The A - Z Guide: Veterans VA Disability Benefits
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On the battlefield, the military pledges to leave no soldier behind. As a nation, let it be our pledge that when they return home, we leave no veteran behind.
Dan Lipinski
Dan Lipinski
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VCAA Letter
Updated October 28th 2009
Your VA is an organization of extremes. In this instance, your Regional Office will either ignore you as if you didn't exist or they'll send you an endless stream of cryptic computer generated communication that nobody understands.
Most of the letters you receive will ask for evidence. Most of what the letter asks for will be stuff you already provided.
Many of you will be angry and frustrated but to err on the side of safety, you'll send the requested evidence again and again.
When you do that VA will then complain about veterans who send them all that repetitive evidence that just isn't necessary. And then another letter will go out to you to request more evidence that they already have.
If we read Senate Report 110-449 - VETERANS' BENEFITS IMPROVEMENT ACT OF 2008 we learn;
TITLE I--COMPENSATION AND PENSION MATTERS; Sec. 101. Regulations on contents of notice to be provided claimants with the Department of Veterans Affairs regarding substantiation of claims. Section 101 of the Committee bill, which is derived from S. 3023 as introduced, would require VA to promulgate regulations relating to the notice provided to claimants seeking VA benefits.
Background. VA's system for adjudicating claims for service-connected disability benefits is intended to be a claimant-friendly and non-adversarial process. Under chapter 51 of title 38, VA has a duty to assist claimants in gathering the necessary information and evidence to fully develop their claims.
A series of CAVC rulings in the 1990s narrowly interpreted the duty to assist concept, culminating in Morton v. West, 12 Vet. App. 477 (1999), which held that VA had no authority to assist. claimants absent verification that the claim was well-grounded. The CVAC found that VA was precluded from assisting a claimant `in any way unless that claimant had first established that his or her claim was well-grounded.' PVA v. Secretary, 345 F.3d 1334, 1338 (Fed. Cir. 2003). As a result of the Morton decision, VA ceased providing any assistance to claimants who did not have a `well-grounded claim' except for the verification of military service and obtaining service medical records.
Congress disagreed with the Court's interpretation of VA's duty to assist and, in 2000, in Public Law 106-475, the Veterans Claims Assistance Act of 2000 (VCAA), clarified and expanded VA's duty to assist claimants. The VCAA reinstated VA's traditional practice of assisting veterans at the beginning of the claims process.
Prior to the enactment of the VCAA, section 5103 of title 38 provided that, if a claimant's application for benefits was incomplete, VA was required to notify the claimant of the evidence necessary to complete the application. Under the changes made by the VCAA, VA is required to inform the claimant of what information and medical or lay evidence is needed to substantiate the claim. The notice must also stipulate what evidence and information is to be obtained by the claimant and what evidence is VA's responsibility. VA is also required to notify the claimant when it is unable to obtain the relevant records.
Since the enactment of the VCAA, various actions, including decisions of the Court and VA's responses to some of those decisions, have led to notices that are not meeting the goal of providing claimants with sufficient, clear information on which they can then act. Instead of simple, straightforward notices that can be easily read and understood by claimants, VA is now routinely providing long, frequently convoluted, overly legalistic notices that do not meet the objective of the VCAA. It is clear to the Committee that there is abundant evidence supporting the need to change the current situation and strong support for doing so.
(Read the rest of the report here)
The VCAA letter is fairly new in that endless stream of junk mail that appears to be intentionally designed to obfuscate and confuse. This one, the VCAA, happens to have some significance attached though so read on.
Thom Stoddart is a veteran and former VA rater. He writes for The Veterans Voice when he's not busy assisting veterans with their claims. You may email Thom at <vetsvoice@blackfoot.net>
The following is provided courtesy of Thom and The Veterans Voice.
That Stupid VCAA Letter
By Thom Stoddert
You made a claim for benefits to the Veteran’s Benefit Administration and then you get a letter from them that makes no sense what so ever. You may be panicked, confused, frustrated, and/or angry. Do not feel alone, you just got a letter that the VA is required by law to send to all claimants with the purpose of helping the claim. It’s called a “VCAA letter”, sent in accordance with the Veterans Claims Assistance Act.
These letters are very general; intended to cover every possible situation and rarely address the recipient’s needs. They are supposed to give the veteran information to help in the claims process. However if you can not understand them, what good are they? Hopefully this month’s article will help when you get this piece of mail that is mandated by public law for the VA to send to you.
The VCAA letter starts off with identifying what you have claimed and gives a little VA law, after this it’s down hill. It asks for evidence you have already sent in. It almost always asks for your DD-214, which in 95% of the cases has already been sent, and they have already verified it. It then asks for you to provide documents that you wouldn’t have and doesn’t really pertain to your claim.
The letter asks you to identify all of the medical treatment that you have received and doesn’t specify for what. You are thinking; “I am submitting a claim for an increase in the rating percentage for my arthritic shoulder, but it seems they want the doctor’s address that treated my cold five years ago.”
I have seen letters asking a veteran for the names, SSN, and ages of all the children who live with him though he was just making a claim for an increase in the rating percentage of his left knee that he injured in the service thirty-five years before. So now where does a veteran begin to make sense of this?
First of all, take the VCAA letter only as seriously as it really pertains to you. If this is not your first claim with the VA, they already have a copy of your DD-214 that they have either received form you or was given to them by the Federal Records Repository. They will most likely have verified the accuracy of your character of discharge. So don’t worry about this request too much.
They may ask for additional personal information. If you already have filled out the VA form-526 completely then they have pretty much all the personal information they need from you. So if they ask for the divorce degree that you got from Mabel in 1951 and it really has nothing to do with your asthma claim; don’t worry about it. First of all, Mabel outlived husband number two and three and lives on the other coast; she doesn’t even know that you have asthma.
What is very important is providing all of the information (name, address, telephone, and times/dates) of the medical providers that have given you treatment for what ever you are claiming. The VA does need this info to support your claim. Unless all of your treatment was at a VA facility, the Regional Office will send you a “release of information” form for each of your previous doctors/clinics giving them permission to release your medical records. This is a time consuming legal requirement that can not be gotten around. So move fast, it is to your benefit.
The VA will make two attempts to get your private medical records. If the doctor/clinic does not comply, the VA will contact you asking you to obtain them and send them in to the Regional Office. If you get a letter like this, hustle, it is to your benefit. In the case of VA medical treatment, the Regional Office does not need your permission to obtain your medical records they can simply look them up on the computers.
Suggestion: when you make a claim with the VA, send in copies of the medical records that refer to your claim. Provide them with the names of the clinics/doctors that have treated you for the claimed condition. If you can get copies of the release form, fill them out and send them in with your claim. Write a letter explaining what you have done and why. In the end, you will have saved a lot of time and it may get your claim adjudicated faster because you have furnished much of the evidence needed for the claim development. Remember that 90% of the time used in determining a veteran’s claim is used in the evidence gathering phase.
Very important: if the VA sends you a second letter asking for a specific piece of information, comply quickly even by telephone or fax(though certified mail-return receipt requested is even better). Always include your full name, address and C-file number/social security number in every correspondence. Sending in information with no way to identify who it is from or who it is for, only fills the trash can. I mention it because it happens every day, and the vet later on goes around bitching that the VA lost his records.
In summary, when you get a VCAA letter, act fast on the requests that do pertain to you and don’t worry about the stuff that does not make sense. If you do make an error the VA will attempt to contact you again and resolve it. But do read the VCAA letter several times.
VHA Handbooks
VHA Directives
Vet Centers
VA Regulations
Veterans Health
Veterans Service Organizations (From the DVA Web Site)
Veterans Service Officers
Newspaper Article of Interest Regards VSO's
Claims and your VSO
Updated November 2nd 2009
(From my email...another example of why I push you to DIY. Nobody cares about your claim but you!)
Jim;
You know, a rope has two ends, if you sever a portion of that rope at either end it becomes shorter! Such is the trickery of the VA and its attempt at self preservation and reduction of the backlog. For this sort of thing to take place there has to be a side deal between the VBA and the advocasy. Keep your eyes and ears open, and follow your nose. Something is beginning to stink.
I am a strong veterans advocate. I have become aware of something sinister going on in the last few months. I refer veterans to our state VSOs for filing a 526 for initial claims, then I help in the development and perfection of the claim.
As never before and of late, I am seeing veterans turned away and discouraged from filing a claim, especially Vietnam era vets, in fact, they have all been Vietnam vets, "boots on the ground." The reasons given are, "you have no diagnosis of PTSD," and yes, I'll admit that we don't have the diagnosis yet, but we are working on it. They are calling it a frivolous claim.This vet had a CIB and two tours, "boots on the ground", Vietnam service and the CIB is clear on the 214.
In another case, the vet had a CIB, a purple Heart, Parachutist badge, Air Metal, Vietnam Service Medal W/ 2 Bronze Service stars, Bronze Star Medal w/ V Device, Vietnam Campaign Medal w/60 Device. His request was to file a claim for PTSD, he was also turned away, Reason, no diagnosis yet.
Another vet had an eighteen month tour of duty in Vietnam, the vet filed a claim in 2007 and was denied. The claim was for Diabetes and Multiple Myeloma, reason given, no diagnosis! I obtained the medical records and on his 2007 AO exam letter there it was, "You have diabetes and Multiple Myeloma!" I escorted the vet to his VSO. We were told by his VSO that,"OK we will ask for reconsideration, but your retro will only have an effective date of the diagnosis, not the date that the claim was filed!" There is another AO exam dated 2009. The explanation, "the AO letter is not a diagnosis, it is for the explicit purpose of your entry into the AO registry." The actual diagnosis according to the progress report of the actual exam and under the title, "Diagnosis," "Diabetes and Multiple Mylenoma!" What gives here? This veteran and his six year old son have been eating out of a garbage can for the last two years!
One more, The Vet served with the 101st ABN, one tour. Was granted 30% for PTSD. Denied retro effective date of date of original claim filed. The reason, "the effective date only goes back to the date of the actual diagnosis, not to the date that the claim was initally filed!
Reply;
This is one of a dozen or so similar reports I've received in recent weeks. I'm disturbed by the direction this is taking and the negative impact it's having on veterans.
I haven't yet been able to pinpoint the source of this call for inaction by VSOs but it's too widespread to be coincidence or a series of isolated incidents. Someone has put the word out and the word is spreading through the usual networks.
That word seems to be that if a veteran doesn't have a current diagnosis of a condition, he or she can't file for it. Vets are being told, particularly in the realm of filing for PTSD, that to file without a firm diagnosis is "frivolous" and that there may be punitive measures taken by VA for such filings. In many cases, that's the last the VSO will see of that individual. Veterans who suffer PTSD often have symptoms of paranoia and feelings of mistrust. If an authority figure counsels them that they may suffer the wrath of the VA, that veteran may shy away from filing and treatment.
I'm also aware that many veterans are being told that they aren't able to file for the condition of Ischemic Heart Disease. Once again, some are told that without a firm diagnosis in their medical record VA won't accept the application for benefits and others have been told that "VA isn't ready yet" to accept such applications.
Let's set the record straight right now. Any veteran may file for any condition at any time. Once the claim is filed, the veteran will be required to show evidence that there is a medical diagnosis consistent with the condition the veteran has claimed.
There is no restriction at all that will prevent a veteran from filing 1 or 100 conditions. Once filed, the veteran may not prevail for any number of reasons. Upon examining the application for benefits VA may summarily reject it as being totally without merit. I never recommend filing claims that are baseless. That wastes resources within our VA and they do that nicely without our help.
The VA does not have to be "ready" to accept your claim for ischemic heart disease. When the Secretary announced that ischemic heart disease would become a presumptive condition, he did not also announce the details of how that would be rated, etc. The lack of any guidelines has created confusion in the ranks. Many veterans and Veterans Service Officers and even VBA staffers don't yet have a grasp as to just what ischemic heart disease actually is.
Nonetheless, I recommend that if you are a Vietnam veteran and you have ever had symptoms of any sort of heart disease, file right away. Symptoms might be as subtle as shortness of breath on exertion, DMII, a stroke or TIA (mini-stroke), any degree of chest pain, a pacemaker or AICD, stents in your heart's arteries, congestive heart failure or difficulty walking short distances.
There is no waiting period required or even suggested by the Department of Veterans Affairs. General Shinseki invited you to file your claim for ischemic heart disease without any qualifying statements as to when or how. If the system needs time to sort out details about how they'll adjudicate these new cases, fine. While we wait for them to get their act together, our effective dates will be carved in stone.
The system only works when you file. Your effective date, the date that your benefits will be retroactive to, won't be set until you file. If you're waiting for a welcome mat to be set out along with some milk and freash baked cookies to greet you, you're going to be very disappointed. If you wait 6 months to file, you'll likely lose 6 months of retroactive benefits.
I have to point out that you seem to have erred in the statement, "the effective date only goes back to the date of the actual diagnosis, not to the date that the claim was initally filed".
Just so everyone is clear on this point...the effective date of your claim is the date that it is received at your VA Regional Office. It is not the date of the diagnosis of your condition. For example, if the Vietnam veteran is diagnosed with DMII in May of 2007 but waits until July of 2009 to file a claim for the benefit, the effective date of his claim is July 2009.
There are some few circumstances that may impact the effective date but in most routine applications for benefits, unless you file, you haven't made a claim and if you haven't made a claim, you don't have any effective date.
The bottom line: If you or anyone you know have been informed that you must have a firm diagnosis of a condition prior to filing a claim, you have been seriously misinformed. If you or any of your brothers and sisters have been turned away and not allowed to file your claim for ischemic heart disease, the person who turned you away has committed a grievous error.
If you're aware of any of the above shenanigans by a VSO, please take a moment to let me know. We need to bring this to a screeching halt asap.
Veterans Service Officer Updated 10/20/2009
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