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VA CLAIMS FOR THE DO-IT-YOURSELFER, PART TWO --

More great advice from Veterans'

Advocate Jim Strickland.
 

 

 

Veterans' Advocate Jim Strickland provides regular columns for
VA Watchdog dot Org.

If you would like to contact Jim about his columns, you can email him here...

The archive of Jim's articles is here...

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Reading my daily email is always a pleasure. The majority of the stuff I get is positive. Some is inspirational and feeds my fire.

Mike Gayron of West Newbury, MA wrote a strong letter to me. Mike told me, “Like you I am thrilled with my VHA health care. DAV...did absolutely nothing for me except discourage me. I recently received a rating of 80% and I give no credit to anyone but myself. I went on the Internet and read every thing I could find about submitting claims and after my initial input I went to work gathering the data. I even went to the National Archives to get my unit information. By doing all that I could to submit a complete package I received my rating in 9 months. I am now waiting on the appeal and the IU rating. I did all this myself also. I have yet to find a VSO that knows as much as I do from my self education and would never recommend using one again.”

Michael Mulraney is a Marine wounded in Vietnam in 1967. Michael worked with his DAV rep but told me, “I...filed with the DAV as my VSO...(I controlled) my claim by using my fax machine. By doing this I had a record of everything I sent. All faxes were sent Sunday because in the past it was difficult to get through. Since 12/04 I have been reevaluated to 170% only because I took the bull by the horns. There is more to this story but the bottom line is I did the ground work and kept on top of my claim.”

I had a lot of mail from Vets like Mike who are choosing to obtain their benefits in a Do It Yourself mode. Mike is completing it alone, Michael worked successfully with his VSO by taking charge. I'll continue to develop the DIY approach in a stepwise fashion.

After you've submitted your application for disability benefits to your Department of Veterans Affairs Regional Office (VARO), you now wait for them to process your application. That wait may be as little as 6 weeks or it may be measured in months. If you have used registered mail, return receipt requested and you're confident that your application was received at the VARO, don't do anything until you have a reply. At this stage of the process, getting impatient and writing another letter to the VARO will lead to confusion.

If you have waited 90 days or so with no reply, call the VA at 1-800-827-1000. That number will connect you to a VA employee who will have some limited access to your file. They should be able to confirm that your benefits application was received and that it is in process. If they confirm that, you should continue to wait out the process. There is nothing to gain by trying to speed things up.

Sooner or later you'll receive information from the VARO that provides you with a confirmation that they are working on your claim. Your case will have been assigned a unique “C-File” number. This letter will spell out details of what they're working on. Read this over carefully to ensure that their definition of your claim is the same as you intended it to be.

The letter usually will go on to tell you that the VARO has included information to inform you of what the VARO will do for you, what you must do to help in the process and how long the process should take. There may be one or more attachments describing your rights and how to help yourself in winning your award. For the most part these are form letters and your VARO will probably include these in every mailing you receive from them.

This letter will have a segment of “What Do We Still Need From You?” This is usually the beginning of a more personal level of information that a VA Ratings Officer or other designated VA staffer wants you to send to them. For example, if you've filed for an award based on PTSD, the letter may request that you provide specific details of the event or events that you claim initiated your condition. There may be a very detailed questionnaire that you'll need to complete.

Much of the information requested at this time may be repetitive. If you've already provided the information they're requesting, don't scribble a note to the effect that you've already given them that, just give it again. This is a way that the VARO satisfies its “Duty To Assist”. They are giving you every opportunity to provide detailed evidence that will help you win that award.

It's been a few weeks since you filed and you've had a lot of time to think about it. If you're like most of us, you'll have thought of a dozen things you could have or should have submitted. Take advantage of this opportunity to review the evidence you've submitted earlier and provide supplemental information if you can.

A few items to check on are the names of treating professionals, dates of treatments, addresses where these people may be reached and so on. If you have been treated at a Vet Center for your PTSD, include as much detail as you can about when and where and who. To the extent that you can, provide details about any and all treatments you've had and include an accurate address for that facility.

Don't write that you were treated at Our Lady of Perpetual Pain Hospital in Texas in 1994. Take the time to search out a specific mailing address where VA may write to request your records. You may even call that hospital to ensure that your records will be available to VA. Many civilian hospitals today use contractors to manage medical records and medical records requests. Your hospital may have long ago archived your treatment records with a vendor in another state and that vendor may charge you to seek out, copy and mail that all important document.

The VARO will rarely go beyond a simple letter to the facility you provided requesting your records. If they don't get a reasonable reply in a short time, they may not pursue it any further. If you don't pay attention to these details, you may be missing some important evidence that you could have easily retrieved for yourself.

Often enough it's to your advantage to retrieve these records yourself and copy them on to your VARO. The VARO has a duty to assist you in getting your important civilian medical records. This duty to assist doesn't require them to make numerous telephone calls. If they hit resistance, they may not get the documents you need to win.

I'll remind you that you are trying to prove to another person that your claim has merit. The person who is looking at your claim really doesn't care if you get a high rating and years of retroactive pay or nothing at all. All he or she cares about is that the letter of the law has been followed. You must prove that your claim is valid. That person sitting at their desk reviewing your claim can't simply accept that you say that a thing happened or that your medical condition exists. Although the VARO is required to give you the benefit of the doubt in instances where a claim isn't clearly supported by evidence, it rarely works that way. After the initial application, this is your best opportunity to submit evidence and information leading to evidence.

Use this time wisely. This should be the last time you submit evidence to your VARO. There's no hurry now. When you filed that initial application, you set the date that your benefits will be retroactive to when your award is granted to you. You now have one year from the date of this letter from VARO to reply. Take some of that time to get this done right.

Consider providing statements from people who knew you at the time of your injury or who served with you. It's important to remember that these “Buddy Statements” always end with a signature along with the sentence, “I certify that the information I have given is true and correct to the best of my knowledge and belief.”

Have you provided the VARO with all of your pharmacy records? Have you had employment physicals that you should inform the VARO about? Have you ever been required to undergo a physical examination for insurance purposes or to obtain a license of some sort? Are there any police reports or an employer's “incident reports” that may provide evidence in support of your claim?

In most of these letters you'll find a “VCAA Notice Response” form. This refers to the Veterans Claims Assistance Act of 2000. Simply stated, the VCAA requires the VARO to notify the Veteran of all the evidence requirements to complete the claim and the responsibilities of the VARO and the Veteran. With this response form you are offered the opportunity to tell the VARO that you have not yet finished submitting evidence to them and you do not want them to adjudicate your claim until you have finished providing evidence.

Alternatively, you may tell your VARO you have provided them with everything you have and that you want them to adjudicate your claim as soon as possible.

If you've completed the required tasks to this juncture and you're satisfied that you've offered all the evidence that you're going to get, you should mail that form back and tell the VARO to move ahead with no further delay.

Even after you've mailed your VCAA Response, you may receive more requests for information from the VARO. You'll probably also receive notices that will tell you, “We're working on your claim. We're sorry for the delay.” If you've mailed in all your evidence and you've sent the VCAA Notice Response, don't do anything. There's rarely any particular pattern to these mailings, they're simply the VARO's way of fulfilling their Duty To Assist. Save those letters along with your other VARO paperwork and wait it out.

At this juncture you may also receive a notice that schedules you for a Compensation and Pension (C&P) exam. We've discussed the C & P exam in other articles and we'll address it again in the near future.

You may be a year or more into this now and it's natural to become impatient. You might feel that your claim is being ignored or that it's been lost. If you need reassuring, dial the 800 number I gave you earlier. Don't begin a letter writing campaign to the VARO telling them to hurry up or offering comments about their efficiency. Unless you are submitting “new and material” evidence to support your claim, every letter you write will slow your claim down.

This is no time to write to your Congressman. To be honest, I can't think of a good time to write your congressman about your VA benefits claim. I don't personally know of any instances where an inquiry by the Representative's office has had any substantial impact to resolving a routine claim. The fact is that it may delay your claim while your file is pulled out of the line for review. You'll get a form letter sent out by a Congressional Aide that tells you the VA is doing all it can.

If you've followed the instructions you've received from the VARO and you've filed your initial claim and now supplemented it with any additional evidence, you're done. Sit back and wait for that award you deserve.

Or the denial. We'll talk about that next.

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Larry Scott  --