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Posts Tagged ‘Disability compensation’

Should I just withdraw my claim and start over?

January 18th, 2012

We hear from many of our clients that they have been advised to just withdraw their claims and file new claims, rather than submit additional evidence in support of the pending claim.  Is this a good idea? 

Absolutely not!

This often comes up when you have a claim with missing evidence – let’s say you had a back injury in service and you have a back disability now, but you didn’t have any medical opinion saying that your current back disability is related to your injury in service (a “nexus opinion”).  You filed the claim in 2008 and it’s been at the Regional Office since then.

You talk to a doctor who tells you that he does think there’s a relationship between the two, and he writes you an opinion, explaining why he believes that there is a relationship.  The best thing to do is to submit that opinion to the Regional Office (be sure to keep a copy and to either take it in person or send it certified mail!)

Someone tells you, “Oh, no, things will happen much faster if you withdraw your claim, then submit a new one with all the evidence.”  Here’s the problem – if you do that and are then granted benefits, your claim would be effective as of the date you filed your new claim, not the date you filed your original claim.  So, you could lose as much as 4 years of back benefit payments if you do this.

Under the law, the “effective date” of a claim is generally the later of the day the claim arose (say, when you developed your current back disability) or the date VA received your claim.  If you withdraw the claim filed in 2008 and file a new claim to reopen with your new evidence in 2012, the effective date of your claim will be 2012, not 2008.

The bottom line – it’s always better to continue an ongoing claim when you obtain new evidence than to withdraw the claim and start over.

Sandra W Wischow FAQs, Veterans Benefits Claims , , , ,

Filing a New Claim with VA

November 4th, 2011

VA Form 526 is used to initiate a new claim. Use this form if you wish to file a new claim for disability or pension benefits. VA Form 526b is also used to file claims for increased ratings or to reopen a previously denied claim. Be sure to follow the directions closely. Claims for VA benefits are initially made in writing to your VA Regional Office (“RO”). You can contact your local RO to obtain forms for filing your claim by calling 1-800-827-1000. After developing your case, the RO will send you a decision, called a “rating decision.”

The following information is provided as a general guideline. Providing the information listed below is not a guarantee that you will win your case, however, if VA doesn’t have this evidence, it is likely that your claim will be denied.

Service connection: In order to have the best chance of getting a claim for service connection granted, you should make sure VA has the following evidence: (1) medical evidence (in writing from a doctor) saying what your current disability is, (2) evidence (from yourself or your service records) showing that you had some sort of injury in service, or medical evidence that you contracted a disease or that your condition got permanently worse in service, and (3) evidence in writing from a doctor that the condition you now have began in service, or, if it began before service, that it was permanently aggravated during service.

If you are applying for service connection for post-traumatic stress disorder (PTSD), a veteran will now be able to establish the occurrence of an in-service stressor through his or her own testimony, provided that: (1) the Veteran is diagnosed with PTSD; (2) a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted confirms that the claimed stressor is adequate to support a PTSD diagnosis; (3) the Veteran’s symptoms are related to the claimed stressor; and (4) the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service and the record provides no clear and convincing evidence to the contrary.

Reopening a claim: If you have made a claim for service connection for a disability and the claim was denied, but not appealed, the law requires that you “reopen” your claim before VA will consider it again. In order to reopen the claim, you must first submit “new and material” evidence. Basically, this means you must look at the reasons the VA denied the claim the first time, and submit some new evidence that fixes the problem. For example, if your claim was denied the first time because you had no evidence that your current condition was related to service, you will need to submit some evidence that does link your condition to service.

Increased rating: If your claim is for entitlement to an increased rating, you can learn what criteria will be used to assign your rating, by looking at 38 C.F.R. (Code of Federal Regulations) Part 4. (This should be available at your local library or courthouse). If you look at a rating decision, there will be a four-digit code listed next to each condition. These codes, called “Diagnostic Codes” are listed in the CFR. You can see there what you need to show in order to get a higher rating for your condition. The best thing to do to prove your case is to document (preferably through medical evidence) that you have the symptoms listed for the higher rating.

Total disability due to individual unemployability: To receive unemployment benefits from VA, you must have evidence that your service-connected disabilities, by themselves, make it so that you can’t work or that even if you can work a bit, you can’t do so in such a way as to make income to meet the poverty line. The best way to document this is to have your doctor explain that you can’t work as a result of your service-connected disabilities by themselves. Just showing that you can’t work or that you can’t find work is not enough to receive this benefit.

Brenda Keener is a paralegal with Goodman Allen & Filetti.

bkeener FAQs, Veterans Benefits Claims , , , ,

WHY IS VA SO SLOW? What Can You Do About It?

August 17th, 2011

Why is VA so slow to process claims?

VA is a huge government bureaucracy. All bureaucracies, whether government or corporate, are slow, inefficient, subject to channeled thinking. They are inherently cautious and have many interconnected parts, and actions require multiple reviews and sign-offs. Political influences on, and scrutiny of, government bureaucracies increase the natural cautiousness.

Understaffed, undertrained, overworked, overwhelmed. VA handles hundreds of thousands of claims. Many have merit but not all do. Some people, seeing a federal fund of money, regard VA benefits as a possible source of easy money. With responsibility for the use of taxpayer money, VA must sort through all the claims to separate the bogus from the legitimate. The agency is challenged to find, train, and retain enough qualified employees to deal with this burden of work.

Conflicting incentives. Sometimes the very measures taken by VA to speed processing of claims result in losing ground. For example, when VA creates incentives for clearance of claims faster, the easiest way to deal with a claim quickly is to deny it, often without doing all the proper development. This results in appeals and redoing the claims, sometimes over and over.

Creeping bias. Most VA employees, however effective or ineffective, are sincerely trying to do their jobs properly. Dealing with such a vast number of claims, however, sometimes creates a sense of skepticism on the part of reviewers. This suspicion that most claims are without merit can result in denial because of a tendency to favor evidence adverse to the claim or insist upon corroboration of evidence that should not require it.

What can be done about it?

The short answer is that there is no cure-all; to a certain degree the system is what Congress has established, limited by realities of claim volumes and the labor market. But there are some things that can help avoid undue delay.

Support claims. If you are preparing to file a claim, collect or think about the necessary evidence to prove it. Claims for service connection require showing a current disability that is related to an event of injury or disease manifestation in service. Unless the disability is obvious, such as an amputation or scar, you will need medical records to demonstrate it. VA will request necessary records if you identify sources, but as the patient you can often save time by requesting them yourself. If your injury or illness in service is reflected in military records, that will suffice; if not, you can describe it in a statement but VA will usually want corroboration, so you should solicit statements from witnesses – fellow soldiers, family members, co-workers who are familiar with the events. Finally, unless you have documented symptoms that have continued since service, you will need to establish an evidentiary connection between the in-service event and your disability. This usually requires a medical opinion, which VA may or may not obtain on its own; again, time can be saved if you get an opinion yourself.

Simplify. Having multiple claims also causes delay, especially if they are not proceeding simultaneously. VA cannot rub its stomach and pat its head at the same time. Claims at different stages require attention by different personnel in VA, and the claims file can only be in one place at a time.

Heed notices. If your claim is denied, pay close attention to the reasons given in the Rating Decision or Statement of the Case and consider how to address them. You may need to obtain additional evidence on the elements discussed above.

Be insistent but polite. Bureaucrats are human beings (strange but true!). Like any human, a government employee responds better to courtesy and respect than to threats or anger. Dealing with VA is often infuriating, but losing your cool accomplishes nothing because, realistically, VA employees have little pressure on them to handle any particular claim promptly. But it is important to keep steady pressure on VA. Call or write VA about pending action at regular but reasonable intervals, about every 30-60 days. Writing to your congressional representative cannot force any particular decision by VA but it can sometimes help focus some attention on a file if it has been languishing without action for a long time. Do not resubmit evidence, as this simply bulks up the claims file and causes delay.

Last resort. There is one mechanism to compel attention and possibly action by VA if delay becomes extraordinary. It is possible to petition the Veterans Court for an extraordinary writ of mandamus, an order directing the agency to do something. It is called extraordinary because the court regards it as an extreme measure, to be done only in the most egregious cases. The court very seldom actually issues a writ; sometimes just filing the petition, however, prompts the agency to get something moving again.

We would be happy to answer questions about any of this information.

David E Boelzner FAQs, Veterans Benefits Claims , , , , ,

Tips – When mailing documents to the VA

July 19th, 2011

Filing a claim for VA benefits can be a daunting task. It often requires the veteran to fill out and submit many forms or documents to the VA. Gathering this information can be very time consuming and in some cases costly. Therefore you want to ensure that the documents you sent are received at the VA and added to your claims file eliminating the need to resubmit if lost or misplaced.

Keeping track of what documents or forms that are sent to the VA can be challenging yet very important. The VA is a large agency and the possibility of documents being lost or misplaced is great. Here are few things to remember when submitting anything to the VA:

1. Always maintain a copy of what you are sending to the VA for yourself.
2. Do not send the original document unless otherwise instructed by the VA to do so.
3. If possible, send documents to the VA by certified mail requiring a signature confirming receipt.
4. Make sure the documents you send have your name and claims file number clearly listed on the document.
5. If you received a letter from the VA requesting that you send a document(s) pay close attention to what address you are instructed to send the document to.
6. Make a phone call to the VA to confirm receipt of the documents you sent.
7. If you are represented by an Attorney or Service Organization, before you submit anything to the VA discuss with them best practices when mailing documents to the VA.

Following these simple tips may alleviate the need to resend documents and diminish the possibility of your documents being lost or misplaced.

To locate VA forms or find out more information regarding the VA claims process, visit the VA’s website at www.va.gov .

mglover FAQs, Uncategorized, Veterans Benefits Claims , , , ,

New conditions added to Agent Orange presumptive list

October 14th, 2009

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

Sandra W Wischow Agent Orange, Veterans Benefits Claims , ,

Are you getting a raise this year?

June 26th, 2009

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

Sandra W Wischow Veterans Benefits Claims , ,