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Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities. Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Tuesday & Wednesday at 7AM Central.
Take control of your medical evidence related to your benefits and visit https://podcast.prestigeveteranmctx.info/veteran/ for more information and to connect directly with us!
Hey, guys. It's Leah V from Prestige Veteran Medical Consulting. I'm a US army veteran physician assistant and former compensation and pension examiner. So today, have Rebecca Deming from ProVet Legal on. For those of you who don't know her, she is a VA disability attorney out of Florida, and she's been on with us several times and drops tons of, like, great information on the veterans, the VBA and VA claims process.
Leah B:So for those of you who don't know her, Rebecca, would you mind introducing yourself?
Rebecca Demming:Sure. Thanks, Leah. Rebecca Deming. I run ProVet Legal, which is a law firm. We currently have four attorneys that specialize exclusively on VA disability claims and survivor benefit claims.
Rebecca Demming:And then obviously a support staff, to help us make sure we're gathering the evidence and, developing the cases to help you guys win your claims. So it's awesome to be here with you, Leah.
Leah B:Thanks for joining us. And for any veterans out there who would like to reach out to Rebecca with any questions, I'm gonna have her, website information in the comment section. I'm sorry. Not in the comments. In the information section of this video.
Leah B:So let's just jump right in because we wanna talk about changes, like updates, twenty twenty five year in review, just hot topics and what has happened in the VA claims process over the past year. So can you tell us, Rebecca, just what are some of the the biggest kinda changes and updates to the VA disability rating schedule that you have seen over the past year or so?
Rebecca Demming:So in 2024, VA did make some updates to the, the gastrointestinal set of disabilities. So GERD, is now very difficult to get a compensable rating because it used to be rated under hiatal hernia. And now when they're looking at GERD, they're looking at how many times you've had procedures to address, strictures in your esophagus, which I've had very few clients actually have that procedure, whereas it used to be rated just based on substernal arm pain and epigastric distress and, those kinds of heartburn symptoms and regurgitation and gas. Now it's really something that they're looking to see if you've had medical procedures, and not just medication to manage it. But IBS has gotten a little bit easier to get a higher rating on on IBS.
Rebecca Demming:So the GERD has gone down. IBS has gone up a little bit. It's a little bit of a a flip flop there. And, celiac disease is now a, is now officially in the rating schedule. It used to be rated by analogy, and they've added a code for that.
Rebecca Demming:So those were all in 2024. We have not seen any major changes in 2025 to the rating schedule. There've been some proposed changes. They initially thought those changes were gonna drop in April 2025. I think we actually did a a video around April kind of warning people that those, those changes were imminent.
Rebecca Demming:And they didn't drop in in April, then VA updated it, and they were saying they're estimated to to be implemented in August. And now the latest is that they're still somewhat expecting them to to be implemented by the 2025, but it seems a little bit more, I don't wanna say wishy washy, but, we're not gonna VA's not making any promises about when those changes are gonna be implemented. And those changes impact mental health. They impact sleep apnea. And I think there were some respiratory ones that were also potentially gonna be impacted.
Rebecca Demming:And we just don't know exactly, when they're gonna be updated, or if they're ever actually gonna implement the those updates to the schedule that have been proposed.
Leah B:Well, in tinnitus too, that was a big one too that's
Rebecca Demming:being proposed. Right? And
Leah B:as I recall, you mentioning about the gastrointestinal stuff from 2024, I'm pretty certain that GERD and IBS, one of the positive things for that is that they used to be, there used to be pyramiding for those. Right? And now they can be rated separately, and not be sort of having that overlap. Is is that accurate?
Rebecca Demming:Yes. Yeah. I I mean, so it used to be that VA said, oh, well, they both cause epigastric distress, which is basically bloating in in the stomach area. And so you can't have a rating for both GERD and and IBS. And to me, one is totally upper GI system and one is lower GI system, and I never really understood why they pyramided those, meaning that they would only give one rating for whichever one was higher.
Rebecca Demming:So now you can get separate ratings for them. But the flip side of that, like I mentioned, is that it's very difficult to get a compensable rating for GERD. So what we're seeing is people are getting a compensable rating for IBS, and now they're getting a separate rating for GERD, but it's a 0% rating as opposed to just getting the one rating for both, which from a money perspective is essentially the same thing. Right. Do you have the the esophageal strictures that you're getting treated regularly, then you would be able to potentially get compensable ratings for both.
Leah B:Sure. Sure. So, you know, has VA kinda moving moving on from that, has VA made the process faster or more veteran friendly in your opinion in the past over the past year?
Rebecca Demming:I do think stuff has been moving faster over the past year. I know that VA is implementing more artificial intelligence. So we're seeing decisions on supplemental claims sometimes within a matter of weeks where it used to be closer to six to eight months at a minimum for a supplemental claim, in most cases. So stuff is moving faster. They're leveraging that AI.
Rebecca Demming:But the flip side of that, of course, is that, I mean, we had errors when humans were doing it, but there's different types of errors when AI is is, looking at a claim. And so if you're not as precise about what conditions you're writing on your forms, it sometimes gets confused, and it's it's really looking for those one to one matches. So if you, had claimed degenerative disc disease and VA denies it, and now you're claiming a supplemental claim for back condition, I think a human would say, oh, back condition is the same as degenerative disc disease. Mhmm. And AI might look at that and just say, oh, they're two separate conditions.
Rebecca Demming:So I think there's still some, learning curve for the AI models that are to to get stuff, but it is speeding stuff up to a certain extent. Yeah. I mean Board the board is also moving faster. I know we'll probably do a whole separate one on talking about the board process, but in a lot of cases, we're seeing board decisions in one to two years, sometimes less than a year, even without advancement on the docket, which is when VA kind of fast tracks your your board case. So stuff is moving faster, and I think a lot of that has to do with, the implementation of AI.
Leah B:Sure. Are there any other digital tools, that you're aware of or portals for submitting claims that are making things easier for veterans?
Rebecca Demming:Yeah. I think the va.gov website allows veterans to upload stuff a lot. I don't know if it's easier in 2025 than it was in 2024, but I think more vets are taking advantage of using that that site, and you're just not risking that something's gonna get lost in the mail if you're mailing evidence to the evidence intake center at VA. There's also tracking tools on that va.gov, which will help track the status of the claim. I know our clients are you know, not only do we get the notification when a decision comes in and we can see it in in their, VA portal, but they're getting notifications about the different stages of where stuff is.
Rebecca Demming:The one caveat, I'll say that, you know, you get a notification if a decision comes in, and that's great. You know that something's happened. But knowing what the stages are, I think sometimes gives people a false sense that they understand where they are in the system because stuff can kinda go in circles in VA. So sometimes you'll make it in front of the rating officer. The rating officer looks at it and then says, oh, wait a minute.
Rebecca Demming:We actually need another opinion on this. And then it gets sent all the way back to get a new you know, you thought you were about to get a decision, but now you're getting scheduled for a new exam. And you're like, what the heck? It said that I was at this stage, and now I'm moving back. And it just kind of as stuff goes through and has more and more eyes on it, those raters will look at it, and they have the duty to assist.
Rebecca Demming:And so if they think that there's evidence that's missing, they'll kick it back. And so you you could kind of, like, shoot some ladders. Like, you think you're moving forward, and then all of a sudden, you're back in evidence develop evidence development again.
Leah B:Sure. Sure. And I've I've heard that a lot from, just from you guys, from different attorneys, and from veterans that they kind of those emotions kinda go up and down because they can, you know, in a day, be in evidence gathering to the next stage, to the next stage, and then back down, and, that can be, I'm sure, frustrating.
Rebecca Demming:Yeah. It you know, it's frustrating for us as the representatives because we have our systems in place. We check multiple times a day. We're checking VA's internal system where we see everything that's every new documents that's been uploaded for our clients. And if VA is sending our clients the push notification, you know, they might get something at 3PM, and we were gonna pull it at 4PM.
Rebecca Demming:And, you know, they're saying, what's going on in my case? And we even haven't even had a chance to get in there and review it. You know, I might have been in a meeting with another client or on here filming with you, Leah, or, you know, something else. And we move pretty quickly, but those push notifications, I think, are going out, like, the second that a new decision drops and and then the clients expect us to have instantaneously read and processed the the decision. So as much as we want our clients to get information quickly, it it can be frustrating from our perspective too because we need time to review and process it.
Leah B:Sure. Are there so I know PACTAC changed a lot of things over the past, you know, few years or whatever. Are there any new presumptive conditions that were added in 2025 that you wanna speak on?
Rebecca Demming:There were no new presumptive conditions added in 2025, but what has happened with the PACT Act is it's a little bit of a pendulum. And so the PACT Act created not only a list of presumptive conditions, but it kinda heightened VA's duty to assist in developing memorandums about toxic exposure risk activity. So you may have seen a terror memo in your file or heard the term terror memo. It's toxic exposure risk activity. And so for a while when when PACT Act came out, VA was just like, everything's TERRA.
Rebecca Demming:And so, you know, you'd you'd file for mental health and osteoarthritis in your knee, and VA would develop to see whether the burn pits were a tear exposure that caused your knee injury. And you're like, no. I was a parachute jumper and, you know, paratrooper and injured my knee. Mhmm. Jumping out of airplanes and, you know, has nothing to do with the burn pits, but VA would get an opinion.
Rebecca Demming:And then it would just confuse the system because you'd have a negative terror memo in your system about your knee and VA would deny based on that, and they wouldn't love it the right thing. So terror, even though it was, like, really helpful, it kind of causes overdevelopment in this nonsensical area. And I think in 2025, VA finally kinda calmed down on that. And so they're really only getting terror memos now on things that are likely related to toxic exposure risk activity. So toxic exposure risk activity could be radiation.
Rebecca Demming:It could be agent orange. It could be burn pits. It could be other toxins, jet fuels, the firefighting foam, those kinds of things. And so VA is really only getting those terror memos now if the condition is something that's likely related to that, and they're sort of pulling away from getting a terror memo for every condition that someone's claiming, which is nice.
Leah B:Sure. From from a CMP standpoint, have you noticed anything from a compensation and pension standpoint that there has, been any changes for the better or worse one way or another for your clients?
Rebecca Demming:I think the notification of C and P exams has gotten a little bit better. The the vendors that they're using are a little bit better. We're seeing fewer of the exams going through the VA system itself. I think audiology often goes through VA. Sometimes mental health goes through VA.
Rebecca Demming:But for the most of for the bulk of the other conditions, they're going to the third party contractors. And it's, I'd say the notification is about the same. The quality of the opinions the notification has gotten better, but the quality of the opinions is is about the same with the same kind of number of errors and and, lack of of thinking. Some some of the examiners are wonderful. I don't wanna throw everyone under the bus.
Rebecca Demming:I know, Leah, you've done some C and P exams, and so there are some really good examiners out there that look out for the veterans. Obviously, we're working on the appeals. So Sure. We ended seeing, some of the more frustrating ones.
Leah B:Sure. Now when you talk about notifications, are we talking about like, I've I've heard it echoed throughout veteran communities for years, just the, hey. Such and such CMP company called me, didn't leave a voice mail, and then the next thing I hear is that, you know, my claim was canceled because I didn't schedule an exam. Is that the kind of notification you're talking about? Is that they're getting better about following you know, making sure that they're connecting with the veterans?
Rebecca Demming:Well, since they are getting better at making sure they're connecting with the veterans, I mean, I think a lot in the past, we we would hear those stories about those companies calling it 4AM and then being like, oh, we didn't get through to them. I guess they can't come. And now they really are connecting. It is still an issue. You know?
Rebecca Demming:Always tell my clients, if you can make the exam, don't try to reschedule it because it's they're only allowed to reschedule, I think, once before they have to kick it back to VA, and then you're dealing with VA to re request the exam. And you could add months of delay when it might have been as easy as just rescheduling a meeting to be able to show up at that exam in the first place. So it it is still a pain if you're trying to reschedule stuff, but I'm not seeing as many kind of missed notifications or the exam company, trying to reach the veteran and not getting through to them as as we were even just a few years ago.
Leah B:Sure. So sort of wrapping up on this topic, do you do you think that there are, any changes that we haven't touched on or final thoughts that, you know, you wanna go over for veterans just regarding the process in the future?
Rebecca Demming:I would say with the if you have a claim for tinnitus or sleep apnea, which are the ones that are potentially gonna have negative changes in the works, I would work on getting your claim submitted as soon as possible so you can be grandfathered in under the current regulations. The mental health one is supposed to, be more favorable and and help veterans get higher ratings. I I've had people ask me, should I wait until those ratings come out to file a new claim? And, I mean, that might be something it's definitely a case by case situation depending on what their symptoms are. But if you think you're underrated, I a lot of times, I would just say go ahead and file for an increased rating on on something or go ahead and file now.
Rebecca Demming:And then if the new, rating code comes into effect and gives you a more favorable rating, then you you get, the benefit of whatever's more favorable, either your grandfather didn't under the more favorable one, or if the new code is is more favorable, you get that benefit. So there's no reason to wait for it. And for the ones that are potentially gonna be decreasing the ratings, I'd go ahead and get those in as soon as possible even though they may never drop. But, you know, we we're being told that it should hit by the end of the year, so I'd go ahead and get those those in. And then final thought, I guess, is just that it's kind of a constantly evolving process.
Rebecca Demming:They're always trying to update their systems. They're adding new AI. They're changing the way they train people. They're changing their contracts for the C and P exam companies. So the way it is now or the way it is when your buddy went through the the claims process may not be the same as, you know, the process that you go through in the coming year or in two years from now.
Rebecca Demming:So it just kind of in terms of wait times or in terms of how well the exam companies communicate with you or, how well they're using AI, how how quick stuff works, that kind of stuff. It's just kind of a constantly evolving, battlefield.
Leah B:Well, alright. Well, thank you so much for joining us as always today, Rebecca, and, I'm excited, to see your new podcast that that you're about to, get out there. So when is when is that coming on? When are you getting that started? 2026, or are you trying to get it out before the end of the year?
Rebecca Demming:No. We're we're hoping to launch in the January 2026. So we'll Okay. We'll have the exact launch date, for you soon.
Leah B:Okay. You guys, make sure you check that out. Check out Rebecca's website for she's got a great blog and some great information there as well. As always, thank you for joining us. And, you guys out there, if you have questions, please drop them in the comments, and we'll try to get a response to them, as soon as possible.
Leah B:And please like and subscribe. And, Rebecca, again, thank you for joining us today.
Rebecca Demming:Awesome. Thank you, Leah. Thank you, guys.
Leah B:See you guys later.