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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!
Guys. It's Leah Bee from Prestige Veteran Medical Consulting. I'm a US Army veteran, physician assistant, and former compensation and pension examiner. Today I have Rebecca Deming from ProVet Legal on to kind of go over some really important topics about filing VA disability claims. So for those of you that don't know her, she's done a lot of great content with us and brings a wealth of knowledge to the table from the legal and administrative side of VA claims related matters.
Leah Bucholz:Rebecca, do you want to just give them a quick intro to who you are and your experience?
Rebecca Deming:Rebecca Deming, I own ProVet Legal. It's a law firm that specializes in helping veterans and their dependents access VA disability benefits. I am married to a Navy veteran and I spent about a decade, a little bit longer, working with military in different capacities overseas and in The U. S. So happy to be here supporting our veterans and helping you guys navigate this very complex system.
Leah Bucholz:Yeah. So let's just jump right in. So filing a disability claim can be super complex and confusing because there's different things that you can file for, whether it's an appeal or a new claim or an increase or whatever. There's different ways that you can file for a claim and so Rebecca is gonna try to make this a little bit easier to like take in and make it maybe less overwhelming for some of you guys because there are a lot of tools out there if you can access them and know where to access them that can kind of take this burden a little bit and make it a little bit lighter for you. So I think the first thing that we wanted to go over was about eligibility.
Leah Bucholz:So how can someone determine their eligibility for even filing a claim?
Rebecca Deming:So first of all, obviously you have to be a veteran and you have to have discharge that is other than dishonorable. So even sometimes an OTH and other than honorable discharge might qualify depending on the circumstances and VA will look into that. That's called a character of discharge determination. So if you have a general or an honorable discharge, you're good to go. Administrative discharge, if you have an other than honorable, there's going be some extra level of scrutiny, but it's not a total bar.
Rebecca Deming:If you have a dishonorable discharge, you want to try to find, I mean, you might, it might be a full bar, but if there's circumstances around that related to your PTSD or, misunderstandings with your command or, something else, there are attorneys who specialize in helping people get their discharge upgraded. So that might be worth spending some money on because the lifetime of benefits that you can get from accessing this if you're eligible is well worth the upfront investment.
Leah Bucholz:For sure.
Rebecca Deming:So that's the first thing. And then the second thing is you have to have a disability, which is really kind of any sort of medical condition for the most part. I mean, obviously there's exceptions to everything, but it doesn't have to be like an amputation or a serious head injury. It could be, but it could also be gastroesophageal reflux disorder, GERD, or migraines, or IBS, or arthritis. So you have to have a current disability.
Rebecca Deming:Know a lot of people say like, Oh, had COVID in the military, so therefore I should claim that now or something. I was exposed to something in the military, so I get an automatic claim. Have to have a current disability. The fact that something might develop later down the line doesn't entitle you to benefits. You don't have to have all of the proof.
Rebecca Deming:Some people are like, Well, I need to have everything lined up. It's like, no, you just kind of have to, you know, there's some companies out there that will tell you just throw everything against the wall and see what sticks. I think people should do some internal personal audit on do they have a disability and do they legitimately think that there's some reason why this might be connected to service? Could be wrong. You you don't have to be right on the first application, but, you know, if you were in a car accident last week, and you're trying to claim that your injuries from that car accident are related to your service ten years ago, like.
Rebecca Deming:That's not gonna pass the SNF test.
Leah Bucholz:Right, and everything's sort of in context. There's no black and white answer for everything. And I actually just did a video on this a few days ago, sort of unrelated, but you made me think of it, the presumptive within one year stuff. So people seem to think that if they were diagnosed with anything within one year, that's gonna automatically get service connected, and that's just not true. So for example, if I separated from service three months ago and I break my leg in a car accident tomorrow, that's clearly not related to service.
Leah Bucholz:Right? So, there's not not an always or never situation, and you have to really look into the context of that disability. Presumptive within one year has its own list anyways that I've got a video on if you'd like to go take a look at it. But not to get too far off track, but just as you were saying, Rebecca, everything has context. Right?
Rebecca Deming:Right. And if existing condition, like, those are usually not service connected unless they were aggravated during service. And so, yeah, like you said, there is nuance there. And so I don't think veterans need to get too bogged down in the weeds on, you know, is my claim going to win? I think you just have to have some kind of like, I put some thought into this and I think there's a decent chance that this was caused or aggravated by service and that I actually have a condition right now.
Rebecca Deming:You may not have a diagnosis, but you're having these symptoms. So like, you know, I haven't gone to the doctor yet, but my back hurts a whole lot. Like that may not be enough to win the claim, but that's enough to initiate a claim and kind of trigger VA to look into stuff for you sometimes.
Leah Bucholz:So what kind of supporting documentation do you think is important when you're getting ready to file a claim?
Rebecca Deming:So that's kind of a double edged sword. I mean, the more prepared that you can be the better. So if you have copies of your military personnel records, your medical, your service treatment records, your post service treatment records, those statements from buddies that something happened in service, your D-two 14, which would be part of your military personnel records. If you have all of that, you kind of want to pull together the key pieces that show that you're eligible, that you're a veteran with eligible service and an honorable or general discharge typically, and as much supporting evidence to show that something happened in service and that you have a current disability and the two are related. Like, that would be the kind of the gold standard, but I think people get bogged down by that standard and they don't know where to begin to find their DD214.
Rebecca Deming:And so filling out the form itself, you don't have to have the copy of your DD214. VA has a duty to go get that. And so if you give them your social security number and some of the information on the questions in the form, they'll go get that information for you. They'll also get your service treatment records, your military personnel records. They can also help you find personal private doctor records, but you have to flag those for VA.
Rebecca Deming:Like, they don't automatically know where you treated. But if you need help getting those records, I don't think that I think people get paralyzed by like, I don't even know where to begin to find all these records. And so they just don't start their claims. So if you have them, that's great. If you don't, don't worry too much about it.
Rebecca Deming:Start with just filling out the form and then if there's holes that VA can't find stuff, they'll let you know and then you can focus on getting those records that VA can't find.
Leah Bucholz:So I know we've done other videos before on the different types of appeals but today we're gonna kind of focus on those new claims. So we're talking about filing, when you're talking about filing a claim, whether you're doing it on behalf of a veteran or a veteran's doing it themselves, I guess it's important to determine what type of claim that they're gonna file because there are a few different ones. Can you touch on that a little bit?
Rebecca Deming:Sure. So there are a few different ones and it kind of depends on where you are. If you're still in service and you're within a few months of getting out, you can file a BDD claim, which is basically just giving VA a head start. Those are great because assuming your active duty, anything that gets diagnosed during active duty service time is almost automatically going to be connected. I mean, obviously there's some of those nuances, but it gives you a head start and helps kind of develop that evidence.
Rebecca Deming:If you've already gotten out of service, the question is, you filing your original claim, which is the very first claim that you've ever filed? Or are you filing if you filed a claim like maybe you filed initially for your knees and your back and then a couple years later you're like, oh I didn't realize I could file for sleep apnea and GERD and headaches. So that's a new claim. It's going be on the 526EZ, which we're going to go over, but it's not your very first original claim. For those, you don't have to kind of prove that you're a veteran again, you just have to prove the stuff related to those claims.
Rebecca Deming:Or do want do it as well, right? Then there's, you're filing, like let's say that you're already service connected for your knee, but your knee's gotten a lot worse in the past ten years, And so you want to file a new claim for an increased rating. You're still going use the 526EZ, the new claim form to file for that increased rating, which is different than if you're, you know, if you're appealing something and saying, I disagree with VA's rating on this because they missed that it's worse than it was. If VA got something wrong, you know, ten years ago, and you want to reopen it because you've got new evidence that shows that it's surface connected or that it's worse, then you're going to file it on a 20 dash nine ninety five, which is the supplemental claim form. And so it kind of feels like a new claim because you're reopening something, you're starting from scratch, but because it's previously been denied, it's a different form.
Rebecca Deming:And so sometimes people I think forget like, hey, you know, they got out, they filed a whole bunch of stuff. They don't remember what was granted, what was denied. And then ten years later, they're going to file for stuff again. And so they might put it on a 5.6EZ, the new claim form and be able to kick it back. And we see this a lot in veterans like, didn't, you know, why did I get this kicked back?
Rebecca Deming:It's because you had, you know, ten years ago you'd filed for headaches, you filed again for headaches. Can't put that on the new claim form, you have to put it on a supplemental claim form and you need new and relevant evidence. So a piece that VA was missing from the original denial.
Leah Bucholz:And I don't wanna go too far off on a tangent here, but I see and I hear, I mean, don't get involved in this, but I hear veterans often, maybe they filed a claim for sleep apnea related to burn pit exposure, right? And they get denied and then they say, oh, I'm gonna file it to my PTSD. And they think because they've changed the theory of the connection that they're gonna file another new claim, but that's not the case. Right, Rebecca? It's it doesn't matter if the reason or the rationale that you believe condition x is related to your service is now to something else.
Leah Bucholz:It's still not a new claim because
Rebecca Deming:Right. That would be a supplemental claim. So the new evidence there might be a new theory of service connection. So, you know, you originally thought it was from your TBI and now you think it's from your burn pits or whatever. So you're going to send in medical literature that shows that it's related to burn pits or you know, whatever it is.
Rebecca Deming:That's a new theory but it's not a new claim.
Leah Bucholz:Right. So what are the ways that, what are the methods that people can file new claims?
Rebecca Deming:So there's a few ways that you can go about filing a new claim. You can go into your VSO and in person they'll sit down with you and go through the paperwork and whether they'll kind of pull up the app online and walk you through it, or give you the paper and kind of make sure look over your work and make sure that you're doing it correctly. That is a great option for a lot of people, especially if this system just seems overwhelming. They don't charge anything. You should never pay somebody to help you with filing a new claim.
Rebecca Deming:VA actually prohibits people from charging money for filing for new claims. So if someone is charging you or if they're saying, I'm going get pushed into the back pay for filing a new claim, that's not ethical and you should look for somebody who will help you file the new claim for free. And the reason for that, at least right now, is that VA has a duty to assist Veterans. And there's times where VA gets gets it wrong and then you need to hire a professional to help you correct VA's errors and you're gonna pay for that, that's fine. If VA is doing their job and kind of doing all the legwork to help the veteran improve their case, and then there's some claims agency on the side that's getting paid.
Rebecca Deming:That's just not ethically correct. So, you can work with somebody, an accredited claims agent of to help you fill out your initial application. You can also do it online. There's an online form that, not even a form, it's kind of like an application or, you know, step by step. It'll walk you through and answer one question at a time and do drop down boxes and fill out the form that way.
Rebecca Deming:You can also go online and print out the form and I think we can walk through that and kind of answer some of the common questions about that form. And then if you print that out, can drop it off at the VSO's office, you can mail it in, you can fax it in. So you have a few different options, your kind of level of tech savvy and comfortability is, and how much help you kind of need filling it out. If you're more comfortable just doing it at 2AM in your pajamas on your bed, then the online version might be the best option for you.
Leah Bucholz:Yeah, so I'm gonna pull that up so veterans can see sort of where they can go to look at some of these options. Not only where they can go to the options, but a lot of what Rebecca and I have just discussed. Va.gov I think does an amazing job of having health documents that basically break down step by step what you need to do. It is so overwhelming, and I understand that. But, like, if you just use the resources and go and read it, it's actually pretty simple.
Leah Bucholz:So they break it down like what we call Barney style, right, for those of you old school people like me. So let me add this. So this is from va.gov. Okay? So this website is va.gov/disability/howto file a claim.
Leah Bucholz:If you just simply Google how to file a claim va.gov, right, it's gonna you're gonna it's gonna be one of your first things that pop up. Now a lot there's a lot of these agencies out there that try to use the keywords to get you sucked into their website. Just make sure it's a va.gov website that is showing you this information.
Rebecca Deming:Great. Thanks for pulling this up, Leah, because I think, you know, people can see this and, like, it depending on which landing page you hit on it might be a little bit different, but you're seeing the actual VA emblem. This is what VA sites look like.
Leah Bucholz:Yeah, and then you can even sign in like if you've got a va.gov account, you can sign in and, start your application, actually. So we're gonna go over the paper form, but I think it's really important for you to understand that this I'm not gonna read all this stuff, but just a lot of what we talked about, learning about eligibility, learning about different forms. There's a video here that VA has made on YouTube. I haven't checked it out, but it might be helpful. Evidence, like Rebecca mentioned.
Leah Bucholz:So the online option I have personally done because I'm a veteran, it is super straightforward. I know it can seem overwhelming to do it but they do a really good job of like step by step. It's not like 500 things on the same page. It's like here's step one and it asks you some basic questions. It's gonna be the same questions that are basically on the paper application, but don't be afraid to to use it.
Leah Bucholz:You can always hit pause on the application also. Once you start that intent to file, I think you have, like, three hundred and sixty five days or whatever to finish it. Right.
Rebecca Deming:Yeah. You don't have to you don't have to have everything lined up. You can kinda start the application and then be like, okay. And I'm gonna go gather my medical evidence or, think through stuff before I finish the application.
Leah Bucholz:Right. So I'm gonna pull up that form here so we can so there was a hyperlink to the paper form. Okay? And then it takes you here and it tells you when to use the form. It also gives you a link back to the online tool, but let's download this form.
Leah Bucholz:Hang on one second. Let me jump to Okay, I'm on the fifteenth page here. Alright. Okay. So Rebecca, I don't know if you wanna jump in and sort of talk about just some of these basic instructions.
Leah Bucholz:It's super important to go over.
Rebecca Deming:I'm not gonna read the instructions to people, but I think the first eight pages of the form are instructions and they have links to the sections that they reference. So some of it's general information that's kind of helpful and the difference between the different options, instructions on where to submit it. And then it's got specific instructions for the different sections on how to answer the questions or what they're really asking for in those questions. So, you know, it's eight pages of super small print, where to mail it, but it is divided up. You can kind of like reference back.
Rebecca Deming:I'd probably print that out. If you're working on the paper form, I'd print it out and put it to the side and then reference back. If you run into a section where you're like, how am I supposed to answer this? Do we really need that information?
Leah Bucholz:Spend like ten minutes, twenty minutes reading over those parts as necessary.
Rebecca Deming:And hopefully this video will sort of I'm not going to tell you not to read the instructions, but hopefully this video will answer a lot of the questions so that you can kind of get through reading those instructions a lot more quickly. So, the first question up at the top, now, upper right hand corner is for VA. So don't write anything where they tell you not to write stuff. Obviously. The first one is whether you're doing an FDC program standard claim process IDES or BDD, and that is described up in the instructions.
Rebecca Deming:IDES is when you're doing a medical board separation, you'll be instructed if that's the one for you. The program, like, were talking about is really great if you're still active duty, but you're getting ready to separate from service because they'll help you develop the evidence. I mean, there's nothing better than developing the evidence and sending you to medical exams while you're still in service because how can they say that's not connected unless it was preexisting. Most of the time you're going to want to click. If you're already out of service, most of the time you're going to want to click the fully developed Claim program that just means that.
Rebecca Deming:Either you'll send VA records or alert them to where they are. If you're the standard claim process, VA will kind of go out of its way a little bit more to help you collect your private medical records, but that's going to add a lot more time to the processing. Even if you don't have everything or you need VA's help getting certain things, the fully developed claim program typically is going to speed stuff up for you.
Leah Bucholz:Sure.
Rebecca Deming:Okay, then this is kind of your identifying information. It kind of goes without saying you do need to put your social security number on this page and then at the top of every page below. The one question that I think is really important to answer there is whether this is your first time filing a claim or not. Because it was your first time filing a claim, You're going to need to put more information in there because you're triggering. It's the first time you're triggering VA to go find your DD214, find your service treatment records, find your personnel records.
Rebecca Deming:And so they need a little bit more help locating that stuff. And so there's more questions down below that you're going to have to answer. If you've already filled out one of these forms for your first claim, and now you're filing claims for something else, you know, year or two later, it's okay to skip over some of the stuff because VA already has your branch of service and where you served and that kind of stuff. It's when I keep scrolling down. Change of address that's if you have changed your address, you want to add that in.
Rebecca Deming:If your first claim, then obviously that doesn't even apply. It's important to keep VA up to date on your address. There's that box at the top to enter your social security number. The homelessness section VA will process your claim more quickly if you are homeless or at risk of becoming homeless because of their commitment to make sure that all veterans have stable housing. So, you know, being at risk of homeless could be you're sleeping on a friend's couch or you don't have stable housing or whatnot.
Rebecca Deming:It doesn't have to mean like you're, you know, you're living in a homeless shelter, you know, on the streets. If you're not at risk of being homeless, you don't even have to click no to the top box. You can just skip over the section entirely. The next section is new. They've added this to the form since the PACT Act came into effect in 2022.
Rebecca Deming:I believe I just started seeing this in the past few months. Definitely within the past year that they've added this on, but this is because VA will presumptively link certain conditions to certain exposures, and even beyond presumptive, they'll go above and beyond to kind of look into whether on a facts found basis, certain toxins caused certain conditions. They want your help. They'll have your military personnel records, but they want your help identifying if you served in certain areas. And if you did what dates, the more specific you can be better.
Rebecca Deming:Think you have to be a 100, you know, you're like, oh, was it June or July of twenty seventeen that we deployed? Know, VA is not going to sit there and go, oh, you lied because you said July and was actually June. Do the best you can to fill this out, But I think with with everything here, you want to be honest, but I don't think trap. I think people get paralyzed because they can't find all the details. So they just kind of start and then stop.
Rebecca Deming:I wouldn't put a note in there say to the best of my knowledge or approximately 50 to this date, or leave the month empty and put the year or something if it was a while ago and you just don't remember. Have you been exposed to any of the following? If you think you have, I would click yes. Most people know they've been exposed to it to a certain extent. You may not know what was burning in the burn pit or which chemicals you were exposed to.
Rebecca Deming:But do your best to answer these because it will help VA do the extra development to get stuff connected.
Leah Bucholz:Yeah. And if there's if there's other things, they have a other block. Right? So if you have, you know, like,
Rebecca Deming:Fire fighting film, I think, isn't on there.
Leah Bucholz:Fast exposure or if maybe there's some paints or toxins, you know, paints or chemicals that you were using on a daily basis or different fuels or, you know, whatever. Right? You can indicate it there so that they know maybe they're gonna do that PERA exam and they know to, like, kind of address some of those things rather than just guess.
Rebecca Deming:Then they have that tiny box for those of you who had multiple deployments. You know, like, well, which one should I list? List your extra dates at the bottom. Okay. And then here they've got an example.
Rebecca Deming:This is getting into how to list your claims on there and they have examples. I don't know that it's an exact science. You list your condition and we'll talk a little bit about what to list as a condition. Then you list examples the exposure type and examples of how the disability is related to service. So here they have hearing loss, it was caused by noise, and then how was noise related to service?
Rebecca Deming:Well, they were heavy equipment operators in service. I went to the firing range in service then date of onset. And this is for most people is going be kind of a guess or a best estimate, especially for conditions that are progressive or gradual. It's not like you woke up one day and had ringing in your ears unless unless there was one incident where you woke up. But yeah, you want to kind of show when, when the condition began.
Rebecca Deming:So you're listing your current so you're listing your current disabilities and. And so these are, I have had this question asked before, like, I have to list all my disabilities? These are your disabilities that have not already been service connected. The new ones that you want me to consider on this claim form. If you're if you've already filled this out for most of your claims, and now you just want to add your knees, you don't have to list all your other conditions.
Rebecca Deming:This claim form is just for the new ones that you want to able to look at. So you're just going put your knees on here. You don't have to relist everything. In terms of how to describe your condition, you want to be both as specific as possible, but also cast as broad of a net as you can. So if you don't know exactly what's going on in your back, if you write back condition, that's enough to trigger VA to look at your back and is it intervertebral disc syndrome?
Rebecca Deming:Is it degenerative arthritis? Is it low back pain? Excuse me, low back strain? You know, it could be some combination of those. If you put low back pain VA is going to look at all of those and they might give you multiple ratings for, you know, depending on which part of your back is injured or whatever.
Rebecca Deming:The flip side is you want to try to direct VA. So if you know what's wrong with you, you want to direct VA to look at that thing. You're not, you know, if you know that you've got a herniated disc at. L4 L5 and that's the main thing that's wrong with your back and you've got medical records to support that, you may want to say herniated disc at L4 L5. Will sometimes I know you'd said it's not a separate claim if you have different theories of service connection for something.
Rebecca Deming:If there's space, I will sometimes list them on separate lines though on the same application form, just because that very clearly triggers VA to look at the different theories of service connections. They're not separate claims, but I'm asking VA to look at, was my sleep apnea caused by burn pits? Was my sleep apnea caused by obesity secondary to PTSD and my knees? Sleep apnea caused by just by PTSD and tinnitus? So each one that I don't know exactly what caused it, but I want to able to look at each one of those theories.
Rebecca Deming:I might list it, you know, three times here. You don't need to do that. I'm just trying to make. Make it as kind of simple for VA personnel to follow my train of thought as possible. VA does have a duty to assist, so if you write something on there in a confusing way they should get clarification or if you kind of cast too broad of a net they should do some exams to try to narrow it down and help you help figure out what exactly is wrong.
Rebecca Deming:You want to steer them in the right direction while giving them enough room to. To capture everything that's actually going on with you. And then you just you don't have a whole lot of space to write in here how something is related to service. So it's just a sentence or a few words of Agent Orange in Vietnam. Yeah.
Rebecca Deming:Noise exposure. On the range.
Leah Bucholz:Hurt me in 1994, you know, lifting a wall locker, whatever.
Rebecca Deming:Okay. So this part is if treatment began from 2005 to present, you do not need to provide the date. So if you're treating at a VA facility, VA has access to those. If you treated at a VA facility prior to 2005 and you want VA to try to access those records, you wanna to tip them off like, Oh yeah, I was treating at the Hampton VA in 1996. Okay.
Rebecca Deming:So you want to give them the dates or, you know, I don't have the dates. But again, you're trying to if they're doing record searches for you, you want to steer them in the right direction as much as possible. Okay, and this is the section if you've already on page 12. If you've already filled out an application, this is your second or third application for different conditions. I usually leave most of this blank.
Rebecca Deming:I probably would fill out the branch of service, but mean VA already has this. They've already gone and gotten your DD214. They already have a file open for you. So they don't need this information again. But like, like we talked earlier, should I get my DD214 before I file a claim?
Rebecca Deming:If you have it, that's great. If not, filling out this information is what's going to trigger VA to be able to put in those records requests to find your, your service information and your service treatment records. Okay, this section is kind of interesting the service retired pay and we won't go into detail on this right now, but we can definitely do another talk about the combat related special compensation and concurrent retirement disability pay. And I believe Congress is contemplating some new bills that would allow veterans under any circumstances to receive all of their retired pay and all of their VA disability. But as it stands right now, are some offsets under certain circumstances.
Rebecca Deming:So you want to fill this out honestly, because, and this is just your, your VA or your, DOD retirement pay or separation pay or severance pay. They're not asking you if have a pension from working at the fire department for twenty years after you got out of service, like, don't care about all of your assets. They're just trying to see if there's an offset between the DOD retirement pay and and VA disability pay.
Leah Bucholz:Sure. Is that Richard Sarrat? Is that one of the ones that are
Rebecca Deming:they're kinda looking at right now? Mhmm.
Leah Bucholz:Yeah. Pretty interesting. We won't go over it, but if you guys have time, go Google the Richard Star Act.
Rebecca Deming:Yeah. And if if you have the time to lobby for with your representatives on it or reach out to your representatives, mean, I personally think it's. It's BS that your retirement pay something you earn based on the amount of time that you spent in service and your rank and the service that you provide to this country. Your disability pay is to compensate you based on the amount of injury and disability that you succumbed during service or because of service. So to offset them, I just think is I think it's morally wrong, but obviously legally right now, it's still possible under certain circumstances.
Rebecca Deming:Okay, so this one, you just want to kind go through an answer. If you answer it incorrectly and VA overpays you, they can generate a debt and go after you for debt. And it could be a small amount each month. But if I've had situations where VA didn't realize they were overpaying someone and then ten or fifteen years later, they try to go back and collect it. Now we're talking $30,000 debt or something.
Rebecca Deming:You want to be honest with this stuff.
Leah Bucholz:Yeah. Especially if you are someone who received like a severance for, you know, maybe you got chaptered for out of the military for, you know, you took the chapter, I think it's chapter eight for pregnancy, right? You decided to get out because you wanna be a mom or maybe you got chaptered for whatever the reason, they're gonna in a lot of circumstances, they're gonna take that out of your earnings. Right? They're gonna recoup that money.
Leah Bucholz:Again, we won't get into that too much today, but that's sort of what that severance section is separation severance pay is about. Right?
Rebecca Deming:Yep. And then the next section is super important. You don't want VA mailing you paper checks, especially with the state of the U. S. Postal Service recently.
Rebecca Deming:And if start this claim, and then it takes two years between different appeals or whatever to get paid and by then you've moved. You don't want the mailing. I mean, they can mail you a paper check and I've had plenty of clients who receive paper checks and it's fine, but. It's much smoother if. The money gets deposited into your bank account automatically.
Rebecca Deming:Will say I've learned recently it actually has to be an FDIC insured bank. So I've had a handful of clients that bank with these, like, they're not really banks like Chime or like the online, like Venmo is their only form of banking, like these electronic payment things. And the U. S. Department of Treasury cannot deposit and VA through Department of Treasury cannot deposit money into a Chime account.
Rebecca Deming:So you actually have to have a bank account with a banking institution. That makes sense.
Leah Bucholz:So then just
Rebecca Deming:here's And then the here's where you sign and just look at it carefully. If you are the veteran sign where it says veteran's signature and date there, and then you don't need a witness unless you are incapable of signing. So if you, you know, if the veteran is paralyzed and can only sign or illiterate whatever, and can only sign with an X, then you need a witness. It's very rare that you're going need a witness for signing this. On the, if it's your very first, if your original claim, initial claim with VA, the veteran does have to sign it.
Rebecca Deming:After they filed one, if they file for new conditions down the line, then their representative can sign on their behalf. If you scroll down, there's other places for the or an attorney to sign. So you just want to make sure you actually have a wet signature. You don't want to type your signature in VA will frequently reject applications. They just if you just type in your name, You can do a drawn signature on the computer, but you actually do want to have something that looks like a signature on there.
Rebecca Deming:Then there's extra pages if you don't have enough disabilities on the first one. I will say, you you want to cast a broad net, you want to file for things that you actually have, but like all of the things that you actually have that could possibly be related to service. But you don't want to cast such a broad net that you're kind of logging the VA system and VA is trying to figure out, like, you know, they're sending you for 20 exams. I know there's in some circles, there's been bad guidance where they say, oh, well, if we're supposed to burn kits, you automatically have a claim. If you don't have a current disability, you don't have a claim right now.
Rebecca Deming:So you want to put some thought into this. I see this extra page with another 20 lines on it and it kind of makes my head spin like, if it's the first time you're filing a claim and you're very disabled, you might have 20 or 40 conditions because you might have three conditions on your right knee and three conditions on your left knee and multiple things related to respiratory and multiple things related to gastrointestinal and each joint might be messed up. Like there are some Veterans that legitimately have a lot of stuff. Just be mindful that listing 40 things on here is likely to delay the processing of the claim if they're not legitimate. So you wanna stick to the stuff that's that's got a legitimate reason that that could be service connected.
Leah Bucholz:Well, I have just a couple more questions for you. So that was the end of the application. I just have a couple more questions for you. So let's talk about so after that's filed, I think my next question was about C and P exams.
Rebecca Deming:Right? So, so VA has, like I said, VA has the duty to assist you. They're going to spend some time before they even schedule C and P exams. Going to spend some time pulling together your service treatment records, getting some whatever medical records, your VA records, if you're treating at a VA hospital. And then they'll look at it and they'll kind of see, is there enough here for us to trigger our duty to assist?
Rebecca Deming:And so if you list stuff and you have no records of anything happening in service, you didn't put anybody statements that anything happened in service, you don't have any records of a current diagnosis, you just put it on the form, it's not going to trigger VA's duty to assist and they're not going to send you to a C and P exam. But if there's kind of just enough there that, Hey, something happened in service or, I have a current diagnosis. I think it's related to service. VA will send you to a C and P exam and those are usually done through contracted examiners. I believe Leah, you're qualified as a C and P examiner for some of the companies, right?
Leah Bucholz:Yeah, so I previously worked for several of the exam companies and I think I don't wanna say a 100% of them are being contracted out now, but most of them are being contracted out. So, I've got a lot of videos on what happens in a C and P exam. So if you have a particular condition that you'd like to go, you know, the format is generally the same. They're gonna send you a packet in the mail, tell you about who your examiner is, the date and the time, you know, how long the person has been a C and P examiner, what their specialty is. And that's that's pretty much it.
Leah Bucholz:Then you just show up and they go through the DBQ with you, the the individualized disability benefit questionnaires for whatever that condition is. And then they submit that information back to VA so that the adjudicators can review that along with the rest of your evidence. Right?
Rebecca Deming:Yep. And we do get questions a lot like, do I have to go to the C and P exam? I mean, it's a nuanced question. You should probably talk to your VSO or representative, but if you're doing this on your own, it's important to understand that VA essentially, at least at the initial levels, they need some guidance on both. Is it service connected?
Rebecca Deming:And if it is, what, what are your symptoms in a way that aligns with how the rates it so they're going to need that. If you're you're just sending in your treatment notes and somebody letters or something, and then you say, I don't want to go to. A C and P exam because I don't trust VA or something. VA is going to deny that claim. Even if you have a nexus letter, very often if you don't have a disability benefit questionnaire that kind of says, yes, your range of motion was 45 degrees on this joint and 23 degrees in that direction or whatever, or you've got very frequent and prolonged migraines, productive of severe economic and adaptability, you know, like if those boxes aren't checked for VA, not, they might say, well, yeah, we think they have a condition because we see a diagnosis and we see that it's connected, but for all we know it's rated 0% because we don't have this disability benefit questionnaire.
Rebecca Deming:You really, in the very beginning, I'd say it's a rare circumstance and there are some veterans that will develop the stuff and kind of get those DBQs filled out and get the nexus letters and then just say, Hey, I don't want anyone else to look at this. But for the most part, it's usually good in the beginning to go to these exams. And if you get a bad examiner or you've got an issue, I'm sure we could do a whole another. You've done many on them on how to deal with the C and P exams. But in the beginning, yeah, you want to help VA help you get the evidence they need to do a grant.
Rebecca Deming:Then you're sort of narrowing down the issues that you might need to appeal on. So, you know, maybe they'll grant three out of five. Now you're just working on gathering evidence or gathering some legal theories on the final two conditions.
Leah Bucholz:So can you submit additional evidence while the claim is still open? Can a veteran do that?
Rebecca Deming:Yes, you can. And VA is required by law to review it depending on when you send it in. You know, examiner may not have time to see it. If you send it in after the exam was, or after the decision was written, before it was finalized, they may not have time to re review it and change the decision. But yeah, at any point that an exam that a claim is pending, can add in additional evidence and VA is supposed to consider it.
Leah Bucholz:So what happens after your C and P exam while you're waiting for your VA's decision?
Rebecca Deming:Deep breaths and meditation. It's VA and it's a bureaucratic system. And so it kind of your claim file gets bounced from kind of employee to employee with different checks and balances throughout. So, you know, you've got the initial, you file your claim. So initially they're going to gather the evidence and then they're going to determine whether there's enough to send you to a C and P exam.
Rebecca Deming:And then they're going to send you to the C and P exam. Then they're going to wait for that exam company or that examiner to upload the exam results into the system. They can review them to see if those exams meet their criteria or are adequate or if they need to send them back for any kind of revisions or additional questions. Once somebody signs off that those CMPs are adequate for rating purposes, then your claim gets marked as ready for decision, which means like VA's got all the evidence that it thinks it needs to make a decision. It may be a good decision or a bad decision.
Rebecca Deming:It doesn't mean they think they have everything they need to grant. It just means they've got enough to make a decision on it. Then that file gets put into kind of a queue to be assigned to a rating officer. That rating officer could look at the evidence and say, actually we need, you know, additional clarification on this exam that could kind of re trigger something to go back. So it's hard from the outside to know like how long something's going to take, But there are different stages and I think people will see that or, you know, the stuff that we see on our end on the veteran benefit management system as a representative is a little bit different than the veteran facing portals.
Rebecca Deming:And so sometimes you're like, my claim file's on the reviewer's desk. Like, well, you don't know which reviewer or how long they have to review that file or which pieces they're looking at. So it could be that they're making a decision that day. It could be that it's gonna be another couple months. It's really hard to kind of predict exactly where you are in the system after you have that exam.
Leah Bucholz:Yeah, it's just so variable. So from my perspective, which is a little bit different, know, va.gov, I think you and I looked at it earlier said that their average turnaround time on these claims is a hundred and thirty five days right now. That's for new claims. I don't know about for supplemental claims or different appeals, but, you know, and that's information you can look at on va.gov, but that doesn't mean you know, I've seen people get their claims approved in a week. Right?
Leah Bucholz:I've seen, you know, exactly if they're I think they're testing out this AI and these these different automated systems to, like I think those are more so for, increases than necessarily brand new claims, which an increase can be a new claim essentially, but not a new new claim. It's a new anyways, I'm going down rabbit hole there. But I've also seen where from the examiner standpoint, like, you know, maybe somebody in my office did an exam on somebody. They submitted it, and quality control sent it you know, went to VA, and VA said, oh, there's an issue with this. Send it back to the examiner.
Leah Bucholz:So maybe the rater had it. And like you said, they said, oh, this is not, sufficient, you know, for rating purposes. We need to ask an additional question. So they send it back to the examiner. Maybe the examiner's on vacation.
Leah Bucholz:Maybe the examiner quit. Maybe the examiner died. And then guess what? They're probably gonna have to order a whole brand new exam because they can't get clarification on the exam, you know, or perhaps they send it to a third examiner or a second examiner to review what the first one did. So there's so many what ifs that it's like Yeah.
Rebecca Deming:And the question could be did the examiner not answer the question right or was the question written so poorly that no one in their right mind could ever answer that question in a way that would give any kind of clarity on the claim? So they have to rewrite the exam request and then have someone answer that different exam request. So there's a lot of bureaucracy and I think people kind of want the simple answer, like, you know, from start to finish, how long is it going to take? And, you know, VA estimates one hundred and thirty five days, you know, like you said, like, I had another client who was their claim was incorrectly flagged for terminal illness. And so they decided that it was an appeal, but they decided it in like a couple of days.
Rebecca Deming:She's like, you're amazing. You move so fast. I'm like, you know, VA thinks you're terminally ill. And she's like, Am I? I'm like, No, it's just somebody clicked the wrong box.
Rebecca Deming:I mean, not that I know of, you know. But for whatever reason that one got moved really quickly. And then there's others that you're like, this should be really simple, like I've got all the evidence and it's just sitting on someone's desk and they're not clicking the next box to move it to the next stage or you know they're taking the full amount of time before they move it to the next stage. Or something needs to be reviewed. Yeah, there's just so many reasons why stuff could take longer that's really outside our control.
Leah Bucholz:All right, so I just have a couple more questions for you before we wrap up. So once you, so you're waiting for that decision and then you finally receive a decision. So what happens after you receive the decision or how do you receive it?
Rebecca Deming:So you'll receive the decision in the mail. If you're working with a VSO, they might get an electronic copy and be able to tell you before you receive it in the mail. And if you're monitoring it online, I think you have some access to information, but I don't think you have the full rationale on why something was granted or why it was denied or, you know, so you're waiting until you get that decision in the mail. And then you have a year from the date of that decision typically to file an appeal. So if you think that they denied something that they should have granted, or if they rated something, but they rated it too low, you want to look at the reasons why they denied it.
Rebecca Deming:You don't want to just refile. At that point, that'd be a good time to, if you're not already working with a VSO, Accredited Claims Agent or an Accredited VA Attorney, it might be a good time to reach out to somebody because you're not just throwing something like, Oh, that didn't work. Let me try again. You want to kind of look at what was wrong. Was I missing something that VA needed or was VA just stupid or was the examiner?
Rebecca Deming:And you're not going get a copy of that exam. But an accredited claims agent or an accredited attorney will be able to see the C and P exam. And so we'll be able to see if there was something wrong in the way that that exam was written that might trigger a duty to assist error or we'll say, hey, at this point it really makes sense to get a private medical opinion and so we'll send them to Leah or whoever the expert is that's best suited for that kind of opinion.
Leah Bucholz:Wouldn't it be wonderful if at some point VA starts putting claims related doc I mean, I know they started adding rating decision letters, which I think is really cool. But if they start putting like the C and P exams, I mean, course, if you had a C and P exam at the VA, that will likely be in your VA blue button medical records. But like those outside exams, if they start making those and they're accessible if you, you know, request your claims file, but it takes a while. Right?
Rebecca Deming:It takes a year and then by then you I mean, it often takes a year or more to get those claim files and you only have a year to appeal. So by the time you get access to those records, you've already had to make the strategic decision of what kind of appeal to file or whether to file an appeal. Yeah, I think they should be made available to veterans. I mean, I think that they're worded so poorly so often, and they're really confusing that I understand VA's concern that if we make these available in the way that they're currently formatted, it's just going to cause more confusion. So if you're going to access it, you should access it through someone who has more experience kind of understanding what this means and is this favorable and, you know, what but it's your information.
Rebecca Deming:So I think veterans should have access to it. Probably the the long term answer would be to make the forms less confusing and more understandable. Yeah.
Leah Bucholz:Do a better doing a better job, making sure that there aren't a bunch of inaccuracies and, mistakes. But again, like you mentioned earlier, it's like a bureaucratic system and it's just a challenge, but we're all working through it together. And I think VA is doing its best to try to make improvements for veterans. So I don't have any more questions for you. I hope this was informative for you guys out there watching.
Leah Bucholz:Maybe it can ease some of the stress and tension on doing these types of things. And if not, you know there are people out there, VSOs, like I mentioned earlier, I have a great video on how to access you know, va.gov search criteria for any kind of accredited claims agent, attorney or VSO. You can go watch my video on that or you can just jump over to va.gov and look for the accreditation search tool. Rebecca is an amazing attorney if you need help with appeals. You know, I'm gonna put her information in the comment sec or not the comments, in the description of this video, but it's ProVet legal.
Leah Bucholz:And if you haven't caught any of our other videos, you might wanna go and check some of those out, especially the one about when to hire a VA attorney. That's a really great video we did together. But outside of that, thank you so much for being here with us again today, Rebecca. It's always amazing when you're on, so thanks for your time.
Rebecca Deming:Yeah, thanks for having me, Leah. Yeah, like you said, hopefully this sort of was a soft dive into it and eases some of the anxiety about just the paralyzation of just getting started and so more people can kind of get started with the process and get the benefits you guys deserve.
Leah Bucholz:All right. Well, thanks again for watching guys. Please drop some comments and like subscribe and we'll talk to you guys later. Thanks.
Rebecca Deming:Thanks, bye.