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How The Claim Process Works?


VietnamVetsWife
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Question

Hi everyone! I'm new to the VAs way of working and am wondering, does the same claim examiner do the claim from the beginning to the second to last step where it's approved and then notification is sent or is it passed from examiner to examiner and does it work the same in all RO's? Thank you all!

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Hi Vietnams VetsWife. Welcome to the claims request world. The answer to your question is no. The same claims examiner does not always work your claim. The VA RO's always rotate digits when it comes to assigning claims. Like they assign the last two digits to whatever team will handle your claim. On note on this is in the near future all RO's will do anybody claim regardless of state you are in because of the national mission and the VA going paperless. These are the steps when it comes to handling claims. First it is received at intake processing,then received at a RO. Next the claim is cested or put in the system as an official claim. Then a Veteran Service Rep develops whatever is on 21-526ez,526b,etc like maybe treatment from VA clinic that you list on 21-526 and private treatment from a private doctor that you list on 21-526,or goes out for federal records like service treatment records from military to verify you had these issues in military.Then if claim warrants an exam then veteran gets exam. Once exam is received back from VA clinic and is clear as far as doctors notes and assessment, then goes onto Rater for decision. Once decision is made it is sent for a award in order to get you paid or if denied letter will be sent out regardless. Keep this in mind as I wish all veterans knew even myself when I started out with my claims and that is to gather your own private treatment from your doctors or if you are claiming IU/Individual Unemployability you need to make sure to get your own most recently employer that you were fired from or quit. This is a little guidance and hope it helps. Like I always say don't wait on VA cause for them to go out for federal records or your last employer it is 30 days on those request making for a little wait. One thing you could have done was file an informal claim until you get the needed information that way it locks in that date for what they will pay back to. Example say you go file on March 1, 2015 that is your date of claim but if you would have done June 1, 2014 then your date claim would be March 1, 2015 so when you get approved for compensation they would pay back to June 1, 2014. Informal claim is so you have to file within a year of informal claim. SORRY FOR CONFUSING YOU!!!!!!! HOPE THIS HELPS<<<<<<

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Hi Mont, thank you for explaining it for me. I'm confused though, as in my husbands case, for almost 2 months Ebenes was showing the evidence requested from the VA medical records was overdue ( I faxed the DBQs hoping it would get the claim moving) how does the VA not have access to their own medical records? I'm also confused how the VA can pay a disabled vet for years and then the Vet passes away and they tell his spouse after 2 years of paying her spouse benefits the vet was not on file ( This case was in the news in the NYC area recently) and they took away her benefits.

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Great info from Mont36. I second his suggestion on gathering your own medical records (private and VA). Yours is not the first case I have seen on this website where the VA regional office advised a claimant they were having trouble getting VA medical records which is ridiculous since they work for the same agency. Do not depend on the VA to gather any evidence for you. Even though the VA has a duty to assist, they have their hands full and will not put the same effort into gathering evidence as a claimant would. You are your own best advocate. Also a good idea to familiarize yourself with 38 CFR part 4. This will give you an idea on how the VA determines the disability rating percentages for different medical conditions.

Good luck to you and your husband.

Georgiapapa.

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