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Frequently Asked Questions.
DESCRIPTION: I really don't know much about the VA claim process-can you explain it to me in a few short words? If I am a veteran and I have been hurt or I got sick in service, how do I start my claim? So let's say I file my claim, is that something I would need help with, where would I go to get help?
I really don't know much about the VA claim process-can you explain it to me in a few short words? Sure. The VA awards two basic kinds of benefits; disability compensation payable to any vet who has a service-connected disease or injury and pension, payable to veterans who served in war time who have a disease or injury that is not related to military service. There are two other kinds of benefits payable: dependency and indemnity compensation (DIC for short) payable to surviving spouses, dependent children or dependent parents when a vet dies from a service connected disease or injury, and section 1151 benefits payable whenever a vet is injured by bad VA medical treatment or is hurt in a vocational rehabilitation program sponsored by the VA.
If I am a veteran and I have been hurt or I got sick in service, how do I start my claim? You fill out a VA claim on standard form VA 21-526 and file it with one of the 58 VA regional offices in the United States and the Phillipines. A fill-in-the-blanks electronic Form 526 is available from the VA website, www.va.gov You can submit that form directly on line and it will be sent to the Regional Office nearest you. You can complete the form on a typewriter or in long-hand and mail it to the VA Regional Office nearest you.
How do I find out which Regional Office to send my claim to?
The VA website has a facilities locator map. Find the state you live in, click on your state, and the screen will display the name and address of the Regional Office in your state. It's that easy.
Can I file a claim over the phone? No.
So let's say I file my claim, is that something I would need help with, where would I go to get help? There are trained men and women working for various veterans organizations as National Veterans Service Officers at every Regional Office. For instance, at the Wilmington Regional Office, the American Legion, Disabled Veterans of America, Order of the Purple Heart, Paralyzed Veterans of America, Veterans of Foreign Wars and Viet Nam Veterans of America have veterans service officers with offices in the same building, 1601 Kirkwood Highway. You can make an appointment with one of these officers by phone or by coming in in person and "signing in" for an appointment. The Philadelphia and Pittsburgh Pennsylvania Regional Offices have the same arrangement.
In Delaware, the Delaware State Veterans Commission has county service officers who will help you with a claim, one for each of our three counties. Pennsylvania has more than sixty county veterans service officers, usually located in your county court house, who will help you with your claim.
So let's say I get a claim prepared with the help of one of these Veterans Service Officers-what happens next after I file my claim?
The Regional Office "develops" your claim-that means that VA employees are assigned to your claim to get your service records, your VA hospital treatment records, if any, and any records held by another federal agency, like Social Security Disability files. This takes anywhere from 90 days to more than a year. Once the VA has your records, or as much as can be found, another group of VA employees called Rating Specialists go over all the records to see if you have a disability that is service connected. Meanwhile, you will get a notice to go to the nearest VA hospital to get examined by a doctor to prove your claim.
Can I send in my own private doctor's records and letters and hospital records from private hospitals? Yes, you can and should put in all your medical records from private doctors and hospitals. Although the VA will try to obtain those records for you by mail if you sign a release form, your best bet is to get them all yourself because you are entitled a copy of all your health records under the Patient's Bill of Rights.
So let's say I get my private medical records and copy them for the VA, what happens then? The VA evaluates everything, your service records, VA records, your private records and makes a Rating Decision. You get a copy of the decision. If the decision gives you a disability rating that you believe is fair compensation for your health issues, that's the end. Your check will come at the end of the month.
Well, suppose I get turned down, what then? You should call us for help. At minimum, you need to send the Regional Office written notice of disagreement within one year of the date of your adverse rating decision. Now this doesn't have to be fancy-there are three required elements: You identify the rating decision you disagree with by date, you state you disagree with the decision, date and sign the notice. You don't have to use any prescribed form. In fact, a notice of disagreement written on toilet paper with lipstick is legally as valid as something prepared on expensive stationery in a law office, so long as it meets the three requirements.
What happens next? Usually, the Regional Office will send you a letter asking if you want a Decision Review Conference locally or a"normal appeal to the Washington-based Board of Veterans Appeals. When we take a case, we almost always ask for the Conference, because we can informally work with a senior rating specialist who can change the rating decision and it's an informal negotiating session. If you ask for a Conference and you don't get a fair shake, you still have the right to appeal to the Board of Veterans Appeals. What is the Board of Veterans Appeals anyhow? It's the VA's internal administrative review board. There are 56 Veterans Law Judges who hold hearings all over the US, either by traveling to a Regional Office for an in-person hearing, or by interactive video hook up with the Board's Washington office. The Board has the power to change a decision made by a Regional Office and send the case back to the Regional Office-that's called a remand order- to "get it right."
If your clinic or someone else represents me, what happens at our hearing? First, the Veterans Law Judge will describe the process and swear in all the people who will testify. Then your representative makes a short opening statement outlining what the evidence will prove. Your representative will ask you and all other witnesses questions to show the Judge what the true story of your claim is-you can also submit more papers, such as a new doctor's report, or a "buddy statement" from someone who knew you in the service and can verify that you were hurt, or in a particular place-the judge may have questions to put to the witnesses-and then your representative makes a closing argument. This takes about 30-45 minutes' time.
Does the judge tell you if you've won or lost? No. The judge makes a decision after the tape transcript is typed up and he or she studies the law and regulations. It takes anywhere from three months to a year after the hearing before you get your decision.
If I disagree with that decision is that the end? No. You can either ask the Chair of the Board to reconsider the decision or you can appeal to the Court of Appeals for Veterans Claims. You have 120 days' time from the date of your Board decision to do either one.
This is all too complicated for me- who can help me with all this, particularly with an appeal to the Court? That's what our program does-we take appeals not only from the Regional Office to the Board, but appeals from the Board to the Court of Appeals for Veterans Claims if the Board made an error of law or fact that the Court can undo.