The A to Z Guide to VA Disability Benefits
JimStrickland912
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Yesterday I dared to struggle. Today I dare to win.
Bernadette Devlin
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How To Communicate With Your VA Regional Office
(Also see the topic Letters)
Other than the evidence that supports the claim of disability, there is no detail more important than how the veteran communicates the facts of his application and evidence to the VBA. Whether the veteran chooses to seek help through an intermediary such as an NSO or a CVSO or to maintain complete control of the process, getting information delivered inside the secure walls of the VA Regional office (VARO) is a critical part of the mission.
The stories of lost folders, misplaced evidence, folders and files containing papers from one or more other veterans and worse are legend. Ask any veteran who has had dealings with their VBA and the odds are good that you will soon hear a story of a lost piece of paper that resulted in an unjust denial.
While VBA provides a set of services on-line that allow the veteran to apply electronically for benefits or to ask questions via email, I recommend that these services be avoided. The VBA also provides a national toll free number that is there to ask questions of a VBA representative and once again, I recommend avoiding this service.
I recommend that the only communication from the veteran to the VBA is that done by certified mail with a return receipt requested. Faxing, emailing, calling or even hand delivering to an intermediary to pass your documents on to the VBA do not provide the security and guarantee of a certified letter. Once you have the green postcard returned to you with an official stamp or signature in place, you can be confident that your documents are delivered.
It's often repeated that a fax machine provides proof positive of delivery by its production of the print out that will verify transmission of the documents. While the machine does provide proof that a transmission was made, there is no way to tell how well the machine that received it was functioning at that moment. Paper jams, empty toner cartridges and other mechanical malfunctions are commonplace.
Your documents should be delivered neatly and readable by the individual who will have influence on your case. Each page should be numbered in order and your name and Social Security number should be affixed appropriately.
You should keep copies of every document you send and as soon as you have your return receipt, correlate the receipt with those documents just in case. Spending a little extra time getting organized at this point will be well worth it if there is any question of what evidence was provided and when.
A "Cootie", Veterans Day parade, Beaufort, SC 2007
How To File A Claim
At any point after a veteran has completed military service and he or she believes that military service has caused an injury or illness (called a "condition" by the VA) or that a preexisting condition was aggravated by military service, the veteran may file an application for disability compensation.
There are no time limits or restrictions except in a few very limited circumstances. As a rule, the veteran may seek disability compensation for any condition they reasonably believe was caused or aggravated by their service at any time.
The initial filing of a claim for disability benefits is simple. The veteran may file the appropriate forms himself or he may seek representation and assistance from an accredited Veterans Service Officer who will likely work for a Veterans Service Organization. At this stage of the process, the veteran is not allowed to pay anyone to represent them. In practice, this means that a veteran who wants to have someone representative him or her will likely use the services of a VSO, as very few attornies work on preparing initial claims.
More about representation follows later. For the purposes of this chapter, we will assume that veterans who read on are interested in filing the claim for themselves.
Prior to filing your claim you should consider some of the basic elements that are required to obtain an award of benefits.
(1) You must be eligible. In other words, you must have served and possess a discharge that is other than dishonorable. If your discharge is other than honorable but not dishonorable, there may be restrictions on the type of benefits you may receive.
(2) You must have an current injury or illness (condition) that can be attributed to your service. This means that you should have a fairly clear diagnosis in a medical record prepared by a qualified health care provider, preferrably a physician. The more precisely defined the condition is in the record, the better it is for your application for benefits.
(3) You must have evidence to support your claim. The strongest evidence is that of an event that is recorded in a Service Medical Record (SMR) and a detailed description of the cause of the injury or illness leading to the condition, as well as how it was treated and any residual effects of the event. If the condition is related to a non-combat related event, documentation of the accident or incident that caused a condition (such as a broken bone), documentation of an admission to a military or other hospital, a record of treatment and follow-up care. Not everthing is required for every claim, but the more supporting evidence, the better chance of an award.
(4) Your medical evidence must be clear enought to prove to VA that your current condition is connected to the in-service event - this is called "service connection" or "nexus." Without a service connection, all the evdence in the world of a current medical condition and an event in service will not result in an award of benefits.
I suggest that you consider another set of requirements before you file a claim for yourself. You should be well organized and prepared to deal with the requirements of a lot of paperwork, copying of files and searching for evidence. It helps if you are familiar with the way to conduct a search for records on the Internet, use a word processor, own or have access to a scanner and copier and you're confident that you have the patience to deal with details. The VA process, even at its best, is slow, prone to error, and requires constant attention. A veteran who can organize his or her information and keep good records of interactions with VA during the claims process is much better positioned to be successful.
If you believe that you meet these requirements, you should proceed to apply for your deserved benefits.
You should file your claim as soon as possible after you decide that you are eligible to apply for benefits. This is because the date of filing (when the claim form is received by VA) establishes the start date of your award. You do not need to wait to file your claim until you have gathered all the supporting evidence. You'll have plenty of time to submit your evidence after you file. Waiting until you gather every last piece of evidence only costs you money because VA will only pay you from the date of the claim, no matter when the condition began.
You may file an informal or a formal claim. An informal claim may be as simple as a brief letter to the VA stating you wish to file a claim. The VA will accept that and then ask you to complete the VA Form 21-526 to formalize your claim. If you are reading this, there is really no reason to file an informal claim because eventually you have to complete the formal claim form anyways. Also, there are often disputes over informal claims and you risk VA later not recognizing your claim.
The much preferred method to file a claim is to complete a VA Form 21-526. The link will take you to the 23 page form on the VA web site. This is a PDF document and that requires that you have the free PDF reader installed on your computer. That PDF reader is available by clicking here.
As of this writing, the Form 21-526 on the VA site is "fillable". This means that you may complete the form by using your computer to type information into the required places. After you've done that and finished the form, you may print it out for mailing to the VA Regional Office that will serve you. If you aren't comfortable doing that, you may print out copies to complete in ink and mail to VA.
If your computer refuses to cooperate with you, you may go to any VA facility such as a regional office, VA medical center or clinic and they will provide you with one. You may also call 1-800-827-1000 to ask that a form be mailed to you.
Before you begin, carefully read through the instructions. While the form isn't difficult to complete, understanding what will be required before you begin will save you time and frustration.
Once you've completed and signed the form, it's time to mail it in. The VA doesn't want all those instructions so you may keep those for your records. Be sure you keep a good copy of the completed form for yourself.
It should be mailed to the VA Regional Office (VARO) in the state where you live (or the closest VARO if you live in a state with more than one) using Certified Mail with Return Receipt requested. I strongly recommend that this is the only way that you should ever send documents such as forms and evidence to the VARO. I do not recommend using a fax machine, any sort of email or even hand delivery. Certified mail will provide you with signed evidence of delivery just in case a document goes missing.
Once you've mailed off your 21-526 application and you have the receipt proving delivery in hand, you should begin in earnest to gather the evidence you'll need to support your claim. VA will eventually notify you that they have received your application and over the next few weeks and months you will receive letters that will remind you to submit any and all evidence possible.
It's worth noting that the letters you'll receive will often be repetitive and they'll make you wonder if VA has received anything you've sent in already. Not to worry, the letters are computer generated and are part of the requirement that VA has to assist you in developing your claim. You should keep everything you receive from VA in case you run into a problem about whether or when something was or was not sent to you. If you get into the habit of putting everything you send to and recieve from VA in a file in by date, you will have no trouble finding whatever information you may need in the future. If you've used certified mail and return receipts, you should save each one of the certified receipts and return receipts with the documents that they go with. Also, if you have the receipts, VA received your documents and they'll get around to them in turn.
If you do not receive any letter from VA in about two months, you may want to send another copy of your claim and a copy of the certified mail and return receipts, along with a cover letter explaining to VA that you sent in the form before, but have not received any acknowledgement. This will usually prompt a response.
You are probably going to receive a notice or a call about a compensation and pension exam. Even if it's short notice and it may be inconvenient for you, you should make every effort to get to the exam as soon as possible. If you just can't make it on the date scheduled, notify VA at your earliest convenience. If you don't show up for an exam or if you're extremely late for a scheduled exam, the VA may default to a denial of your benefits and you then have a real issue to confront.
Now you wait. You may wait six months to a year before any progress is made. During this time it's important that all you do is wait. Don't call the VA to ask why it's taking so long, don't write angry letters to your Senator or Congressman. Any action you take now, other than submitting supporting evidence, is likely to slow your claim down. The VA is estimated by various sources to be a year or more behind in the processing of some 400,000 to 800,000 claims. Yours is in line with those and if you have done your job well with your application and evidence, your claim will eventually have its turn to be rated.
The only time I recommend that you ask VA to speed up your claim is if you are truly critically ill or your doctors do not believe you will outlive a long wait. In that case, VA may prioritize your claim for processing after you've notified them. The notification of your desire to have your claim prioritized should be sent as a brief letter via certified mail and should include a statement from a physician as to the seriousness of your condition.
If it sounds simple to file a claim for disability compensation benefits, it's because it is. Winning your claim after you've filed is another matter entirely. If you do this part of the process well, you've just markedly increased your chances of a good result.
But your task isn't complete. If you aren't confident you can do all that, you should seek a representative. Even if you do ask a representative such as a VSO to help you, the VSO will want you to be involved in your own claim. You may be told that, "This isn't a spectator sport!" Your VSO will do a much better job for you if you're actively helping to gather evidence an getting good copies of evidence to the VSO for review.
A related article is here.
How To Write A NOD Letter
Eventually it is more likely than not that you will receive a notice from the Veterans Benefits Administration (VBA) advising you of an action that you disagree with. The notice may be a denial of your application for benefits, a notice of an apportionment action against your benefits, notification of a proposal to reduce your benefit amount because you're in violation of the "fleeing felon" regulations or a host of other issues.
Any letter from the VBA that suggests that an action is about to occur that may cause you to lose benefits must be addressed quickly. The sooner you respond to such notice, the more likely it is that the outcome will be favorable to you.
Receipt of such a letter from VBA is no reason to panic. If you work quickly and thoughtfuly, you'll interrupt or reverse the process without too much fanfare.
As with all actions and communications with VBA, the written letter is a powerful tool to have at your disposal. A well crafted letter is a physical object that must be faced by the VBA. In contrast, a telephone call to the toll free number is probably not going to garner any attention at all for you and a false sense of security may make you miss a time requirement. Faxing isn't much better...fax machines are notoriously unreliable.
The letter delivered via certified mail, return receipt requested is the best way to ensure the delivery of your document.
As with all written communication to your VBA, the letter should be professional in appearence, to the point with no unnecessary verbiage and be as brief as possible while including the required language.
Here is a template that you can use;
01/01/2010
Department of Veterans Affairs
Regional Office
P.O. Box 01234-5678
Your VBA City, State
Zip
Your Name and All Relevant Numbers (SSN, C-File, etc.)
Dear Sir/Madame:
I have received your letter dated (enter the date of the VBA letter). In that letter you have advised me that (my benefits are denied, you propose to reduce my benefits, someone has asked to apportion my payments, you believe I am a fugitive felon, or any other action VBA has advised you of).
Please accept this document as my Notice of Disagreement with your (name the action or proposed action).
I request that you take no action to reduce or modify my monthly benefit amount at this time.
I request that I be allowed a personal hearing and de novo review of my file and this (proposed?) action by a Decision Review Officer.
Thank you for your kind attention to this issue. I await your notice that my personal hearing has been scheduled.
Respectfully submitted,
Joseph Sixpak
Address
Telephone Numbers
Email Address
You'll notice that there is no argument in this letter to tell VBA why you believe they've erred. This letter is only intended to halt whatever process is occurring and to buy you some time to think of how you should respond.
The VBA believes that your timely notice is very important. They don't hold themselves to any such time limits. A brief letter like that above will satisfy any 30 day rules. By getting this to VBA within 30 days of the date of the letter they sent to you, you've put the ball back into their court. It's now up to VBA to schedule that hearing.
Before the hearing, if you're able, you should present your evidence and argument that will prove why VBA has made a mistake in trying to reduce your benefit. You may mail it in, enclosing a cover letter similar to the letter above that explains your position. If you've done a good job, you may get a notice that the personal hearing isn't required and the matter may be dropped.
At the very least, you've bought time in which you may prepare a good defense, consult with an advocate and you're much more in control of how the process will affect you.
How To Increase An Existing Rating
The veteran who has an existing condition or conditions that are rated and compensated as service connected may experience a worsening of the condition with time.
At any point along the way, the veteran who believes that the existing rating is too low may ask for an increase. To request or file for an increase is a simple procedure. The veteran need only to write a letter to the VA Regional Office and clearly state that he or she believes that an increase in the benefit is appropriate, why you believe that an increase is proper and then provide evidence to support the claim for an increase.
The usual process will begin. The veteran will be notified by letter that the VARO has received the veteran's request and evidence will be requested. A Compensation and Pension examination will be scheduled, medical records reviewed and a decision will be made by a Ratings Veterans Service Representative.
If your request to increase your rating is denied, all the usual appeals processes apply so if you feel strongly about your case, you should proceed to the appropriate type of appeal.
I'm often asked if there is a risk to requesting an increase in an existing rating. The answer is always, "Yes". Your VA is always on the lookout to ensure that you are "appropriately" rated. This means that your percentage of disability rating should match your physical condition as closely as possible at all times.
Your VA practices this theory to enforce the lowest rating possible. Any time you request an increase brings your file under scrutiny of an individual who has as the first order of business to review it for any errors that may have caused you to receive a rating higher than you deserve. I've seen numerous instances of veterans who request that their rating be increased from 50% to 70% and they receive back a "Notice of Proposal To Reduce Benefits" to 20%. The usual reason given by VA is an "improvement" of the rated condition.
Veterans Day, Beaufort, SC 2007
How To Write A Letter To The Veterans Administration
The well written letter is the most powerful tool in your belt.
Knowing that telephone calls to the RO don't connect you to an RO and knowing that a fax may misprint even though it sends you a positive message, writing a letter is usually the first, best and only solution for any issue you may have with the VBA.
While you don't need the skills of an English teacher to write an effective letter, there are a few things you shouldn't do as well as those you must.
As a giant bureaucracy, the VBA is a paper machine. Although the dawning of the computer age was to rid all our offices of paper, it seems to have just given everyone their own printer along with reams of paper.
The format of a letter to a veteran from the VBA is stark.
Although italics, boldface and large font sizes are used for emphasis, there is no other attempt to do anything but convey a factual message. Reference numbers and dates are clearly visible for the ease of the reader.
Your correspondence in return to the VBA should mimic this closely. Never use colors in the font schemes, rarely use and bold fonts and never type IN ALL CAPS to emphasize your points. Use plain white sheet paper of a medium grade quality.
Your message on that piece of paper becomes a legal document. If your case should happen to enter into a lengthy appeals process, the document you write today may be read again in a court room setting in Washington 5 or more years in the future.
Your letter establishes the tone of who you are and your level of professionalism to the reader. Since you aren't appearing in front of the person who will read your communication, this letter becomes your opportunity to impress them with your knowledge and to seel them on why that should adjudicate your request favorably.
When writing to VBA you should only make statements of fact that are relevant to your case. The reader will not be able to respond or consider your personal theories of how unfair the VBA is to veterans or how you may have fallen on hard times.
Your insults toward the VBA will be ignored. I believe that most VBA Veterans Service Representatives will do their best to allow a veteran a little leeway if they are angry and have to blow off a little steam. However, a steady stream of insults is just a waste of everyone's time and I can't imagine that it doesn't have some negative effect on a decision maker.
If you feel compelled to write such a letter, do so. Then throw it away and set about the task of writing what will help you with a minimum waste of everyone's energy.
You will find that you may address any issue with the VBA most effectively with a letter. Whether making a statement to support your claim, requesting an increase to your existing benefit, asking for copies of your records, protesting or disagreeing with an action or attempted action by the VBA, you should respond by letter.
Below are the basics of writing an effective letter to VA.
Always include the date at the beginning of the document, the correct address of your VA Regional Office, your full name and any reference numbers such as your Social Security number of VA C-File number. If you are replying to correspondence from VA, they will often tell you to use a coded number when replying so insert that here too. The salutation should be worded to ensure that you are addressing either a male or a female reader.
The first part of every letter to VA will look like this;
01/01/2009 VIA CERTIFIED MAIL
Department of Veterans Affairs
Regional Office
1234 Anywhere Street
VA City, VA State
ZIP 09876-4321
Reference: Your Name
Relevant Numbers (From VA correspondence to you)
Dear Sir/Madame;
Once you've addressed your letter properly, you then state your case as briefly as possible. Your letter must be courteous, to the point, simple to read and factual. Making demands, criticisms, telling your life story or otherwise straying from a professional appearance will slow down the process and may hurt your case.
The body of your letter should look like this with appropriate verbiage to describe your particular request or issue;
I am writing you to (request an increase in my existing benefit, tell you that this is my Notice of Disagreement with a decision, advise you that I have added a dependent through marriage or childbirth, wish to make an additional claim, ask for a personal hearing, request a copy of my folder, or whatever you want to resolve with the VA.)
If you have evidence that will support your request or actions, it is appropriate to include copies in this letter. In the body of the letter, list the evidence you're including and remember to put your name and a reference number (most often your SSN) on each page. If your letter will run more than 2 pages each page should be labeled as "Page 1 of 3", etc.
You should write the letter in your own words. Include all the details that you believe matter while remembering the individual who will read it has limited time. I've heard it said that anything beyond a 2 or 3 page document or a letter that rambles endlessly isn't going to be read thoroughly.
Make your points and close your document courteously and professionally;
Thank you for your kind consideration of my request.
Respectfully submitted,
Signature
Your Name
Address
Email Address
Telephone Number(s)
Don't quote or copy and paste endless paragraphs of verbatim Title 38 references.
This may be the most common error I see when a veteran writes to the VA. If you believe that a rule, regulation or law has a direct correlation to your claim, you should cite it as a reference to support your argument but don't copy it all into your communications.
They have their own copies of all the rules and when you add more unnecessary work to the pile that waits on their desk, it's hard to imagine that it wouldn't annoy the person making decisions on your case.
Your communication to the VA is a sales pitch.
You have a theory that you want the reader to agree to. The reader is most often a Veterans Service Representative or a Ratings Veterans Service Representative and it's your task to convince that individual that to honor your request or award your benefit is the right thing to do.
This letter is one of your best opportunities to close the deal.
A related article is here.
How To Challenge A VA Proposal to Reduce or Take Away A Veteran’s Monthly Compensation
Click Reductions and Severances
Katrina J. Eagle, Attorney at Law
http://www.veteranslawoffice.net/