Tip For Filing Claims

From: "DocMelson.com" <docmelson@docmelson.com>

X-RCPT-TO: <Will@willpete.com>

Here are some tips for dealing with the VA and filing claims

There are two types of claims as defined by the VA: Formal and informal. If you call the VA or write them a letter requesting a benefit, this is considered an informal claim. It establishes the date of the claim and is usually valid for one year. A formal claim is one that is in writing on the forms prescribed by the VA. When you file the formal claim, be sure to point out the date of the informal claim and enclose a copy of your original informal claim. This can mean a lot of money for you if you prevail in your claim.

Always keep copies of anything you send the VA. They are notorious for loosing paperwork. It's best to hand deliver documents if you can. Make two copies and have them date stamp the one you will keep for your records. If you can't hand deliver them, send them by UPS or Federal Express and then call the delivery agent and get the name and time/date of the person who signed for them. Attach the shipping receipt to your copy of the documents.

Understand that it's your responsibility to file a claim that complies with the federal rules and regulations. There are three parts to a complete VA claim: Evidence that a disease or injury occurred in service; evidence of a current disability; and a nexxus or connection between the two. Recent changes to VA law, caused by the Morton decision of the Court of Appeals for Veterans Claims, have given the VA authority to reject claims as "not well-grounded" if they do not clearly meet the three requirements above. In most cases, you would be better off getting an experienced veterans service representative to handle your claim for you. If you insist on doing it yourself, make sure you well ground your claim or you will get it back in the mail from the VA telling you that it is not well-grounded.

After you file your claim and wait a reasonable time for the VA to adjudicate it, write to the VA requesting that they tell you the current status of your claim. It probably won't help speeding things up but it may trigger them to send you a form letter telling you that your claim is "at the rating board". This is enough to prove that they got the claim which is important for establishing the effective date of the claim later on.

Request a pre-decisional hearing. Keep on requesting it until they acknowledge your request. You are entitled to a hearing and they won't give you one until you hassle them into it. Be prepared to present your evidence in support of your claim at the hearing.

Don't ignore anything they send you. Respond with a letter to every document they send. If they deny your claim, write them a letter saying simply "I disagree with your decision" and tell them what you disagree with and why. This is called a letter of disagreement and triggers the appeals process.

Understand that you are entering into a long-term relationship with the VA. It usually takes one to two years to get a claim adjudicated to begin with. Add another year or two for an appeal to the Board of Veterans' Appeals and if that fails, add another two years for the claim to get to the Court of Veterans' Appeals and be heard. The court might remand your claim back to the BVA for further development and this could add another year or two to the process. Some veterans have been fighting the VA over a claim for ten years or more.

You should also understand that to many VA adjudicators and rating specialists, you are just another vet trying to get something that you aren't entitled to. Their attitude will reflect this and you'll soon find out that the VA is the most unresponsive department of the federal government. Rating specialists, the ones who decide your claim, are paid a starting salary of about $28,000 per year. They consider the pay so bad that they have a bad attitude to start with. The upper positions of the VA are all political jobs and they have their own agenda that usually does not coincide with yours.

Do consider getting a representative to handle your claim. You can select from NVOA, other veterans organizations, your state Department of Veterans Affairs or a local county veteran service officer (CVSO). Check with other veterans in your area to determine who has the best record for winning veterans claims and go with that representative. Going it alone is risky business. You need all the help you can get, and an experienced representative can make great difference in the results you'll get.

As mentioned above, to establish service connection you must prove the connection between your disability and and what happened to you in your military service. If you have copies of your service record or service medical records that describe the injury or accident then these will do. If you don't have them, you need to obtain your records. You can get them from the National Personnel Records Center in St. Louis MO. The address for NPRC is:

You should file a form SF180 to obtain the records and your local VA office has this form. Call them at 800-827-1000 and ask them to mail it to you. You can just write a letter to NPRC and request the records. When you write, ask them to include a copy of every document in both sides of your service records. State the period of time you were hospitalized and where you were treated and request copies of the treating facilities records for that period of time. Medical facility records are stored in a different place than service records and you won't get them if you don't specifically ask for them.

If you have ever been treated for the disability since your service, write to the doctor or treating facility and request copies of all records in their possession.

If you are ordered to report for a compensation and pension examination, DON'T MISS THE APPOINTMENT. The VA can, and usually WILL, consider this grounds for denying your claim. If you live a long way from the facility where you will be examined, go there the night before to make sure you're on time for the appointment.

The doctor is required to examine your VA Claim File and any medical records in the file. If he, or she, doesn't, point it out to them and make sure they do. If they still don't, immediately write a letter to the VA Regional Office and complain that the examination was inadequate for rating purposes and demand another examination.

Consider having an examination with a private doctor at your expense. Get a copy of the "Physician's guide for disability examinations" from the VA or a service rep and give it to your doctor. Explain to the doctor that he has to state in his report that he conducted the exam in accordance with the physician's guide. Promptly file copies of the doctor's report with the VA using VA form 21-4138 "Statement in Support of Claim".

Recent changes in VA regulations permit VA doctors to offer written opinions as to your medical condition and the origin of your problems. The VA letter establishing this rule is 98-052.

If everything fails and your claim is turned down, even after filing an appeal with the Board of Veterans Appeals, get an attorney to file your appeal with the Court of Veterans Appeals. This is the only time you can use an attorney in your fight with the VA. You MUST have a denial of your claim from the BVA before you can hire an attorney.

There are many good attorneys that are experienced in dealing with the VA. You can obtain a list of them from:

You can find a list of attorneys on our website by clicking this link.

Finally, if you can't find the information you need to file your claim and you need advice on where to go or who to see to get help, contact us at:

We do represent veterans in claims and we may have a representative in your area. If we don't, we'll try to help you find one from another organization. We can provide you with a lot of information to help you along the way.

You can get a lot of information from the NVOA 'Veterans' and 'Benefits' mailing lists. These are networked mailing lists that come to you in email everyday. They contain a wealth of information about claims and benefits. There's no charge and all you need to do to subscribe is to visit our mail list page, select the mail list you would like to receive and you'll start getting email messages everyday with a lot of valuable information. If you have any problems getting on the mail list, send an email message to webmaster@nvo.org.

Good luck with your claim.

 

 

"When the way comes to an end, then change - having changed, you pass through."

      I. Ching

 

 Bruce "Doc". Melson

http://www.docmelson.com/