 |
 |
 |
NAM VETS ANSWER QUESTIONS
If you are a veteran and you need assistance with filing a claim with the VA for a
service connected disability, I may be able to help. I have helped veterans with claims for Agent Orange
related conditions as well as claims for PTSD. I will also work with Gulf War vets.
The purpose of
this guide is to assist you, the veteran, dependent or
survivor, in
presenting your claim in the best way possible to the U.S.
Department of
Veterans Affairs (VA). To accomplish this, it is best that you
work with a trained veterans representative.
This guide
mainly focuses on the VA service-connected disability compensation
program. This
program makes monthly payments to veterans with disabilities
related to
their military service. These payments are intended to make up for
the lost wages
that the disability causes.
Details about
other VA programs like health care, education benefits,
nonservice-connected disability pensions, insurance or home loans are not
explained in
this guide. However, the description in this guide of the method
of gathering
evidence to present a compensation claim and of the process
followed by the
VA in compensation claims generally applies to all claims at
the VA. Other
resources are available to help understand other VA programs and
to learn more
details of the compensation program. (See last page.)
Not all of the
tips given here fit every case. The tips described below,
however, should
be followed unless you hear a very convincing argument not to.
STEP 1: GET
HELP
It is a good
idea to get a representative to help you present your claim to
the VA. VA laws,
regulations and procedures are very complicated and
time-consuming.
It can be frustrating to make sense by yourself of how the VA
works.
Because there
is a legal limit on when you can pay an attorney to represent
you at the VA,
you will probably not be able to get a lawyer to help you
unless the
lawyer is willing to handle your case pro bono (free of charge). If
the Board of
Veterans’ Appeals denied your appeal within the past year, you
can hire and
pay an attorney. (For more on getting a lawyer, see last page.)
Most veterans
rely on one of the veterans service organizations or state or
county veterans
service agencies.
No matter who
you select to represent you, it is important that you be
personally
involved in your case and make certain that everything that should
be done, is
done.
Although it can
be a difficult task, shop around for the best representative.
Talk to the
prospective representative; ask if there are any limits on their
service; get a
feel for the person who will be working for you before you sign
a power of attorney appointing the person as your representative.
STEP 2:
APPLY
When to Apply: You should notify the VA of the benefits you want at the
earliest possible time. From anywhere in the U.S., you can call the
nearest
VA
Regional Office (VARO) by using the following number: 1-800-827-1000. Do
not
wait until you have gathered all the evidence you think you need. Every
day
you delay can mean another day of benefits lost forever. If you were
discharged less than one year ago, it is vital to apply before that first
year is up because a special rule applies in your case.
Warning: Do not
be discouraged by a VA employee who says you are not entitled
to the
benefits. Put your claim in writing and insist on a written reply from
the VA.
How
to Apply: To help you apply and remember important deadlines, use the
Worksheet provided at page 7. To apply, you do not need to go to the VA
or
get
the official VA form. Just send the VA a letter. This is called an
informal claim and will count as an application (although you will
eventually be required to fill out some VA forms). If you have not heard
back from the VA within a month you should call to confirm that your
application has been received.
What to Apply For: Be clear about what you are applying for. If you have
several health problems, list each of them and their impact on your daily
activities. Work with your representative to be specific about the
disability(s) you list.
STEP 3: GET
EXAM
If your
application lays out a specific health problem, the VA should schedule
you for an
examination by a doctor at a VA hospital. This exam should be to
find out if
your current condition is related to your military service and to
find out how
serious your condition is.
One strategy to
consider before the VA exam is to get a private exam first.
I can give you
the official examination procedures used by
the VA doctors.
Ask your own doctor to follow these procedures to be sure to
get a detailed
report. Present the private report to the VA Regional Office;
it might decide
that a VA exam is not necessary. If you do have to have a VA
exam, give a
copy of the private report to the VA doctor. It is very important
to have the VA
doctor agree that your medical problem exists and record when
the condition
first appeared.
The VA may
reimburse some of the cost of traveling to a VA exam.
STEP 4: COLLECT
EVIDENCE
To win VA
benefits, you must have convincing reports or documents—some kind of
evidence—to
support your application. Collecting good evidence and presenting
it properly to
the VA are the keys to winning. These are also the most
time-consuming
chores you and your representative will have to do.
Before you
collect evidence, be sure you know what is relevant to your claim.
Review the VA
regulations with your representative so you will know what is
important to
provide and what is unnecessary. For example, if you want to
prove your
present condition is related to problems you had on active duty ten
years ago, you
need to show three things: (1) you have a current medical
problem, (2)
you had this same medical problem in service, and (3) you
continued to
have this problem during the ten years that have passed since
your release
from active duty. You cannot skip over one of these factors and
expect the VA
to grant your claim. Other times, you only may need to show that
your condition
began within one year of your release.
Also, if you
have a 10 percent evaluation and think you should get more,
review the VA
Schedule for Rating Disabilities so you will know exactly what
symptoms are
necessary to get a higher evaluation. I have this schedule and can send it to
you
Even though the
VA may try to get some of your records, it is important that
you and your
representative also get the records. Do not assume the VA will
get all the
records that are important.
The VA may
contact you for evidence or for permission to write to your doctor
for your
medical records. Your response to any VA request for evidence should
be made only
after consulting with your representative.
The following
records are some of those you and your representative may need
to get.
VA
Records
You have a
right to a free copy of your entire VA file. You should exercise
this right so
that you will know what records or decisions have been made
about you and
to make sure the VA records are accurate. Write a letter that
says: “I am
exercising my rights under the Privacy Act of 1974 to obtain a
free copy of
all my VA records.” Send that letter to the VA Regional Office
holding your
claims file and to each VA Medical Center that treated you.
Military Personnel Records
Get a free set
of your complete military personnel records. Request military
records
yourself (or through your representative) directly from the National
Personnel
Records Center in St. Louis using a Standard Form 180, Request
Pertaining to
Military Records. This form is available from your
representative
or any VA office. Other military records may be important such
as records
documenting your combat experiences in Vietnam. These records may
be available
through the Environmental Support Group, 7798 Cissna Road,
Springfield VA
22150.
Military Medical Records
Evidence of
treatment in a military hospital is the best way to show that the
disease or
injury began in service. If you were seen at sick call or treated
as an
in-patient or out-patient at a military hospital, state you want those
records and, if
possible, include the name of the unit you were attached to
when seen at
sick call (and the year) and the name of the hospital (and the
year) and the
type of medical treatment you received.
Private Medical Records
If you were
hospitalized in a private, non-VA hospital, or obtained treatment
from a private
doctor or clinic, the VA may want to see those records. You can
wait for the VA
to get them or you can ask for copies yourself. You may have
to pay a fee to
get the records.
Medical
Research
Sometimes no
treatment records are available. If you simply tell the VA that
in your opinion
your current problem is related to your military service, the
VA is likely to
deny your claim. Sometimes a medical textbook can describe how
your original
in-service problem could turn into your current problem.
Referring to
such a textbook can force the VA to look more carefully at your
claim. Research
on medical conditions can be done through the nearest public
library,
medical school library or library at the nearest VA Medical Center,
VARO or private
hospital.
STEP 5: PRESENT
EVIDENCE IN WRITING
You do not help
yourself if you simply dump a wad of loose records on the VA.
Organize the
records and explain their significance in a letter you and your
representative
prepare together. The material submitted to the VA should be
the evidence
you and your representative have obtained which is relevant to
your case. You
must have a neatly typed (or really neatly handwritten)
statement of
what the evidence shows and why it supports your claim.
A typical
statement lays out the important facts of your case in a clear
fashion and
then argues how the law or the VA regulations apply to these
facts. The
statement should also argue against any reasons the VA might give
for denying
your claim, and argue that these reasons are not valid.
STEP 6: PRESENT
EVIDENCE AT HEARING
You almost
always want a hearing at the VA Regional Office if it denies your
claim. The
hearing will be before an official (the hearing officer) who has
not been
involved with your case. A hearing gives you and your representative
the opportunity
to address the reasons given by the VA in its denial letter.
In almost 40
percent of cases considered by a hearing officer, the benefits
are granted. If
you have nothing to add or if your representative has a good
reason for not
having a hearing, it may not be worth taking the time to have
one.
IF YOU LOSE AT
VARO: APPEAL
If the VA
Regional Office (VARO) says your disability is not service-connected
or if the
percentage of disability is lower than what you think is fair, or if
the VARO
otherwise turns you down, you have the right to appeal to the Board
of Veterans’
Appeals (BVA).
Notice of
Disagreement
The first step
in making your appeal is to send the VARO a “Notice of
Disagreement”
(NOD). A Notice of Disagreement is a letter saying that you
“disagree” with
the denial. Be sure to include in your NOD, the date of the
VA’s denial
letter and be sure to list the benefits you are still seeking.
Statement of
the Case
In response to
the Notice of Disagreement, you will get a “Statement of the
Case” (SOC)
from the VARO. This will repeat the reasons stated in the VA’s
denial letter
why your claim was denied and will recite the relevant VA
regulations.
Once you get
the SOC, you have two options. First, if you think that you can
overcome the
reason for the denial by getting more evidence or by better
explaining
things to the VARO, you should hold off going to the Board of
Veterans’
Appeals until you have tried again at the VARO. This should be done
with the help
of your representative who can help you do this without losing
your right to
eventually go to the BVA.
Second, if
nothing further can be done at the VARO, you should complete the
process of
appealing to the BVA by filling out a VA Form 9, “Appeal to Board
Veterans’
Appeals,” which is usually sent with the Statement of the Case.
Deadline: You
have 60 days from the date on the SOC to file the VA Form 9 OR
you have the
remainder of the one year from the date the VA first denied your
application.
Whichever deadline is later applies.
Appeal to
BVA
An Appeal to
the BVA is a statement on a VA Form 9 (or in a letter) explaining
what is wrong
with the VARO decision and why your claim should be granted. You
mail it to the
VARO. Your representative can help you with this form.
Request
Hearing: The VA Form 9 asks if you wish to appear at a hearing at the
BVA. You almost
always want a formal hearing where you appear in person to
present your
case to the BVA. If you do not want to appear in person or
cannot, you
will have an “informal” hearing which is only a review of your VA
claims file and
any other papers you submit.
If you want a
hearing, you must decide the location of the hearing:
(1) whether to
go to Washington, D.C.; or
(2) whether to
wait for a travel Board panel of the BVA to come to your VARO.
A travel BVA
hearing is before a member of the BVA who travels from
Washington,
D.C., to hear cases at a VARO. The advantage of having your case
heard by a
travel BVA hearing is that it may be easier for you physically (and
financially) to
get to your VARO for a hearing than to travel to Washington,
D.C. One
disadvantage is that it is sometimes over a year before the BVA
travels to a
VARO.
BOARD OF
VETERANS’ APPEALS
The first thing
to remember about your case at the Board of Veterans’ Appeals
(BVA) is that
you should not be pushed into having a hearing before you are
ready. If you
need a postponement of the hearing, notify the BVA as soon as
possible.
You should also
be sure that your representative has thoroughly prepared your
case before the
hearing. Discuss your case with your representative well in
advance of the
hearing. Ask to see all statements written by your
representative
and other documents before they are submitted.
At a hearing
you can expect your representative to make an opening summary of
your case and
then to ask you a series of questions to highlight the important
facts.
Following that, the BVA member may ask you questions and then your
representative
should make a closing statement.
IF YOU WIN AT
THE BVA
About 20
percent of persons win their appeal at the BVA. Winning at the BVA
can mean
different things: (1) If you applied to show your disability was
related to your
military service, winning can mean the VA agrees your
disability is
service connected. Getting the VA to agree your disability is
service
connected does NOT necessarily mean you will start getting money. The
VARO still must
decide what percentage of disability you should have assigned
to your
condition. If you disagree with that decision, you have the right to
appeal it to
the BVA, following the same procedures as before. (2) If you
applied to have
your disability rating increased, winning can mean increased
monthly
payments.
Money for you: If you are successful, you are not done with the VA. You
still need to start getting payments and keep getting them regularly.
Watch
out
to make sure that you are getting the right amount. (See rates in box on
page 5.) If you believe you are being paid less than you should be (or
more), ask the VA for a “paid and due statement” to confirm the accuracy
of
the
amount it is sending. You should notify the VA if it is not paying you
the
correct amount. If the VA discovers that it overpaid you, it can require
that you repay that amount.
2005 DISABILITY COMPENSATION RATES
DisabilityMonthly Rate
10 percent$108
20 percent210
30 percent324
40 percent466
50 percent663
60 percent839
70 percent1056
80 percent1,227
90 percent1,380
100 percent2289
Veterans whose service-connected disabilities are rated at 30 percent or
more are entitled to additional allowances for dependents. Depending upon the
disability rating of the veteran, monthly allowances for a spouse range from $39
to $94 and for a dependent child, $26 to $88. Additional amounts are provided
for each additional child and there is a higher scale
for children in school after age 18.
Money for your family: If you succeed in getting a 30 percent or greater
evaluation, and you have family, you can get a little bit more for them.
You
will have to submit copies of birth and marriage certificates to get this
“dependents allowance.” You may get an extra allowance for certain
children
who
are attending school.
Deadline: The
Notice of Disagreement must be mailed to the VARO within one
year of the
denial of your claim or you cannot appeal. (You still can reopen
your claim if
you miss this deadline but you lose an earlier “effective date”
for an award of
back benefits.)
IF YOU LOSE AT
BVA: APPEAL TO COURT OR START OVER
If you lose at
the BVA, you have four choices: (1) do nothing; (2) appeal to
the U.S. Court
of Veterans Appeals; (3) ask the BVA to reconsider its
decision; (4)
reopen your case at the VARO.
Do
nothing
If your
representative agrees that you just did not have enough evidence to
win and that
you cannot get any good evidence, it may not be worth your time
to pursue an
appeal.
Appeal to court
If your
representative believes the BVA did not properly address the evidence
in favor of
your claim or did not make sure all the evidence was obtained or
just thinks the
BVA was wrong, consider filing an appeal to the U.S. Court of
Veterans
Appeals.
To appeal to
the court, send your name, address, phone number, and the date of
the BVA
decision, to:
Clerk of the Court
U.S. Court of Veterans Appeals
625 Indiana Avenue NW
Washington DC 20004
FAX: 202-501-5848
To help you
decide if an appeal to the court is a good idea, ask the Clerk of
the Court
(1-800-869-8654) to send you a list of persons who practice at the
court. Review
your case with a few people on that list. More help is
available; see
last page.
Ask
BVA to reconsider
If you can spot
an “obvious error of fact or law” in the BVA’s decision, ask
Reopen your case
If you can get
additional evidence which is both new and material (that is to
say it is
really relevant), reopen your claim at the VARO and start all over
again. Of
course, if your condition gets worse and you think a higher
percentage of
disability is called for, tell the VARO that.
NOTE: Whether
the VA agrees to pay you benefits or not, don’t forget that you
also might have
a good claim for Social Security disability benefits. Contact
the nearest SSA
office to file a claim.
OTHER
MATTERS
Protection from cuts. There are rules that require the VA to give you 60
days advance notice and a chance for a hearing before reducing your
benefits. Work with your representative to exercise your rights. To
postpone
a
reduction, you must request (in writing) a hearing within 30 days of the
notice of the pending cut.
If
you cannot work. If you are rated less than 100 percent disabled, but
your disability keeps you from getting or keeping a job, you should apply
for
increased compensation based on unemployability. Ask the VA for a VA
Form 21-8940.
Important: Keep
a copy of everything you mail to the VA and keep everything
you receive
from the VA.
Keep in touch:
You should talk to your representative at least once per month
while your
claim is pending. Whenever you get mail from the VA, call your
representative
to make sure s/he has gotten it and that you both understand
it.
Ask questions:
If you do not understand something about your case, ask about
it. Don’t worry
about asking a stupid question—your representative works for
you and part of
his or her job is making sure that you understand everything.
Be insistent:
If something needs to be done, insist that it happen. Do not be
talked out of
anything unless you understand what is going on. Insist that
your
representative:
discuss your case with you;
be
familiar with your VA file;
be
able and willing to discuss what the VA regulations require to win your
case and what evidence is needed to win;
discuss your case in-depth well before any hearing;
submit a written statement to the VA before your hearing. S/he should let
you
read the statement before it is submitted.
If your
representative will not do these things, you should find another
one.
Important: It
is important in answering VA requests to completely explain what
you are and are
not sending them. If they ask for documents they already have,
tell them that.
If you and your representative cannot get all of the evidence
the VA is
requesting, explain why you cannot get the evidence and why VA
already has
enough evidence to allow your claim.
WORKSHEET FOR
VA CLAIM
The purpose of
this worksheet is to help you keep track of important deadlines
and to help
guide you in working on your claim.
WARNING: The
description of the VA claims and appeals process contained in
this guide is
not intended to substitute for advice from a competent
representative.
Important laws, rules or procedures may have changed since
this guide was
published. Consult a representative for the latest information.
Your Name
_________________________________
VA Claim #:
_________________________________
SSN:
_______________________________________
Address, Phone
of VARO handling your case
(The nearest
VARO can usually be reached by calling 1-800-827-1000):
___________________________________________
___________________________________________
Representative’s name: _________________________
organization:
_________________________________
address:
____________________________________
___________________________________________
phone:
______________________________________
date signed
Power of Attorney: ___________________
APPLICATION
date of first
contact with VA: _____________________
name of VA
employee: __________________________
date formal
application filed: _______________________
VA INFORMATION
REQUESTS
date of 1st VA
request: ___________________________
date you mailed
to VA: ___________________________
date scheduled
for VA medical exam: ________________
name of
examiner: _______________________________
Did the
examiner have your C-file on hand? ____________
date scheduled
for VARO hearing: ___________________
date of VARO
denial: _____________________________
AFTER VARO
DENIAL
deadline to
file Notice of Disagreement (add one year to date of VA denial) =
date you filed
NOD with VARO: ______________________
date VA mailed
Statement of Case: _____________________
date VA mailed
Supplemental SOC: _____________________
deadline to
file appeal, VAF 9: (whichever comes later:)
60 days from
date VA mailed SOC = OR _________________
one year from
date of VA denial = ________________________
BVA PROCEEDINGS
date you mailed
appeal, VAF 9, to VARO: __________________
date
pre-hearing appointment with rep: ______________________
location of BVA
hearing: _________________________________
date of hearing
before BVA: ______________________________
date of BVA
decision: BVA docket #: _________________________
BVA action:
_____ denial _____ allowance ____ remand
AFTER BVA
PROCEEDINGS
deadline to
file Notice of Appeal with U.S. Court of Veterans Appeals
(120 days from
date of the BVA decision) = ________________
date you mailed
appeal: ________________
CVA docket #:
__________________
CONTACT FOR
STATUS OF CASE
Once your file
has been transferred to the BVA, you can call the BVA
(202-565-5436)
to find out whether your case in undergoing active
consideration
at the BVA. If you are told the case is in “quality review,” you
should receive
a decision within a few days. The BVA allows less than 20
percent of
appeals, denies about 30 percent, and returns about 50 percent to
the VARO for it
to collect more information or to conduct another exam.
As of 1996, it
was taking the BVA about two years to make a decision. If you
are about to
lose your home or are terminally ill, the BVA can consider your
case before
others. Work with your representative to document the need for the
BVA to advance
your case on its docket.
Many veterans
organizations offer a wide range of services. Most states
operate a
department of veterans affairs and many states have a network of
county veterans
representatives. To locate accredited representatives, call or
visit the
nearest VARO.
LAWYERS
There are
limits on when you can pay a lawyer to help you with a VA claim.
Generally, you
can hire a lawyer only after the BVA has decided your claim.
Then you have
only one year to hire a lawyer. Many lawyers work on a
contingency
basis that means you do not have to pay them a fee up front and if
you do not win
benefits, you will not have to pay a fee.
There are no
limits on when someone else (a so-called third party) can use his
or her own
money to hire and pay a lawyer to represent you. This third party
cannot be a
family member who may benefit from your claim. If you use a third
party to hire a
lawyer, the lawyer can represent you at the beginning of a
claim. Also,
there are no limits on hiring a lawyer when the VA is coming
after you
because of a home loan guarantee debt.
Some private
lawyers and some legal aid or legal services offices provide
representation
free of charge at all stages of a VA claim.
This guide may
be excerpted or reproduced for counseling, self-help, and
scholarly
purposes, but not for profit, without further permission; we request
only that
proper credit be given. Any other use requires written authorization
of VVA, ATTN:
National Service Representative, 1224 M Street, NW, Washington
DC 20005-5183.
This guide is one of a series that is being published by VVA
under a
contract with Keith D. Snyder of the Veterans Education Project.
3/96
To contact me
email Me
Donate to keep this site alive
|
|
FOR VETERANS ONLY
|
|
THIS SITE CREATED BY NAM VET WEB DESIGN
© 2001 & 2005
|