Veteran Affairs Disability Claims

Veteran Affairs Disability Claims (2)

Articles written to help you understand disabled veteran disability claims in Orangeburg South Carolina. 

A part of my practice I love is assisting Veterans with the VA claims process.  I spent over 30 years as an Infantry Officer, and cherish my time with those who write that check to Uncle Sam: “Up to and including my life”.  Only around one in twenty Americans are veterans today, so veterans should feel proud of their service, whether for a few years or a few decades, America is safe because of you.  I enjoy being able to help veterans through the compensation claims process of the Veterans Administration.  Some of this article will be personal advice and some will be legal/administrative advice.

 

         First, a bit of personal advice which will transition into the legal. While on active duty or, if in a Reserve Component (National Guard or Reserves) during active duty or drill periods, it is critical to seek medical attention and keep records when injured. When later making VA claims, the first step in the process for VA claims officers is making the “service connection” for the injury.  This means that not only must they find proof of the personal injury, but then proof the personal injury occurred on active duty (including active duty for training or reserve component drill periods). Note that the VA will receive database information about the veteran’s service, but may not have evidence of certain time periods on active duty.  For example, a Senior ROTC Cadet injured while on active duty for training (training for commissioning) is covered by VA compensation.  When VA receives the database information years down the road when the veteran makes a claim, they may only have the DD 214 starting when the cadet became an officer. The veteran would need to show evidence of being on active duty when the injury occurred. Part of the evidence is the documented treatment of the injury, but also the evidence showing the veteran was on active duty.

 

        Second, when submitting the claim it’s important to gather whatever evidence is available of the injury occurring on active duty (or active duty for training or RC drill). It’s also critical to have all of the treatment records starting at the time of the injury, but going beyond into the time of making the claim.  The determination of a disability rating starts with the determination an injury occurred on active duty, but then goes to the effects of the injury on the veteran.  Issues like degradation of function (of injured body part) and restricted range of motion are generally determined by both records and VA (usually contracted) exams. The VA exam will usually be scheduled at some point after the claim, and the findings of that exam are critical. However, the prior medical records memorializing the injury (and effects of the injury) are equally critical.

 

        Third, be ready for either a denial or a substandard rating (based on what the veteran knows of the injury). That is absolutely not the end of the claims process.  The next step is a supplemental claim, though that is a claim in which the veteran presents information not already provided to the VA and requests that new information be considered.  Along with the Supplemental claim, the veteran should consider a sworn statement (form 4138) in which the veteran explains the evidence and offers his sworn statement as evidence.  This is where attorneys can assist.  If the supplemental claim is denied, and the justification of the denial does not comport with the evidence provided, the veteran can request a “Higher Level Review” of that claim.  The veteran can also request a higher level review on the denial of the original claim, but it’s usually best to submit a supplemental claim first, and at least include a sworn statement.

 

       Lastly, if the supplemental and/or higher level review is denied, the veteran can continue with new supplementals (if he has new information not known by the VA).  This is usually the point the veteran considers a true “appeal” versus supplemental claims or reviews.  This takes much more effort and time compared with the claims and reviews. A “Veterans Service Officer (VSO)” can help, but it’s good to consider an attorney. My recommendation is considering an attorney after the first claims denial, as the attorney can help prevent the aggravation involved with further denials and the need to make a formal appeal. 

 

        I end by giving a “Thank you for your service” to all veterans!

 

 

            After serving in the Army for over 30 years, about half active duty and half reserve component, and multiple deployments, I have become personally familiar with the Veteran Administration (VA) System since my retirement in December 2020.  I write this article as both a lawyer who practices some military law and also as a veteran who has learned nuances of the system through experience.  This article will be focused on the initial stages of making a claim for VA disability compensation and a supplemental claim in the event of a claim rejection or unsatisfactory disability rating.

 

           First, it’s important to start the VA disability claims process early.  Without going into details, it is most advantageous to submit the VA claim before retirement or non-retirement discharge from service. In that event, your claim is processed more rapidly and at a higher priority than otherwise. After leaving service, it is still important to act diligently with making a claim or claims.  If claims are made within a year of discharge (for this article, it is assumed the discharge is under honorable conditions), any disability compensation granted will be backdated to the time of discharge and payment will include backpay to that date. 

 

          In putting together the claim, it’s important to gather all potential evidence of the “service connection” of the claim and the seriousness of the disability. For an injury occurring during training or operations, the medical documents from the treatment of that injury are critical. It’s important that any injuries suffered while on active duty are memorialized by a visit to a military health care provider.  Ensure that the medical records include the service connection of the injury. For example: “SM appeared for treatment for a twisted knee incurred during a parachute landing fall while on field training”.  In addition to the initial treatment and evaluation records, it’s important to show records of follow up evaluation and/or treatment. Recording witnesses to injury is recommended, as their statements to witnessing the injury can become necessary evidence. 

 

          The VA will review all documentation submitted, and pull records from various databases they have available (military records, potential medical insurance records, etc.).  They will assess each claim separately, so they may give a rating to one claim and deny another (for example, give a 10% rating for hearing loss, while denying an ankle injury).  The level of rating will determine the monthly compensation check which will be directly deposited into the veteran’s account.

 

        In the event a claim is denied or given a substandard rating for the level of injury, the veteran should consider immediately file a VA Form 20-0995, Decision Review Request: Supplemental Claim. The veteran has only one year to make this claim, and if successful in overturning a rejection or receiving a higher rating, the claim will backdate to the filing of the original claim (which backdates to discharge if the original claim is made within one year). In this claim process, the servicemember must provide new evidence not previously considered.  This is the time to scour records and documentation and potential witnesses who can provide statements to provide new information. In the case of one claim, the rejection was based on the grounds the serious injury was preexisting to an “initial enlistment physical”.  This was clearly incorrect, as the veteran had been injured at an Army School as a Cadet, and the physical referenced in the rejection was right before commissioning a year after the injury. The records of this person being injured as a Senior ROTC Cadet on Army orders (orders going beyond a month) were the critical documents that were not considered and the key to overturning the rejection.

 

       In future articles, I will write about higher appeals procedures.  It’s important to consider the help of an attorney with claims, as the lifetime effects of a claims decision go well beyond what would be paid to an attorney. That is particularly the case after a claims rejection.  Lastly, thank you for your service!

 

By Bill Connor

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