Veterans Administration Claims
Have you received an answer from the veterans administration on your claim for disability benefits?
Were you denied benefits?
Do you believe you deserve a rating that is higher than the one you received?
Have you filed your notice of disagreement?
Mr. Culp is a VA accredited lawyer. If you would like Mr. Culp to review your case please contact him for an appointment. Before contacting Mr. Culp, please make sure you have your latest denial or most recent decision from the board of veterans appeals or the statement of the case or supplemental statement of the case from the regional office.
VA Claims Process
Under the veterans' benefits system a veteran, a veteran's dependents or a veteran's survivors can make claims for VA benefits. A claim must be in writing and signed by the claimant. It should specify what benefit the claimant wants and include the veteran’s social security number. Once a claim has been submitted, VA has a duty to make reasonable efforts to assist the clamant in getting evidence helpful to the claim. This is sometimes called the “duty to assist.” A claim should be submitted to the nearest Regional Office of the Department of Veterans Affairs.
Once a claim has been submitted to a Regional Office, the Regional Office is required to render a decision on the claim, called a “rating decision.” The claimant will receive a written notice of the decision from the Regional Office. This notification will inform the claimant that the claim has been granted or denied, and provide a brief explanation.
If a claim is denied, the claimant can appeal. Even if the claim is granted, the claimant may be entitled to even greater benefits – that is, more money and possibly additional health care – and can still appeal the decision. For example, if a veteran is granted service connection for a knee disability, but doesn’t agree with the percentage disability rating assigned, or the effective date of service connection, he can appeal the rating or the effective date or both. If a claimant wants to appeal a decision, he or she should file a Notice of Disagreement with the Regional Office. There is no required form for a Notice of Disagreement, but it must be in writing and express disagreement with the decision. It must be filed within one year of the rating decision, or the appeal will be closed.
After receipt of a Notice of Disagreement, the Regional Office must prepare a document called the Statement of the Case. A Statement of the Case should further explain to the claimant the reason for the adverse decision, but frequently it simply repeats the text of the rating decision. That does not mean that the Statement of Case is unimportant, because it should also provide notice to the claimant of the controlling laws and regulations the Regional Office used to support its decision. Even more importantly, the Statement of the Case will inform the claimant that in order to continue the appeal, the claimant must sign and submit a VA Form 9 to the Regional Office. This Form should be included in the mailing from the Regional Office with the Statement of the Case.
In order to ensure that the appeal survives and to maximize the chance that greater benefits will be awarded, the veteran must not only file a Notice of Disagreement, but also must timely file a VA Form 9. This is a critical. VA appeals are a two-step process; completing the first step (filing a Notice of Disagreement) and omitting the second step (filing the VA Form 9) will very likely cause the claimant to lose the appeal. The VA Form 9 must be filed within strict time limits: either within 60 days of the receipt of the Statement of the Case, or within one year of the date of the rating decision by the Regional Office, whichever is later. If it is not filed within that time, the appeal is closed and the claimant may lose significant benefits, including money. This can be confusing, but the bottom line is that a claimant should file their VA Form 9 as soon as possible after receiving the Statement of the Case.
Once a claimant has perfected an appeal by filing a VA Form 9, the veteran’s claims folder (maintained by the Regional Office) is transferred to the Board of Veterans' Appeals (called the BVA or Board) in Washington, D.C. The BVA is a group of judges specializing in veterans’ benefits law called Veterans Law Judges, who make the decision on the appeal. The BVA may take any one of three different actions in an appeal. The first option is for the BVA to affirm the decision of the Regional Office and deny the appeal. The second option is for the BVA to reverse the decision of the Regional Office and grant the benefits sought. The third option is for the BVA to send the case back to the Regional Office (known as a “remand”) for further processing, and may order the Regional Office to provide additional evidence, such as a new VA examination. A remand is not an adverse decision. After the remand processing ordered by the BVA has taken place, the claim will either be granted by the Regional Office, or denied by the Regional Office and then returned to the BVA for a final decision.
If the claimant does not like the BVA’s decision, the claimant can appeal that decision to the United States Court of Appeals for Veterans Claims (CAVC). A veteran has 120 days from the date stamped on any adverse BVA decision to file a Notice of Appeal with CAVC. Failure to file a timely appeal will very likely mean that the appeal will die. I highly recommend that if you are considering filing an appeal with CAVC, you should discuss this with an attorney.