The A - Z Guide: Veterans VA Disability Benefits
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Appeals
























































































































































































































































We estimate that over 50% of all initial applications for benefits will be denied.

It doesn't matter if the claim is well grounded or not. It is likely that your claim will require an appeal.

VAWatchdog advises that veterans must expect that their benefit application will be denied and that the veteran should be prepared to appeal. This is a routine and ordinary part of the process.

Denial of the initial claim  should not cause the veteran undue anxiety. Most claims are won on appeal.

In every award (denial of award) letter there is information about why the veteran was denied. Now is the time to carefully read through that. You may want to read it a number of times. The information contained in the letter may be full of errors itself and it won't always be easy to understand.







It Can Be Done: Suing The Veterans Administration
Jeffrey A. Milman, Esq. Founding Partner at Hodes-Milman-Lieback-Mosier


VA Malpractice

There are nearly 25 million veterans living in the United States today. These brave men and women who defended our nation deserve compassion and care. The U.S. Department of Veterans Affairs is responsible for providing health care and other benefits to these veterans and their dependents; however, in recent years a number of veterans associations and regulatory groups have drawn attention to substandard care and conditions at many VA hospitals.

This epidemic of substandard care can have a detrimental effect on the victim’s quality of life, and may even result in permanent injury or even death. If you believe that you or someone you love may have a VA hospital medical malpractice claim, the lawyers at Hodes Milman Liebeck Mosier can help.

Our experienced team has the knowledge and resources to assist you in taking legal action against the Veterans Administration under the Federal Tort Claims Act, a process that can be unduly confusing and complex without the guidance of an attorney with particular experience in filing malpractice claims on behalf of veterans.

VA malpractice is medical malpractice, and victims are entitled to appropriate compensation for their hardship and suffering.







Jim's Mailbag...hosted at Stateside Legal 



Jim;

In thinking ahead, I wanted to be prepared when the VA denies either all or part of my claim. Appealing is a time consuming process. I understand that there is a "reconsideration" process, that might be more useful.  Is this the case?  I am sure there are examples on the website, sorry for asking this as a duplicate question.  Thanks.

Reply;

I don't recommend reconsideration. When VA sends you a denial, the claim has been adjudicated by a Ratings Veterans Service Representative (RVSR). The RVSR is at the top of the food chain at that level of decision makers. The claim was perfected (prepared for the RVSR) by a Veterans Service Representative (VSR).

To request reconsideration sends your folder right back to them. Unless you have *new* evidence that hasn't been reviewed previously and is *material* to the claim and *not repetitive*, the reconsideration will very likely give you the same denial for the same reasons.

The next level up the chain of command is the Decision Review Officer Process (DRO). The DRO is a more senior person who (at least in theory) is better trained and more experienced than the RVSR. The DRO Process assures you of a de novo review. The DRO is not allowed to be a person who has had any dealings with your claim earlier so you have a fresh perspective. The DRO has authority to agree with the original decision, modify a part or parts of the earlier decision or throw out the earlier decision for something completely new and different.

We have had great luck with the DRO Process. I believe that the DRO is often the first person who will actually read the claim folder front to back. I do not trust that the RVSR does that since that person is on a production quota with a bonus tied to volumes of claims completed.

We recommend that most denied veterans retain an attorney, even for the relatively simple DRO Process appeal. This is a change in my thinking. Prior to 2007 veterans couldn't hire a lawyer to represent them to a DRO Process appeal. Now that the laws changed and there are lawyers with plenty of skill and experience, I'm finding it to be an advantage to just proceed right to a good lawyer rather than messing around with what can be a very complex and unfriendly process.

This depends on the veteran. If the vet feels good about arguing his own appeal, then he or she may consider that option. We recommend that any appeal be turned over to an experienced veterans law attorney if the vet has any doubts.










What to do when the denial letter arrives  

Do your best to decipher the reasoning VA offers you for the denial. That may be the very problem you need to correct to perfect your appeal.

Or, there may be a lack of evidence that VA overlooked. The rater may not have understood your claim as well as he or she should have.

In any case, don't get angry, get analytical and smart. Anger wastes time and you have deadlines to meet.

Once you've read and you understand the reasons for denial, you now must think of how to explain your appeal clearly.

We'll use the example of evidence that wasn't considered or seems to have been overlooked in the decision process.


Let's say that your claim was for a knee injury that occurred during active duty. You were treated at a clinic and then a hospital. Then your knee continued to bother you for the duration of your active duty service. You had 2 more clinic sick calls prior to discharge.


In the denial letter VA may have told you that; "There is no evidence of a knee injury occurring during your service." Don't worry about that. It happens all the time. Overlooking or ignoring information that you're sure is in your record is common at your VA.


(Are you sure the information is in your record? Have you retrieved a copy of your records? If not, as you file your appeal you should also seek out a copy of every document that you are able to find.)


Within a month of receiving the denial letter, you should proceed to formally appealing it. This is easy and you don't need any help to do it. It's as simple as using the template below and writing a letter to the Regional Office. 









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The Notice of Disagreement (NOD) Letter   


DATE

VIA Certified Mail, RRR


VARO Address


Reference (Your Name, SSN and any reference numbers on the award [denial] letter)


Dear Sir/Madame;


I am in receipt of your letter of DATE. In that letter you have denied my application for a disability rating I claimed DATE.


Please accept this letter as my Notice of Disagreement (NOD) with your decision.


My reason for this NOD is (briefly describe).


I request a Decision Review Officer Process (DRO) appeal and I request a personal hearing.


Respectfully,


YOUR NAME

ADDRESS
Etc.
















The Steps To An Appeal   

* Veteran files a claim the usual way.

* The usual process occurs; This may take 12 to 24 months.

* The veteran receives the letter from VA that denies the benefit.

* The veteran then chooses how to appeal. There is a one year time limit.

* The veteran may then retain a lawyer, tell VA that a DRO Process appeal is desired or the vet may seek a BVA hearing.

* If DRO Process is the chosen, the appeal is handled at the Regional Office.

* If BVA is desired, the claim will be "perfected" by the RO prior to being sent to BVA. This may equal DRO Process.

* If BVA claim is denied, the veteran may proceed to the CAVC.

* VAWatchdog does not recommend reconsideration.

* VAWatchdog recommends that almost all appeals be handled by an expert attorney.












We urge vets to talk with an attorney.

It doesn't cost anything to discover your options.

VAWatchdog does not recommend that any veteran proceed beyond the DRO Process unless he/she is represented by a skilled attorney.

Appeals, indeed all claims, have become much more complex. This has opened a door to the VBA making more mistakes than ever before. Along with all this is the fact that VBA has become more willing to fight appeals.

Veterans need an advocate who is trained in law and skilled at the task.

Read How To Hire A Lawyer 














M21-1MR

- Appeals

Table of Contents
Section A - General Information on Appeals
Section B - Notice of Disagreement (NOD)
Section C - Decision Review Office (DRO) Review Process
Section D - Statement of the Case (SOC) and Supplement Statement of the
Case (SSOC),
Section E - Filing a Substantive Appeal
Section F - Docketing, Certification, and Claims Folder Transfer
Section G - Board of Veterans Appeals (BVA) Decisions and Remands
Section H - Board of Veterans Appeals (BVA) Hearings
Section I - Court of Appeals for Veterans Claims (CAVC),
Section J - Special Appeal Issues and Cases
Section K - Veterans Appeals Control and Locator System (VACOLS)





Decision Review Officer Process

The steps that the Veterans Benefits Administration (VBA) will follow
to adjudicate your claim for disability benefits are complex and detailed.

Your claim is received, checked to determine your eligibility, evidence is
gathered and put in place in your folder, you are given a Compensation
and Pension examination, you are notified a number of times of your
opportunity to submit more evidence and the folder is perfected by a
Veterans Service Representative (VSR). Eventually your claim is ready
for adjudication and it marches on to the desk of the Ratings Veterans
Service Representative (RSVR).


Decision Review Officer (DRO) Review Process Overview
 














The Board of Veterans Appeals (BVA)  

The Board of Veterans' Appeals (also known as "BVA" or "the Board") is a part of the VA, located in Washington, D.C.

Members of the Board review benefit claims determinations made by local VA offices and issue decision on appeals.  These Law Judges, attorneys experienced in veterans law and in reviewing benefit claims, are the only ones who can issue Board decisions.  Staff attorneys, also trained in veterans law, review the facts of each appeal and assist the Board members.   {38 U.S.C. §§ 7103, 7104}

Anyone who is not satisfied with the results of a claim for veterans benefits (determined by a VA regional office, medical center, or other local VA office) should read the "How do I Appeal" pamphlet.  It is intended to explain the steps involved in filing an appeal and to serve as a reference for the terms and abbreviations used in the appeal process.

Considering a BVA Hearing? Select a Video Hearing.


Board of Veterans' Appeals Decisions Search

To conduct a search of BVA's decisions, enter the word or group of words you are looking for in the fields below. From the resulting list, you can connect directly to individual decision texts or you can return to this page to conduct additional searches. Personally identifying information has been removed, so searching by the Veteran's name, C-File or Social Security Number will not be effective. Decisions are loaded monthly, usually within 45 days after the end of each month.

Veterans Law Review (Copies & Submissions)

Vol.1, 2009 

Vol.2, 2010 

Vol.3, 2011 

Vol.4, 2012 

Vol.5, 2013



VA Pamphlet 01-02-02A, April 2002 " How Do I Appeal " (PDF)
 

















The Court of Appeals for Veterans Claims (CAVC)

How To Appeal a Board of Veterans' Appeals Decision

You must have a final decision from the Board of Veterans' Appeals before appealing to this Court. (The VA Regional Office is not the Board of Veterans' Appeals.)

If you are not sure of the status of your claim at the VA or BVA, please call the BVA status line at 202-565-5436.

Required Steps for Filing an Appeal:

1. The appellant must file a written Notice of Appeal (NOA) that includes all of the following information:

  • A. Current name
  • B. Current address
  • C. Current telephone number
  • D. Current e-mail address
  • E. VA claims file number
  • F. Date of Board decision being appealed

2. The Notice of Appeal (NOA) must be received not later than 120 days after the date on which the Board mailed the notice of the decision to the last known address of the appellant.

Please Note: The date stamped on the front of the BVA's decision is the date it was mailed.

3. A $50 nonrefundable filing fee, paid by check or money order payable to the "U.S. Court of Appeals for Veterans Claims," or a Declaration of Financial Hardship must be received by the Court no later than 14 days after you send the Notice of Appeal (NOA)s.

4. File the Notice of Appeal (NOA) and filing fee or Declaration of Financial Hardship with the Court by mail, fax, or e-mail to the following address:

    Clerk of the Court
    United States Court of Appeals for Veterans Claims
    625 Indiana Ave. NW, Suite 900
    Washington DC, 20004-2950
    Fax: (202) 501-5848
    E-mail: e-submission@uscourts.cavc.gov

E-mailed pleadings must be in separate PDF files.

5. Once the appeal has been docketed, the Clerk will send a Notice of Docketing to all parties advising them of the date the Clerk received the Notice of Appeal (NOA). The Clerk will also note what is next required of both the appellant and the Secretary.

Note to attorneys: If a Notice of Appeal is filed by a representative or someone other than the one making a limited appearance, a Notice of Appearance and fee agreement must be also submitted according to Rule 46(d)(2) and (6) of the Court's Rules of Practice and Procedure.

For more information, please read rules 3 and 4 of the Court's Rules of Practice and Procedure.

Additional Information: