Too Sick To File A Claim

[Wings]

HOWDY! IT'S ME, WINGS! LOL!

Whatis theregulation that backs up the vets argument that s/he was too sick to file a claim within the first year (months) of discharge. I know I read it in the CFR somewhere! Maybe under Chapter 17? Please help if you can ;-) HUGS!!!!!!

[free_spirit_etc]

I found this, but it is just showing the waiver for pension, not compensation.

Free

§3.400 General.

Except as otherwise provided, the effective date of an evaluation and award of pension, compensation or dependency and indemnity compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is the later. (Authority: 38 U.S.C. 5110(a))

(a) Unless specifically provided. On basis of facts found.

( Disability benefits:

(1) Disability pension (§3.3). An award of disability pension may not be effective prior to the date entitlement arose.

(i) Claims received prior to October 1, 1984. Date of receipt of claim or date on which the veteran became permanently and totally disabled, if claim is filed within one year from such date, whichever is to the advantage of the veteran.

(ii) Claims received on or after October 1, 1984.

(A) Except as provided in paragraph ((1)(ii)( of this section, date of receipt of claim.

( If, within one year from the date on which the veteran became permanently and totally disabled, the veteran files a claim for a retroactive award and establishes that a physical or mental disability, which was not the result of the veteran’s own willful misconduct, was so incapacitating that it prevented him or her from filing a disability pension claim for at least the first 30 days immediately following the date on which the veteran became permanently and totally disabled, the disability pension award may be effective from the date of receipt of claim or the date on which the veteran became permanently and totally disabled, whichever is to the advantage of the veteran. While rating board judgment must be applied to the facts and circumstances of each case, extensive hospitalization will generally qualify as sufficiently incapacitating to have prevented the filing of a claim. For the purposes of this subparagraph, the presumptive provisions of §3.342(a) do not apply.

(2) Disability compensation:

(i) Direct service connection (§3.4(:D). Day following separation from active service or date entitlement arose if claim is received within 1 year after separation from service; otherwise, date of receipt of claim, or date entitlement arose, whichever is later. Separation from service means separation under conditions other than dishonorable from continuous active service which extended from the date the disability was incurred or aggravated.

(ii) Presumptive service connection (§§3.307, 3.308, 3.309). Date entitlement arose, if claim is received within 1 year after separation from active duty; otherwise date of receipt of claim, or date entitlement arose, whichever is later. Where the requirements for service connection are met during service, the effective date will be the day following separation from service if there was continuous active service following the period of service on which the presumption is based and a claim is received within 1 year after separation from active duty.

HOWDY! IT'S ME, WINGS! LOL!

Whatis theregulation that backs up the vets argument that s/he was too sick to file a claim within the first year (months) of discharge. I know I read it in the CFR somewhere! Maybe under Chapter 17? Please help if you can ;-) HUGS!!!!!!

[mountain tyme]

§17.275 Claim filing deadline.

(a) Unless an exception is granted under paragraph ( of this section, claims for medical services and supplies must be filed with the Center no later than:

(1) One year after the date of service; or

(2) In the case of inpatient care, one year after the date of discharge; or

(3) In the case of retroactive approval for medical services/supplies, 180 days following beneficiary notification of authorization; or

(4) In the case of retroactive approval of CHAMPVA eligibility, 180 days following notification to the beneficiary of authorization for services occurring on or after the date of first eligibility.

( Requests for an exception to the claim filing deadline must be submitted, in writing, to the Center and include a complete explanation of the circumstances resulting in late filing along with all available supporting documentation. Each request for an exception to the claim filing deadline will be reviewed individually and considered on its own merit. The Center Director may grant exceptions to the requirements in paragraph (a) if he or she determines that there was good cause for missing the filing deadline. For example, when dual coverage exists CHAMPVA payment, if any, cannot be determined until after the primary insurance carrier has adjudicated the claim. In such circumstances an exception may be granted provided that the delay on the part of the primary insurance carrier is not attributable to the beneficiary. Delays due to provider billing procedures do not constitute a valid basis for an exception.

[63 FR 48102, Sept. 9, 1998]

Supplement Highlights reference: 31(1)

[Wings]

Free, Thank you! That is the regulation I remembered reading!

Unfortunately, I do not think it will apply to my claim at all.

I am trying to show an effective date of discharge, but for my mental disability ignorant service officer, DD-214 showing incorrect data . . . bla bla bla.

I do have solid evidence on record of an "informal claim" and am claiming that CUE was prejudical and completely "barred" my PTSD claim from advancing in the first instance, at discharge.

I have a California "State" Form that used by County Social Services that the veteran hand-carriied to the County Veteran Service Office to establish VA Benefits, but there is no "526" of record!!

HAS ANYONE EVER WON A CLAIM THAT WASN"T ON VA FORM 21-526 ???????

[free_spirit_etc]

I remember reading that a long time ago, but I didn't fully understand the difference between pension and compensation at that time. Odd that they would grant it for pension and not compensation. I do know I have read you don't have to be unable to file for a whole year. You only have to show you were unable to file within the first 30 days of that year.

But it looks like it only applies to pension.

I think lots of informal claims have been won. If you make a claim - and the claim is not "complete" then the VA is supposed to mail you a form to complete your claim. If they do not mail you the form - the claim is supposed to be considered still pending. The time limit for submitting the form is not supposed to start until they mail it to you.

Sec. 3.150 Forms to be furnished.

(a) Upon request made in person or in writing by any person applying

for benefits under the laws administered by the Department of Veterans

Affairs, the appropriate application form will be furnished.

Sec. 3.155 Informal claims.

(a) Any communication or action, indicating an intent to apply for

one or more benefits under the laws administered by the Department of

Veterans Affairs, from a claimant, his or her duly authorized

representative, a Member of Congress, or some person acting as next

friend of a claimant who is not sui juris may be considered an informal

claim. Such informal claim must identify the benefit sought. Upon

receipt of an informal claim, if a formal claim has not been filed, an

application form will be forwarded to the claimant for execution. If

received within 1 year from the date it was sent to the claimant, it

will be considered filed as of the date of receipt of the informal

claim.

( A communication received from a service organization, an

attorney, or agent may not be accepted as an informal claim if a power

of attorney was not executed at the time the communication was written.

© When a claim has been filed which meets the requirements of

Sec. 3.151 or Sec. 3.152, an informal request for increase or

reopening will be accepted as a claim.

Free

Free, Thank you! That is the regulation I remembered reading!

Unfortunately, I do not think it will apply to my claim at all.

I am trying to show an effective date of discharge, but for my mental disability ignorant service officer, DD-214 showing incorrect data . . . bla bla bla.

I do have solid evidence on record of an "informal claim" and am claiming that CUE was prejudical and completely "barred" my PTSD claim from advancing in the first instance, at discharge.

I have a California "State" Form that used by County Social Services that the veteran hand-carriied to the County Veteran Service Office to establish VA Benefits, but there is no "526" of record!!

HAS ANYONE EVER WON A CLAIM THAT WASN"T ON VA FORM 21-526 ???????

[john999]

Wings

I know what you are talking about. I think you would have to show that you were incompetent to file a claim within one year of discharge in order to get the retro to the day after discharge. It is in the VBM somewhere. If you were in a nuthouse or in a hospital you might have a chance to get around the one year regulation. The one year after discharge is almost like you are still in the service for many conditions if you file for disability. I will look in the VBM and see what I can find. If there is a rule they is an exception.

[Josephine]

Free, Thank you! That is the regulation I remembered reading!

Unfortunately, I do not think it will apply to my claim at all.

I am trying to show an effective date of discharge, but for my mental disability ignorant service officer, DD-214 showing incorrect data . . . bla bla bla.

I do have solid evidence on record of an "informal claim" and am claiming that CUE was prejudical and completely "barred" my PTSD claim from advancing in the first instance, at discharge.

I have a California "State" Form that used by County Social Services that the veteran hand-carriied to the County Veteran Service Office to establish VA Benefits, but there is no "526" of record!!

HAS ANYONE EVER WON A CLAIM THAT WASN"T ON VA FORM 21-526 ???????

Wings,

Not one time did I ever fill out a VA form for any compensation. I

wrote them a letter, they accepted and never mailed me any forms to

fill out.

I won without the Formal Traditional Way of doing things.

Betty