R i g h t a r d i a: the Veteran's PTSD handbook

Monday, February 8, 2010

How to prevail in a VA Claim

by the Major

This article takes an unconventional view of the VA claim process and suggests many Veterans are using the wrong approach. Let's start off by describing how to fail in a VA claim.

Your doctor tells you you have a tumor in your right ear. The tumor is causing severe hearing loss and vertigo. You are certain that your exposure to X-ray equipment while you worked as an X-Ray technician in the Air Force caused the tumor.
You visit a Disabled Veteran Organization and talk to a service officer who assures you you will be declared disabled by the VA. You briefly fill out a VA Form 21-4138 and VA Form 21-526 with a copy of your DD Form 214.

Six months later you get a letter from the VA indicating sympathy for you condition but advising you that it is not service connected. You scratch your head and wonder where to go next.

The rest of the article describes how to appeal the denial. To avoid further denials, you must do a lot of homework.
First, you need a copy of your military health records before you even submit a claim. If you don't have a copy, you can request them through the VA regional Office (VARO). It may take several months to get them.
If you are working, consider your appeal to be a part time job. You should spend at least two or three weekends preparing for the appeal and may have to schedule appointments with your primary care physician and specialists.

Take ownership of the appeal. You will be disappointed if you think that overworked vet service officer will pull your appeal out of the fire.
If you are retired or unemployed, consider the VA appeal to be a full time job. If you need assistance from a veteran's organization, Rightardia suggests the local state veterans' service office. State veteran's service officers are often better trained and have more experience than some of the private organizations that help vets.
You need to have a good team of doctors, preferably these are people who have limited experience with the VA. Your doctor's, in particular, any specialists should be board certified. Most VA doctors are not board certified and some are not even licensed in the state. The VA even uses Physicians Assistants (PA) for Compensation and Pension (C&P) physicals.
Interview the doctors and find out if they are willing to help you with the claim. (If not, find another doctor.) Some may be under contract with the VA and may not want to assist. Other MDs may looks at the VA Disability process as something simply for the most needy Americans. There are, in fact, special procedures for people who are losing homes, totally disabled and are unemployed. This does not preclude someone in better circumstances from filing a a valid claim.
Take you military records to you doctor and have them perform a records review. Also ask them if they will write a letter in support of you claim. You can even draft the letter and email it or put it on a CD so the doctor can edit the letter. It may take several weeks before you get the letter back from the doctor. Most of the doctors will be happy to assist if you have a bona fide claim. Indicate in your letter to the VA that a records review was performed.
A valid claim is a key issue because one doctor The Major consulted with indicated that 80 per cent of the VA claims are fraudulent. If you are one of these fraudsters, don't waste your time. You cannot makes a silk purse out of a sow's ear with the VA. Don't waste your time or the government's time if you know your claim is bogus.
Distinguish between primary and secondary conditions. Suppose your doctor has identified an acoustic neuroma during an MRI that is affecting you hearing. The acoustic neuroma is the primary condition. The hearing loss in the secondary. In this example, you may need a letter both from an oncologist about the acoustic neuroma and another letter from an Otolaryngologist that explains the extent of you hearing loss.
Also take a close looks at Veterans Benefits Administration References such as the Web Automated Reference Material System (WARMS) 38 CFR - Book C, Schedule for Rating Disabilities at http://www.warms.vba.va.gov/bookc.html

click graphic to enlarge

Saturday, August 29, 2009

Books on winning a VA disability appeal

Rightardia comment: The Major just successfully completed a long ordeal with the VA that began in the 1990s. He met with veteran's organizations and two congressmen and no one told him about any of these books. He got some of his information from the Internet and some other guidance from certain Veterans' Service Officers (VSO). Some of the VSOs have been chastised for doing too good of a job. Most of the VSO's seem to move on after two to three years.

Maj. John D. Roche, USAF (Ret.), served as a bomber pilot, had combat duty in the Korean and Vietnam Wars, and held a variety of administrative assignments. He later worked for sixteen years as a claims adjudicator specialist for the Veterans Administration and as a Veterans’ Service Officer for Pinellas County, Florida, where he was a tireless advocate for veterans and their families.

Roche enjoyed one of the highest rates of wins on appeal in the state. The Claim Denied book is based on his experience as a successful practitioner, many years of independent research, and personal consultations with some 80,000 veterans, widows, and dependents. Roche is also the author of The Veteran’s Survival Guide, Second Edition (Potomac Books, 2006) and The Veteran’s PTSD Handbook (Potomac Books, 2007). He lives in Palm Harbor, Florida.

The Veteran's Survival Guide, Second Edition and Claim Denied are considered bibles for former soldiers who have applied for VA Disabilities.

He has also written a third book on Post Traumatic Stress Disorder that has affected many veterans returning form the Iraq and Afghanistan Wars. Also, check the following link for a guide on his major recomendations in filing a claim with the VA: 10_Veteran_Rules_to_Follow.pdf