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Tbird

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  1. The VA C and P Exam is not about convincing the Dr. your injury is service-related. It's about letting them conduct their exam and come to their conclusion. What is that Perspective? Honestly, it comes down to recognizing that the purpose of the VA C and P Exam is NOT to convince the doctor that your injury is service-connected but to let them conduct their exam and draw their conclusion. Ultimately, your current disability is or is not related to military service. Regardless of what the doctor says or what the VA Rater says, the limitations or symptoms are either related or not to your time in service.” Chris Attig Veterans Law Blog A doctor’s opinion can’t change what is or is not. It’s just another piece in the puzzle of proof. And the C&P Exam is just another piece of that puzzle. It is not the only piece – but if we view it as such, we often make our claims harder than they should be. And we certainly make them more stressful. Reprinted here with permission from Veterans Law Blog 1. Every C&P Exam has 2 Goals. The first goal is to have the doctor confirm that your injury, disability, or limitations are related to your military service – to prove the Nexus Pillar – and/or to establish the degree you are disabled – the Impairment Pillar. The second goal is to draw out the “evidentiary gap” in your claim through a C&P exam. The evidentiary gap is the difference between what is IN the record and how the VA SEES what is in the record. If you are denied service connection, it is almost always because of an evidentiary gap. Rather than throwing a haystack at the RO and then yelling at the VA for not finding the needle – let the Examiner tell you what is missing by reading their opinion. The key is NOT to provide excessive amounts of information in your C&P exam – keep your answers short and “make” the doctor get into your file to review the evidence. They tell you what is missing by what they focus hardest on. It is THEIR report which shows the evidentiary gap – not your statements in the C&P. This brings us to the next tip…. 2. Answer only the questions the VA C and P examiner asks. If the doc asks, “How are you doing,” and you throw the entire history of your claim at her over the next 15 minutes, what happens? She zones out. She doesn’t hear what you are saying and may find it hard to care about it. I get emails daily – some are 8-9 pages of micro-detailed histories of a VA Claim. It’s hard to read them. It’s hard to understand them. It’s hard to pick up the phone and call that person because I know I will get more facts I don’t need. Listen, I’m really good at doing this work, and while there are some real shit-bird doctors out there, there are some really good ones. They know how to call out the information they need to get the facts to understand the situation. So just answer the question you are asked – not the question you want to answer. But when you do answer the question, follow Tip #3 3. Keep it Simple and Basic. Limit what you say to symptoms and limitations or nexus to brief statements. If you can’t answer the question “Why is your injury related to military service?” in under 20 seconds, you are talking too much. Here’s a great example of how you might respond to a VA C&P Examiner’s question about nexus: “You should defer to my Claims File as that has my complete position on why my injury is related to my service….but, very generally….. Because of the in-service injury to my right knee, I began to overcompensate. Now my left knee needs replacement.” or “I was raped in basic training, and during the rape, my attacker broke my jaw. I now cannot eat or swallow properly.” or “I was diagnosed with prostate cancer while in service.” The more you talk, the more ways an examiner has to deny your claim without ever looking at the file. The less you talk – the more direct and to the point you are – the more they have to read the file. 4. Be Polite and Courteous – and Know What the Examiner has to Deal With. I’ve said it before – there are some real shit-bird docs in the VA system. There’s the examiner that comes into the room – grumbly and angry – and tells you that you have five minutes to tell your story. There’s the examiner that will hear something different than what you said – and twist your words to fit their medical theory. And there are the examiners that just plain don’t get it – they may not have the medical training needed to draw the conclusion they are being asked to draw. Even if you are a VA C&P Examiner reading this, I think you would agree that you can think of a colleague who is not doing what they are required to do. Smile. Be pleasant and courteous. Know that even if this doctor concludes that there is no nexus between your military service and your condition, it will not be the end of the world. There are ways to “correct” a bad C&P Exam. Your C&P Examiner has a short time to talk to you. They will have 15-20 (or more) exams daily. Each exam will be for a Veteran with at least 750+ pages of records to comb through. These examiners have something in common – they work in an overburdened system that overloads them with information and gives them minutes to sort through it. Sometimes they will have to draw conclusions about complex conditions they are not trained to handle. And a good bit of the time, they will make mistakes. They will get it wrong. It’s not the end of the world if they do. But what is essential – in the grand scheme of fixing this system – is that we treat every C&P Examiner with a modicum of courtesy and respect. Say hello. Smile. Be pleasant and courteous. Know that even if this doctor concludes that there is no nexus between your military service and your condition, it will not be the end of the world. There are ways to “correct” a bad C&P Exam. There are other types of opinions that you can use – like the Disability Benefits Questionnaire (DBQ). Get their name, and talk to them about their background – and after the exam, write down thorough notes about what happened – good and bad – in the exam. What did they test? What did they measure? What body parts did the doctor look at – and not look at. Suppose you are going to legally attack a bad C&P Exam. In that case, you will need this information to challenge the methodology, measurements, and conclusions. And you won’t be able to do this if you start the exam on a sour note. So – above all – be courteous, civil, and concise. 5. Don’t Act Like a “Professional Claimant”. C&P Examiners do exams – dozens a day – every day for weeks on end. When you are exposed to this many Veterans, you start seeing patterns. Especially if you are a doctor trained to identify and analyze patterns of symptoms and limitations in a medical condition. Listen, C&P Examiners can spot the Professional Claimant a mile away. And if they see you as a Professional Claimant, it will taint the exam and the outcome of the exam. So resist using legalistic phrases, theories, and concepts. Talk like a human being – not a lawyer or a VSO. Tell the doctor about your symptoms. Your limitations. Have a concise statement of why you think your disability and service are related. (Take a look at the first post in this series to get an example of how to put together such a concise statement). And whatever you do, don’t go off on rants about the VA Process, complex legal theories, or past errors. The system is screwed up – we all get that. But one VA C&P Examiner isn’t going to fix the whole system or remedy every past error in your case. So keep it simple and basic: talk only about the symptoms and limitations of your disability, and have a one-sentence statement about nexus to tell the doctor when you are asked. 6. Do NOT Advocate to – or Debate With – the C&P Examiner. C&P Examiners are doctors – not lawyers and not judges. Though their opinion will carry some sway – a lot of sway – with the Rater in your claim, in the end it is just an opinion. Let them draw their opinion. If it is negative, or doesn’t fit the facts, there are other doctors with other opinions that the Rater or BVA can balance and weigh to find the truth. Do NOT try to prove your claim to the examiner. Most Vets that do try to prove their claim end up overwhelming the C&P Examiner with facts that he or she may or may not be able to process in the moment. They will overload them with case law and legal language – much of which is irrelevant to the Doctor. And remember – there is a mortal battle between doctors and lawyers. Since the first lawyer sued the first doctor, they have always had a very cat-and-dog relationship (I say this somewhat “tongue in cheek”). If you start talking like a lawyer, you are going to shut that doctor off to understanding your medical condition, and I can guarantee that your exam will end with a negative opinion. Think about it in the context of your most recent job or profession – if someone walked in and started barking all this legalese while telling you how to do your job, what would your reaction be? You’d feel bullied or attacked. You’d feel insulted and marginalized. You might zone out on the person talking, and miss what they are really trying to say. Or you might do whatever you had to do to get that person out of your office, or cubicle, or maintenance bay. Nobody likes being bullied. So don’t advocate your claim to the C&P Examiner – it’s not the time and place to advocate for your claim. It is the time to talk about symptoms and limitations – and to DRIVE the examiner back into your C-File and medical records to study the claim. Rather than launch into the medical and legal theory of your claim, and spend 15 minutes forcing the C&P Examiner to “zone out”, why not push them to look at the records. Consider this exchange: Doctor: Tell me about your sleep apnea symptoms since you left the military. Veteran: My medical records and claims file detail all of the symptoms – the many apneas throughout the night, my need for a CPAP, the daytime sleepiness problems from getting a good nights sleep – but the bottom line is that since service, I wake up several times each night gasping for air, and the only relief I get is when I wear this CPAP machine. You got your point across – succinctly. You pushed the Examiner to look at the facts (and if she doesn’t, that will be obvious in her decision). And you did it in a concise and courteous way. Bottom line – the C&P Exam is not the time to be an advocate or a lawyer. Keep your discussion limited to symptoms and limitations only, and your one-liner about why you think it is service-connected. Far too many veterans approach their VA C&P exam like it’s a hearing or a trial. The result of this is that the VA C&P examiner acts like a lawyer and defends the VA’s position. In other words, you get an adverse – and very legalistic – VA C&P exam opinion. Are you ready to experience different results in your VA C&P exam? If so, then this post is just for you. The tips and strategies in this post center on a common theme: If you want better results in your VA C&P exam, don’t lecture the examiner. Paint a picture of how your disability affects you. By the way, this is the third post in a 3-part series offering tips an strategies for having a better experience in a VA C&P exam. You can read the first set of tips by clicking here, or click here and read second set of tips. 7. Know What is “At Issue” in the VA C&P Exam. In earlier tips, I told you to talk only about symptoms and limitations, or if you had to, have a brief statement (20 seconds and 1 sentence) that explains why you think your condition is service connected. But this begs the question – how do you know what is going to be discussed in your VA C&P Exam? This comes back to knowing the 4 Pillars of a VA claim. If you don’t understand these 4 pillars, and how to prove service connection to the VA, you will struggle in your VA C&P exam and likely get poor results. I’ve prepared an entire video training course for you to learn everything you need to know about proving VA service connection – I recommend you start learning there. You can read about all 4 Pillars by clicking here. But let’s talk generally. Your VA C&P exam will invariably involve issues in only 2 of those pillars: diagnosis (Pillar 2), nexus (Pillar 2), or impairment rating (Pillar 3). If your exam is for a condition that has not been service connected, there is a good chance that it is either a “nexus” exam or a “diagnostic exam”. Let’s talk about the diagnostic exam. Remember that the VA has a Duty to Assist? While I tell veterans all the time not to confuse the “Duty to Assist” with “Actual Assistance”, there is one scenario where I think the VA does a good job of assisting Veterans in their claims. That scenario arises if you have not yet had your medical condition diagnosed – in certain situations, the VA is required to send you for a diagnostic C&P exam to diagnose your medical condition before a decision can be made about service-connection or impairment rating. If, however, there is no reasonable possibility that the condition could be service-connected even if diagnosed, the VA does NOT have to send you for a diagnostic C&P exam. If your exam is not a diagnostic C&P exam, then you can be sure that the doctor will want to talk to you about “nexus” and the “impairment rating” criteria. So here’s what you should do – first, prepare your brief statement as to why you think your condition is related to military service – keep it short and sweet (see Post #1 for a great example) and remember that the goal is to force the Examiner into the C-File to study your medical and military service records. Next, look up the rating criteria in 38 CFR Table 4 to determine what factors the doctor will want to know when deciding on your rating percentage. Click here to learn how to find out what your Impairment Rating criteria are. Focus on these symptoms and limitations in your discussion. Lastly, if you have enough time before your exam, prepare a summary of your medical records for the doctor to review – even if he or she already has the C-File in front of them. I explain exactly how to do this in my Training package – How to File a VA Claim. In that video, I will teach you how to assemble and organize the medical evidence that proves your claim for service connection by using my unique “VA Claim Map“. It’s not hard to do, and it will help you keep your claim organized. Many doctors have really appreciated the summary of the claim that we sometimes send with our clients to C&P Exams. 8. When you talk about your condition, paint a picture. When I tell my clients this tip, I tell them to think “Toilet Bowls”. I had a client that was going in for a VA C&P Exam to re-evaluate the impairment rating on his knee condition. The prior VA C&P doctors had never considered the “instability” in his knee joint when low-balling his rating in the past. So we knew this exam would focus on the instability of the Veteran’s knee. In our prep for the C&P Exam, I asked my client to describe his knee instability. Here’s the story he told me. “When I use the restroom at work, I cannot get off the toilet bowl without help. I tried, but I ended up breaking the toilet paper rack because it could not support my weight without breaking. I was laying on the floor in my own piss while my co-workers helped me stand up and get my pants on. I have this problem at home, and in public restrooms everywhere – I cannot stand up off the toilet on my own because my knee is so weak and unstable.” That story is particularly effective in describing problems with knee stability. Why? Because the veteran painted a picture that used a toilet bowl. Nobody can easily forget that kind of visual images. Now, I’m not saying to describe all your symptoms using a “Toilet Bowl” example – what I am saying is that you should paint a picture for the examiner of how the symptoms affect your daily life and work activities. In a claim for aid & attendance, don’t say: “I need help getting dressed”. Instead say: “My 16 year old daughter has to help me zip my pants every morning because my Parkinson’s prevents my fingers from being able to work my own zipper.” In a claim for PTSD rating, don’t say: “I have trouble getting along with co-workers”. That’s not a picture – it’s just a statement that every other Veteran is probably telling the same examiner. Paint the picture, and say: “I spend 2 hours a day hiding in the bathroom at work on the floor of the handicapped stall because I’m so scared of being around other people with my PTSD.” See what I’m saying? Don’t state symptoms. Paint a picture of how they impact your daily living – especially in your home, social and work lives. But be careful, though – don’t embellish. Everyone can spot someone engaging in self-serving hyperbole or exaggeration (you know the type – in the military we called them “Bulls**t Artists”). Just describe the problems your symptoms are giving you in your daily living and working activities by painting a picture of when and how often they surface. 9. Get the Doctor’s name and a Copy of your VA C&P Exam. I’ve shared this tip before – when the exam is done, ask the Doctor for his/her business card – or just their name if you can. Be friendly about it – not confrontational. Why do you want to do this? Because the Veterans Court has said that unless you challenge a doctor’s credentials, you are allowing the VA to presume that they doctor was competent and the exam was adequate. So, get the doc’s name. Then read up on how to challenge the doctor’s credentials in a Notice of Disagreement if your VA &P Exam comes back adverse or negative. And then – I cannot stress this enough – get a copy of the C&P Exam. Before the Ratings Decision comes out, if you can. Here’s how to go about getting a copy of the C&P Exam using the Freedom of Information Act (FOIA). 10. After the VA C&P Exam – Write Down your Notes. A growing issue in the arena of veterans benefits is the adequacy of the exams that VA C&P Examiners provide. You may not have a lawyer now, but if you do someday, it will be incredibly helpful to your attorney to know the step-by-step process of what happened in your VA C&P Exam. This is particularly true in a VA C&P Exam to rate a knee injury: the doctor must consider so many things (range of motion, instability, functional loss, pain, flareups, and more) that knowing what the doctor did and did not ask you to do during a VA C&P exam can be critical to challenging it later. What tests did the Doctor perform? What questions did he ask? Did she use any tools or instruments to take any measurements? After you leave your exam, take 20 minutes, sit down, and write – to the best of your recollection – a step by step of what happened in the exam. Doesn’t need to be perfect. Doesn’t need to have every word. Just enough for someone to look at later and assess whether the tests that the Doctor did – if they did any at all – were adequate to achieve the purposes of the exam. Just write the key facts of what happened, what was measured, and what tests were performed. If you are feeling particularly lawyerly, type your notes into a Sworn Declaration like this one, and sign and date it the day of the exam. Tuck it away in your records and then, if your attorney or representative needs it later, you have a document contemporaneous to the exam that discusses what happened and didn’t happen. This will make your statements about the inadequacy of the exam years down the road far more credible – because they weren’t blurred by time or memory bias.
  2. Everything Veterans Affairs does with your service-connected disability compensation claim is governed by law. You may want to bookmark this page as a reference as you proceed with your claim. It can be a bit daunting. Just remember, the U.S.C. is the law, the C.F.R. is how they interpret the law, and last but certainly not least is the V.A. adjudication manuals, which is how they apply the law. The law's section covering veteran's benefits is Title 38 in the U.S.C. The C.F.R. is usually written 38 C.F.R. or something similar; V.A. frequently requested manuals are listed below. U.S.C. United States Code U.S.C.A. United States Code Annotated U.S.C.S. U.S. Code Service C.F.R. Code of Federal Regulations United States Code is the law, and the U.S.C. is the government's official copy of the code. The U.S.C.A. contains everything printed in the official U.S. Code but includes annotations to case law relevant to the particular statute. Like the U.S.C.A., the U.S.C.S. contains everything printed in the official U.S. Code but includes annotations to case law relevant to the particular statute. The C.F.R. is the interpretation of the law. VA M-21 Compensation and Pension Manual VA M-21-4 C & P Authorization Procedures VA M28-3 Vocational Rehabilitation Internal Control in Vocational Rehabilitation and Counseling View full record
  3. Everything Veterans Affairs does with your service-connected disability compensation claim is governed by law. You may want to bookmark this page as a reference as you proceed with your claim. It can be a bit daunting. Just remember, the U.S.C. is the law, the C.F.R. is how they interpret the law, and last but certainly not least is the V.A. adjudication manuals, which is how they apply the law. The law's section covering veteran's benefits is Title 38 in the U.S.C. The C.F.R. is usually written 38 C.F.R. or something similar; V.A. frequently requested manuals are listed below. U.S.C. United States Code U.S.C.A. United States Code Annotated U.S.C.S. U.S. Code Service C.F.R. Code of Federal Regulations United States Code is the law, and the U.S.C. is the government's official copy of the code. The U.S.C.A. contains everything printed in the official U.S. Code but includes annotations to case law relevant to the particular statute. Like the U.S.C.A., the U.S.C.S. contains everything printed in the official U.S. Code but includes annotations to case law relevant to the particular statute. The C.F.R. is the interpretation of the law. VA M-21 Compensation and Pension Manual VA M-21-4 C & P Authorization Procedures VA M28-3 Vocational Rehabilitation Internal Control in Vocational Rehabilitation and Counseling
  4. VA Disability Claims Glossary will aid you as you pursue your VA Claim. There are words, acronyms, abbreviations, and more...the VA has its own language. VA Disability Claims Glossary VA Disability Claims When searching for information, it’s important to get the acronyms right. FR is Federal Register. CFR is the Code of Federal Regulations. U.S.C. is the United States Code. Pub. L. is Public Law. Stat. is U.S. Statutes at Large. E.O. is Executive order. Proc. is Proclamation sec. is a section of a Public Law or the United States Code Advance on the Docket A change in the order in which an appeal is reviewed and decided – from the date when it would normally occur to an earlier date. ALJ Administrative Law Judge AOJ Agency of Original Jurisdiction Appeal A request for a review of an AOJ determination on a claim. Appellant An individual who has appealed an AOJ claim determination. Axis Multi-axial systemThe DSM-IV organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of disorder or disability: Axis I: Clinical disorders, including major mental disorders and learning disorders Axis II: Personality disorders and mental retardation (although developmental disorders, such as Autism, were coded on Axis II in the previous edition, these disorders are now included on Axis I) Axis III: Acute medical conditions and physical disorders Axis IV: Psychosocial and environmental factors contributing to the disorder Axis V: Global Assessment of Functioning or Children’s Global Assessment Scale for children and teens under the age of 18 BMAO Board medical advisor opinion Board The Board of Veterans’ Appeals. Board Member, An attorney appointed by the Secretary of Veterans Affairs and approved by the President, who decides veterans’ benefits appeals. Board of Veterans’ Appeals The part of the VA that reviews benefit claims appeals and issues decisions on those appeals. BVA Board of Veterans Appeals BVA Hearing A personal hearing, held at the BVA office in Washington, D.C., or a regional office, is conducted by a member of the Board. A BVA hearing can be held via videoconference from some regional offices. Also, see Travel Board Hearing. C & P Compensation and Pension C-FILE VA Claims Folder CFR Code of Federal Regulations Claim A request for veterans’ benefits. Claim Number A number assigned by VA that identifies a person who has filed a claim; often called a “C-number.” Claims File Same as claims folder. Claims Folder The file containing all documents concerning a veteran’s claim or appeal. Court of Veterans Appeals An independent court that reviews appeals of BVA decisions. COVA U.S. Court of Veterans Appeals CUE Clear and Unmistakable Error Decision The final product of BVA’s review of an appeal. Possible decisions are to grant or deny the benefit or benefits claimed or to remand the case back to the AOJ for additional action. Determination A decision on a claim made at the AOJ. Docket A listing of appeals that have been filed with BVA. Appeals are listed in numerical order, called docket number order, based on when a VA Form 9 is received by VA. Docket Number The number assigned to an appeal when a VA Form 9 is received by VA. By law, cases are reviewed by the Board in docket number order. DRO Decision Review Officer DSM IV Diagnostic and Statistical Manual of Mental Disorders 4th Edition DSM 5 Diagnostic and Statistical Manual of Mental Disorders 5th Edition EAJA Equal Access to Justice Act En banc In the bench. Full bench. Refers to a session where the entire membership of the court will participate in the decision rather than the regular quorum. In the U.S., the Circuit Courts of Appeal usually sit in panels of judges, but for important cases, they may expand the bench to a larger number when they are said to be sitting en banc. File To submit in writing. FOIA Freedom Of Information Act GAF Global Assessment of Functioning Scale (Use of GAF Score ceased in 2014 with the publishing of the DSM 5) GOE Gathering of Evidence on eBenefits. Hearing A meeting, similar to an interview, between an appellant and an official from VA who will decide an appellant’s case, during which testimony and other evidence supporting the case is presented. There are two types of personal hearings: Regional office hearings (also called local office hearings) and BVA hearings. HISA Home Improvement and Structural Alterations Program IFP In Forma Pauperis In the character or manner of a pauper. Describes permission given to a poor person (I.e., indigent) to proceed without liability for court fees or costs. An indigent will not be deprived of his rights to litigate and appeal: if the court is satisfied with his indigence, he may proceed without incurring costs or fees of court. IG Inspector General Infra Below, under, beneath, underneath. The opposite of supra, above. Thus we say primo gradu est – supra, pater, mater, infra, filius, filia: in the first degree of kindred in the ascending line, above is the father, and mother, below, in the descending line, son and daughter. Issue A benefit sought on a claim or an appeal. For example, if an appeal seeks a decision on three different matters, the appeal is said to contain three issues. IU Individual Unemployability Local Office Hearing A personal hearing conducted by an RO officer. A regional office hearing may be conducted in addition to a BVA hearing. Member of the Board, An attorney appointed by the Secretary of Veterans Affairs and approved by the President, who decides veterans’ benefits appeals. Motion A legal term is a request that some specific action is taken. Motion to Advance on the Docket A request that BVA reviews and decide on an appeal sooner than when it normally would be based on the appeal’s docket number order. Motion to Reconsider A request for BVA to review its decision on an appeal. New and Material Evidence a. A claimant must submit “new and material” evidence to reopen a previously disallowed claim. (1) To qualify as “new” evidence under 38 CFR 3.156, evidence, whether documentary, testimonial, or in some other form, must be submitted to VA for the first time. For example, a veteran injured while on duty may not have realized immediately that the condition required medical attention and may have sought treatment later that evening from a private physician. A compensation claim might later be denied if the service medical records contain no mention of treatment for the condition. Should the claimant subsequently submit proof of treatment by the civilian physician, that information would constitute new evidence on which the claim could be reopened? (2) A photocopy or other duplication of information already contained in a VA claims folder does not constitute new evidence since it was previously considered; neither does information confirming a point already established, such as a statement from a physician verifying the existence of a condition which has already been diagnosed and reported by another physician. Even though such a medical evaluation is from a different doctor, it offers no new basis on which the claim might be reopened unless it contains new information, such as evidence that the condition first manifested itself earlier than previously established. b. In order to be considered “material” under 38 CFR 3.156, the additional information must bear directly and substantially on the specific matter under consideration. (1) For example, if VA has previously determined that a back condition claimed by a World War II veteran is not service-connected, evidence that the claimant received treatment shortly after release from active duty might be considered new and material if the VA had previously been unaware of that treatment. However, information addressing only the current severity of the condition submitted now, over 40 years after service, may not have a bearing on the issue of whether the condition was incurred or aggravated during military service and does not warrant reopening the prior claim. (2) Statements and affidavits attesting to the claimant’s good character since his or her release from active duty are irrelevant if the issue is the character of the claimant’s military service, but any new information offering mitigating circumstances for an action that resulted in an “other than honorable” discharge would address the specific issue under consideration and would warrant reopening the claim. (3) A medical opinion is not material if it relies on historical facts which are wholly inaccurate. c. A determination by VA that information constitutes “new and material evidence” means that the new information is sufficiently significant, either by itself or in connection with evidence already of record, that it must be considered in order to decide the merits of the claim fairly. It does not mean that the evidence warrants a revision of a prior determination. d. A decision not to reopen a claim because the evidence submitted is not new and material is an appealable decision. The claimant must be furnished notice of procedural and appellate rights. NOA Notice of Appeal NOD Notice of Disagreement Notice of Disagreement written statement expressing dissatisfaction or disagreement with a local VA office’s determination on a benefit claim that must be filed within one year of the date of the regional office’s decision. NVLSP suggests adding this to 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 could 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.” NSLI National Service Life Insurance NSO National Service Officer Per Curiam By the court. A phrase used to distinguish an opinion of the whole court from an opinion written by any one judge. Sometimes it denotes an opinion written by the chief justice or presiding judge or a brief announcement of the disposition of a case by the court not accompanied by a written opinion. PFD Preparation For Decision on eBenefits PL Public Law POA Power of Attorney PTSD Post Traumatic Stress Disorder Regional Office A local VA office; there are 58 regional VA offices throughout the U.S. and its territories. Regional Office Hearing A personal hearing conducted by an RO officer. A regional office hearing may be conducted in addition to a BVA hearing. Remand An appeal returned to the regional office or medical facility where the claim originated. Representative Someone familiar with the benefits claims process who assists claimants in preparing and presenting an appeal. Most representatives are Veterans’ Service Organization employees who specialize in veterans’ benefits claims. Most states, commonwealths, and territories also have experienced representatives to assist veterans. Other individuals, such as lawyers, may also serve as appeal representatives. RO Regional Office RO Hearing A personal hearing conducted by an RO officer. A regional office hearing may be conducted in addition to a BVA hearing. ROA Record on Appeal SC Service Connection SMR Service Medical Record SOC Statement of Case SSA Social Security Administration SSDI Social Security Disability Income SSOC Supplemental Statement of Case Statement of the Case Prepared by the AOJ is a summary of the evidence considered, as well as a listing of the laws and regulations used in deciding a benefit claim. It also provides information on the right to appeal an RO’s decision to BVA. Substantive Appeal A completed VA Form 9. Supplemental Statement of the Case A summary, similar to a SOC, that the VA prepares if a VA Form 9 contains a new issue or presents new evidence and the benefit is still denied. A Supplemental Statement of the Case will also be provided after an appeal is returned (remanded) to the RO by the Board for new or additional action. TDHR Texas Department of Human Resources TDIU Total Rating Based on Individual Unemployability Travel Board Hearing A personal hearing conducted at a VA regional office by a member of the Board. United States Court of Veterans Appeals An independent court that reviews appeals of BVA decisions. USC United States Code VA Veterans Administration VA Form 9 This form, which accompanies the SOC, formally initiates the appeal process. VAMC Veterans Administration Medical Center Veterans’ Service Organization, An organization that represents the interests of veterans. Most Veterans’ Service Organizations have specific membership criteria, although membership is not usually required to obtain assistance with benefit claims or appeals. VJRA Veterans’ Judicial Review Act VRO Veterans Administration Regional Office VSO Veterans’ Service Organization Well Grounded A well-grounded claim requires three elements: (1) a medical showing of a current medical condition; (2) lay or, in certain circumstances, the medical evidence of disease or injury in service; and (3) medical evidence showing a nexus between the asserted injury in service and the current disability. Where medical evidence is required, medical journal articles alone will generally not suffice unless they are enhanced by a physician’s opinion stating that the current disability was related, is likely to be related, could be related, or even possibly was related to service. A physician’s opinion need not be conclusive to establish a well-grounded claim. Alternatively, both the second and third elements above can be satisfied by the submission of minimum evidence (a) that the condition was “noted” during service or during an applicable presumption period; (b) that there has been post-service continuity of symptomatology (as to which lay opinion can suffice; and (c) medical, or in some rare circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. Writ of Mandamus: A writ of mandamus is an order issued by a court to compel an agency to act on a decision that has been unreasonably withheld. It is used in the VA context when the VA does nothing on a claim after you have asked that it be decided. It cannot be used to compel a particular result — say, service connection — only that the VA go up or down on it. View full record
  5. VA Disability Claims Glossary will aid you as you pursue your VA Claim. There are words, acronyms, abbreviations, and more...the VA has its own language. VA Disability Claims Glossary VA Disability Claims When searching for information, it’s important to get the acronyms right. FR is Federal Register. CFR is the Code of Federal Regulations. U.S.C. is the United States Code. Pub. L. is Public Law. Stat. is U.S. Statutes at Large. E.O. is Executive order. Proc. is Proclamation sec. is a section of a Public Law or the United States Code Advance on the Docket A change in the order in which an appeal is reviewed and decided – from the date when it would normally occur to an earlier date. ALJ Administrative Law Judge AOJ Agency of Original Jurisdiction Appeal A request for a review of an AOJ determination on a claim. Appellant An individual who has appealed an AOJ claim determination. Axis Multi-axial systemThe DSM-IV organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of disorder or disability: Axis I: Clinical disorders, including major mental disorders and learning disorders Axis II: Personality disorders and mental retardation (although developmental disorders, such as Autism, were coded on Axis II in the previous edition, these disorders are now included on Axis I) Axis III: Acute medical conditions and physical disorders Axis IV: Psychosocial and environmental factors contributing to the disorder Axis V: Global Assessment of Functioning or Children’s Global Assessment Scale for children and teens under the age of 18 BMAO Board medical advisor opinion Board The Board of Veterans’ Appeals. Board Member, An attorney appointed by the Secretary of Veterans Affairs and approved by the President, who decides veterans’ benefits appeals. Board of Veterans’ Appeals The part of the VA that reviews benefit claims appeals and issues decisions on those appeals. BVA Board of Veterans Appeals BVA Hearing A personal hearing, held at the BVA office in Washington, D.C., or a regional office, is conducted by a member of the Board. A BVA hearing can be held via videoconference from some regional offices. Also, see Travel Board Hearing. C & P Compensation and Pension C-FILE VA Claims Folder CFR Code of Federal Regulations Claim A request for veterans’ benefits. Claim Number A number assigned by VA that identifies a person who has filed a claim; often called a “C-number.” Claims File Same as claims folder. Claims Folder The file containing all documents concerning a veteran’s claim or appeal. Court of Veterans Appeals An independent court that reviews appeals of BVA decisions. COVA U.S. Court of Veterans Appeals CUE Clear and Unmistakable Error Decision The final product of BVA’s review of an appeal. Possible decisions are to grant or deny the benefit or benefits claimed or to remand the case back to the AOJ for additional action. Determination A decision on a claim made at the AOJ. Docket A listing of appeals that have been filed with BVA. Appeals are listed in numerical order, called docket number order, based on when a VA Form 9 is received by VA. Docket Number The number assigned to an appeal when a VA Form 9 is received by VA. By law, cases are reviewed by the Board in docket number order. DRO Decision Review Officer DSM IV Diagnostic and Statistical Manual of Mental Disorders 4th Edition DSM 5 Diagnostic and Statistical Manual of Mental Disorders 5th Edition EAJA Equal Access to Justice Act En banc In the bench. Full bench. Refers to a session where the entire membership of the court will participate in the decision rather than the regular quorum. In the U.S., the Circuit Courts of Appeal usually sit in panels of judges, but for important cases, they may expand the bench to a larger number when they are said to be sitting en banc. File To submit in writing. FOIA Freedom Of Information Act GAF Global Assessment of Functioning Scale (Use of GAF Score ceased in 2014 with the publishing of the DSM 5) GOE Gathering of Evidence on eBenefits. Hearing A meeting, similar to an interview, between an appellant and an official from VA who will decide an appellant’s case, during which testimony and other evidence supporting the case is presented. There are two types of personal hearings: Regional office hearings (also called local office hearings) and BVA hearings. HISA Home Improvement and Structural Alterations Program IFP In Forma Pauperis In the character or manner of a pauper. Describes permission given to a poor person (I.e., indigent) to proceed without liability for court fees or costs. An indigent will not be deprived of his rights to litigate and appeal: if the court is satisfied with his indigence, he may proceed without incurring costs or fees of court. IG Inspector General Infra Below, under, beneath, underneath. The opposite of supra, above. Thus we say primo gradu est – supra, pater, mater, infra, filius, filia: in the first degree of kindred in the ascending line, above is the father, and mother, below, in the descending line, son and daughter. Issue A benefit sought on a claim or an appeal. For example, if an appeal seeks a decision on three different matters, the appeal is said to contain three issues. IU Individual Unemployability Local Office Hearing A personal hearing conducted by an RO officer. A regional office hearing may be conducted in addition to a BVA hearing. Member of the Board, An attorney appointed by the Secretary of Veterans Affairs and approved by the President, who decides veterans’ benefits appeals. Motion A legal term is a request that some specific action is taken. Motion to Advance on the Docket A request that BVA reviews and decide on an appeal sooner than when it normally would be based on the appeal’s docket number order. Motion to Reconsider A request for BVA to review its decision on an appeal. New and Material Evidence a. A claimant must submit “new and material” evidence to reopen a previously disallowed claim. (1) To qualify as “new” evidence under 38 CFR 3.156, evidence, whether documentary, testimonial, or in some other form, must be submitted to VA for the first time. For example, a veteran injured while on duty may not have realized immediately that the condition required medical attention and may have sought treatment later that evening from a private physician. A compensation claim might later be denied if the service medical records contain no mention of treatment for the condition. Should the claimant subsequently submit proof of treatment by the civilian physician, that information would constitute new evidence on which the claim could be reopened? (2) A photocopy or other duplication of information already contained in a VA claims folder does not constitute new evidence since it was previously considered; neither does information confirming a point already established, such as a statement from a physician verifying the existence of a condition which has already been diagnosed and reported by another physician. Even though such a medical evaluation is from a different doctor, it offers no new basis on which the claim might be reopened unless it contains new information, such as evidence that the condition first manifested itself earlier than previously established. b. In order to be considered “material” under 38 CFR 3.156, the additional information must bear directly and substantially on the specific matter under consideration. (1) For example, if VA has previously determined that a back condition claimed by a World War II veteran is not service-connected, evidence that the claimant received treatment shortly after release from active duty might be considered new and material if the VA had previously been unaware of that treatment. However, information addressing only the current severity of the condition submitted now, over 40 years after service, may not have a bearing on the issue of whether the condition was incurred or aggravated during military service and does not warrant reopening the prior claim. (2) Statements and affidavits attesting to the claimant’s good character since his or her release from active duty are irrelevant if the issue is the character of the claimant’s military service, but any new information offering mitigating circumstances for an action that resulted in an “other than honorable” discharge would address the specific issue under consideration and would warrant reopening the claim. (3) A medical opinion is not material if it relies on historical facts which are wholly inaccurate. c. A determination by VA that information constitutes “new and material evidence” means that the new information is sufficiently significant, either by itself or in connection with evidence already of record, that it must be considered in order to decide the merits of the claim fairly. It does not mean that the evidence warrants a revision of a prior determination. d. A decision not to reopen a claim because the evidence submitted is not new and material is an appealable decision. The claimant must be furnished notice of procedural and appellate rights. NOA Notice of Appeal NOD Notice of Disagreement Notice of Disagreement written statement expressing dissatisfaction or disagreement with a local VA office’s determination on a benefit claim that must be filed within one year of the date of the regional office’s decision. NVLSP suggests adding this to 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 could 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.” NSLI National Service Life Insurance NSO National Service Officer Per Curiam By the court. A phrase used to distinguish an opinion of the whole court from an opinion written by any one judge. Sometimes it denotes an opinion written by the chief justice or presiding judge or a brief announcement of the disposition of a case by the court not accompanied by a written opinion. PFD Preparation For Decision on eBenefits PL Public Law POA Power of Attorney PTSD Post Traumatic Stress Disorder Regional Office A local VA office; there are 58 regional VA offices throughout the U.S. and its territories. Regional Office Hearing A personal hearing conducted by an RO officer. A regional office hearing may be conducted in addition to a BVA hearing. Remand An appeal returned to the regional office or medical facility where the claim originated. Representative Someone familiar with the benefits claims process who assists claimants in preparing and presenting an appeal. Most representatives are Veterans’ Service Organization employees who specialize in veterans’ benefits claims. Most states, commonwealths, and territories also have experienced representatives to assist veterans. Other individuals, such as lawyers, may also serve as appeal representatives. RO Regional Office RO Hearing A personal hearing conducted by an RO officer. A regional office hearing may be conducted in addition to a BVA hearing. ROA Record on Appeal SC Service Connection SMR Service Medical Record SOC Statement of Case SSA Social Security Administration SSDI Social Security Disability Income SSOC Supplemental Statement of Case Statement of the Case Prepared by the AOJ is a summary of the evidence considered, as well as a listing of the laws and regulations used in deciding a benefit claim. It also provides information on the right to appeal an RO’s decision to BVA. Substantive Appeal A completed VA Form 9. Supplemental Statement of the Case A summary, similar to a SOC, that the VA prepares if a VA Form 9 contains a new issue or presents new evidence and the benefit is still denied. A Supplemental Statement of the Case will also be provided after an appeal is returned (remanded) to the RO by the Board for new or additional action. TDHR Texas Department of Human Resources TDIU Total Rating Based on Individual Unemployability Travel Board Hearing A personal hearing conducted at a VA regional office by a member of the Board. United States Court of Veterans Appeals An independent court that reviews appeals of BVA decisions. USC United States Code VA Veterans Administration VA Form 9 This form, which accompanies the SOC, formally initiates the appeal process. VAMC Veterans Administration Medical Center Veterans’ Service Organization, An organization that represents the interests of veterans. Most Veterans’ Service Organizations have specific membership criteria, although membership is not usually required to obtain assistance with benefit claims or appeals. VJRA Veterans’ Judicial Review Act VRO Veterans Administration Regional Office VSO Veterans’ Service Organization Well Grounded A well-grounded claim requires three elements: (1) a medical showing of a current medical condition; (2) lay or, in certain circumstances, the medical evidence of disease or injury in service; and (3) medical evidence showing a nexus between the asserted injury in service and the current disability. Where medical evidence is required, medical journal articles alone will generally not suffice unless they are enhanced by a physician’s opinion stating that the current disability was related, is likely to be related, could be related, or even possibly was related to service. A physician’s opinion need not be conclusive to establish a well-grounded claim. Alternatively, both the second and third elements above can be satisfied by the submission of minimum evidence (a) that the condition was “noted” during service or during an applicable presumption period; (b) that there has been post-service continuity of symptomatology (as to which lay opinion can suffice; and (c) medical, or in some rare circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. Writ of Mandamus: A writ of mandamus is an order issued by a court to compel an agency to act on a decision that has been unreasonably withheld. It is used in the VA context when the VA does nothing on a claim after you have asked that it be decided. It cannot be used to compel a particular result — say, service connection — only that the VA go up or down on it.
  6. Be clear in VA Disability Claims. If the VA needs to ask for clarification, it just slows the process. I want to share some insight on how veterans can help themselves get their claims through the system as quickly as possible. I will also share some of my frustrations with the many system-clogging claims that I receive and must address. First, here’s some general info on claims processing steps in my office: Next, for claims, the veteran’s C-file is retrieved from the files and sent to the development section. Development then sends a letter acknowledging receipt of the claim and lists the claims. This letter should also include the release of information form(s) 4142 so that private medical records (not VAMC) that the veteran says are relevant to the claim can be obtained. When the veteran returns the signed forms, the VA contacts the care provider by mail requesting the records. Sometimes, we receive no response and must request the records again. This also delays the decision process. Please be aware that many VA Regional Offices, including mine, receive thousands of pieces of mail every day. Each of these must be stamped with the date received. This takes time. When all records are received, or it is determined that records are not obtainable, the claim goes to the Rating Board. 1. Hints I hope are helpful: Be clear about what you are claiming. VA policy says that we must respond with a letter acknowledging and listing your claimed conditions or conditions for which you are claiming an increase. If we need to ask for clarification, it just slows the process. An unclear claim is “nerve condition.” This could mean nerve damage or a mental condition. Please be specific. Put your claimed conditions where they can be found at the beginning. The development people are buried in paper. A rambling explanation with claims hidden in a lengthy text can get missed. I can’t count the number of times that I’ve had to send a claim back to the development section for another letter to the veteran acknowledging the missed claim. Another delay. I understand that some veterans cannot afford to pay for copies of their private medical records. However, if at all possible, include copies of relevant medical records with your claim. It really does speed the process. We have to give the doctor or hospital 60 days to respond to our request before sending a second request. They have 30 days after that. If they don’t respond, we do no more because it is ultimately the veteran's responsibility to provide relevant private records. Relevant is the key. I go through every piece of paper sent in support of the claim. If, for instance, you claim knee problems, your psychiatry and gynecologist records, billing/insurance statements, etc., are not needed, they just slow my ability to decide the claim. More is not better; relevant is. Help us to help you. Do get copies of your service medical and personnel records when you are discharged or from the National Personnel Records Center (NPRC). If VA has them, request copies. It’s free, folks. It just takes a bit of effort on your part. Yes, the VA and other agencies do lose/misfile records. It stinks, but this is the reality of any monstrously huge agency such as the VA and NPRC. Without these records, my hands are tied. I may personally believe you, but I must have in-service medical evidence for most claims. Don’t send in additional claims before you get a decision on the initial or increased claim. Depending on the issues, this can cause the processing of your claim to be sent back to the beginning. 2. Frustrations: Think before you claim. Is this really a disability? Is this a condition that occurred in service? I must address each claimed condition no matter what it is. We have daily production requirements. Therefore, a claim with numerous issues, especially meritless ones (more on that later), tends not to get handled as quickly. Our office processes 600-700 claims per week. We return to work on Monday, only to find many or more new claims. Most of us are hard workers who care about the quality of our decisions. It is frustrating to be accused of delay tactics when the sheer volume of claims and the complexity of many claims make it impossible to schedule a VA exam or render decisions as quickly as the veteran would like. I apologize to you. I’m pedaling as fast as I can Most veterans are sincere and want only what they deserve. Some are in desperate financial shape and are hoping we can help. My heart and my best efforts go out to them. Others may not realize a claimed condition is not a disability. Others… Here are just a few examples of some disability claims that I have received that cause a slowdown in an already overloaded system: compensation for a venereal disease contracted and cured in 1971, abnormal PAP smears (weird cells but not malignant or showing other diseases); tubal ligation, circumcision, vasectomy (the last 3 are voluntary: and unless there were medical complications are not disabling); exposure to local people; my wife’s miscarriage; numbness of the legs due to spinal anesthesia administered in the 1960s (this from a veteran serving a life prison sentence. No spinal anything in service: but the prison treatment records show diabetes with leg neuropathy); claims for injuries, medical conditions, and diseases that occurred long after the veteran left service (that are not presumptive, i.e., Agent Orange, radiation-related); claims for medical problems that occurred while a dependent spouse. Veterans working for the VA do NOT have their disability claims rated by the Regional Office where they work. Employee veterans do not even have access to our VA files. They are stored at another VA office. And I can personally attest that military veteran VA employees do not get preferential treatment for their claims. In my experience and others in my office, we go through the same process as other veterans. The difference is that we know what is required to decide a claim more quickly. I’m glad to share this with you and hope it helps.
  7. Be clear in VA Disability Claims. If the VA needs to ask for clarification, it just slows the process. I want to share some insight on how veterans can help themselves get their claims through the system as quickly as possible. I will also share some of my frustrations with the many system-clogging claims that I receive and must address. First, here’s some general info on claims processing steps in my office: Next, for claims, the veteran’s C-file is retrieved from the files and sent to the development section. Development then sends a letter acknowledging receipt of the claim and lists the claims. This letter should also include the release of information form(s) 4142 so that private medical records (not VAMC) that the veteran says are relevant to the claim can be obtained. When the veteran returns the signed forms, the VA contacts the care provider by mail requesting the records. Sometimes, we receive no response and must request the records again. This also delays the decision process. Please be aware that many VA Regional Offices, including mine, receive thousands of pieces of mail every day. Each of these must be stamped with the date received. This takes time. When all records are received, or it is determined that records are not obtainable, the claim goes to the Rating Board. 1. Hints I hope are helpful: Be clear about what you are claiming. VA policy says that we must respond with a letter acknowledging and listing your claimed conditions or conditions for which you are claiming an increase. If we need to ask for clarification, it just slows the process. An unclear claim is “nerve condition.” This could mean nerve damage or a mental condition. Please be specific. Put your claimed conditions where they can be found at the beginning. The development people are buried in paper. A rambling explanation with claims hidden in a lengthy text can get missed. I can’t count the number of times that I’ve had to send a claim back to the development section for another letter to the veteran acknowledging the missed claim. Another delay. I understand that some veterans cannot afford to pay for copies of their private medical records. However, if at all possible, include copies of relevant medical records with your claim. It really does speed the process. We have to give the doctor or hospital 60 days to respond to our request before sending a second request. They have 30 days after that. If they don’t respond, we do no more because it is ultimately the veteran's responsibility to provide relevant private records. Relevant is the key. I go through every piece of paper sent in support of the claim. If, for instance, you claim knee problems, your psychiatry and gynecologist records, billing/insurance statements, etc., are not needed, they just slow my ability to decide the claim. More is not better; relevant is. Help us to help you. Do get copies of your service medical and personnel records when you are discharged or from the National Personnel Records Center (NPRC). If VA has them, request copies. It’s free, folks. It just takes a bit of effort on your part. Yes, the VA and other agencies do lose/misfile records. It stinks, but this is the reality of any monstrously huge agency such as the VA and NPRC. Without these records, my hands are tied. I may personally believe you, but I must have in-service medical evidence for most claims. Don’t send in additional claims before you get a decision on the initial or increased claim. Depending on the issues, this can cause the processing of your claim to be sent back to the beginning. 2. Frustrations: Think before you claim. Is this really a disability? Is this a condition that occurred in service? I must address each claimed condition no matter what it is. We have daily production requirements. Therefore, a claim with numerous issues, especially meritless ones (more on that later), tends not to get handled as quickly. Our office processes 600-700 claims per week. We return to work on Monday, only to find many or more new claims. Most of us are hard workers who care about the quality of our decisions. It is frustrating to be accused of delay tactics when the sheer volume of claims and the complexity of many claims make it impossible to schedule a VA exam or render decisions as quickly as the veteran would like. I apologize to you. I’m pedaling as fast as I can Most veterans are sincere and want only what they deserve. Some are in desperate financial shape and are hoping we can help. My heart and my best efforts go out to them. Others may not realize a claimed condition is not a disability. Others… Here are just a few examples of some disability claims that I have received that cause a slowdown in an already overloaded system: compensation for a venereal disease contracted and cured in 1971, abnormal PAP smears (weird cells but not malignant or showing other diseases); tubal ligation, circumcision, vasectomy (the last 3 are voluntary: and unless there were medical complications are not disabling); exposure to local people; my wife’s miscarriage; numbness of the legs due to spinal anesthesia administered in the 1960s (this from a veteran serving a life prison sentence. No spinal anything in service: but the prison treatment records show diabetes with leg neuropathy); claims for injuries, medical conditions, and diseases that occurred long after the veteran left service (that are not presumptive, i.e., Agent Orange, radiation-related); claims for medical problems that occurred while a dependent spouse. Veterans working for the VA do NOT have their disability claims rated by the Regional Office where they work. Employee veterans do not even have access to our VA files. They are stored at another VA office. And I can personally attest that military veteran VA employees do not get preferential treatment for their claims. In my experience and others in my office, we go through the same process as other veterans. The difference is that we know what is required to decide a claim more quickly. I’m glad to share this with you and hope it helps. View full record
  8. Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL This has to be MEDICALLY Documented in your records: Current Diagnosis. (No diagnosis, no Service Connection.) In-Service Event or Aggravation. Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service” This is also known as the “Hickson Elements” for a later case. Why you need to know: If all three of these things are not documented in your medical and service records, you will need to obtain this documentation before getting service connected. This applies whether you applied last week or 10 years ago. Note: Secondary Service Connection and Presumptives are a little easier. If you have a diagnosis, and a doctor says that your diagnosis is at least as likely as not due to your (service-connected condition), then you need not AGAIN establish an in-service event or aggravation. A presumptive Service connection means if you meet the applicable criteria, your condition is “presumed” to be caused by military service. You will still need a current diagnosis, but you may get a bye on the nexus if you meet the requisite criteria for presumptive conditions. Hickson Elements –In order to establish a service connection for the claimed disorder, there must be: 1. medical evidence of a current disability; 2. medical, or in certain circumstances, lay evidence of the incurrence or aggravation of a disease or injury in service or during the presumptive period; and 3. medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247, 253 (1999). From VA.gov More on Caluza Triangle from member Broncovet: View full record
  9. Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL This has to be MEDICALLY Documented in your records: Current Diagnosis. (No diagnosis, no Service Connection.) In-Service Event or Aggravation. Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service” This is also known as the “Hickson Elements” for a later case. Why you need to know: If all three of these things are not documented in your medical and service records, you will need to obtain this documentation before getting service connected. This applies whether you applied last week or 10 years ago. Note: Secondary Service Connection and Presumptives are a little easier. If you have a diagnosis, and a doctor says that your diagnosis is at least as likely as not due to your (service-connected condition), then you need not AGAIN establish an in-service event or aggravation. A presumptive Service connection means if you meet the applicable criteria, your condition is “presumed” to be caused by military service. You will still need a current diagnosis, but you may get a bye on the nexus if you meet the requisite criteria for presumptive conditions. Hickson Elements –In order to establish a service connection for the claimed disorder, there must be: 1. medical evidence of a current disability; 2. medical, or in certain circumstances, lay evidence of the incurrence or aggravation of a disease or injury in service or during the presumptive period; and 3. medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247, 253 (1999). From VA.gov More on Caluza Triangle from member Broncovet:
  10. 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: Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, disabilities resulting from common etiology or a single accident, disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, multiple injuries incurred in action, or 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 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. 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. View full record
  11. How to file a VA disability claim Eligibility Fully Developed Claims Be sure to fill out your claim completely. Gather any evidence (supporting documents) you’ll submit yourself when you file your VA disability claim. Sending all your supporting documents and your claim will help speed up the process. Forms You May Need Evidence to Support Your Claim To support your VA disability claim, you can provide certain documents that may help strengthen your case. These documents include VA medical records and hospital records, which can relate to your claimed illnesses or injuries, or they could show that your disability rating has worsened. Private medical records and hospital reports are also helpful, as they could relate to your claimed illnesses or injuries or show that your disability has worsened. Additionally, supporting statements from family members, friends, clergy members, law enforcement personnel, or people you served with can provide valuable insight into your claimed condition and how and when it occurred or worsened. Depending on the type of claim you file, you may need to gather the supporting documents yourself or ask for help from the VA to gather evidence. It's important to note that the VA will review your discharge papers (DD Form 214 or other separation documents) and service treatment records as part of the process. If you need more information about the evidence required for your claim, you can learn more on our website. Learn more about the evidence we’ll need for your claim. Supporting Evidence You do not have to provide any supporting evidence for your claim initially. However, the VA may require a claim examination to obtain more information about your condition. If you need more time to gather supporting documents, you can save your application and complete it later. It is important to note that you have up to one year from the date the VA receives your claim to submit any supporting evidence. The VA will consider the date you started your application as your date of claim as long as you complete it within 365 days. Learn more about VA claim exams (C&P exams) Below is from the VA's website. Please check this link for what the latest is. This information is current as of 03/2024 How do I file a claim for compensation? You can file a claim online now. File for disability compensation online You can also file for disability compensation in any of these 4 ways By mail File your claim by mail using an Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ). Get VA Form 21-526EZ to download Print the form, fill it out, and send it to this address: Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444 In person Bring your application to a VA regional office near you. Find a VA regional office near you By fax If you’re in the U.S., fax your application to 844-531-7818. If you’re outside the U.S., fax your application to 248-524-4260. With the help of a trained professional You can work with a trained professional called an accredited representative to get help filing a claim for disability compensation. Get help from an accredited representative. Should I submit an intent to file form? If you plan to file for disability compensation using a paper form, you may want to submit an intent to file form first. This can give you the time you need to gather your evidence while avoiding a later potential start date (also called an effective date). When you notify us of your intent to file, you may be able to get retroactive payments (compensation that starts at a point in the past). Note: If you file for disability compensation online, then you don’t need to notify us of your intent to file. This is because your effective date gets set automatically when you start filling out the form online—before you submit it. Find out how to submit an intent to file form What happens after I file my VA disability claim? Find out what happens after you file You don’t need to do anything while you’re waiting unless we send you a letter asking for more information. If we schedule exams for you, be sure not to miss them. Check your VA claim status How long does it take VA to make a decision? 158.4 days Average number of days to complete disability-related claims in February 2024 More information about filing disability claims Claim types and when to file Learn about standard claims, supplemental claims, secondary claims, and more. Evidence needed for your disability claim Find out what evidence we’ll need to support your disability claim. Disabilities that appear within 1 year after discharge Find out if you can get disability benefits if you have signs of an illness within a year after being discharged from service. Get help from an accredited representative Find out how to work with a trained professional called an accredited representative to file your claim. Supporting forms for VA claims Find additional forms that you may need to support your claim. Below is a link to the VA's website explaining disability compensation before you leave the service. It has some good information, so I've included it for you below. Click the link to download the mlc-disability.pdf Disability Compensation MILITARY LIFE CYCLE (MLC) ONLINE RESOURCE GUIDE The VA Disability Compensation module introduces the VA disability compensation (pay) benefit. This Online Resource Guide (ORG) provides web links to important resources related to the course. The VA.gov website offers current resources, tools and contact information for all VA benefits and services. VA TAP ONLINE COURSES The VA TAP Course Catalog is a comprehensive resource that includes information about all VA TAP course offerings, direct links to on-demand web-based training, and downloadable resource materials. To access these courses, navigate to the VA TAP Course Catalog. You may also scan the QR code at the top of this page. Then, select from the courses available in the VA TAP Curriculum. KEY VA RESOURCES Links The VA.gov website offers current resources, tools, and contact information for all VA benefits and services that may be available to Service members, Veterans, their families, caregivers, and survivors. VA home page COVID-19 Information Frequently Asked Questions (FAQs) VA benefits hotline: 1-800-827-1000 Hearing impaired: 1-800-829-4833 Technical Issues: 1-800-983-0937 VA Regional Offices VA Office Locations VA DISABILITY COMPENSATION VA Disability Compensation Video, “Paul applied for VA disability compensation before he left the military.” Video, “For Greg, VA disability compensation makes life easier.” Video, “With VA disability compensation, Maranda can focus on healing and advancing her career.” Video, “VA has understood that I needed things that I didn’t even realize I needed.” Eligibility for VA disability benefits How to apply for a discharge upgrade About VA DIC for spouses, dependents, and parents SERVICE CONNECTION Video: “Compensation 101: What is Service Connection?” PACT Act PACT ACT Frequently Asked Questions 2022 PACT ACT: Understanding Health Care Eligibility and Benefits Veterans Service Organizations (VSOs) DISABILITY RATINGS AND COMPENSATION RATES Video: “Compensation 101: How did I get this rating?” HOW TO APPLY How to file a VA disability claim Benefits Delivery at Discharge (BDD) Claims (from 90 to 180 days until separation) Filing overseas Fully Developed Claims (FDC) (from 89 days to 1 day until separation) Separation Health Assessment (SHA) Standard Claims (claims not eligible for the BDD or FDC programs) Claim effective dates DISABILITY PROCESS CLAIMS SELF-SERVICE TOOL VA.GOV Videos: “The New 526 Disability Form on VA.gov” “Getting Started: Section 1 of the Digital 526 Disability Compensation Tool at VA.gov” “Add Contentions: Section 2 of the Digital 526 Disability” “Add Evidence: Section 3 of the Digital 526 Disability Compensation Tool” “Getting Started: Sections 4 and 5 of the Digital 526 Disability Compensation Tool” Self-Service Disability Compensation Claims Tool at VA.gov DISABILITY COMPENSATION AND OTHER PAYMENTS DOD Wounded, Ill, and/or Injured Compensation and Benefits Handbook Concurrent Retirement and Disability Pay (CRDP) Combat Related Special Compensation (CRSC) Combat-Related Special Compensation (CRSC) (VA.gov) Combat-Related Special Compensation (CRSC) and Concurrent Retirement Disability Pay (CRDP) ADDITIONAL RESOURCES Getting started with State Veteran Benefits and Services? guide VA Welcome Kit Long-term care VA automobile allowance and adaptive equipment VA clothing allowance Fiduciary program VA health care COMPACT Act Housing grants VA life insurance Veteran Readiness and Employment (VR&E)
  12. 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: Remand the claim for the development of more evidence; Deny your appeal (also known as affirming the VA denial of your VA Disability claim); 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. 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. View full record
  13. 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: Remand the claim for the development of more evidence; Deny your appeal (also known as affirming the VA denial of your VA Disability claim); 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. 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.
  14. 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. 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 View full record
  15. 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. 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
  16. 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: Obtain your Military Service and Medical Records by mailing (certified, return receipt requested) an SF-180, found here: Download SF-180 You can obtain your full VA treatment records from the “release of information” window at the center where you receive treatment. Please review the CD-ROM (PDF file) for all chronic medical conditions, treatments, and diagnoses—chronicity is critical! 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”. Next, search USC 38 part 4 for your CHRONIC DIAGNOSIS, found here: 38 CFR 4 Schedule for Rating Disabilities Match the conditions and rating percentage to the CHRONIC diagnosis in your medical records. Review the DBQ the C&P examiner “must” use to rate your current condition, found here: List By DBQ Form Name. 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. For example, here’s a search for Sleep Apnea secondary to chronic Sinusitis: Google sleep apnea secondary to chronic sinusitis Look for evidence in these cases that would support your claim, and THEN match and find your evidence – NEVER, EVER lie! 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. NUMBER every single page, make copies, and wait. Make someone sign for your mailed package – VA has NEVER lost my packages! 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: Hearing loss, Peripheral Vestibular Disorder, and Tinnitus. Digestive disorder. Skin disorder. VA’s 2015 Decision on these three Claims. STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS – PG-1- redacted.pdf STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS – PG-2 – redacted.pdf STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS FOLLOWED BY TINNITUS – PG-3 – redacted.pdf DBQ WITH TINNITUS – HEARING LOSS & PERIPHERAL VEST DIS – AMENDMENTS_Redacted.pdf C&P EXAMINER’S DBQ FOR EAR CONDITIONS.pdf STMT SUPPORT CLAIM – RHIODS 2014 – redacted.pdf DBQ FOR RHOIDS – FOR C&P.pdf STMT SUPP CLAIM – ECZEMA 60% – PG 1-2.pdf STMT SUPP CLAIM – ECZEMA 60% – PG 3.pdf STMT SUPP CLAIM – ECZEMA 60% – PG 4.pdf 2015 DX REDACTED FOR HADIT_Redacted.pdf View full record
  17. 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: Obtain your Military Service and Medical Records by mailing (certified, return receipt requested) an SF-180, found here: Download SF-180 You can obtain your full VA treatment records from the “release of information” window at the center where you receive treatment. Please review the CD-ROM (PDF file) for all chronic medical conditions, treatments, and diagnoses—chronicity is critical! 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”. Next, search USC 38 part 4 for your CHRONIC DIAGNOSIS, found here: 38 CFR 4 Schedule for Rating Disabilities Match the conditions and rating percentage to the CHRONIC diagnosis in your medical records. Review the DBQ the C&P examiner “must” use to rate your current condition, found here: List By DBQ Form Name. 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. For example, here’s a search for Sleep Apnea secondary to chronic Sinusitis: Google sleep apnea secondary to chronic sinusitis Look for evidence in these cases that would support your claim, and THEN match and find your evidence – NEVER, EVER lie! 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. NUMBER every single page, make copies, and wait. Make someone sign for your mailed package – VA has NEVER lost my packages! 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: Hearing loss, Peripheral Vestibular Disorder, and Tinnitus. Digestive disorder. Skin disorder. VA’s 2015 Decision on these three Claims. STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS – PG-1- redacted.pdf STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS – PG-2 – redacted.pdf STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS FOLLOWED BY TINNITUS – PG-3 – redacted.pdf DBQ WITH TINNITUS – HEARING LOSS & PERIPHERAL VEST DIS – AMENDMENTS_Redacted.pdf C&P EXAMINER’S DBQ FOR EAR CONDITIONS.pdf STMT SUPPORT CLAIM – RHIODS 2014 – redacted.pdf DBQ FOR RHOIDS – FOR C&P.pdf STMT SUPP CLAIM – ECZEMA 60% – PG 1-2.pdf STMT SUPP CLAIM – ECZEMA 60% – PG 3.pdf STMT SUPP CLAIM – ECZEMA 60% – PG 4.pdf 2015 DX REDACTED FOR HADIT_Redacted.pdf
  18. 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. View full record
  19. 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.
  20. 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.
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  22. 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: Get an eBook version of the Sleep Apnea Field Manual Get a paperback real-book version of the Sleep Apnea Field Manual 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.
  23. 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: Get an eBook version of the Sleep Apnea Field Manual Get a paperback real-book version of the Sleep Apnea Field Manual 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. View full record
  24. 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. View full record
  25. 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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