VA Disability Appeals Process Explained
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- Опубліковано 20 тра 2020
- www.theveteran.coach
Disclaimer: The Veteran Coach and Patriot Consulting LLC are NOT an accredited agent, VSO, attorney, or entity recognized by the Department of Veterans Affairs (VA) and are not affiliated with the VA in any way. The Veteran Coach and Patriot Consulting LLC does NOT assist veterans with the preparation, presentation, and prosecution of VA disability claims for VA benefits. Veterans shall prepare and file their own claim or work with an accredited representative, many who offer services for FREE. Under no circumstances does The Veteran Coach or Patriot Consulting LLC provide medical or legal advice.
Hey Ms Laura
I really enjoy your presentation you're always very informative about everything. I would love for you to continue about the appeal process and preparedness from the informal conference calls. Always nice to view you videos. Hope you're not affected by the power outages but if you please take care of yourself and family as best you can. Praying for you and family 🙏
Your presentation was by far the best explained. Thank you much!
Your advice really helped me secure an appropriate rating after being initially denied. Thank you.
So glad, congratulations!
Thank you, very intelligent advice and beautiful to boot.
Your the best thank you!!!
Thank you sooo much for this informative video!!
You are so welcome! Thank you for the support :)
Excellent info in a short time period. Thank you!
Glad it was helpful!
Very good information. I my claim was just closed about a week ago. I claimed PTSD and many areas of pain, shoulders, back, knees and neck. Not to mention hearing loss. The only area that was not denied was PTSD. I received a 50% rating. one of my diagnoses was shoulder strain with IVDS and degenerative arthritis. I know this is a very common injury sustained from thousands of veterans. I have no medical evidence to support that any of my denied claims were service related because I was too stubborn to go to the doctor to have them checked out.
I feel lost and have been dealing with extreme anxiety since I received my claim status. I can’t even think about how I’m going to be able to win an appeal. Maybe your videos will help. I definitely hope they do. Thank you.
Operation Iraqi Freedom 2004
I’m in the same boat as you. Pretty much the same scenario. I received my rating a few days ago. Uphill battle but not gonna give up.
Oh forgot I have a Informal Conference tomorrow. Wish me luck. Will keep you posted on how it went
Thank you so much, that was very informative. You appear to really know your stuff. I was denied twice and sent in another supplemental appeal with a statement from my wife of 38 years who claims I've had problems with my left knee as long as she can remember. My ETS physical states a defect with my left knee and I sent in that paperwork and its still a fight. Their main disagreement is that it was not chronic but it was and was diagnosed while in service. Signed, Keep trying...
If you need a second set of eyes to review your decision letters and case, let us know! Stay in the fight!!
Thanks for getting back to me. I sent in my second Appeal with a statement from my wife saying I have been complaining about my knee ever since I got out of the service. I was diagnosed with a left knee defect while in the service and I still have to fight them. It is more likely than not my defect occurred while in service of 7 years.@@TheVeteranCoach
Good Info
Keep it coming!!
Thanks! Will do!
I never been rated by QTC at 100% by QTC for my right ankle and left knee and still they call the examiner to ask her to do a new report on January 14th when they do that
I got a 0% rating for a nasal fracture today. Would you suggest higher level review or supplemental ?
Thank you so much. I am upset at the VA and will be appealing, well my husband. My husband was granted 30 percent rating in 2009 for a heart condition. He just got denied and increase even though he is now on a Beta blocker that has been increased three times. HCM is one if the conditions out of five we were trying to get increase. He got a 0 rating in 2009. We file for increase, go 10 percent which didn't change pay. My husband is on three meds now for HBP. He was taken off one that cause severe pancreatitis. He got a 10 percent rating in 2009 for glaucoma in 2009. We file for increase and didn.t get any, even though he has two procedures done on his eyes. Recently he had a stint put in bother eyes that cause some issues. He got 0 percent for sinus, Rhinitis when my husband can't even get out of bed some days because of these issues. Also can you explain evidence of workload of 3.1-5.0 METS? I look for to hearing from you about what route to take.
Hey there! Just seeing your comment. Please send me an email at laura@theveteran.coach and we can see about setting up a quick consultation!
T/F
"IF, a disabled veteran ON SSDI,
(considered 'totally and permanently disabled'/ due to inability to attain and maintain employment mentioned)
applies for IU, effective date, based upon SSA findings (aged 49-56), should (meaning IS IT 'REQUIRED') THE VA 'automatically', use the SSA records OR is my 'current' VA representative 'negligent' for NOT insuring the SSA records were used or even 'mentioned' in the HLR process for -Compensation Issue"?
FYI folks (paying 33% of ANY compensation VA standard is 20% for direct payment to VA representative)
@t
(f) Presumptions and discharge.
(1) Fees which do not exceed 20 percent of any past-due benefits awarded as defined in paragraph (h)(3) of this section shall be presumed to be reasonable if the agent or attorney provided representation that continued through the date of the decision awarding benefits.
Fees which exceed 33 1/3 percent of any past-due benefits awarded shall be presumed to be unreasonable.
These presumptions may be rebutted through an examination of the factors in paragraph (e) of this section establishing that there is clear and convincing evidence that a fee which does not exceed 20 percent of any past-due benefits awarded is not reasonable or that a fee which exceeds 33 1/3 percent is reasonable in a specific circumstance
Since last October I went from 0 to 80 percent for 1151 Left Drop Foot. Three Supplemental Claims, Two Higher Level Reviews and BVA Appeal exceedingly Granted with no Representative. Who does that? It was a nightmare but they made some of the most blatant errors on each and every Claim and as a Marine I attacked. The BVA increased me from 60 percent to 80percent. Gave me SMC for loss of use and had the RO start a TDIU Claim that goes back to him for approval or denial. I'm currently 90 percent. It can get done with alot of stress involved.
Stay in the fight! If you have questions, feel free to comment here and I'll see if I can help. That last 10% is a b*$@#!
Yes it is.
great info! I just got 90% awarded and they left off several things. Looking for the fastest appeal as I have slam dunk to 100%. just don't want to wait forever! lol
Right now the Supplemental Claim lane is faster!
I got raided for 100% impairment however they still VA still insists that I go through a supplemental claim when I'm already rated at 100% IU for impairment of my left knee what course of action do I take in this
Great info and I just have a question. A little background, I EAS’d out of active service in March of 2015 and began my Va claims process before I left. In September of that same year I received my rating but some of the things I claimed were considered not service connected, I didn’t know I could appeal anything at the time. Now 2021, I have continued problems with some of the things they said weren’t serviced connected and after medications, physical therapies, x rays and mris they sent me to a doctor outside of the VA and he says I need surgery. Is there a way I can now appeal this finding since the doctor told me to possibly fix it I would need surgery?
You can always appeal! Since its been a few years, you will likely not receive back pay, but if you are able to get it service connected it would be a huge win and its never too late, especially since you have new evidence
and treatment history for your conditions. The big thing to get it "service connected" is showing the VA that the injury was more likely than not, or at least as likely as not, caused or aggravated by your service. Sometimes this requires a medical provider's opinion, or nexus letter, but sometimes with enough medical records and supporting documents its not necessary!
Good info. Bad echo
I'm sorry! I am working on getting some sound panels or a lapel mic to help with that!
I had a really bad HLR and denial of benefits. The representative even told me my cnp exam was incomplete but still denied me. Also, my ITF was ignored and they cheated me out of 1 year of back pay which just so happens to be the most owed. I HLR it and they denied it based off facts not associated with my claim 🤔😒 and I never spoke with anyone after requesting to speak with a representative.
Inwould recommend filing a supplemental claim, including a statement in support from yourself explaining the timienline and events. If you appeal your HLR with a supplemental within your 1 year, that original ITF date should still stand.
I file for dependency of my daughter going to college but they told me that the college was not a VA accredited school One year has passed How can I appeal list clear in mistakable error After the one-year mark
Hi , great explanation ,I have a question I have a service connected corneal scars I was granted .0 percent (I claimed as eye condition right eye ) should I have claim as a scar 7800 ? They also put down I dry eye syndrome, personally I a lot of deferent things wrong , I have photophobia , floaters,dry eye syndrome and more
Hi there! Scars can be rated specifically if they are painful, which it sounds like yours are, so I suggest filing for an increase to see if you are able to get a rating of 10% which would provide compensation! Most are rated off of size and pain, but I am unsure how they would "measure" a corneal scar but is certainly worth pursuing. If you have multiple issues with your eyes, you can claim them as secondaries. Ex. Dry eye syndrome secondary to corneal scars. If you have additional questions, please let me know!
On form 20-0995 Supplemental Claim- For #12, would compensation be the correct box to check for the appeal process?
Yes!
Questions. When you do a written HLR what should it consist of.
Unfortunately now the VA is considering Statements of Disagreement as new evidence, and then often convert your HLR into a Supplemental Claim. I have recently seen a huge shift towards supplemental claims versus HLRs due to missed informal conference calls leading to lost claims in the HLR route. I am planning to do an update video soon!
I submitted an increase for existing conditions but the VSO said “Left” and not right for not my knee and hip. They gave me 10% for both wrong sides, but missed a few things like arthritis in the hip and knee. Also, I have a torn meniscus in my knee that I found out recently but I have a medical record (MRI) from back when I was on active duty that shows the tear.
Which process for an error on existing things AND a new condition?
You can file an appeal such as a Supplemental Claim with your new evidence and medical records for the issues that they got wrong, and file new claims online for anything that has not previously been claimed.
I was denied plantar fasciitis because they could prove it was from my military. All my care is done at the VA. Should I appeal, see a private dr with my private health insurance get evaluated and if he/she feels its very possible have them write a letter? I can also write a support statement and my wife can write a statement about the pain and issues she sees?
Any way to connect the dots between your medical condition and your time in service is helpful and evidence for an appeal. Personal and buddy statements go a long, way, but sometimes an official "nexus" from a doctor is necessary. It all depends on your case specifically, so if you have additional questions feel free to reach out! laura@theveteran.coach
Does anyone know if you can do a supplemental claim lane, then after those results you can do a higher level review?
Absolutely! You cannot however do a higher level review to a higher level review.
I applied for a PTSD disability rating with PTSD statements AND Buddy Letters for 8+ stressor events. The VA ignored these and even though I had 4 VA Contract PTSD C&P Exams. I later discovered that 3 of those C&P exams were with the same evaluator who basically said I was lying and didn't have PTSD because it was not in combat and I was never given a medal. I am currently being treated (with medication) by the VA Durham Medical Center Mental Health Clinic (since 2017) but still have anxiety, nightmares, insomnia, depression, & suicidal thoughts (this Covid-19 & social unrest isn't helping either). I have been advised to call the White House VA Hotline but have not done that yet. What are my options?
I would 100% call the WH hotline and complain about your unfair treatment. There is no room in the VA for non-vet-friendly providers, its so sad! I would highly suggest getting an Independent Medical Opinion from a non-VA Doctor. We have a network of trusted Psych providers that we work with through VA Claims Insider if you are interested in going that route. That should provide you with additional ammunition to go forward with a new supplemental claim. We could also advise you on how to write a stellar personal statement to make sure you are sharing all the important details of your case so your voice may be heard. If you would like to sign up, please use the following link! www.vabenefitsexpert.com and we can set up a quick one-on-one strategy session!
@@TheVeteranCoach I am already signed up with VACI Elite & Mastermind and have a coach who advised me to call the WH VA Hotline. I had a VACI sponsored PTSD Exam from Dr. Swanholm 24 JUN 2019. My VA Contract PTSD C&P Examiner at first refused to even look at the 21-0960 form he gave me and then when she did she ragged on it telling me that it was not admissible as it was out of state and that his findings were all wrong.
So I originally filled for migraines on June 18, 2018, where it would backdate to my sets date since it was within the year when I filed. I never knew in the beginning that your appointments confirmations state which DBQ are to be asked about by the VA C & P examiner. I remember only being asked when my migraines first started and nothing more and then skipped to other claims. Even though I did not even know back in Feb 2019 when I received my 80% rating, that I got a 0% rating based on not being asked the appropriate questions but the examiner. I tried to complain about this but was told nothing can be done except file a Notice of Disagreement (NOD) which I did back in August 2019, which was within the one-year window. Even though I did another claim for migraines and have gotten my 100% since almost a year ago, they only backdated to my intent to file date which was Feb 2019 and not when I initially filled for migraines that would backdate it to when I got out in July 2017. I only found out this week that they no longer accepted NOD VA form 21-0958 since Feb 2019 so it was probably thrown out and I had been waiting for the decision. Is there still a way I can fight it because the C & P examiner never asked the questions about the frequency and severity of my migraines or how it effects me back in my c & p exam in Aug 2018. I know so much information but I only have 2 more days to file and was told about the new 3 options just yesterday.
I would call the VA White house Hotline number and see if they can adjust your effective date based on those issues. You now have 1 year from the date of a decision to fight these type of issues, but there is still a chance since there was an error on your case with your NOD. Here is the number. Comment back if you have other questions! 1-855-948-2311
Thanks Ma'am and thank Goodness for you,,, could you elaborate on how underrated certified combat veteran's should react to get a new look at multiple underrated service connected ( like 4 or more, all at 0-percent), could someone please help us Desert Stormers, I finally got health-care,,, after multiple attempts, being out for 30 years, yes, out since 1992, I just got va healthcare in 2022,, and I have had sufficient combat 🏅 since 1991🤔🤔🤔
Hey there!! Send me an email at laura@theveteran.coach I would love to help!
I know how to fight one! Believe that
I just wish the supplemental claim was as easy as the initial claim. Like I wish I could just do it all online instead of having to actually submit paperwork
You can do it online now! Direct upload option online for appeals
@@TheVeteranCoach where do you do that? Im looking on the VA website and it still says to file a supplemental claim it must be by mail or in person.
As to continue VA don't want to be wrong in their decision-making that they dropped the ball in 1995 when I got out with a medical discharge but Hocus Pocus is gone
Is the a "choose your path" kinda deal, or can I move from one to the other if outcomes aren't favorable?
You will have to wait until one appeal is complete and closed in order to open one again. One considers new evidence, and one does not. You con continuously appeal with new evidence and supplemental claims. However, you can not do a Higher Level Review after a Higher level review.
I have a question. What if your condition gets worse after your TDRL re examination?
You would need to submit a request for an increase. That's easy and can be done from va.gov :)
Hi. Just had my migraines secondary to ptsd denied 2x. I had my dbq & imo looked at by a senior ex va rater who said that my dbq & imo was not completed correctly & lack sufficient information. I still filed for HLR anyway. however, when the decision comes back ( good or bad) i will get another dbq & imo and make sure they are actionable and sufficient - do not like to waste funds. do you have any suggestions on completing the 0995 ?
If youd like an evaluation on your decision letter I can help tell you what was wrong with it exactly
Let me know!
Went to c&p for throat condition in reality hiata hernia/gerd should have been claim. Esophagus dbq needed not nose and throat. How to fix this?
You can do a supplemental claim with a statement explaining that you claimed it wrong originally. Example:
Claim: esophagus condition (previously claimed as throat condition)
I received a VA letter stating that I needed proof that I was in a deployment to Macedonia. I have a buddy letter from my treating army medic from Macedonia who wrote about the incident and I have on my DD214 that I received the United Nations Service Medal. Would a buddy letter from my platoon SGT and my team help?
This for a PTSD claim.
Thanks for your help, this stuff is tough to keep up with.especially when I lost everything
VA gave me their famous "Not service connected" for 10 things that I submitted for, eventhough they found "favorable" entries in my record. So tired of going back and forth.. Gave me an appt for 2 claims and then not service connected all 10 at once..
Let me help you! Favorable findings give you something to go off of! laura@theveteran.coach
I would love to help! Without seeing the decision letter, its hard to decide what their thought process was and how to appeal, but we can set up a quick call if you are interested! laura@theveteran.coach
Hello, when I separated from the army in 2008 I was told by the VA doctor that I didn't create enough paper trail for migraines and my left ankle. Well, I was a paratrooper in the 82nd and going to sick call was a no go. My claim was denied and only got 10% for tinnitus. Now, years later I realize I can appeal maybe get, at least migraines, service connected. What is my best option?
Thank you.
Just seeing this comment, hello! A supplemental claim is going to be your best option. You will want to build your case with personal statements, buddy letters if possible, maybe independent medical opinions depending on your specifics. There are many ways to build upon what you have, and some presumptive claims based on airborne status etc. Send me an email at laura@theveteran.coach if you have specific questions!
@@TheVeteranCoach Thanks a lot, I got in contact with a VA representative and he is going to file the paperwork for migraines secondary to my tinnitus. I got letters from friends from the army and my current job, stating that they have seen my suffer migraines. Thank you for your videos they help a lot!!!!
I just received my dads VA claim 18 years after he submitted it
My goodness! If he isn't satisfied with his results, or did not receive any backpay, let me know and I will see if I can give advice on how to move forward!
What if my Cue has been repetitively turned down;due to non compliance of the military branch in question not following the law. Thus causing the VA to not honer the enlistment contract regarding the disability-benefits due to the service member in question. It has been 35 years of constant denials of service connection until 2017. Then the VA just Miraculously granted my claim for service connection with the same original evidence, but, without the original pay deserved by that service member. Should he sue the Air Force, the Military entity in question, or the VA, or both, for the back Pay owed to that service member, Furthermore, that service member never received his out processing briefing describing his disabilities or how to apply for compensation for those disabilities. Moreover, those service acquired disabilities are not described on the SR-88 correctly !to be known as disabilities!!!
The appeals structure has changed, and in order to appeal for backpay it would have had to have been an appeal to the board rather than a CUE, supplemental claim or an HLR. What is the current status of your claims? Do you have any service connections at this time?
any good advice on ACE exam. i appealed my va rating.
Hey there! An ACE exam is a document review in place of an actual in-person or virtual C&P exam.
I had an initial intent to file on October 2018, submitted my claim on September 2019, got denied December 2019 and submitted a supplemental claim on April 2020. I never let the year pass so when I won my supplemental claim I only got backpay to December 2019, shouldn't it have been October 2018?
I would call the White House Hotline to see if you can get them to address the effective date. We have great success with that as a first line of defense for effective date issues. White House VA Hotline: 855-948-2311
Any way to contact u personally and have you do any of this for me? Would b so helpful . I am overwhelmed and need help. Thanks :)
laura@theveteran.coach
Can they lower your rating if you appeal and they disagree with what they previously rated you?
If you file an HLR they cannot reduce its only keep it the same or increase. With a supplemental, you usually initiate a new C&P exam and that "could" result in a reduction if you cant show that it's gotten worse.
Can I use a ptsd DBQ for my supplement claim
Yes. If it’s new and relevant evidence.
I was just denied a full 100% because they didn’t accept burn pit exposure for some reason. I don’t know how to support my claim
We could review your case and see if we can assist. Send an email to laura@theveteran.coach and we can get you started!
@@TheVeteranCoach I was never diagnosed and it sucks because I have constant build up of flem. I’m pretty sure that’s why though. I need help. I’ll send you everything. Thank you
I disputed the rating they gave me in 2017 and I have been in remand ever since. are these options still available to me?
If you filed your appeal with the BVA, you can request that it officially be pulled from the docket and then initiate an HLR or supplemental claim instead. HOWEVER, you would lose that backpay from 2017; Supplementsl and HLR appeals must be initiatef within 1 year of decison to qualify for backpay.
Can I bring Evidence to my va doctors appointment
Absolutely, you can always bring your evidence with you and reference them to stay on track if you get nervous or forgetful. The examiner should have everything you submitted with your claim, but it never hurts to bring an extra copy
What's are those degrees on the wall behind you?
Medical certifications and military schools :)
what if its been over a year can you still do high level review
Since it has been over a year, you will want to submit a supplemental claim with additional evidence. You won't get backpay to your original intent to file, but it's never too late to appeal!!
Hi, l submitted a VA claim, was denied and the one yr to file the appeal has passed. Through a coworker, I've been encouraged to resubmit the claim. Do l start from scratch?
It is never too late to appeal! You can always appeal with a Supplemental claim or HLR, even after the 1 year has lapsed, the only difference is you are not eligible for backpay outside of that time window.
Can i still apeal the va decision after 60 days because i was told that i cant so i would apprecaite it if you give anwser.
Its never too late to appeal! You have 1 year from your decision date to appeal and still receive back pay to your original intent to file date. If you go past that 1 year mark, you can still appeal; you just lose out on the opportunity for backpay.
Hello I have had a knee replacement do you have letters I can look at for my appeal. Thanks
Any nexus letters would be private medical information, but if you want to reach out via laura@theveteran.coach I can see what we can do to help!
I like the BVA process..have not lost one even on remanded I sill won..HLR in my view is a waste of time
Hi.. why hlr a waste of time?? Just wanted to know your opinion
@@jenniferrodriguez2661 very seldom you win and the VA merry-go-round you go and time passes by with you wait and suffer...if l m going to wait I had better luck at the BVA..buy it's a vets choice
Ohh wow!!! Fellow Few &proud here. Was stationed at 3rd MarDiv Oki. Is it true though if you do Board Of VA you can’t get another opinion once they give out their findings?? The other appeals you can… cause I’m definitely thinking about doing it your way hearing what your results were.
I need help with a honest nexus letter for a va claim could you give me someone to contact or talk to
Hey there! You can send direct messages via FaceBook at The Veteran Coach - Patriot Consulting LLC or at laura@theveteran.coach
Hello,
I submitted my appeal before the new ways came into play. That said, my appeal is stuck in the old school Veteran appeals board. After waiting over 3 years, my appeal is over 47,000 claims away from being seen by the judge. If I submit new evidence, will it push me back in line? Or would it allow me to move my appeal to one of the new ways?
Thank you,
Ron
Hello! You can request that your appeal be "pulled" from the old appeals system and then you can start over with a supplemental claim which only take a few months. HOWEVER, if you pull from the board, you will lose the potential for all of that backpay. 😬
Thank you. What if I submit new evidence? Would it be possible to move it up the list or get it prioritized?
Ron
You can add new evidence up until 48 hours before your case is seen, but unfortunately it doesn't help move you up the line.
The VA is slow, and people die waiting on their benefits. It's infuriating, but there are pros and cons to the old appeals system.
That's what I'm afraid of. I would like to see my benefits before I die. Thank you
Where do I sign up?
I was assaulted in the line of duty by two intoxicated soldiers from another unit which popped my eyeball out of my head requiring surgery to implant 2 plates in my eye and then my short Army career began to fall apart immediately after and was cut short by minor misconduct infractions that led to a general under honorable conditions discharge my life has been a continuous dumpster fire since this assault happened in 1999 and I was pushed out of the Army. All of this I formation is in my medical paperwork can you help?
How do I start the appeal process?
If you need some assistance on where to get started, check out some of my other videos or email me at laura@theveteran.coach
Are you saying you have doctors?
Hey there! I don't currently work with any medical teams, but there are many out there that are wonderful, and if you would like any recommendations I am happy to send you some information :)
@@TheVeteranCoach Sure.
Thank you also.
The audio is so hard to hear wish she would get a microphone
Most veterans hearing this will have hearing loss and the distant voice is hard to beat
So sorry, thank you for the feedback!
Hi there, I have been denied service-connection for IBS on January 2020. Now, I’m attempting to refile for IBS secondary to NSAIDs chronic use. Do I have to do a supplemental claim for that claim? Can it be done online?
Yes, a supplemental claim is in order. Supplemental claims can now be done online as of just recently!
Wow this is hard to hear need some sound deadening
Thanks for bearing with me!! This was my very first video, there is definitely a learning curve!
@@TheVeteranCoach thanks youngin.
Knee surgery and 0% Oorah….
Appeal appeal!
You're hot. Also your husband or boyfriend is cheating on you. Maybe both of them! But I'm here to console you😊. JK, great video. It's very beneficial.
Hello. Can you please let me know how to get in contact with you. Sorry I don't use Facebook. If you have email or website let me know. Thanks a lot.👍
Hey there! You can email at laura@theveteran.coach :)
@@TheVeteranCoach
Thanks Laura...
My email will be from D. H.
Rick is my nickname. Thx again🙂👍