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Date of Claim - Started vs Submitted on eBenefits

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K_C

Question

Apologies if this has been answered somewhere already--I looked here and on Google but can't seem to find a clear answer to what seems like a simple question. Thank you in advance for any clarity!

So, Date of Claim generally becomes the Effective Date on approved claims. But, what is the Date of Claim when filing on eBenefits?

My understanding has been thus far that the Date of Claim is the date in which you opened/started the claim on eBenefits. In other words, the date you filled out the first form of the series. Once you do this, they email you a receipt with yada yada yada you have 365 days to complete this claim. On my last claim, this is what they counted as the Date of Claim.

On my second claim, they appear to be treating the Claim Submission Date, i.e. the date in which I completed the entire set of claim forms, uploaded my evidence, and submitted.

For example, in this particular case I started the claim in July 2014 by submitting the first few parts of the form. As soon as I submitted the first page of the form, I received the you-have-365-days email. I then proceeded to compile evidence and produce documentation until March 2015, which is when I uploaded my evidence and submitted the claim for processing. They approved part of my claim (yay) but have set the Effective Date to April 01, 2015, whereas I would have expected either July/August 2014 or December 2014 (COLA date).

What am I missing here that leads me to believe they made a mistake? If I'm not mistaken, is this something that can be questioned in a local hearing, which I will be requesting anyway for the part of the claim they denied? Speaking of, how do you deny a painful scar that clearly happened in service? They didn't even give me a C&P for this claimed condition. Very confusing. Off topic I know, but maybe someone already reading this has an opinion on it.

Thank you all for your help!

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Just some documentation supporting the idea that the date of opening the claim is more the Date of Claim than is the date of submission.

 

First, NOLO (http://www.nolo.com/legal-encyclopedia/how-va-determines-effective-dates-disability-compensation-when-veterans-back-pay-starts.h):

Can I Get an Early Filing Date?
If you have not yet applied for benefits, it is to your advantage to notify the VA as soon as possible of your intent to file an application in order to preserve the earliest possible effective date. Filing an informal claim before you officially file your application will give you the largest possible retroactive payment if you are awarded benefits.
Notify the VA in writing or using a Statement in Support of Claim form of your intent to file for disability compensation. Include your name, dates of service, and Social Security number.
After you submit an informal claim stating your intent to apply for benefits, the VA will send you an application form for disability compensation benefits. You must complete and submit this application within one year of receiving it or you lose your right to the earlier effective date based on your informal claim.

 

This leads me to the VA 21-256 (http://www.bcvets.org/pdf/VBA-21-526-ARE.pdf)

Page 2, Top-Right: VA Form 21-526 has four parts. Everyone has to fill out Part A of the form. 

Which is "VA Form 21-526, Part A: General Information". Part A has several sections, all consisting of the same type of basic information you submit when starting a claim on eBenefits but prior to submitting it. e.g. Name, Address, DOB, what you intend to file for, basic Dates of Service, current service status, deposit account information, signature, etc.

The nail in the coffin for me is the email I received from eBenefits upon opening the claim. It states:

We received notification that you initiated a claim for compensation benefits on 07/21/2014. You must finalize your application within 365 days, or your application will be closed and no further action will be taken. If you are a Service member, you have up to one year from your date of discharge from active duty to finalize your application.

You can access your in-process, online application at www.ebenefits.va.gov.

 

I'm convinced that the Effective Date would defer to the date you open the claim and receive this email (barring any situations where you weren't eligible/diagnosed/etc. upon this date of course).

 

Just thought I'd share what I've gathered and where my reasoning stems from.

 

Thank you again!

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I think they need to CUE themselves on the EED they gave you.

You could try that approach  and even file the CUE via IRIS.

Did they give you ,in the award letter, any reason at all for the different date?

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Hi Berta,

Thank you for the response. I haven't received the award letter yet, this is all based on eBenefits information. The Disabilities page shows an Effective Date of 3/15/2015 (The exact date I submitted the claim in full). The VA Summary Letter shows 4/1/2015. (Screenshots attached)

I'm waiting on my VSO to get back with me before I make any moves with the VA. I'm pinging him every step of the way on this if I can. On my very first claim I sent in a letter for reconsideration based on N&ME, but the VA dropped the ball and blamed it on my wording (they saw the words Notice of Disagreement in the first sentence apparently but completely ignored the two crucial words right before it... this is NOT a Notice of Disagreement). So, they decided it must be a request for appeal and just sat on it. I thought I had the entire year to have my hearing, and I made the mistake of trying to be patient with them. The funny thing is they didn't file the appeal even after having the letter they say, based on my wording, meant I wanted to file appeal. I did call about once a month for an update they just continued to give conflicting information. When I finally started pushing around 8 months in and got my VSO involved, it was too late. They finally opened the appeal (they say) but they could not give me a hearing because too much time had passed. My VSO said he could have made sure it didn't happen and I should just go through him for everything, which I will do my best to oblige.

I have contacted Dr. Bash about hopefully getting a report from him for the scar claim that was denied without C&P. From what I know about the appeal avenues available (it still confuses me), the best route seems to be to request a hearing at the VARO, but that has to be done within 30 days of decision if I recall.

Any advice is of course appreciated. Thank you again.

disabilities-effective-date.png

disabilities-va-summary-letter-last-change.png

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Well, my VSO is saying that initializing a claim on eBenefits submits a 526EZ and does not reserve a date of claim. I'm getting all kinds of conflicting information, from various VA employees and even my VSO. I am starting to feel like my VSO is neglecting me and siding with whatever the RO says, even if it seems way off. I write thorough emails with clear questions, and I get brief responses that don't tackle all of my questions. He also said I sent "100's of correspondences" which is flat out untrue. I sent in no more than 5-10 in two years. Some of the more important ones I uploaded to eBenefits and mailed in certified, and some of those letters consisted of several pages of letter and over a hundred pages of annotated medical records for their convenience. I have consistently did my very best to give them everything they could ever need, and it feels like they are essentially picking on me, insulting me for sending in too much. If a vet doesn't send in enough, denial is readily blamed on that. If you send in all the relevant items you have, you get slammed for it too? Catch 22?

I don't want to be with a VSO who doesn't want me around and isn't willing to talk to me or even answer all my questions without sounding like he's too busy to deal with me. But, I don't want to misinterpret his communication and leave a good VSO for a worse one. I've only ever had one, so I'm not sure what I could be getting myself into there.

So, can anyone say with certainty that they know for a fact when you start a claim in eBenefits and you receive the receipt email which states you have 365 days to complete it, whether that is supposed to be the "receipt of claim" referenced in the regulations, or is it just an eBenefits thing? Is the date of claim when you fully submit the claim for processing, then, no matter if you had it opened in eBenefits for months beforehand?

Thank you in advance for any assistance. Best to all!

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Well when did you first file you claim? was it prior to March 24, 2015?

If after then it automatically files you for a intent to file,if before...

If before then check to see if you meet any of the following characteristics of an "informal claim"

a.  Characteristics of an Informal Claim – Received prior to March 24, 2015

Identify an informal claim by any of the following characteristics:

 

·   any communication or action that shows an intent to apply for benefits under laws administered by the Department of Veterans Affairs (VA)

·   an original claim not filed on the prescribed form

·   an unsigned application (except for those received via the Veterans On-Line Application (VONAPP) or VONAPP Direct Connect (VDC), for which VA accepts an electronic signature in lieu of a handwritten signature)

·   evidence of examination or hospitalization in a VA or uniformed services health care facility for a service-connected disability under 38 CFR 3.157 (b)(1), or

·   any communication regarding the death of the appellant in an appeal

-  submitted to the United States Court of Appeals for Veterans Claims (CAVC), and

-  furnished to VA by CAVC.

 

Important: VA only recognizes informal claims received prior to March 24, 2015.

 

References:  For more information on

·   communication regarding the death of an appellant, see De Landicho v. Brown, 7 Vet. App. 42 (1994)

·   claims from unauthorized or unapproved representatives, see 38 CFR 3.155(b)

·   claims that are not filed on the prescribed form, see M21-1, Part III, Subpart ii, 2.D.16.a, or

·   processing informal claims in the Veterans Benefits Management System (VBMS), see the Transformation and Initiatives Pilots (TIP) sheet titled VBMS Informal Claim Control.

 

 

b.  Why Informal Claims were Important

Informal claims were important prior to March 24, 2015 because VA could grant entitlement to benefits as early as the date of receipt of an informal claim as long as the claimant submits a formal claim within one year of the date VA sent the claimant the application form.

 

Reference:  For more information about the time limit for submitting a formal claim, see 38 U.S.C. 5102 (c).

 

c.  Required Elements of an Informal Claim – Received Prior to March 24, 2015

In order for a communication or action received by VA prior to March 24, 2015 to be accepted as an informal claim, the historical version of 38 CFR 3.155 requires claimants to identify the benefit(s) they are seeking, such as compensation and/or pension.

 

If a claimant is attempting to reopen a previously denied claim or is seeking an increased disability rating, he/she must also describe the nature of the disability for which he/she is seeking benefits.  A claimant may accomplish this by identifying the body part or system that is disabled or by describing symptoms of the disability.

 

References:

·   See historical version of 38 CFR 3.157(b) for information about accepting a report of hospitalization or medical treatment

-  as an informal claim for an increased disability rating, or

-  to reopen a claim for pension that VA previously denied for lack of evidence of permanent and total disability.

·   See Brokowski v. Shinseki, 23 Vet. App. 79 (2009), for more information on informal claims

-  for an increased disability rating, or

-  to reopen a previously denied claim.

 

 

 

 

Research 

M21-1, Part III, Subpart ii, Chapter 2, Section D

for more information on establishing effective dates prior to March 24, 2015

In my opinion fire your VSO, send a letter to the VA and the Service Organization stating that you revoke your Power of Attorney for that Veterans Service organization

 

 

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@USMC_VET,

Thank you! This is good information. I cannot thank you enough.

The claim was:

  • Opened prior to March 24th, 2015 (July 2014* corrected)
  • For a NEW claimed condition (not an increase)
  • Opened via eBenefits, the first part of the form was completed which spawns an email receipt saying you have 365 days to complete it
    This is the only part that isn't perfectly clear cut for me. I know eBenefits is not VONAPP, but I do recall instances where they were treated similarly. I also don't know if you eSign on eBenefits upon starting the claim, or upon submitting the completed claim with all evidence. Any thoughts on this?

Thank you for the advice and the next few days will determine whether I leave this VSO I suppose. I don't want to jump out of the pan and into the fire, but I can't keep feeling misled. I am almost out of time to file appeal on my very first claim from last year and was supposed to have an appeal on file already per my VSO. The call center told me otherwise this morning. I was also told that I could not request reconsideration beyond 60 days from initial VARO decision, but the call center told me I have a year. That's what the person said today. Another person on another day, I don't know.

Edited by K_C
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