Help with Your VA Claims
by Paul Kasper
Rather than tell a "War story" how about the way to obtain the benefits from the Veterans Administration? Some of the health issues
you have, may be related to your time in service. You need to read this at least twice -then Save it to begin a claim or to file an appeal on
a decision if you feel you need to upgrade your current status with the VA.
1. Gather all the military, private and VA medical records (get copies made). Always keep a copy of anything you send off to the VA.
2. Review your military medical records and make a list of every ailment that you had while on active duty.
3. Cross reference all you military ailments with your civilian ailments. If the problem persists or a secondary issue has cropped up as a result of the issue that developed during your time in the military then you need to apply for that issue (as a secondary issue). Also, if you were affected by Agent Orange, Project Shad, etc., anything that may have caused an illness affecting your health and ability to function normally.
4. Go to the VA web site and download all the Fast Letters, Memo's and any other documentation that will support your case.
5. Go to the DAV, PVA and any other VSO web sites and bookmark them (and download anything related to your claims). Also, many sites have excellent Agent Orange, Project SHAD and many other programs you may not know you were involved in. Collect information including possible related health issues, duty locations, etc.
6. Get statements from all private doctors or other medical providers. Have them state that your problems are DEFINITELY service connected. If the doctor uses the word possibly or probably the Medical Provider will have given the VA the excuse it needs to dismiss the doctors statement. But, if all the doctor can say is probably, don't throw it away. Get more than one doctor to say the same thing then write if two doctors say the same thing. Then the reasonable doubt rule should apply and the probability is slim that the issue ISN'T service connected.
7. Get statements from anyone who knows you and your issues. Have these individuals state how the problems affect you (example: It is hard to bend over, or squat, or hear, etc..) Did you know you can get statements from anyone that knows you, yes your wife, kids, parents, co-workers even the guy/gal walking along the street. All of these people can contribute! All their statements are evidence that must be considered. If you have them put their phone number down on the statement and request the adjudicator to call (not if they have any questions), the adjudicator is required to call.
8. Go to http://www.findlaw.com or http://www.veteransresources.net/database.html and look up all Court of Veteran Appeals, US District Court, US Court of Appeals and Supreme Court decisions that affect your issues. Use these sites to support your other evidence. Do your own legal research! It does not hurt to overload the initial information. Better to be covering all sources than not to have enough to solidify your claim.
9. If you have been going to a Vet Center, get a copy of their records. They are independent of the VA medical system (CAPRI) so you need to get a statement or copy of your provider's notes or both from your treating health (mental and physical) worker.
10. If you have gone to Voc Rehab, you were evaluated by them. Do a Privacy Act request and get all copies of evaluations and anything else (to include reports of contact [ROC]). The Voc Rehab evaluations carry some weight, since they are independent evaluations. Get copies of the contractor evaluations and the VA's Voc Rehab evaluations.
11. Go to http://www.warms.vba.va.gov/bookc.html. Look up what your issue is and determine the percentage that you want to apply for. Now 98% of the Veteran Service Rep's (VSO's) will tell you not to give a percentage, but if you don't ask for a percentage and you are awarded 0% for an issue, you can't complain because they gave you exactly what you asked for. If the adjudicator denies your issue and you did not ask for a certain percentage, then you have to prove they didn't follow proper procedure (this is very hard to prove). Your VSO will tell you that the law can change. Great, if it increases then just fax, email (w/receipt) or mail in an updated request. If the percentage decreases, you don't need to do anything. The Veterans Claims Assistance Act of 2000 allows you to use the law that is most favorable to you to be applied to your claim so don't change your percentage.
12. If you have been seeing a counselor at the VA Hospital or civilian counselor, then get him/her to write you a statement of how bad they think you are. Plus, write up a statement on your own, let the adjudicator know about your background, your stressors and how this effects your daily life. Always and I mean always have this statement lean towards your being suicidal, wanting to kill people and your wanting to harm not only yourself but others. You should also ask ex's, friends, church members, etc., anyone that might help verify and support your claim.
13. Current law favors the Vet. The VA fights it but you can use this to your advantage. Invoke VCAA. Read, understand and learn what VCAA can do for you. If you are within a year of the VCAA letter you received, then you have rights to reopen old cases, don't let that pass. (VCAA=Veterans claims assistance act).
14. Go the VA web site, go to the http://www.va.gov/vbs/bva/ or http://www.veteransresources.net/database.html to research all BVA opinions on your issues. These legal opinions as well as the courts opinions narrows the focus of how the adjudicator can look at the evidence.
15. You need to put together a narrative that reads like a graduate paper. You will refer to evidence that you collected (items 1-9) as well as other information suggested. You tell your story as to how you were injured or became exposed or affected by what you saw/heard. I would also compile all the evidence by issue. Yellow highlight all that pertains to you and your issues. Site this in your narrative.
16. You are entitled to claim all periods of active duty, all periods covered under Vocational Rehabilitation and any injuries suffered under the care of the VA for the purposes of disability claims (issues). You need to list all periods of active duty, to include ADT (active duty time) and reserve time. There are limited benefits for non-active duty personnel. By stating the periods of active duty, and providing documentation (such as copies of orders), you will increase your chances of winning your claim.
17. Go to your private doctor. Have him do the C&P exam the correct way. Go to the C&P office at your local VA Hospital (if your too far away, have them either email or fax to you the exam criteria). Make sure he is a specialist (preferably board certified) in the field. Then show him the exams you were given by the VA as well as all your personal medical records on this issue. Ask him if he concurs with their exam. If he doesn't, get him to put it in writing and cite the different tests that he performed to support his conclusions. Thus you beat them at their own game. When you write it up, make sure you had the "COMPLETE" C&P exam done by a private doctor and the VA doctor's refused to perform the proper tests. Under the reasonable doubt rule, you have proven your case, and they failed to prove theirs.
The VA is like a willful child. You have to pull the child by the ear and lead it in the direction that you want it to go. If you let anyone else do this for you, then your doing yourself a disservice. The VSO's are overworked and after you leave their office, will pull up a template and plug in the issues and submit a formatted claim. Which one do you think will have a better chance.
The only way to speed up your claims is for you to be dying. There is no accelerated claim process. Trust me when I say this, your situation is no worse than most, I have seen worse. Some individuals claims had gone on for 22 years. I have heard of longer. My guess is you will get something but not what you expect unless you follow the steps I have outlined above. The money you get will be minimal compared to what you need. If you have a rating of at least 20%, then you should apply immediately for Vocational Rehabilitation (if you haven't already done so). Voc rehab will give you between $500 to $600 a month while your in school (full time). At the same time you can retrain for a new career.
You all know your stories, tell the VA how you were injured or became ill, cite the times you went to the medical facility, and later the follow-up care you have received from your private doctor. Invoke the REASONABLE DOUBT clause as well as VCAA. Site VBA and Court of Appeals legal cases that support your claim that you are entitled to a certain percentage rating.
YES, review the ratings percentages. Think of your worst day (pain, etc.) and rate yourself on that basis. After a few years your pain will probably be at that level, unless you can get the symptoms reversed somehow.
I listed every time I went to the doctor, provided a copy of that medical record, highlighted the medical record and bunched them together in a group so the claims examiner did not have to hunt for the information. I IDIOT-proofed the claim! I wrote my claims and other peoples claims (and they received almost everything they have asked for) because I looked for the weaknesses in the claim and found the law or regulation that supported that weakness.
I also looked up medical studies to support my claim and provided those studies (where my case might be weak or a secondary issue) to help in the adjudication process. I especially like VA or DoD or National Institute of Health medical studies. Its hard to argue with yourself when yourself (the government) has come to the conclusion that the problem exists and what the symptoms are (which are the same symptoms you're reporting).
Remember, the service organizations receive thousands of requests for representation. These organizations use canned letters that are okay, but not necessarily in your best interest. If you provide them with most, if not all, of the research, it will make their life easier when they go to write the cover letter. They will know what cases to cite and can do a better job in supporting you (if you choose to use them).
I constantly hear/read about the VA messing things up, but I never hear of anyone taking the bull by the horns and doing anything about it. Most people rely on the VA to do the right thing. Or you rely on the service organization to do the right thing. Don't count on them. You have to be responsible for your own actions.******
Having done the prep work for the appeals, I can state one good reason why they take forever. You as the veteran did a lousy job of documenting what was needed to win. You had enough evidence to raise doubt in their minds, but not enough evidence to justify or prove you have a existing issue and if the issue was aggravated by the service, or voc rehab or your visit to the VA. Follow the steps below to gather as much evidence as possible. If that fails, the BVA paralegals have 3-5 4" binders full of address and other resources that they can call upon to develop your case. If you want to win, you have to do a better job at preparing your case.
My Turn: If you follow the steps listed above, would you let me know how well you did on your claim. Thanks. To date, I have a 90% success rate.