NARA, call 202–741–6030 or go to http://www.archives.gov/federal_register/code_of_federal_regulations/ibr_publications.html.

(b) If the diagnosis of a mental disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination. 

(Authority: 38 U.S.C. 1155)

[61 FR 52700, Oct. 8, 1996, as amended at 79 FR 45099, Aug. 4, 2014]

§ 4.126 Evaluation of disability from mental disorders.

(a) When evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran's capacity for adjustment during periods of remission. The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination. 

(b) When evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign an evaluation solely on the basis of social impairment. 

(c) Neurocognitive disorders shall be evaluated under the general rating formula for mental disorders; neurologic deficits or other impairments stemming from the same etiology (e.g., a head injury) shall be evaluated separately and combined with the evaluation for neurocognitive disorders (see § 4.25). 

(d) When a single disability has been diagnosed both as a physical condition and as a mental disorder, the rating agency shall evaluate it using a diagnostic code which represents the dominant (more disabling) aspect of the condition (see § 4.14). 

(Authority: 38 U.S.C. 1155)

[61 FR 52700, Oct. 8, 1996, as amended at 79 FR 45099, Aug. 4, 2014]

§ 4.127 Intellectual disability (intellectual developmental disorder) and personality disorders.

Intellectual disability (intellectual developmental disorder) and personality disorders are not diseases or injuries for compensation purposes, and, except as provided in § 3.310(a) of this chapter, disability resulting from them may not be service-connected. However, disability resulting from a mental disorder that is superimposed upon intellectual disability (intellectual developmental disorder) or a personality disorder may be service-connected. 

(Authority: 38 U.S.C. 1155)

[79 FR 45100, Aug. 4, 2014]

§ 4.128 Convalescence ratings following extended hospitalization.

If a mental disorder has been assigned a total evaluation due to a continuous period of hospitalization lasting six months or more, the rating agency shall continue the total evaluation indefinitely and schedule a mandatory examination six months after the veteran is discharged or released to nonbed care. A change in evaluation based on that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. 

(Authority: 38 U.S.C. 1155)

[61 FR 52700, Oct. 8, 1996]

§ 4.129 Mental disorders due to traumatic stress.

When a mental disorder that develops in service as a result of a highly stressful event is severe enough to bring about the veteran's release from active military service, the rating agency shall assign an evaluation of not less than 50 percent and schedule an examination within the six month period following the veteran's discharge to determine whether a change in evaluation is warranted. 

(Authority: 38 U.S.C. 1155)

[61 FR 52700, Oct. 8, 1996]

§ 4.130 Schedule of ratings—Mental disorders.

The nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) (see § 4.125 for availability information). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in § 4.125 through § 4.129 and to apply the general rating formula for mental disorders in § 4.130. The schedule for rating for mental disorders is set forth as follows: 

9201 Schizophrenia

9202 [Removed]

9203 [Removed]

9204 [Removed]

9205 [Removed]

9208 Delusional disorder

9210 Other specified and unspecified schizophrenia spectrum and other psychotic disorders

9211 Schizoaffective disorder

9300 Delirium

9301 Major or mild neurocognitive disorder due to HIV or other infections

9304 Major or mild neurocognitive disorder due to traumatic brain injury

9305 Major or mild vascular neurocognitive disorder

9310 Unspecified neurocognitive disorder

9312 Major or mild neurocognitive disorder due to Alzheimer's disease

9326 Major or mild neurocognitive disorder due to another medical condition or substance/medication-induced major or mild neurocognitive disorder

9327 [Removed]

9400 Generalized anxiety disorder

9403 Specific phobia; social anxiety disorder (social phobia)

9404 Obsessive compulsive disorder

9410 Other specified anxiety disorder

9411 Posttraumatic stress disorder

9412 Panic disorder and/or agoraphobia

9413 Unspecified anxiety disorder

9416 Dissociative amnesia; dissociative identity disorder

9417 Depersonalization/Derealization disorder

9421 Somatic symptom disorder

9422 Other specified somatic symptom and related disorder

9423 Unspecified somatic symptom and related disorder

9424 Conversion disorder (functional neurological symptom disorder)

9425 Illness anxiety disorder

9431 Cyclothymic disorder

9432 Bipolar disorder

9433 Persistent depressive disorder (dysthymia)

9434 Major depressive disorder

9435 Unspecified depressive disorder

9440 Chronic adjustment disorder 

General Rating Formula for Mental Disorders

 

 

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[100 Percent Rating - How I Did It!]

One afternoon a few years ago, I Googled "I've had it with the VA." That simple "search" born out of utter frustration led me to "Hadit.com." And there it all started! As of two weeks ago, I'm rated 100% (long overdue). And I am still NOT done with the VA.

 

From Member Ping Juice

Greetings: I am grateful that one afternoon a few years ago, I Googled “I’ve had it with the VA.” That simple “search” born out of utter frustration led me to “Hadit.com.” And there it all started! As of two weeks ago, I’m rated 100% (long overdue). And I am still NOT done with the VA.

For those looking to do their research, I offer this process:

1. Obtain your Military Service and Medical Records by mailing (certified, return receipt requested) an SF-180, found here: Download SF-180
2. You can obtain your full VA treatment records from the “release of information” window at the center where you receive treatment.
3. Please review the CD-ROM (PDF file) for all chronic medical conditions, treatments, and diagnoses—chronicity is critical!
4. Identify the incident, event, or situation in service that “caused” this condition. If it’s in your active duty medical records, that’s extremely valuable. If it manifests after service, you’ll need to find a way to “connect” it to service – the “nexus”.
5. Next, search USC 38 part 4 for your CHRONIC DIAGNOSIS, found here: 38 CFR 4 Schedule for Rating Disabilities
6. Match the conditions and rating percentage to the CHRONIC diagnosis in your medical records.
7. Review the DBQ the C&P examiner “must” use to rate your current condition, found here: List By DBQ Form Name.
8. Search for VA court cases on your condition(s) to understand how the VA Regional Offices will likely “rule and rate” your claim. HINT: the cases tell you what evidence supports a claim.
9. For example, here’s a search for Sleep Apnea secondary to chronic Sinusitis: Google sleep apnea secondary to chronic sinusitis
10. Look for evidence in these cases that would support your claim, and THEN match and find your evidence – NEVER, EVER lie!
11. Gather all your evidence, write up a Statement in Support of Claim, found here:  Veterans Affairs Statement in Support of Claim and mail it certified return receipt requested.
12. NUMBER every single page, make copies, and wait.
13. Make someone sign for your mailed package – VA has NEVER lost my packages!
14. Before you go to a C&P, review your evidence, especially the questions the Dr. will ask from the DBQ. I usually handwrite a list of the 6-7 items that support my claim. I make sure the examiner sees this. I’m so done with the VA, I walked into my last C&P with my 4″ binder and the Dr. understood I knew what is going on. A C&P exam is a LEGAL MEETING, not medical treatment. 

 

I submitted my last three claims in July, which were fully decided correctly in six months. Help the VA help YOU! And, most importantly, never, never, never, ever give up. Be relentless! Most grateful, PJ 

I got a request to see how I wrote Claims, so here they are:

1. Hearing loss, Peripheral Vestibular Disorder, and Tinnitus.
2. Digestive disorder.
3. Skin disorder.

VA’s 2015 Decision on these three Claims.

1. STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS – PG-1- redacted.pdf
2. STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS – PG-2 – redacted.pdf
3. STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS FOLLOWED BY TINNITUS – PG-3 – redacted.pdf
4. DBQ WITH TINNITUS – HEARING LOSS & PERIPHERAL VEST DIS – AMENDMENTS_Redacted.pdf
5. C&P EXAMINER’S DBQ FOR EAR CONDITIONS.pdf
6. STMT SUPPORT CLAIM – RHIODS 2014 – redacted.pdf
7. DBQ FOR RHOIDS – FOR C&P.pdf
8. STMT SUPP CLAIM – ECZEMA 60% – PG 1-2.pdf
9. STMT SUPP CLAIM – ECZEMA 60% – PG 3.pdf
10. STMT SUPP CLAIM – ECZEMA 60% – PG 4.pdf
11. 2015 DX REDACTED FOR HADIT_Redacted.pdf

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[VA Appeals Process]

There have been some changes within the VA appeals process. It is no longer referred to as such; it has undergone a significant transformation and is now known as the decision review process. This change was implemented to make the process more efficient and effective for those involved.

Suppose you disagree with a VA decision made on or after February 19, 2019. In that case, rest assured that you have multiple options available! The decision review process has been designed to provide three distinct avenues (Supplemental Claim, Higher-Level Review, or Board Appeal) for you to continue pursuing your case.

Each option provides different advantages, and you can select the one that best aligns with your specific circumstances and needs. And the best part? If you choose an option and find that the result doesn't meet your satisfaction, you're not stuck with that outcome. You are fully entitled to try out another eligible option.

Remember, the process may seem daunting, but you are not alone. Continue to persevere and advocate for the benefits you deserve. Keep going. You got this!

From VA.gov VA decision reviews and appeals

 

Request a decision review

• Decision review option: Supplemental Claim

You can file a Supplemental Claim if you have new and relevant evidence that we didn't have when we reviewed your case before.

• Decision review option: Higher-Level Review

  Ask for a higher-level reviewer to review your case. You can’t submit new evidence with a Higher-Level Review.

• Decision review option: Board Appeal

  You can appeal to the Board of Veterans’ Appeals and have a Veterans Law Judge review your case.

• After you request a decision review

  Find out what happens after you request a decision review.

• Contested claims

  If you’re one of multiple people claiming a benefit that only one party has a right to, find out how to request a decision review.

• Insurance claims

  If you have an insurance claim, find out how to request a decision review.

• Fiduciary claims

  If you have a fiduciary claim, find out how to request a decision review.

Manage your decision reviews and appeals

• Check your VA claim status

  If you have already requested a decision review or filed a legacy VA appeal, sign in or create an account to check your status.

• Manage your legacy VA appeal

  If you filed a Notice of Disagreement for a decision dated before February 19, 2019, learn about the legacy VA appeal process.

More information and resources

• Choosing a decision review option

  Find out which decision review option is right for you.

• Frequently asked questions

  Get answers to frequently asked questions about decision reviews.

• Get help requesting a decision review

  A Veterans Service Organization or VA-accredited attorney or agent can help you request a decision review.

• Manage your VA debt

  Check the status of debt related to VA disability compensation, non-service-connected pension, or education benefits. You can also make payments or request help.

• The Appeals Modernization Act

  Learn more about how this law improves the claims and appeals process.

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[What items did you receive thru Voc Rehab ILP]

Kitchen Stool

Digital Pill Box Organizer

Memory foam car seat cushion

Zero-Gravity Workstation

Mobility Scooter

 

• The zero-gravity workstation I requested was delivered, but it collapsed and threw me out the first time I used it, crushing my computer.
• I had it picked up the next day and provided my counselor with the return receipt.
• Unbeknownst to me, my counselor had gone on emergency leave, and it was pretty apparent that I had fallen through the cracks. After I complained, someone called, and then I went through two counselors within a week of the first phone call. My third counselor told his supervisor that he was unaware that I had returned the workstation. I provided the return receipt again, along with the date and time I sent it to my original counselor.
• I asked them to replace it with a computer from a different manufacturer, which seems to be built better. I am still waiting. I asked for a computer to replace the one that was broken, and they told me they weren’t an insurance company.
• My original counselor told me they could help me put a bathroom in the basement where my room is. She had me jump through all kinds of hoops, apply for HISA, The HISA grant was approved but couldn’t find anyone to do the job for that amount of money. She told me to apply for SAH and SHA, and even though I told her I didn’t qualify, she said it was just part of the process. The new counselor says no, they won’t help with the bathroom.

So, this has been going on since 2019. I had my lawyer send them a letter and I had my congressman contact them, So now they say it’s a high priority, but who knows. I’ll keep you posted.

[4 Things Veterans Should Know About VA Sleep Apnea Disability Claims]

Quote

True story. And I’ve been getting asked these questions for years. On top of that, for about two years, I noticed at my VA Benefits law firm and on the Veterans Law Blog that Veterans of all eras were seeking my help – from Vietnam to Cold War to Afghanistan and beyond – appealing their VA Sleep Apnea disability denials. In short, I was seeing the sleep apnea disability hit the Veterans community like a typhoon! So a couple of years ago, I started trying to figure out WHY the sleep apnea disability was such a problem in the Veterans community. Chris Attig Veterans Law Blog 

The following is reprinted with the permission of Veterans Law Blog.

 

Trust me when I tell you this: a VA Sleep Apnea disability diagnosis has little or nothing to do with obesity and neck girth. In the end, I wrote a book about how to claim and service connect the sleep apnea disability through the VA. But I also learned a few extra things that I would like to share with you about the VA Sleep Apnea Disability claim.  And that’s what today’s video is all about:

I asked:

• Why were so many Veterans seeking service connection for sleep apnea?
• Why was sleep apnea affecting Veterans across all generations
• Why was it so hard for so many Veterans to win their VA sleep apnea disability claims?
• I talked to doctors (cardiologists, pulmonologists, sleep specialists, and more) about the three different types of sleep apnea disability diagnoses.
• I talked to hundreds of Veterans (from just about every era) and looked at dozens of their C-Files to see if I could figure out why some Veterans won their VA Sleep apnea disability claims, and others did not.
• I read just about every BVA Decision I could find on VA Sleep Apnea Disability appeals for a whole year.

Do you have questions about how to service connect sleep apnea claims?

You aren’t alone.  Winning a VA claim to service connect sleep apnea is hard.  Winning a VA Sleep Apnea is much harder.  In fact, winning your VA sleep apnea claim can feel like you just led your team to victory in the World Cup.

It’s almost as much work and can often take as much dedication. Veterans ask me more about sleep apnea than any other question about the VA Benefits Law.  Closely followed by PTSD, Hearing Loss, Tinnitus, and TDIU.* Can I service connect sleep apnea without a sleep study in service?

* What if it wasn’t diagnosed until years after service –  can  I service connect it then?* Can Agent Orange cause Sleep Apnea?  What about PTSD?* How do I appeal the VA's denial of my Sleep Apnea? I got so many questions that I began to do a lot of research into how to service connect Sleep Apnea claims and what is happening with Sleep Apnea in the Veteran’s community.

Here are 4 lessons I learned that I want to pass on to you – if you can really learn and understand these lessons, you will have the power to really improve and service connect sleep apnea claims and appeals.
1: Sleep Apnea is a Killer
2: Sleep Apnea is affecting a LOT of Veterans
3: The VA & BVA really struggle to Service Connect Sleep Apnea claims
4: More Veterans Should be Able to Service Connect Sleep Apnea

Lesson #1: Sleep Apnea is a Killer.

There are three things that the human body cannot live – or function – without: Blood/Oxygen, Food/Water, and Sleep.

You can lose a kidney and live a full and complete life.  You can lose your arms and legs and still survive.

But if your body cannot get sleep, you will die.  In fact, sleep deprivation is a common form of torture, as many of us know all too well. That’s what Sleep Apnea does – while you are sleeping, you stop breathing.

You cut off oxygen to the brain and blood, and other body systems break down.

If you are lucky, you start breathing again. Not a lot of VSOs or advocates get this when helping a Veteran file a VA Claim. They think of Sleep Apnea as a disease of the obese, and then they tell them one of the big Fairy Tales about VA Claims.

Lesson #2: Sleep Apnea is affecting a LOT of Veterans.

In the year I spent researching the Sleep Apnea Field Manual, I learned that 39 medical conditions – common among Veterans – can cause or aggravate sleep apnea.

39 Medical Conditions!!

Here are just a few:

• * Damage to the brain from a TBI (Traumatic Brain Injury)
• * Heart conditions
• * Post-Traumatic Stress (PTSD)
• * Nerve conditions
• * Rhinitis
• * Diabetes

Here are a few examples of how Sleep Apnea has affected Veterans from all different eras of service:*. Don D. (he asked me not to use his real name) served mostly during the Cold War and was in the best physical shape of his life – he was an avid weight-lifter.  That is, until he damaged his knees in service and had to get a knee replacement at a military hospital.  After that knee replacement, he could no longer lift weights; the sudden weight gain that resulted caused his obstructive sleep apnea.* Several Desert Storm, OIF, and OEF Clients have had Traumatic Brain Injuries that interfere with how their Nervous System works and, as a result, have a different kind of Sleep Apnea (oversimplified, where the brain’s signals to breathe don’t make it through to the lungs).* Many Vietnam Veterans exposed to Agent Orange suffer from sleep apnea.  They are ALL experiencing a “Perfect Storm” of Sleep Apnea problems: breathing disorders, mental health conditions, heart conditions, and diabetes are all causing an epidemic of Sleep Apnea in our Vietnam Veterans.No wonder Sleep Apnea is affecting so many Veterans – sleep apnea can be the result of other disorders or medical conditions.

Lesson #3: The VA & BVA really struggle to Service Connect Sleep Apnea claims.
I believe that the VA and BVA do not take Sleep Apnea seriously.  I think that far too many raters and BVA judges think of sleep apnea as “made-up medicine.”

Perhaps they’ll have to spend a night with someone who suffers from obstructive sleep apnea, hear the suffocating snoring, experience the fear that the person will stop breathing altogether, and continue not to take seriously claims for sleep apnea. Or perhaps when they realize that Sleep Apnea is going to be as big an issue for our current generation of Veterans as Agent Orange-related conditions are to Vietnam Veterans, they will take it seriously. Either way, Veterans have an uphill fight to connect their sleep apnea service.

Here’s a Statistic that will shock you:

From April 2013 to April 2014, the BVA denied  76% of Veterans' Sleep Apnea appeals. Translation: 3 out of every 4 of you will see your sleep apnea claims and appeals denied…unless you learn how to prove your Sleep Apnea Claim the right way

Lesson #4: More Veterans Should be Able to Service Connect Sleep Apnea.

I spent nearly a year researching Veterans and their Sleep Apnea claims.  I talked to several doctors and sleep experts.  I read hundreds of cases. I talked to hundreds of Veterans and read their C-Files to see where they went wrong. I learned that to win your Sleep Apnea claim. You are going to have to put your Sleep Apnea Claim together right.

This is where I come in.  I can teach you how to do that.  I can teach you:* HOW to prove your  Sleep Apnea Claim – for any of the three types of Sleep Apnea you have.* The EASIEST Way to prove Sleep Apnea.* WHAT evidence to use and which path to Service Connection to use.* WHERE to get the Lay Evidence that will give REAL POWER to your Sleep Apnea Claim.* To prove your Sleep Apnea is service connected… without a sleep study in the military?* The importance of a medical expert opinion in your Sleep Apnea claim.  (In many cases, a medical expert report or opinion may be crucial to success).* The SPECIFIC EVIDENCE you will need to prove another medical condition caused your sleep apnea* How the VA will rate your sleep apnea condition after granting Service Connection.

How can you learn more about these things?  Check out the Sleep Apnea Field Manual.  There are three ways to get it:

1. Get an eBook version of the Sleep Apnea Field Manual
2. Get a paperback real-book version of the Sleep Apnea Field Manual
3. Check out this VA Sleep Apnea Field Manual Package and get the knowledge you’ll need to take back the power in your VA Sleep Apnea claim.

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[Veterans Day World War I Ended On The 11Th Hour Of The 11Th Day Of The 11Th Month Of 1918 And All Was Quiet On The Western Front...]

 

Veterans Day World War I Ended On The 11Th Hour Of The 11Th Day Of The 11Th Month Of 1918 And All Was Quiet On The Western Front...

Veterans Day is set aside to honor all those who served their country in war and peace. It is also known as Armistice Day and Remembrance Day. In 1954, President Dwight D. Eisenhower legally changed Armistice Day to Veterans Day, honoring all war veterans. 

 

Raymond Weeks of Birmingham, Alabama, organized an Armistice Day parade for that city on November 11, 1947, to honor Veterans for their loyalty. Later, U.S. Representative Edward H. Rees of Kansas proposed legislation changing the name of Armistice Day to Veterans Day to honor all Veterans who have served America.

In 1954, President Dwight D. Eisenhower signed a bill proclaiming Nov. 11 as Veterans Day and called upon Americans everywhere to re-dedicate themselves to the cause of peace. He issued a presidential order directing the head of the then-known Veterans Administration (now the Department of Veterans Affairs) to form a Veterans Day National Committee to organize and oversee the national observance of Veterans Day.

In 1968, Congress moved Veterans Day to the fourth Monday in October. However, it became apparent that Nov. 11—the end of World War I—was historically significant to many Americans. As a result, Congress formally returned the observance of Veterans Day to its traditional date in 1978.

Tomb of the Unknown Soldier

The Veterans Day National Ceremony is held each year on Nov. 11 at Arlington National Cemetery. At 11 a.m., a color guard made up of members from each military branch renders honors to America’s war dead during a tradition-rich ceremony at the Tomb of the Unknown Soldier.

The president or his representative places a wreath at the tomb, and a bugler sounds taps. The balance of the ceremony, including a parade of flags by numerous Veteran Service Organizations, takes place inside the Memorial Amphitheater, next to the tomb.

Each year, there is a competition to design the Veterans Day poster. This year, there were more than 60 entries from people ranging from school-aged children to graphic designers with decades of experience. When all ballots were tallied, “The Bugler” by Gene Russell, a service-connected disabled Army Infantry Veteran and VA employee, was selected.

Here are links to some Veterans Day events around the country.

View the full article.

The Great War & Armistice Day

Though the Treaty of Versailles was signed on June 28, 1919, November 11 remained in the public imagination as the date that marked the end of the Great War. In November 1918, U.S. President Woodrow Wilson proclaimed November 11 as the first commemoration of Armistice Day. The day's observation included parades, public gatherings, and a brief pause in business activities at 11 a.m. On November 11, 1921, an unidentified American soldier killed in the war was buried at Arlington National Cemetery in Washington, D.C.; the U.S. Congress had declared the day a legal federal holiday in honor of all those who participated in the war. On the same day, unidentified soldiers were laid to rest at Westminster Abbey in London and at the Arc de Triomphe in Paris.

 

On June 4, 1926, Congress passed a resolution that the "recurring anniversary of [November 11, 1918] should be commemorated with thanksgiving and prayer and exercises designed to perpetuate peace through good will and mutual understanding between nations" and that the president should issue an annual proclamation calling for the observance of Armistice Day. By then, 27 state legislatures had made November 11 a legal holiday. An act approved May 13, 1938, made November 11 a legal Federal holiday, "dedicated to the cause of world peace and to be hereafter celebrated and known as 'Armistice Day.'" In actuality, there are no U.S. national holidays because the states retain the right to designate their own, and the government can only designate holidays for federal employees and the District of Columbia. In practice, however, states almost always follow the federal lead.

 

 

From Armistice Day to Veterans Day

American effort during World War II (1941-1945) saw the greatest mobilization of the U.S. Army, Navy, Marines, and Air Force in the nation's history (more than 16 million people); some 5.7 million more served in the Korean War (1950 to 1953). In 1954, after lobbying efforts by veterans’ service organizations, the 83rd U.S. Congress amended the 1938 act that had made Armistice Day a holiday, striking the word "Armistice" in favor of "Veterans." President Dwight D. Eisenhower signed the legislation on June 1, 1954. From then on, November 11 became a day to honor American veterans of all wars.

 

The next development in the story of Veterans Day unfolded in 1968 when Congress passed the Uniform Holidays Bill. This bill sought to ensure three-day weekends for federal employees and encourage tourism and travel by celebrating four national holidays (Washington's Birthday, Memorial Day, Veterans Day, and Columbus Day) on Mondays.

 

The observation of Veterans Day was set as the fourth Monday in October. The first Veterans Day under the new law was Monday, October 25, 1971; confusion ensued as many states disapproved of this change and continued to observe the holiday on its original date. In 1975, after it became evident that the actual date of Veterans Day carried historical and patriotic significance to many Americans, President Gerald R. Ford signed a new law returning the observation of Veterans Day to November 11th beginning in 1978. If November 11 falls on a Saturday or Sunday, the federal government observes the holiday on the previous Friday or the following Monday, respectively.

 

 

Celebrating Veterans Day Around the World

Britain, France, Australia, and Canada also commemorate the veterans of World Wars I and II on or near November 11th: Canada has Remembrance Day, while Britain has Remembrance Sunday (the second Sunday of November). In Europe, Britain, and the Commonwealth countries, it is common to observe two minutes of silence at 11 a.m. every November 11.

 

In the United States, an official wreath-laying ceremony is held each Veterans Day at the Tomb of the Unknowns in Arlington National Cemetery, while parades and other celebrations are held in states around the country. Veterans Day is not to be confused with Memorial Day, which is a common misunderstanding, according to the U.S. Department of Veterans Affairs. Memorial Day (the fourth Monday in May) honors American service members who died in service to their country or as a result of injuries incurred during battle, while Veterans Day pays tribute to all American veterans--living or dead--but especially gives thanks to living veterans who served their country honorably during war or peacetime.

 

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[Hadit donations are now tax deductable]

No problem.

[Hadit donations are now tax deductable]

No problem the EiN or Tax ID number is in the footer of all the pages. Here it is for easy reference EIN 92-2360268

[Caregiver Tip Sheets and Check Lists]

Download the PDF below for quick access to these caregiver resources.

caregiver-tips-and-checklists.pdf

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[Hadit donations are now tax deductable]

@Sgt. Wilky

You donate here

When you donate it immediately provides you a receipt for your taxes that you can print out and keep track of. That's about all I know, Rattler will have to jump in with more.

[Commonly Claimed VA Disabilities]

 

Common Disabilities are claimed as service-connected disability. These links will take you to relevant articles and posts on the subject. Tinnitus | PTS(D) | Lumbosacral Cervical Strain | Scars | Limitation of flexion, knee | Diabetes | Paralysis of Siatic Nerve | Limitation of motion, ankle | Degenerative Arthritis Spine | TBI - Traumatic Brain Injury

 

Tinnitus/Hearing Loss | Limitation of flexion, knee | PTS(D) | Lumbosacral Cervical Strain | Paralysis of Sciatic Nerve | Scars | Limitation of motion, ankle | 

Limitation of motion of the arm

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[6 Reasons to Keep Pursuing VA Claims and Appeals – AFTER you reach 100%]

 

View full record

[Request A Copy of Your VA C-File: VA Claims Folder]

Know what VA is reading about you. Request your VA claims file (VA C File).

 

VA Claims File is the infamous C File. We can not stress enough how important it is to View your VA Claims File at the Veterans Affairs regional office (find your Regional VA Office here). Call the VA at 1-800-827-1000 and request an appointment to view your C File (VA Claims File).

• Ensure that all the records in your VA Claims File or C File are yours.
• Check that everything you have sent to the VA is included in your VA Claims File.
• After viewing your VAClaims File (c file) and correcting any mistakes you may find, you should request a hard copy of your C File.

If you’re having difficulty obtaining your VA Claims File from your Regional VA Office, you can file a written Freedom of Information Act (FOIA) Request. See below for more information on FOIA requests.

Read more on Establishing Veterans Affairs Service Connection for Disability Compensation.

When you apply for disability benefits, the VA creates a claims file. Information you send to the VA records the VA obtains on your behalf, and documents created by the VA are all in this file. The claims file is commonly referred to as the “C File.”

When you apply for disability benefits, the VA creates a claims file. Information you send to the VA records the VA obtains on your behalf, and documents created by the VA are all in this file. The claims file is commonly referred to as the “C File.”

Typical Documents in a VA Claims File

When you receive your VA Claims File, don’t be surprised if the documents are disorganized. Also, there may be several document copies even though you only need one. It can take a while to sort it all out. If you want some help with this, you may want to find a VA disability attorney to assist you.

Here are some basic documents you might find in your C File if you have applied for VA benefits. This is not an exhaustive list but merely a description of the most common and important documents you should find in your file. If any of these documents are missing, you will want to obtain them. (See Nolo’s article on obtaining VA records for more information about how to do that.)

DD-214, Report of Separation From Service

This is a very important document. It includes information about your character of service, which can determine your eligibility for benefits. Your DD-214 will also include your dates of service, specialties, any medals received, and other information about your term(s) of service.

Application for Benefits

Any applications for benefits that you have previously made should be included in your C File. This can be important if you do not keep copies before applying.

Denial Letter, Ratings Decision, and Code Sheet

If you have been denied benefits, there should be a letter in your file notifying you of the decision to deny you benefits. Until recently, the VA issued detailed rating decisions explaining why benefits were granted or denied and certain ratings were assigned to service-connected disabilities. The rating decisions do not provide much information and tend to be brief.

There should also be a code sheet accompanying the rating decision. The code sheet contains information about the rating decision, such as the diagnostic code used to assign the disability rating. It also provides information about the effective date of benefits, whether a future reexamination will be required, and additional details about the decision.

If you hire an attorney, they will ask you for a copy of the denial letter, rating decisions, and code sheet.

Service Medical Records

You may find copies of your service medical records in the file if the VA requested these while gathering information to decide your claim. An important document in these records is the report from your enlistment examination. This exam report contains information on whether you suffered from certain medical conditions when you entered service.

VA FOIA Requests

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[VA Dental Benefits and Insurance]

Not every veteran is eligible for VA Dental care. VA does offer dental insurance...

Dental for Veterans - Eligibility and Benefits

VA offers comprehensive dental care benefits to specific qualifying Veterans. What VA dental care benefits do I qualify for? If eligible but not yet enrolled in VA health care, you can apply online using the Apply for Health Care Benefits webpage. If not eligible, Veterans enrolled in VA health care can purchase dental insurance at a reduced cost through the VA Dental Insurance Program (VADIP). Read More Here

VA Dental Insurance Program (VADIP)

You may be eligible for VADIP if you meet one of these requirements. One of these must be true: You’re a Veteran enrolled in VA health care, or You’re the current or surviving spouse or dependent child of a Veteran or service member. You’re enrolled in the Civilian Health and Medical Program of the VA (CHAMPVA). Note: Insurance carriers may offer separate coverage options for dependents who aren’t CHAMPVA beneficiaries. VADIP provides coverage throughout the United States and its territories, including Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands.

Read More about VA Dental Insurance Here.

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[Greetings]

Welcome Aboard! Thank you for your service.

[With AI we now have an idea of what the internet thinks of our community…]

Google's AI is Gemini.google.com so I gave it go the other day and wanted to share it with the community. Look at what we built!

i asked:

What is the history of hadit.com veteran to veteran?

HadIt.com Veteran to Veteran: A History of Supporting Veterans

HadIt.com Veteran to Veteran boasts a remarkable 27-year history (as of 2024) of serving veterans. Here's a timeline of its key milestones:

1997: Founded by a veteran, driven by the desire to create a community where veterans could support each other in navigating the Veterans Affairs (VA) claims process.

Early Years: Primarily focused on providing information and resources via a website, including articles, research, and links. This helped veterans understand and navigate the often complex VA disability system.

Growth and Impact: The website gained traction, attracting veterans seeking knowledge and community. The discussion board became a vital space for veterans to share experiences, advice, and offer encouragement.

Community Focus: Unlike many sites focused on "experts," HadIt.com prioritized empowering veterans to help each other. This created a strong sense of peer support and shared understanding.

Challenges and Resilience: In 2022, the website faced an attack, highlighting its impact and relevance. Fortunately, the community rallied, demonstrating dedication and commitment to the platform's mission.

Present Day: Despite competition, HadIt.com remains a trusted resource for veterans, offering:

• Comprehensive information: Guides, articles, and calculators related to VA benefits and navigating the system.
• Active discussion board: A space for veterans to connect, share experiences,ask questions, and offer support.
• Mission and Values: Emphasis on veteran-to-veteran support, empowerment,and advocacy for fair and accessible benefits.

Future: HadIt.com aims to continue its mission of educating and empowering veterans, reaching its "Million Veteran" goal by equipping them with the knowledge and resources they need to access their well-deserved benefits.

Here are some additional points to consider:

• HadIt.com is a non-profit organization, relying on donations and volunteer contributions.
• It caters to veterans, service members, and their families.
• While primarily focused on the VA claims process, it also tackles broader issues impacting veterans' lives.

Overall, HadIt.com Veteran to Veteran stands as a testament to the power of community and peer support in helping veterans access the resources they deserve

[Sleep Apnea as a Secondary to?]

You may find this case helpful for reference https://www.va.gov/vetapp21/Files11/A21018009.txt

Citation Nr: A21018009

Decision Date: 11/09/21 Archive Date: 11/09/21

 

DOCKET NO. 200924-110044

DATE: November 9, 2021

 

ORDER

 

Entitlement to service connection for obstructive sleep apnea, as secondary to posttraumatic stress disorder (PTSD), is granted.

 

FINDING OF FACT

 

The Veteran's obstructive sleep apnea is caused by or is the result of her service-connected PTSD. 

 

CONCLUSION OF LAW

 

The criteria for service connection for obstructive sleep apnea, as secondary to PTSD, are met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 

 

REASONS AND BASES FOR FINDING AND CONCLUSION

 

The Veteran had active service in the U.S. Navy from March 1990 to February 1995.  

 

The Appeals Modernization Act (AMA) creates a new framework for Veterans dissatisfied with Department of Veterans Affairs' (VA) decision on their claim to seek review.  The AMA became effective on February 19, 2019. 38 C.F.R. § 3.2400(a)(1).  The AMA applies to all initial decisions issued after February 19, 2019.   

 

The present matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2020 rating decision issued by VA Agency of Original Jurisdiction (AOJ).  Accordingly, the decision is subject to the AMA.  The Veteran timely appealed this rating decision to the Board in a September 24, 2020 VA Form 10182 Notice of Disagreement.  The Veteran requested the direct review lane, which limits the Board's review to evidence of record at the time of the September 2020 rating decision.

 

Service Connection 

 

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service-the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 38 F.3d 1163, 1167 (Fed. Cir. 2004)). The absence of any one element will result in denial of service connection.

 

Service connection may also be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).

 

Additionally, service connection may be granted on a secondary basis when the evidence establishes (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability.  See Wallin v. West, 11 Vet. App. 509, 512; 38 C.F.R. § 3.310.

 

Service connection must be considered on the basis of the places, types, and circumstances of his service as shown by his service records, the official history of each organization in which he or she served, his or her medical records, and all pertinent medical and lay evidence.  See 38 C.F.R. § 3.303 (a); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) and Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006).

 

1. Entitlement to service connection for obstructive sleep apnea secondary to posttraumatic stress disorder (PTSD)

 

The Veteran maintains that her obstructive sleep apnea is caused by her service-connected PTSD.  The Board agrees and finds that the elements of service connection on a secondary basis have been established. 

 

With respect to current disability, the record reveals that the Veteran was diagnosed by sleep study with obstructive sleep apnea in June 2016.  Accordingly, the Board finds that a current disability has been established.

 

The remaining question is whether the Veteran's obstructive sleep apnea was either caused by or aggravated by her service-connected PTSD. 

 

The record contains numerous positive and negative medical opinions addressing this question.  In February 2020, a VA examiner concluded that the Veteran's obstructive sleep apnea is less likely than not cause by or the result of the Veteran's service-connected PTSD.  However, the examiner cited to a medical journal article supporting the opposite conclusion.  This article notes that a critical review of the literature supports an association between PTSD and sleep disordered breathing in both combat-related and non-combat-related PTSD.  Furthermore, the examiner only cited to this article and did not address the Veteran's lay statements in reaching his opinion.  Accordingly, the Board finds that the examiner's opinion is inadequate and has no probative weight.  However, the Board affords some probative weight to the treatise evidence cited to by the examiner, as it directly addresses the relationship of PTSD to obstructive sleep apnea.  

 

Treating records also include a notation from a doctor in July 2020, who concluded that sleep apnea is a physical condition that is not caused by PTSD.  However, this doctor provided no rationale to support his conclusion.  Furthermore, the medical literature cited to by the April 2020 psychologist indicates that there is indeed a relationship between the two.  Accordingly, the Board finds that this opinion is inadequate and affords it no probative weight.

 

Additionally, a September 2020 VA examiner offered a negative nexus opinion on the basis of direct service connection.  However, the examiner did not offer an opinion as to whether the Veteran's obstructive sleep apnea is caused by or aggravated by her service-connected PTSD.  Accordingly, the Board finds that this opinion is inadequate and affords it no probative weight.  

 

Contrary to these opinions, a private psychologist offered a positive opinion in April 2020.  The psychologist concluded that the Veteran's sleep apnea more likely than not is related to her service-connected PTSD.  In support of this conclusion, the psychologist cited to peer-reviewed scientific studies showing a connection between anxiety, PTSD, and sleep apnea.  Additionally, the psychologist indicated that the Veteran is positive for only two predisposing risk factors for sleep apnea, being African American and obese.  Ruling out other factors for obstructive sleep apnea, such as gender and medical history of deviated septum, stroke, congenital deformity, or chronic diseases of the nose, the psychologist concluded that it is more likely than not that the Veteran's obstructive sleep apnea is caused by her PTSD.  This opinion is thorough and is supported by a complete rationale.  It was based on an interview with the Veteran, a review of her medical records, and a review of the medical literature.  Accordingly, the Board finds that it is highly probative and affords it significant weight.    

 

Another positive opinion was offered by a private psychiatrist in August 2020.  This psychiatrist concluded that that the Veteran developed obstructive sleep apnea due to two phenomena.  First, she noted that PTSD itself leads to disrupted sleep architecture, promotes sleep disordered breathing, and causes neurophysiological changes within the body.  Second, she indicated that the Veteran's obesity with progressive weight gain has played a role in the development of obstructive sleep apnea.  With respect to the former, she noted that PTSD causes nightmares and disorder breathing during sleep and having the condition itself has led to physiological changes in the Veteran that developed into obstructive sleep apnea.  Additionally, the psychiatrist cited to peer-reviewed scientific studies that supports a connection between PTSD and obstructive sleep apnea.  This opinion is thorough and is supported by a complete rationale.  It was based on an interview with the Veteran, a review of her medical records, and a review of the medical literature.  Accordingly, the Board finds that it is highly probative and affords it significant weight.   

 

In sum, the most probative evidence of record, the two private positive opinion and medical literature cited to by the February 2020 VA examiner and two private doctors, demonstrates that the criteria for entitlement to service connection for obstructive sleep apnea secondary to the Veteran's PTSD have been established. 

 

 

 

 

 

GAYLE STROMMEN

 

Veterans Law Judge

 

Board of Veterans' Appeals

 

Attorney for the Board T. Beech, Associate Counsel

 

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

 

[To Clarify Theresa M. Aldrich "Tbird" is the Founder of HadIt.com Veterans]

I am the sole founder of HadIt.com. There is some confusion on the web, and I want to clarify that.

Founder of HadIt.com Theresa M. Aldrich "Tbird" 

Any claims to be the founder or involved in the founding or planning of HadIt.com other than myself, Theresa M. Aldrich, "Tbird HadItcom," are false.

There has never been a staff. There has always been just me, Theresa M. Aldrich "Tbird" Navy veteran—other than a few volunteer moderators on our discussion forum. I have done all the work on the site, including design, research, writing, graphics, marketing, social media, SEO, and more. It has been my life's work for over 27 years.

In 2023, I gifted the site to a nonprofit set up to keep HadIt.com Online. I still act as a board member, provide guidance, and do much of the work until we find some folks to volunteer. I also have a few projects I want to finish up. So I'll be in the background advising the new owner, Rattler, and helping where possible.

[Join Me for a Zoom Chat 11:30 AM CST]

Sorry, I missed you. I will try again tomorrow. 

[Join Me for a Zoom Chat 11:30 AM CST]

Tommy Smith is inviting you to a scheduled Zoom meeting.

Topic: Tbirds Chit Chat
Time: Feb 19, 2024 11:30 AM Central Time (US and Canada)

Join Zoom Meeting
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[Join me for Chit Chat on Zoom 02/05/2025 08:30 - 09:15 AM Click the link]

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[HadIt.com Help You? Let Us Know!]

[Loss of use]

A member was opening old posts and replying to them to advertise his website, and everyone would see because the post would go to the top of the unread content. That is an abuse of our linking policy. If someone wants to advertise, they need to pay for advertising, not disrupt the community by trying to steal traffic from us. It's been dealt with.