Veterans Benefits Blog

UPDATE

The proposed new PTSD regulations are now in effect. The text of the regulations can be found at http://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=K23HwW/0/2/0&WAISaction=retrieve

VA’s fact sheet about the changes can be found at http://www.va.gov/PTSD_QA.pdf

Keep in mind that this does not entirely remove the requirement that PTSD stressors be corroborated - only in specified circumstances, involving situations of hostile military or terrorist activity. The asserted stressor must be consistent with the conditions of the veteran’s service. The new rules also require that a VA examiner give the opinion that the assereted stressor would be sufficient to cause PTSD.

PROPOSED REGULATIONS AUGUST 2009
VA has proposed a change to the PTSD regulations that will eliminate the requirement that a stressor be corroborated if it arises out of “fear of hostile military or terrorist activity.” There will also be a requirement that a VA psychiatrist or psychologist give an opinion that the stressor is adequate to support a diagnosis of PTSD and that the veteran’s symptoms are related to that claimed stressor.

If these conditions are met, the veteran will not have to provide additional evidence to show that the stressor occurred, as long as the stressor is consistent with the places, types and circumstances of the veteran’s service, and as long as there is not clear and convincing evidence that the stressor did not take place.

The PTSD regulations already provided that no additional evidence was necessary if it was a combat-related stressor and the veteran served in combat.

What does this mean in practical effect? If you served in an area where there was “hostile military or terrorist activity” taking place, you no longer have to prove that you were “in combat.” Many times, the combat requirement was used to require additional evidence if the veteran served in a combat area, such as Vietnam or Iraq, but did not have a “combat” MOS. If your official MOS was, let’s say, “aircraft mechanic,” it could be very difficult to convince VA that your stressors were combat related and that you served in combat.

Under the proposed new regulation, VA is now recognizing that other stressors, such as “constant vigilance against unexpected attack, the absence of a defined front line, the difficulty of distinguishing enemy combatants from civilians, [and] the ubiquity of improvised explosive device” are characteristic of “deployment to a war zone,” regardless of whether you were directly serving in a combat role.

It’s important to understand what this doesn’t change – additional evidence will still be required to show that a stressor occurred, if it didn’t take place in a war zone and was not related to “fear of hostile military or terrorist activity.”

The proposed rule, along with VA’s explanation of the rule, can be found at

http://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=207646362677+5+2+0&WAISaction=retrieve

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President Obama is scheduled to sign the Caregivers and Veterans Omnibus Health Services Act of 2010 today, May 5, 2010.

The law addresses a number of issues related to veterans’ health care, including assistance to family caregivers of disabled veterans, expanded health care services for women veterans, greater outreach to rural veterans, and enhancements to VA medical services.

For additional information about the bill, including the full text and a summary, visit http://www.govtrack.us/congress/bill.xpd?bill=s111-1963.

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If you missed the 60 Minutes segment on VA disability claims processing, you can watch it online, at cbs.com.
http://www.cbs.com/primetime/60_minutes/

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On Sunday, January 3, at 7 PM, 60 Minutes will run a segment on delays at the VA in claims processing, titled “Delay, Deny and Hope That I Die.” You can see a preview of the segment at the CBS website, http://www.cbsnews.com/sections/60minutes/main3415.shtml

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You can obtain information from the Senate Veterans Affairs Committee page at
http://veterans.senate.gov/

At that page, click on the tab that says “VA Benefits Claims Process.” That provides information on the process itself, as well as information about the Senators who serve on the Veterans Affairs Committee and how to contact them for assistance.

The House of Representatives Veterans Affairs Committee page also includes a great deal of information about VA, benefits available, and how to get help with your claim. That page can be accessed at
http://veterans.house.gov/

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VA announced on October 13, 2009, that it will add three more illnesses to the “presumptive list” of Agent Orange related diseases: Parkinson’s disease, B cell leukemias, such as hairy cell leukemia, and ischemic heart disease.

In practical effect, this means that a service person who served in Vietnam during the war and has one of these diseases will find it far easier to establish service connection for these diseases.

For the Department of Veterans Affairs news release, see

http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1796

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Senate Bill 407, the Veterans Compensation Cost-of-Living Adjustment Act of 2009 has passed both houses of Congress, and was presented to President Obama on June 25, 2009.

The bill would provide an increase in compensation rates for service connected disabilities and for Dependency and Compensation benefits. If signed into law, the increase in compensation will be the same as the Social Security cost of living increase, or about 5.8%, rounded down to the lower whole dollar amount. The increase would take effect on December 1, 2009.

The complete text of the bill can be found here:

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:s407es.txt.pdf

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When you called to follow up on the claim you submitted, you were told that VA never received a claim from you and they have no record of your ever filing one. Or they asked you to submit medical records, and you just sent them those records a few months ago – but the folks at VA tell you that those records aren’t in your files.

Maybe they got shredded – or are just in a desk drawer somewhere. Last fall, we heard a lot about the claims information found in shredder bins at various Regional Offices. Yesterday (March 3, 2009), the House Committee on Veterans Affairs held a joint hearing of the Oversight and Disability Assistance and Memorial Affairs Subcommittees on “Document Tampering and Mishandling at the VBA.”

Belinda J. Finn, Assistant Inspector General for Auditing of the Office of Inspector General, described the results of the investigation into the shredding incidents. She also discussed the results of “mail amnesty” programs:
“VBA officials also said that some VAROs held “mail amnesty” periods to encourage employees to turn in unprocessed mail and other documents without penalty or repercussions. During an amnesty period in July 2007 at VARO Detroit, VARO employees turned in almost 16,000 pieces of unprocessed mail including 700 claims and 2,700 medical records and/or pieces of medical information. The VARO determined that none of these claims or documents were in VBA information systems or associated claim files. VBA management told us of similar amnesties at other VAROs, such as an amnesty at VARO New York in December 2008 that recovered 717 documents from VARO employees.”

You can find all of the testimony at the House Committee on Veterans Affairs website,
http://veterans.house.gov/hearings/hearing.aspx?newsid=340

What can you do now to try to fix the situation? VA has established special procedures for claims or documents submitted between April 14, 2007 and October 14, 2008. If you submit a duplicate, and tell them that you submitted it during these dates, it will be treated as submitted on the date you originally submitted it. Between November 17, 2008, and November 17, 2009, VA will accept claims asserting that they were actually submitted during the earlier period, and the effective date of the claim will be the date when you originally submitted the claim.

VA has set up a website for information about the shredding incident and the “special handling procedure” that it has established for claims and documents submitted between April 14, 2007, and October 14, 2008. You can find this information at

http://www.vba.va.gov/VBA/SpecialProcedures_qa.asp

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The New GI Bill education benefits will be effective for programs starting after August 1, 2009. To be eligible, you must have had at least 90 days of active duty since 9/11/01, or have been honorably discharged after at least 30 days with a service connected disability. Full benefits require 36 months active duty, or discharge from service with a service connected disability, but reduced benefits are available for lengths of active duty between 90 days and 36 months.

The bill covers tuition and fees up to the cost of the most expensive public college in the state. Tuition and fees are paid directly to the school. There is a $1000 per year stipend for books and supplies, and a housing allowance which varies depending on the region. Private colleges can be paid up to the maximum public college tuition and fees and can also participate, through the Yellow Ribbon initiative, in a program which allows colleges to waive tuition and fees above the maximum otherwise allowed. That additional amount will be matched by the government.

VA’s website has more information about the education benefits. You can find this information at
www.gibill.va.gov.

Since the details of the program are still a “work in progress,” you can also sign up for email notifications of changes or developments in the program.

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When you file a claim for benefits at the Regional Office (“RO”), there are a number of steps in the process:

1.  File claim.
2.  Decision.
3.  If you’re not satisfied with the decision, you must file a Notice of Disagreement (“NOD”) within a year.
4.  The RO will offer you a review either through the traditional process or by a Decision Review Officer.  If your claim is denied again, they will send you a Statement of the Case (“SOC”) along with a Form 9.  You must return the Form 9 to appeal the denial to the Board of Veterans’ Appeals (“BVA”).  This must be done within 60 days of mailing of the SOC, OR, within one year of the original decision, whichever is later.
5.  If any additional evidence is submitted, the RO will then issue a Supplemental Statement of the Case (“SSOC”).  Many SSOCs can be issued, as new evidence is obtained by the RO.
6.  The appeal is certified to the BVA.
7.  BVA makes a decision.
8.  If you’re not satisfied with the BVA decision, you have 120 days to appeal to the Court of Appeals for Veterans Claims.

The Senate Veterans Affairs committee held a hearing on February 11, 2009, regarding the delays in processing claims and suggestions for improving the process.  The representative from Disabled American Veterans presented some interesting statistics on average time lengths for some of these steps:

From the NOD to the SOC: 213 days.
From the SOC to filing Form 9:  44 days
From filing Form 9 to certification to the BVA:  531 days
Much of this delay is caused by obtaining additional evidence and issuing additional SSOCS.From receipt at the BVA to decision:  273 days.

So, altogether this would be 1,061 days from filing an NOD to receiving a BVA decision.  This, of course, doesn’t even include the amount of time it took to get that initial decision after filing a claim, and it doesn’t include the amount of time that it will take if an appeal to the Court is necessary.

You can find the complete testimony at the hearing at the following link:

http://veterans.senate.gov/public/index.cfm?pageid=16&release_id=11839&view=all

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