Informal Claim

[Zechs]

To set my effective date through an informal claim, I know I need to state what condition I'm filing for on a form 21-4138, but do I need to state the symptoms or go into any greater detail?

I'm still gathering evidence, so I don't want to trigger a full claim at the moment, just stake an effective date and my intentions on formally filing within a year.

[Pete53]

Welcome to Hadit. All you really need to do is to notify in writing that you intend to file a claim. You can use symptoms and be general. Best to leave as much leeway as you can.

[Berta]

“just stake an effective date and my intentions on formally filing within a year. “

Do you mean within a year after your discharge?

If that claim is successful the EED will be the day after your discharge.

[meghp0405]

You can save yourself a lot of time by doing the following; obtain a copy of ALL medical documentation to support your claim. Complete a VA FM 21-526ez, VA FM 21-4138, attach all documents and forward to the VARO in your state. By doing this, your claim will be adjudicated within 90 days. by doing this you do not have to worry or not if VA received said documents.

If you want to start a claim, you can submit a VA FM 21-4138 or just write on a piece of paper that you are requesting an evaluation for (disability) and I will forward medical documents at a latter time. This process will vary on the VARO. Thses claims are taking 10-14 months and sometimes longer depending on which state you reside.

I don't recommend this way due to the fact that you will be sending documents to the VA when requested. The VA does have a history of losing documents.

A claim is a claim no such thing as an informal or formal process. You are still requesting an evaluation and VA will treat it as such.

When completing a VA FM 21-4138, I recommend stating only the items that you are requesting an evaluation for. Some vets have come into my office with 3-4 page letters. that's fine, I will send them in. However, I do know for a FACT that the individuals reveiwing your claim will not read statements that are lengthly. this isn't true with everybody, but the rationale for not doing this is that they weigh more on what the medical records state. that's why it is important when you see you Doctor you reveal any and all symptoms in order they may be annotated in your SMR's. I have said this before on this site and I will say it again. I have submitted over 400 fully developed claims in 2012 with the veterans that I have assisted. Each claim was completed within 90 days. The only exception was the claims I did on those military personnel that were retiring. If the retiree was awarded more than 50%, the claim is sent to DFAS for accounting due to the CRDP phase in.

Hope this helps...

[john999]

An admission to a VA hospital can be viewed as an informal claim. It was in my own case twice. Originally and for an increase years later.

John

[Teac]

An admission to a VA hospital can be viewed as an informal claim. It was in my own case twice. Originally and for an increase years later.

John

An admission to a va hospital also puts a stop on your smc payments for housebound or aid and attendance..... so if you can avoid admission to a va hospital because you end up paying one way or another...

[john999]

Teac

How long a stop on HB or A&A? Not permanent????

[broncovet]

Meg

I dont know what RO you are in, but at my RO "There is no such thing as a 90 day claim (awarded)." Oh, you may be able to get a denial, in 90 days, but then it takes 4 years to appeal it to the BVA. For most Veterans, less than 15% of claims are fully awarded on the first RO decision.

The "old" guys know that 90days is not possible but the newbies...they may count on the money in 90 days and they are going to be rudely disappointed. Personally, I applied in 2002, denied in 8 months, AND THIS APPEAL CONTINUES for more than a decade. Mine is not unusual, the typical 100% Vet waits a decade through appeals to get his benefits.

I have been to the BVA TWICE and now its onto the CAVC. Incredibly, I won at the BVA once and the RO refuses to implement EITHER of my BVA awards (Both were partial/full awards).

The "90 day claim" hogwash is usually perpetuated by VA execs who are trying to justify their bonuses. We know better.

All this being said, there are a few limited RO's that may be able to process some claims quickly. Probably Idaho, and some under populated states. Forget it if you live in California, Ohio, and dont even think about New York. There is a great disparity between Regional Offices, which, is in credible considering that the RO's "farm their claims out" (which usually results in additional delays) to less busy states. Even with farming them out, if you check the statistics, there is a wide variation among RO's. By the Way, my claim has been Farmed out to Philadelphia, St. Pete and Roanoke, all of which resulted in additional delays.

If your appeal winds up at AMC...you may as well forget this as you wont see anything for 10 years, that is, if they dont lose your claim altogether, which they have done to me, also.

[manning01]

My normal initial claim took over 2 years. But remember Meg is talking about the Fully Developed Claim (FDC) program which I have one in I submitted Dec 26th 2012 with all the paperwork and there is already movement on it. The VSO's here say they usually complete the FDC's here in Phoenix in 90 days or less, even shorter if you submit the DBQ and IMO with it. Regular claims or NOD's forget it join the crowd and wait for years.

Edited January 3, 2013 by manning01 (see edit history)

[meghp0405]

Meg

I dont know what RO you are in, but at my RO "There is no such thing as a 90 day claim (awarded)." Oh, you may be able to get a denial, in 90 days, but then it takes 4 years to appeal it to the BVA. For most Veterans, less than 15% of claims are fully awarded on the first RO decision.

The "old" guys know that 90days is not possible but the newbies...they may count on the money in 90 days and they are going to be rudely disappointed. Personally, I applied in 2002, denied in 8 months, AND THIS APPEAL CONTINUES for more than a decade. Mine is not unusual, the typical 100% Vet waits a decade through appeals to get his benefits.

I have been to the BVA TWICE and now its onto the CAVC. Incredibly, I won at the BVA once and the RO refuses to implement EITHER of my BVA awards (Both were partial/full awards).

The "90 day claim" hogwash is usually perpetuated by VA execs who are trying to justify their bonuses. We know better.

All this being said, there are a few limited RO's that may be able to process some claims quickly. Probably Idaho, and some under populated states. Forget it if you live in California, Ohio, and dont even think about New York. There is a great disparity between Regional Offices, which, is in credible considering that the RO's "farm their claims out" (which usually results in additional delays) to less busy states. Even with farming them out, if you check the statistics, there is a wide variation among RO's. By the Way, my claim has been Farmed out to Philadelphia, St. Pete and Roanoke, all of which resulted in additional delays.

If your appeal winds up at AMC...you may as well forget this as you wont see anything for 10 years, that is, if they dont lose your claim altogether, which they have done to me, also.

Well Sir, let me say this, I have submitted just over 400 "fully developed claims" in 2012. Each of those claims were adjudicated within 90 days. The only exception were those military personnel that were retiring and had been awarded 50% or greater.Those claims took about 30 days longer due to DFAS computing the CRDP pay. A VA FM 21-526ez has to be completed with ALL suporting documents. I have assisted veterans from the Korean war forward to todays veterans. These FDC claims have been in effect for about 2 years now. This is no " hogwash" as you state. Has nothing to do with va executives justyfing their bonus. The FDC claims are not farmed out and are adjudicated by the state which the veteran resides. I have seen change with the VA. Don't get me wrong they have a long way to go but again the FDC claims are real and they do work. i have been doing this for a long time myself and i can tell you this from my experience with claims, if a claim is sitting somewhere for over 4 years, the claim is missing something, it's not complete. I have seen many on this site say "send them documents all the time", i think this is the worst thing that anybody can do for a claim. most cases each time documentation is sent to VA, the claim is sent back to development phase. Which will add months to your claim. Send in a complete claim and see what happens...

[SolInvictus]

Meg, I have to side with Broncovet on this one. Even if this new FDC is as efficient as you say, how fair or just is it to the rest of the claimants who's only error has been to follow the va's own procedure that existed before the new program. So let me understand this, the vet stands in line for years awaiting adjudication of his claim, the va knows this looks terribly innefficient so instead of streamlining the process on their end and hiring more workers to clear the backlog, the va administrators come up with a new gimmick of starting a new queue for new claimants and holding them up as shining examples of how efficient the new system is. Meanwhile the folks who have been languishing in the old line are left holding the bag and are expected to applaud. This would be funny if the joke wasn't on us. Broncovet is right, when they fix the problem with the real line, we'll be more than glad to show our gratitude, but the magic show in the FDC line isn't fooling anyone. We've been patient, it doesn't mean we're slow.

[broncovet]

Well, Meg:

If, in fact, the VA is doing FDC claims in 90 days...ACROSS THE COUNTY, then we would see a reduction in the backlog...but we have not. In fact it continues to get worse and FDC is just one more unkept government promise and program, or, at least, a promise that is kept "some of the time". It may have even worked in YOUR RO for a while, but I have SERIOUS DOUBTS it is working nation wide. Why do I say this? I have heard way, way, way, too many promises coming from Sec. Shinseki. For example, he said he would "break" the backlog in 2010. Now, the promise has been moved to 2015, which is a convienient number for him because he will be leaving as a new president will be elected in 2016, and they would be a fool to keep Eric after he could not keep his promises.

Here is where Shinseki promised to end the backlog in 2010, in case you forgot. I didnt.

http://www.legion.org/veteransbenefits/90664/shinseki-backlog-will-end-year

If Vets COULD get their claim done in 90 days by submitting an FDC, then there would be such a rush to do so, they would no longer be able to keep up the 90 day promise.

[SolInvictus]

Well, Meg:

If, in fact, the VA is doing FDC claims in 90 days...ACROSS THE COUNTY, then we would see a reduction in the backlog...but we have not. In fact it continues to get worse and FDC is just one more unkept government promise and program, or, at least, a promise that is kept "some of the time". It may have even worked in YOUR RO for a while, but I have SERIOUS DOUBTS it is working nation wide. Why do I say this? I have heard way, way, way, too many promises coming from Sec. Shinseki. For example, he said he would "break" the backlog in 2010. Now, the promise has been moved to 2015, which is a convienient number for him because he will be leaving as a new president will be elected in 2016, and they would be a fool to keep Eric after he could not keep his promises.

Here is where Shinseki promised to end the backlog in 2010, in case you forgot. I didnt.

http://www.legion.org/veteransbenefits/90664/shinseki-backlog-will-end-year

If Vets COULD get their claim done in 90 days by submitting an FDC, then there would be such a rush to do so, they would no longer be able to keep up the 90 day promise.

Broncovet's theory on this issue makes perfect sense to me. It synchronizes perfectly with Thomas Paine's correct summation of the true purpose of all governments once they become self serving- which is to separate the citizen from his rights. The VA in effect has become a governing body which does more to separate vets from their rights to compensation they've earned, than the supposed purpose of the VA which is to efficiently grant and secure those rights. In the name of separating the deserving vets from the frauds, the VA has succeeded in setting up an elaborate scheme that rewards the criminals ( politicians/ contractors and confidence tricksters) instead of the veteran. For every cent they award a vet, a criminal gains a dollar. And the taxpayer and the poor veteran get hosed at every turn. How else are we to explain the pepertually inefficient monstrosity they've set up that only seems to get worse the more they fix it. They've had decades of trial and have very little success to show and they never seem to be in a hurry to get the job done. The only certainty is that they all get paid well, onetime and promise to come back for more pay to fix yesterday's errors.

[broncovet]

My "BS" meter is RED HOT, and screaming uncontrollably. 400 claims in 2012 and ALL of them completed in less than 90 days? Zero "lost evidence"? Zero delayed C and P's? Zero delays? Zero bad addresses? Nope. Not in the real world. You should have tried to tell me that 10% of that 400 were completed in 90 days, I could have stretched it to that. I am not buying it one bit. I have been around too long. Babe Ruth did not hit 400 home runs in a row and you didnt bat 1000 on FDC's either. There are too many things that can/do go wrong at the VA to get all 400 no matter what.

In 10 years of talking to other Vets, I have had exactly ONE Veteran tell me their claim was completed in 90 days or less. And you had 400 of them in a row?

I might believe you if you said you tossed a coin and got heads 400 times in a row. But HOW in the world did you even find 400 Veterans filing claims, in 2012, ALL OF WHICH HAD THEIR ENTIRE SMR's, DD214's and everything they needed ready to file?

Edited January 5, 2013 by broncovet (see edit history)

[cham1968]

So what I should do after almost 2years is refile my claim as an FDC or do I have that opportunity to do so since it's not 1yr after discharge? Then my claim will be done in 90 days or less. Why do they just implement this program for those who have been waiting in line. Since they've already started on the claims simply state to the Veteran what he/she needs to supply to get their claim moving, Oh wait the veteran has already submitted all the information they have and are waiting on other government sources for confirmation WTH MEGHP0405 it's the same old story, forget those who have been waiting let's take care of the NOW. How does that make since I'm betting that 50-60% of claims have all that a veteran can provide with the exception of C&P or other Gov agency information, So the fix is to just skip over those claims. Why can't you Apply the FDC to them Oh because they don't have the information needed from those "other" agencies what a CRock. LMAO Thanks for nothing VA!

Oooh Rahh

[broncovet]

Cham

I recommend:

Do not "refile" as an FDC. You have already filed, and cant reset the clock. Filing again will only confuse VA. However do this instead, in this order:

1. Send an Iris email inquiring the claim status. They could have lost the whole thing, then you will have to refile. It happens, FDC or no FDC.

Keep a record of their email response.

2. Call the 800 number and ALSO inquire the status. Also note what was said, along with time and date, and keep those records.

3. Since 2 years is too long for an initial claim, your address may be incorrect, and you may have a decision but it was not recieved by you for whatever reason. Check to see if your address is correct on ebenefits.

4. Send a 21-4138 documenting that you filed two years ago for xxx benefit. Ask AGAIN for your claim to be adjuticated, referencing your original 2 year old claim.

5. Wait a couple months for responses to the above.

6. If still no answers, file an "intent to file a writ of mandamus".

7. Finally, still no answer file a writ of mandamus.

[meghp0405]

My "BS" meter is RED HOT, and screaming uncontrollably. 400 claims in 2012 and ALL of them completed in less than 90 days? Zero "lost evidence"? Zero delayed C and P's? Zero delays? Zero bad addresses? Nope. Not in the real world. You should have tried to tell me that 10% of that 400 were completed in 90 days, I could have stretched it to that. I am not buying it one bit. I have been around too long. Babe Ruth did not hit 400 home runs in a row and you didnt bat 1000 on FDC's either. There are too many things that can/do go wrong at the VA to get all 400 no matter what.

In 10 years of talking to other Vets, I have had exactly ONE Veteran tell me their claim was completed in 90 days or less. And you had 400 of them in a row?

I might believe you if you said you tossed a coin and got heads 400 times in a row. But HOW in the world did you even find 400 Veterans filing claims, in 2012, ALL OF WHICH HAD THEIR ENTIRE SMR's, DD214's and everything they needed ready to file?

i'm glad your BS meter is RED HOT! maybe it will make you and others like you, take your blinders off, come down off your pedestals and look what's going on. I would think if you moved your negativity to doing something positive, you to can make a difference. I became a veteran service offiicer after I was medically retired after 21 years of service. The process stunk and it still does! I am not a fan of shiniski, never have been nor will I ever be! He needs to go! An office party of 4 million dollars spent and he knew nothing of it? why didn't he report to congress? Why did he send his deputy? he and his black berets need to not just go away, but go the HELL away!

This backlog of claims is serious business! As I stated earlier, ANYBODY can do an FDC! Not just the new guys as you stated. I have done claims for Korean war vets all the way up through these guys that are now getting out of service. And now you want to tell me what I did and what I didn't do? Just who in the sam hell do you think you are? I can show results for each of those 412 FDC claims that were submitted and approved by VA. I can also show you the status of some of the 186 claims that I did, because the veterans didn't want to wait to get all the required documentation. They wanted to hurry up and get their "informal claim" in to set an effective date. Almost everyone of those claims are still being adjudicated. Each time a veteran sends in medical documentation, in more cases than not the claim goes back to the development phase, thus creating and adding additional time to his/her claim. Yes, each of those FDC claims that I and other service officers around here (it's just not me) have had no lost documentation. The claim is sent in as a FULLY DEVELOPED CLAIM. Once VA receives it, the claim goes strait to the development folks who order the C/P exam(s). After the C/P exams are done, the claims go right into rating, decision and notification phases. And here you want to tell me only 40 of my claims were ok? You do not need a full medical jacket to send with each claim. All you need is all supporting documents to the disability that you are claiming. Do you know what DBQ's are? Using them will only increase the speed of these claims. I have seen a total of 936 veterans/widows/widowers for 2012, of those 936, a total of 598 claims were submitted, 412 were FDC and 186 were a VA FM 21-4138 requesting an evaluation for what ever disaability the vet wants to claim. The service officer about two miles down the road seen about 1200 vets. At least that's what he reported at the last DAV meeting. Don't know what his stats were, he didn't report and I didn't ask. Many of the deficiencies you point out in your post would be totally rectified if you had a service officer that knew what he/she was doing. It's our responsibility to inform the vet with the best information we have. There are too many so called street lawyers out there that think they know everything, in fact I and some of my peers have on a continous basis, have to fix many of the errors that were completed by them. Many talk a good game, Babe Ruth had a good game as you so described above, but one thing I don't do is compare veterans. Each veteran is there own person, the paperwork may be the same but the veterans stories, experiences are far from being the same. I have a great volunteer job that I love! And I do well at it. For that I am extremely grateful to the GAOTU for providing me the knowledge and paitence to work with our veterans. Seeing these vets come back and thank me is the greatest gift I could ever receive. of all the vets that I have seen over the past years, I still remember this widow of a WWII veteran, it took almost 4 years to obtain the DIC benefits that she was entitled to when her husband passed years ago. She showed me her bank statement where the VA had paid her just over 183,000.00. She asked me what I wanted or needed. I told her nothing, she then asked me if she could give me a hug. I got up from behind my desk, gave her a hug and that was the greatest feeling any service officer could experience!

[meghp0405]

Cham

I recommend:

Do not "refile" as an FDC. You have already filed, and cant reset the clock. Filing again will only confuse VA. However do this instead, in this order:

1. Send an Iris email inquiring the claim status. They could have lost the whole thing, then you will have to refile. It happens, FDC or no FDC.

Keep a record of their email response.

2. Call the 800 number and ALSO inquire the status. Also note what was said, along with time and date, and keep those records.

3. Since 2 years is too long for an initial claim, your address may be incorrect, and you may have a decision but it was not recieved by you for whatever reason. Check to see if your address is correct on ebenefits.

4. Send a 21-4138 documenting that you filed two years ago for xxx benefit. Ask AGAIN for your claim to be adjuticated, referencing your original 2 year old claim.

5. Wait a couple months for responses to the above.

6. If still no answers, file an "intent to file a writ of mandamus".

7. Finally, still no answer file a writ of mandamus.

Cham; if you retired and submitted a BDD claim, those claims are sent to the Winston-Salem VARO and they are taking awhile. I seen a veteran in my office just before Christmas, his claim to 29 months. It's wrong just plain wrong for any veteran having to wait that long!

Edited January 8, 2013 by meghp0405 (see edit history)

[meghp0405]

My normal initial claim took over 2 years. But remember Meg is talking about the Fully Developed Claim (FDC) program which I have one in I submitted Dec 26th 2012 with all the paperwork and there is already movement on it. The VSO's here say they usually complete the FDC's here in Phoenix in 90 days or less, even shorter if you submit the DBQ and IMO with it. Regular claims or NOD's forget it join the crowd and wait for years.

My normal initial claim took over 2 years. But remember Meg is talking about the Fully Developed Claim (FDC) program which I have one in I submitted Dec 26th 2012 with all the paperwork and there is already movement on it. The VSO's here say they usually complete the FDC's here in Phoenix in 90 days or less, even shorter if you submit the DBQ and IMO with it. Regular claims or NOD's forget it join the crowd and wait for years.

if you would, place a note on here when you receive your rating decision. On your statement above, regular claims can be submitted on VA FM 21-526ez as a FDC. That's what it is! Once you receive an NOD, that being the initial stage of an appeal, your on VA's schedule.

Edited January 8, 2013 by meghp0405 (see edit history)

[meghp0405]

My normal initial claim took over 2 years. But remember Meg is talking about the Fully Developed Claim (FDC) program which I have one in I submitted Dec 26th 2012 with all the paperwork and there is already movement on it. The VSO's here say they usually complete the FDC's here in Phoenix in 90 days or less, even shorter if you submit the DBQ and IMO with it. Regular claims or NOD's forget it join the crowd and wait for ye

Edited January 8, 2013 by meghp0405 (see edit history)

[meghp0405]

Meg

I dont know what RO you are in, but at my RO "There is no such thing as a 90 day claim (awarded)." Oh, you may be able to get a denial, in 90 days, but then it takes 4 years to appeal it to the BVA. For most Veterans, less than 15% of claims are fully awarded on the first RO decision.

The "old" guys know that 90days is not possible but the newbies...they may count on the money in 90 days and they are going to be rudely disappointed. Personally, I applied in 2002, denied in 8 months, AND THIS APPEAL CONTINUES for more than a decade. Mine is not unusual, the typical 100% Vet waits a decade through appeals to get his benefits.

I have been to the BVA TWICE and now its onto the CAVC. Incredibly, I won at the BVA once and the RO refuses to implement EITHER of my BVA awards (Both were partial/full awards).

The "90 day claim" hogwash is usually perpetuated by VA execs who are trying to justify their bonuses. We know better.

All this being said, there are a few limited RO's that may be able to process some claims quickly. Probably Idaho, and some under populated states. Forget it if you live in California, Ohio, and dont even think about New York. There is a great disparity between Regional Offices, which, is in credible considering that the RO's "farm their claims out" (which usually results in additional delays) to less busy states. Even with farming them out, if you check the statistics, there is a wide variation among RO's. By the Way, my claim has been Farmed out to Philadelphia, St. Pete and Roanoke, all of which resulted in additional delays.

If your appeal winds up at AMC...you may as well forget this as you wont see anything for 10 years, that is, if they dont lose your claim altogether, which they have done to me, al