Introduction To Navigating The Convoluted System Called VA Compensation
This post is brought to you by Robert Blake.
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“What branch did you serve in?” is a question I get asked rather often since my wife insists that I drive her fuel-efficient car everywhere, and she has Disabled Veteran plates. While she’s proud of being a Navy Veteran, I always find the looks I get rather interesting when I respond with “oh, not me, my wife’s the Veteran.” While that may not be particularly relevant, what is relevant is how Veterans get to the point of finally being eligible for those Veteran disabled plates, and all the other benefits that go along with being a disabled Veteran. That has been an uphill battle for my wife, and for many other Veterans like her.
While never in the service myself, I got involved in learning the VA benefits system entirely by accident due to the coincidences that my wife is a disabled Veteran, and that I also unintentionally developed friendships with several Veterans who work for VA Benefits (VBA). Over time those friendships evolved into a weekly group “beer night”. The VA employees always loved the expression of shock on my face when they told me stories of how the VA claims process works and doesn’t work.
I’ve been involved with VA benefits through my wife and my Veteran buddies since 2010. I originally started learning the VA benefits system to help my wife with her claim. That then evolved into me helping my friends, and then friends of friends, and then on from there. Since I know both Veterans and people who work at the VBA, I was “voluntold” to assist Veterans with questions. As a result, I ended up helping many Veterans with their disability claims. So while I’m neither a VA employee nor a Veteran, I’ve seen what the benefits process is like from both sides. What’s really interesting, and seems to be the only constant in this entire process of filing for disability benefits from the VA, is that the process is constantly changing.
For example, in 2015 a major law change occurred and Veterans were required to file all their claims on one of many official “prescribed” forms. This then led to the forms being considered outdated when a newer version of the form was released. Absurdly, a lot of Veterans ended up having their ongoing claims canceled for no reason other than they used an expired form. And if those Veterans missed the notifications in the mail, they didn’t even know their claim was canceled. Since then many more changes have gone into effect, particularly in February of this year when the Appeals Modernization Act (AMA) went into effect. The AMA changed nearly everything with how VBA processes claims, not just appeals.
My wife was unfortunate, because, at the time of her discharge, many of the programs that are now offered to those leaving service either didn’t exist or were missed by commands as a requirement. The Transition Assistance Program (TAP) is much improved now, but like many other Veterans, that doesn’t help her now. She can’t go back in time to make sure the doctor notated her reports of injuries. And she’s not alone – this is a common problem for older Veterans.
If you’re still in the military, and you have not had your exit exam, then you need to make sure that you’ve been to the doc for everything that has happened to you. Everything. Why? Because the way that VBA looks at it is, if it’s not in your records, it didn’t happen (with some exceptions). We all know how military doctors work. My wife has told me about her military doctor visits back in the ’90s. Injured your knee? Here’s a Motrin. Concussion? Motrin and maybe an ice pack. Bleeding to death? Take two Motrin and put a pressure bandage on it.
From a VA perspective, this is fair. A Veteran can’t just claim something happened without any evidence of it happening, because then everyone could claim anything (or in some cases everything). So having an injury (or exposure) recorded in your medical record is important. It is evident that something happened in service. Trying to list everything on an exit exam is sometimes not enough. I learned this over and over as I began to help more and more Veterans with their claims.
[Nords note: I know that servicemembers don’t want to see the doc because they might be put on light duty and get too much attention from the chain of command. Or lose specialty pay. Or even lose their qualifications. Yet if it’s not in your medical records, and if it does not need continuing treatment, then you’re highly unlikely to get a VA disability rating for it.]
Here is a (partially tongue in cheek) list of things I’ve learned as an outsider to the VA claim process:
- There is a form for everything, and it’s often not clear which form is the correct one. Sometimes you have to fill out two or three of them before you get it right. Then once you finally get it figured out, the VA changes the forms again.
- Important mail from the VA seems to always get lost in the mail. Unimportant mail like flu shot reminders after you’ve already had one at the VA, get multiplied in the mail and show up every couple of weeks. Important mail about appointments often shows up after the appointments.
- Somehow a signature is always missing on important forms.
- The VA often asks for the same information in four different ways or times, for no apparent reason.
- VA doctors are hit and miss. Some are amazing, and others give you the impression they must have forged their license.
- VA has its own language. They call it VA speak. Because you do not work for the VA, you do not speak VA speak. But the VA requires that you know VA speak to file a claim successfully.
- VA has its own math, they call it VA math.
- VA can take as much time as it wants, and make as many mistakes as it pleases. But the Veteran has 30 days and can make no mistakes.
I’m not entirely exaggerating here.
Setting all humor aside, why is VA compensation so important? It’s simple. Former military members who served their country and have injuries that now prevent them from being able to perform at their full potential have a contractual right to be compensated for those injuries. Due to those injuries, they may no longer be able to secure their dream job, which means they have to settle for something else. Which usually pays less. That’s where compensation comes in. It tries to fill that financial gap so that Veterans, despite their disabilities, can maintain a decent lifestyle and take care of their families, even if they can’t do a job that would pay more. This affects them, and their families.
There are many benefits to VA compensation, other than just the cash compensation. There are too many to mention them all, but I will mention a few. First, the money is tax-free, so if a Veteran qualifies for retirement, s/he can accept VA compensation instead, and save on taxes. (In some cases Veterans can get both retired pay and VA compensation). Disabled status can save you money on tolls, property taxes, or other state benefits that vary by state. Veterans can get a VA loan to save money on home loans. And based on the level of disability/compensation, there are a myriad of other benefits that can really make a difference for a Veteran and his/her family. Those pennies add up. Disability may also potentially provide school benefits. Veterans might be able to have their college paid for. And based on the level of disability, they might be able to get education paid for their children as well.
But first, to get to those benefits, the hardest part awaits: getting the VA to service connect a condition due to the military. The biggest obstacle that I’ve seen is that Veterans do not speak VA speak, but the VA requires them to. I’ve also learned over the years that VA employees don’t always speak the language well either. Then there is the fact that the laws and VA bureaucracy are constantly changing. The more I learned, the more frustrated I got with the process, and I’m not even the Veteran!
[Another Nords note: When you leave active duty, even with a VA disability rating, you can still join the Reserves or the National Guard. A 30% VA disability rating is not unusual. It’s even possible to serve in the Reserves/Guard with a 100% VA disability rating, with waivers. See the “Related articles” links below.]
So how does a Veteran navigate the VA system without getting lost? It depends on what stage you’re in:
Still on Active Duty
1. Report everything to your doctor.
Everything. Twisted your ankle? Go get that Motrin. Have a headache again, ask for Motrin for your headache. Had a commander mistreat you and are not in a position to report it? Write a letter to your mother/best friend and date it, and have them save the envelope it arrived in. (An email works too, I’m not sure if anyone writes real letters anymore).
2. Ask for your medical records. Review them.
See what diagnoses you have been given on paper versus what you were told in person. Look at your medications list. Look at what injuries are documented. Make sure it’s all there. If not, time to go to sick call just for the reason of correcting your records.
3. File your claim before discharge.
You can file up to 180 days prior to discharge. Even if it’s a disability that is not bothering you now, if you have a diagnosis, you can at least get 0% service-connected for it. That is important because when (if?) that condition gets worse, filing for an increase is a matter of going to an exam and not a hopeless attempt at trying to convince the VA that it happened in service.
4. Include copies of your service treatment records when you file your pre-discharge claim.
This is a requirement for the pre-discharge claim to be considered as such.
Within One Year of Discharge from Active Duty
1. File an Intent To File (ITF) right away.
This will preserve your date of claim and allow you more time to gather evidence and file. This is important if you’re close to being at one year from discharge, as everything changes after 365 days post-discharge.
2. Gather records from your non-VA doctors (if applicable).
Start getting any records from them that are related to things that you intend to file for. Anything to show treatment from service on is helpful. If you’ve been seen at a VA medical facility, the VA benefits division will have access to those records. Just tell VBA which VA medical facility has the records.
3. File your claim and be ready to show up for an exam.
You should receive a notice for an examination within a couple of weeks of filing your claim. Watch your mail closely for appointment information. Even better, consider signing up for MyHealth-VA.gov (MyHealtheVet). You will be able to find out about VA appointments there (but not appointments with private contractors).
4. Report EVERYthing at that exam.
You only get one exam that results in a full-body list of everything wrong with you, and this one is it – the claim you file within one year of discharge. You may have more than one exam. Based on what disabilities for which you file they might send you for a general full-body exam, and then a specialist, such as an audiologist. But typically it’s a general exam. The specialists are (generally) only included for mental health, audiology, ENT, and eyes. Undiagnosed conditions due to service in “Southwest Asia” have their own specialty exam, and there are a few other exceptions I won’t go into.
More Than One Year After Discharge from Active Duty
1. File an Intent to File (ITF) and notate the date you filed it.
- You have one year to get your records together after you submit your ITF.
- Note 1: If you’re filing for a claim for something for which you’ve been previously denied, an ITF is not accepted. This applies to supplemental claims, higher-level review claims, and appeals.
- Note 2: If you are utilizing one of these above methods, your claim must have been “continuously prosecuted” – meaning you pursue one of those processes within the allowed time frame (usually one year).
2. Request a copy of your file from the VA if you previously filed a claim.
- Otherwise, you’ll have to request it from the National Personnel Records Center (NPRC).
- Having a copy of your records provides you with an invaluable tool because it allows you to review what the VA is basing its decisions on, and allows you to evaluate any inaccuracies.
- Don’t wait until the last minute to request your records, they can take several months to receive. And if you’re close to your deadline for filing for a denied claim, don’t wait, file now.
3. Review your military records.
- Note all the injuries that were reported.
- Look for any medals that are noted (Combat Infantry Badge, Purple Heart, parachutist badge, etc.).
- Notice what job (MOS) is listed.
- Then consider, what did you actually do? If you did other jobs, were they reported in your records? Review them and see what is actually in your records. Knowing what is in your records is essential to succeeding with a claim.
4. Gather all relevant medical records from your non-VA doctor(s).
- Get those records, or fill out the correct form for the VA to request them. It’s always better to get them yourself, for a variety of reasons.
5. Reach out to your family and friends.
- Did your roommates in service constantly complain about your snoring and now you have sleep apnea? Have them write a buddy statement about how you kept them up all night.
- Did a fellow soldier witness you falling on your knee in PT? Have them write a statement.
- Did you write your mom a letter about how you had no ear protection during an exercise and now you can’t hear? If there is something that occurred but is not officially documented, get a buddy statement.
- You might want to get a buddy statement even if something is documented. When you’re years out post-service, and you’re from the days of limited record-keeping, buddy statements can be helpful – assuming the VA can verify that your buddy actually served with you.
6. File that claim and submit everything you’ve gathered.
Tip 1: Hearing Loss and Tinnitus
- Hearing loss and tinnitus are an exception to the rules regarding what evidence is needed to establish service connection if filing more than one year after service. VA is required to provide an exam with a medical opinion regardless of MOS. The trick is, submitting enough statements regarding what the source of the noise was to convince the examiner that the hearing loss and/or tinnitus was due to service.
Tip 2: Buddy Statements
- Buddy statements play a huge role as evidence in situations where records are limited. The trick is that the VA has to verify that your buddy served with you. Your buddy will have to provide his/her service information along with a credible statement that does not conflict with what is in the VA records.
Tip 3: Secondary Medical Conditions
- Secondary medical conditions are more common than you might think. Make sure you are communicating with your doctor about all of your symptoms. They may be able to educate you about what additional conditions may result from existing primary medical conditions. Secondary conditions may be actionable for compensation purposes.
Tip 4: Previous Claim Denials
If you’ve been denied for a disability previously, make sure you are submitting the correct form for the type of claim you are filing, and make sure it is the current version of the form.
After Submitting Your VA Claim
1. Save copies of all your records.
- While the VA doesn’t intentionally lose records, things happen, and records get lost. Maintaining your own copy is your best defense. This is another reason to get a copy of your file from the VBA.
2. Watch your phone and your mail.
- Exam notification will likely be by phone, but sometimes they just schedule you and all you get is a letter. However, you should get a phone call. If it is a letter, sometimes the letter arrives after the date of the exam, so be proactive about exam appointments.
- Check your eBenefits account regularly to see what stage your claim is in. If you don’t have an eBenefits account you need to get one.
3. After the exam, watch for that decision letter.
- You have limited time from when they send out the notice to when you can argue the decision (through one of the various methods) and still keep your initial claim date.
4. If you are denied, file the appropriate appeal within the time allotted.
- The VA is unforgiving if you are a day late. There are also now several types of appeal options, which is a complicated enough topic that it is beyond the scope of this article.
VSO or No VSO?
Veteran Service Organizations (VSOs) can help and are free, and there are many that are VA accredited. But finding a good VSO can be tricky. If you choose to get help, don’t be afraid to ask a lot of questions of prospective VSOs, to make sure they actually know what they’re talking about.
There are some excellent VSOs that are highly recommended, and there are some that can cause harm to your claim. So be careful in choosing one by asking about their credentials, and maybe even going with one that someone else highly recommends.
Change is Constant with VA Disability Compensation
Don’t fall in the trap of “You figured it out, so that’s how it is”. The laws change constantly, I can guarantee that. Every time you do something new with VA benefits you are going to have to learn things anew (at least partially if not fully). Sometimes VA operational changes take a while to catch up with the law changes. For example, the recent Vietnam blue water laws that state any Veteran that served during certain years of the Vietnam war, and was on a ship within 12 miles of Vietnam waters, is considered to have been exposed to Agent Orange. Veterans are filing their claims, but the decisions will not be made until January of 2020.
Your best defense is to read the letters you get from VA very carefully, as those will be based on the latest laws and regulations. However, I will say that while the AMA changed the way claims are processed at VA, the basic concepts have not.
There are concepts that VA employees take for granted because they are employees and have been trained on the laws. Veterans experience frustration because they rarely have a clear picture of what is needed by the VA, or why they are denied; or what to do when they are denied. So after troubleshooting denials and assisting with appeals for the “I’ve lost count” time, I asked myself, how do I tell all Veterans all at once how to fix a troubling claim, or better, prevent the problems in the first place?
The answer is I wrote Succeed With VA Compensation. I’m not intending this to be a sales pitch; there are simply too many details and nuances to include in a single article, or even a series of articles, to cover everything. This is the latest edition and includes the Appeals Modernization Act that took effect this last February (2019) and is as up to date based on current laws as possible.
About the Author
Robert Blake is a “regular Joe” who works in medical research in his “day job”, but who decided to write a book to help Veterans because he knows far more about VA benefits regulations and processes than any non-VA employee ever should. He also maintains the website succeedwithva.com where you can find current news and information about VA benefits and healthcare.
The Military Guide to Financial Independence and Retirement Price: By Doug Nordman: This book provides servicemembers, veterans, and their families with a critical roadmap for becoming financially independent.
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