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Suggestions Anyone?


Berta

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Jerrel Cook just asked me to be his guest at startdust.com SVR vets broadcast this coming Wednesday 6:30 PM EST.

http://www.stardustent.com/

In the past I discussed the AO issues etc- and the VCAA on the SVR show(Cong Filner by the way will be next week's guest again and I will be call in on my proposed amendment to the VCAA which he has-just was getting ready to mail him a letter-maybe just best to talk to him on the air- the show is taped and archived)

I feel that I should do a review of the whole claims process -

and offer some suggestions to the newly returning Iraq and Afganistan vets and those overseas who listen to the podcast overseas via their PCs----

dont know if many of you listen to these broadcasts by way of your PCs-

if so any suggestions for the topic ?

I plan a widow-widowers DIC show for the future and covered Sec 1151 claims already -

but want to cover some basics on claims- good idea/ or not- thanks Berta

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I don't know if this suggestion is worthy of discussion on the program where you will participate, but...

It is my understanding that there are teams at each RO and their duties include those within the partial quotation from a HADIT elder which follow my comments.

Since there are teams at each RO I assume that each team has assigned work within that team. If their are multiple teams doing the same work, is the mobility concept used to ensure first in-first out (with the exception of the guidance to process GW claims first)? In other words, if one team has progressed to a point where their workload using the time-in-VA scorecard is ahead of other teams, are members of the "ahead" team used to upgrade/enhance the other teams' output (using mobility to other elements)?

I used this concept in the Army as well as at my post-Army employment at a university and enjoyed significant sucess with it. I did not originate this idea--many of my peers used the same procedure with equal success.

________________________________________________________________________________

"After you send VA your Formal claim, there are a number of “teams” at your local regional office that process your application."

"There are essentially six "teams" at a Regional office that 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 VSR (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 theses 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, SMR's 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. 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 though 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, 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 information you already sent them, you should always respond with a letter via certified Mail with 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 insure 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 go ahead and 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. "

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  • Community Admin/Founder

has there been a discussion yet on unemployability vs 100% that seems like it might be a good topic.

i think a show or two on the wounded warrior act migt be helpful

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  • HadIt.com Elder

Hello Berta,

last night when I connected, the connection speed was 7.2 k. No phone at all when it rains, heavy fog or snow.

So downloading is difficult sometimes.

Basic training for claims? Good idea!

You can start by hitting them with the truth.

Their regional office (RO) level rating specialists, teams etc, may create any fraudulent statement they wish and substitute it for the ratable medical opinions they receive from their own C&P examiners, hired medical consultants or your own private Dr's medical opinions.

Example: Brain trauma? "The VA's opinion is this happened post service after eating his Mom's Chile".

Yes, it's an acceptable practice of VARO rating specialists.

The identity of those raters that do this in order to deny or obstruct your claim, is protected. No one signs their name to it.

VARO rating teams will send your records to one internal medicine Dr after another, window shopping for an unfavorable Independent Medical Opinion,(IMO)to rebut any favorable one you've turned in. You do not have to be examined.

The VA will seldom use a specialists for a Medical Opinion. It will almost always be an "Internal Medicine" MD, even if the BVA orders a specialist.

If this was not an acceptable practice by the DVA raters, it would almost end the backlog in claims.

If your still in service, start getting copies of your medical records now and get it rated at separation or be prepared to fight the DVA the rest of your life.

Never give up if you have a valid claim

Allan

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Good ideas- thank you all-

TDIU- in my opinion- needs an entire show at some point at SVR-

Vike posted here (in the search feature) the whole 9 yards on the claims process-

I am going to focus on the process -but I have done this shows before and one never knows what turn the discussion will take-

We have call ins at their toll free number -1-877-213-4329

and often a caller raises such an important issue that the format changes-

always good information for vets comes out of that-

Allan-I will say it as it is -the VA is a battleground and our weapons are evidence and the regs themselves-

and the most important letter a claimant ever gets is the VCAA letter with the election notice.

If this letter is deficient-as I have said here before- in my opinion the claim is doomed---and the thousands of remands due to this RO error at the BVA prove that point.

I will just get together some preparation and when they open the call in lines- I will just take it from there.

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Berta,

If you could put in a quick blurp about, if a claimant gets a denial they need to be sure and check that ALL of their evidence was considered and VA may give them ammunition to support their claim in the wording of VA denials, SOC's & SSOC's.

You have engrained this in me. Thank you for that. Have a nice strong voice so they all hear you loud & clear, you will do great!

carlie

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  • HadIt.com Elder

Berta; thank you for being here and all that you do.

I do encourage you offer straight talk about initial claims filing and appeals. I recall, after service, when I was told to file a claim, I did so, but without using a correct request in the first place. For example, I was told to submit for anything and everything that was a condition that i had in the military. Part of this worked part did not, because I didnt use the "medical condition" name. For example, I had to learn the hard way to say "I had back pain". Thats basically what I wrote. Sure different than explaining that "I have current lower lumbar pain as a result of a military automobile accident and have been seen for this condition throughout my years in the military. The lumbar pain reduces my ability to have fulltime current employment to provide for my family".etc.

I had to learn the hard way, I didnt develop a good claim. Also if I had to redo something else, I would keep a journal, with doctors names, military events, freinds and coworker addresses.

Now the years roll on and we strive to gain disability compensation for good health long ago rendered on behalf of military service. cg

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  • HadIt.com Elder

For many Veterans the claims process is long and hard to understand. I think it is important to remind Veterans with claims that it is not personal although it surely seems that way. What I mean is that the VA does this to most of us not just a few.

I think that we should develop and publish a check list or worksheet that the Claimant can keep close. It seems to me that the most important thing to keep track of is deadlines.

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it may be a good idea to expand on Larrys comments about the Mistakes the VA makes concerning claims processing and adjudication errors.

If these can be brought to light and more people are aware of them, Then a solution may be in the near future.

Personally I think is is designed to be this way. I may be a little unfair but I am one of those Vets whose Retro and claims go back til 1994.

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  • HadIt.com Elder

One thing for the guys who are still in service would be to pound it into their heads to get an exit physical and keep copies of all their SMR's and any hospital records or treatment records they can get. If it is in your military records that you were sick or got injured life is much easier. If I had not been treated in service and had the records I would not have gotten service connected I think. The odds were just too great. Also that they need to file within one year of discharge for disabilities. For us old vets we learned the hard way what it is to try and prove a disability is SC years after discharge.

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  • HadIt.com Elder

True, be sure that EVERY health issue 'endured' is listed,dental too, either by technician,doctor or individual on form before signing. Take the entire time for the appointment as well, dont rush and dont let someone "whitewash" the form (pc? oh well.sorry). Then be sure to copy medical records for self. Berta, you rock! cg

One thing for the guys who are still in service would be to pound it into their heads to get an exit physical and keep copies of all their SMR's and any hospital records or treatment records they can get. If it is in your military records that you were sick or got injured life is much easier. If I had not been treated in service and had the records I would not have gotten service connected I think. The odds were just too great. Also that they need to file within one year of discharge for disabilities. For us old vets we learned the hard way what it is to try and prove a disability is SC years after discharge
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John- my daughter said they insisted at outprocessing that everyone leave with their SMRs.This was 3 years ago-USAF.

She got a copy of every med rec as it occurred when she was in anyhow-

Also they have the oppotunity to go to the VA breifings about claims. She went to the NAvy breifing instead of the AF one for some reason and said it did cover alot (but of course not the real nitty gritty)

I recommended to the Dole Shala commission (they are in a hearing today) MANY suggestions for new vets-

the mil could publish a few flyers as handouts- covering these suggestions-

I sure told the Commission this new vets have to be aware of the many sites on line like hadit that are available for claims help-mil.com has the complete GI bill run down and also many sites cover CRSC and CRDP.

I sent a long letter- and made many suggestions--

we will find out soon if Dole/Shalala acted on any of them-

MANY vets sent them recommendations- thank you all- who did that-in this case the Gov actually asked us to respond-

and they sure heard from many veterans.and widows.

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