Claims Disallowed

[free_spirit_etc]

Under 3.157 is a claim that is disallowed / denied for the reason that the

disability was not compensable in degree... -

does that mean service connection was denied because they couldn't find a "current" disability? Or does that mean that the vet was GRANTED SC - but at zero percent - and thus the claim was granted, but compensation denied?

Free

[Chuck75]

Sounds like the current VA alternative "wording" to the older SC 0% compensation that is now frowned upon. Seems (If I understand it), that 10% is supposed to be the minimum if SC is decided these days.

This is one that I'd ask for clarification. Since denied is in the wording, I guess that an NOD would be the next step.

Under 3.157 is a claim that is disallowed / denied for the reason that the

disability was not compensable in degree... -

does that mean service connection was denied because they couldn't find a "current" disability? Or does that mean that the vet was GRANTED SC - but at zero percent - and thus the claim was granted, but compensation denied?

Free

[Rockhound]

Under 3.157 is a claim that is disallowed / denied for the reason that the

disability was not compensable in degree... -

does that mean service connection was denied because they couldn't find a "current" disability? Or does that mean that the vet was GRANTED SC - but at zero percent - and thus the claim was granted, but compensation denied?

You got a good question here. You may very well have to go to the source on this one. or to one ot the service orginzations, if you do not have a service officer, to get your answer.

RR B)

[carlie]

Here's some interesting information --- if we can understand it, lol.

http://www.va.gov/vetapp05/files3/0518547.txt

Over the last 40 years, various VA General Counsel(GC)

opinions, Veterans Benefits Administration (VBA) papers, and

decisions of the Court have addressed the matter of when a

hospitalization or examination report can serve as a claim

for benefits.

In an April 1960 unpublished GC opinion, it was determined

that the provisions of VA regulation 1157 relate to

acceptance of a report of hospitalization as a claim for

increased compensation are applicable whenever there is an

increase in overall disability of a veteran who already has

an award based on service-connected disability, irrespective

of whether the particular increase related to a disability

for which compensation had previously been awarded. VAOPGC

(April 4, 1960).

The GC upheld that April 1960 opinion in September 1981. The

GC concluded that a report of VA hospitalization in the case

of a service-connected veteran was considered a claim for

increased benefits even though the disability concerned was

other than the one from which service connection had already

been established. VAOPGC (September 29, 1981).

In a May 1984 opinion, the GC modified its position,

determining that the date of outpatient or hospitalization

admission might be considered a possible effective date for

payment of compensation benefits only where service

connection had already been established for the disability

for which the claimant was subsequently hospitalized or

examined. The GC indicated that the modification was made in

response to a changed statutory effective date scheme. It

was noted that the prior interpretations were inconsistent

with the current legal authority, which, among other things,

required that a claim for benefits be specific. However,

although notice of hospitalization may not suffice as an

informal claim when a veteran service-connected for one

disability is hospitalized for a different disability for

which service connection has not been granted, it is possible

to grant an increase as of an effective date earlier than the

date of claim based on increased disability ascertainable

within the preceding year. VAOPGC (May 24, 1984). (See

current 38 C.F.R. § 3157 referencing or a claim specifying

the benefit is received within 1 year.)

However, more recently, in Sears v. Principi, 16 Vet. App.

244, 249 (2003), the Court determined that 38 C.F.R. § 3.157

pertained to a defined group of claims, i.e., as to

disability compensation, those claims for which a report of a

medical examination or hospitalization is accepted as an

informal claim for an increase of a service connected rating

where service connection has already been established. The

decision implicitly invalidated the prior GC opinions. See

Gallegos v. Gober, 14 Vet. App 50, 55, rev'd 283 F.3d 1309

(Fed. Cir. 2002). Prior to Sears, 38 C.F.R. § 3.157 was

interpreted to mean that an increase was sought in the level

of compensation overall, not just an increase for a

particular disability. Thus, if compensation was in effect

for any disability, then a report of a VA medical examination

or hospitalization was accepted as an informal claim for

increased benefits to include for compensation for a

different disability, if a claim specifying the benefit was

received within one year. However, Sears is precedent and

controlling and invalidates this interpretation.

[carlie]

I've sent an email to Jim Strickland to see if he can do

some indepth discussion on 38 CFR 3.157, tonight on

Stardust Radio.

To get more info read Berta's post

here: http://www.hadit.com/forums/index.php?showtopic=18289

To join in the show or just listen go

here: http://www.stardustent.com/svr.htm

Hope this will be helpful.

carlie

[william n]

i can tell u this if it applies....if a veteran who is service connected for a mental disability went into the "domicillary progam" at the VAMC and was being treated for depression or whatever..they qualifified for 100% SC after 30 days(inpatient)..Sooo, what the VA did was scale the program back from 45 days to 28 days so the vets coukld no longer collect the 100% rate and bounce with a pocket full of loot....Thats a fact at the Bay Pines VHAMC..Regards, william

Edited June 18, 2008 by william n

[jbasser]

Under 3.157 is a claim that is disallowed / denied for the reason that the

disability was not compensable in degree...

There are several ratings inthe schedule thet have no zero percent rating or criteria for zero percent.

Hypertension is one. Even there is no 0 percent criteria, They still give out 0 percent ratings.

Compensable in degree: Your ailmet must meet the rating criteria for whatever degree of severity.

It sounds like a bit of confusing information and I am sure it was intended toi be this way.

J

Edited June 18, 2008 by jbasser