Fdc Claims Processing

[harleyman]

This past couple of weeks the VA has changed the way FDC claims are processed. We have just received more training and Fast Letters and emails on the FDC claims processing. These FDC claims were originally processed by the special ops team, then they were moved to the express teams. As FDC claims have increased, partially because the word is out that they move more quickly, but mainly because VA has been working with the VSOs, asking them to "push" FDC claims. The number of new claims filed as FDC claims has skyrocketed.

The FDC claims are now making up about 29% of all new claims filed. The VA has moved the FDC claims where they will be worked by all teams depending on the issues claimed. And they will have priority status on all teams.

1 to 2 issues only -worked by Express Team - called quick easy claims- usually less experienced VSR/RVSRs

3 or more issues (and /or all issues of IU and DM) - worked by the more experienced CORE team

FDC that includes priority processing such as homeless, MST,TBI - worked by the Special Ops Team, handles special issues

All teams will work these claims as a priority with working toward a 90 days completion average. (remember average) some will take longer than others for sure. This is based on the amount of development needed on the Federal side. There is no development on the Veteran's side in an FDC claim. Once you file the claim you cannot send in any other information or respond to any letters the VA sends you about your claim or it will be excluded from the program.

You may have to decide if the information you are being asked for will have an affect the decision, and is it worth pulling the claim from the FDC program in order to get the results you want in the end rating decision. It might take longer for a decision but remember all decisions are ultimately based on the evidence. If VA asks for something and you don't send it because you want a quick decision, you may get a denial because the VA needed more evidence.

Inherently, FDC letters are suppose to be complete when they are submitted with no further involvemnt needed from the Veteran. So if you file a FDC claim, and VA sends you something regarding your claim,, read your correspondance from VA very carefully, and then decide to respond or not to respond. As once you send in addtional information your claim is excluded from the program- H

Edited October 5, 2013 by harleyman

[Berta]

Harleyman said :

"There is no development on the Veteran's side in an FDC claim. Once you file the claim you cannot send in any other information or respond to any letters the VA sends you about your claim or it will be excluded from the program."

So,in essense, these claims do not require VA to send the claimant the VCAA letter?

"So if you file a FDC claim, and VA sends you something regarding your claim,, read your correspondance from VA very carefully, and then decide to respond or not to respond. As once you send in addtional information your claim i excluded from the program- H"

Excluded from FDC but still with appellate rights,once excluded ......????? and then does the VA send the VCAA letter to advise the claimant what is lacking in the claim,if they are no longer a FDC claimant?

[harleyman]

Harleyman said :

"There is no development on the Veteran's side in an FDC claim. Once you file the claim you cannot send in any other information or respond to any letters the VA sends you about your claim or it will be excluded from the program."

So,in essense, these claims do not require VA to send the claimant the VCAA letter? Yes, that is correct. The VA FORM 21-526 EZ now contains all the DTA information as an adjunct to the form. So the Veteran lists his claimed condition(s) and he reads the 4 pages (not possitive how long it is as it keeps getting longer) of 5103 (VCAA) information now included with the EZ FORM, and when he signs the form (mandatory signature for FDC claim), he is confirming he has been advised what is needed to support his claim, and VA has met thier duty to assist the Veteran, in his claim process for benefits sought. NO signature on the form no FDC claim.The Veteran will not received a 5103 (VCAA) notice from VA for a FDC claim, that meets the VA criteria. BUT..... there is always an exception when it comes to VA...keep reading.

"So if you file a FDC claim, and VA sends you something regarding your claim,, read your correspondance from VA very carefully, and then decide to respond or not to respond. As once you send in addtional information your claim i excluded from the program- H" If you get a letter frm VA regarding your FDC claim, then the VA is letting you know in cases like yours there is certain information that must be included with the claim. (This does not MEAN you didn't send the information with your claim, it means the VA had more information they needed to send you as thier Duty to assist. It will be up to the Veteran to decide if he hs submitted the evidence the VA is talking about. (I know this is hard to understand).

Berta, an examle of the above situation would be:

The Veteran files an FDC claim for a condition denied more than one year. (What is new and materail N&M)

N&M claims are not coverd under the FDC VA 526EZ forms

The Veteran did send in his new and materail evidence with his FDC claim

Since DTA for N&M is not part of the 526EZ- VA has to send a 5103 letter to the Veteran for the N&M issue ONLY

The Veteran gets the letter, but knows he sent in his new and materail evidence. So he doesn't respond to the letter because he is confindent he sent in the N&M evidence he is good to stay in the FDC program

same scenerio, but the Veteran thinks, OH , NO! the VA must not have received my evidence they sent me a letter telling me I need to send in evidence, I need to send it again or they must think I need more evdence. So the Veteran submits a letter from his spouse or something other evidence. He is now excluded from the program because he responded to the VA N&M letter.

Excluded from FDC but still with appellate rights,once excluded ......????? Once excluded, it will then be processed in the traditional manner for that specific type of claim. All FDC claims as well as traditional claims will all have the usual appellate rights, but the DTA inforamation for FDC is included in the form, for an excluded claim it will go back to th traditional process which includes a 5103 (VCAA) letter to the Veteran.

and then does the VA send the VCAA letter to advise the claimant what is lacking in the claim,if they are no longer a FDC claimant? Yes, as stated above. However, it will no longer be handled as part of the FDC priority processing. Once a claim is received it will be screened to make sure it qualifies as an FDC claim.

I am in the process of trying to get Fast letters and MEMOs, training materail to Hadit, but I am limited on computer resources right now and it's a lot of information and I don't have scanner/ fax capabilities at home, it mght come to Hadit by snail mail, well see how things play out.

Edited October 5, 2013 by harleyman

[Snake Eyes]

So when the VA sent me a letter stating they need a record from a doctor named in my claim, and I provide it, I'm automatically disqualified from FDC? I suspect the item they're requesting was already filed with the claim but may not have had the practice's name and address as doc offices do nowadays.

This may be moot. The form requests gross pay for last twelve months and I already replied to the letter asking for net pay. Is this some kind of trick? :-)

[Snake Eyes]

So when the VA sent me a letter stating they need a record from a doctor named in my claim, and I provide it, I'm automatically disqualified from FDC? I suspect the item they're requesting was already filed with the claim but may not have had the practice's name and address as doc offices do nowadays.

This may be moot. The form requests gross pay for last twelve months and I already replied to the letter asking for net pay. Is this some kind of trick? :-)

[Snake Eyes]

UPDATE... I read the development letter more carefully... apparently, submitting my FDC after opening it informally is considered a "second claim" -- when I did the phone informal, apparently, the guy opened it as a TDIU and left out the other contentions.

So it's now a standard claim, though when I uploaded the documentation I reminded them the FDC was just the final claim from the informal opened by phone. MAYBE they'll grant mercy one time :-)

[rootbeer22]

Snakes Eyes:

I'm also being told now that if someone submits a FOIA that that's considered another claim which appears to disqualify claims also, that makes not sense to me in an era when the records are all supposedly digitised and it's a very simple action to release copies of the files. I've been very concerned that not all of my records were digitised so that was the reason for the FOIA.