Understanding the VA Claim Process

The following is an article written for the MI Legionnaire Newspaper in September of 2012 by then American Legion Department of Michigan Veteran Service Officer Suzette Price.  Suzette is now the Veteran Services Director for The American Legion Department of Ohio.

As frustrating at times the process is, there is a process and Veterans should understand it and be patient.
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By Suzette Price, former MI DVSO, now Director of Veterans Services for the Department of Ohio American Legion

This article appeared in the Michigan Legionnaire September Issue 2012 page 10

Greetings Legionnaires, from the 12^th floor of the federal building in Detroit,  The American Legion Department of Michigan Veterans Service Office.  For the past 16 months I have had the honor and privilege of working with the best veteran’s service organization in the nation and serving many of you.  During those 16 months I have learned many things about the claims process and as I take phone calls from veterans I understand the frustration many feel from the long wait times for their claim.  Our commitment is to service those claim as best and expediently as possible.

In May of 2011 I was trained that the claims process was anywhere from six to nine months long. Today, the claims process is 18 to 24 months long. The claims being filed has severely increased and the hiring of VA employees has failed to parallel with the growth in claims, thus resulting in a serious backlog.  Please understand if you file a claim today it might take up to 2 years to receive a decision from the VA.

The DVSO’s here at the regional office unfortunately have to work within the same time frame as the Department of Veterans Affairs in order to get things done respectively. The VA is not capable of conforming to the American Legion standards of claims processing which means we have to meet the VA more than halfway the majority of the time.

Three phases to a filed claim

There are three phases to a filed claim, (1) Development (2) Rating (3) Authorization. The development phase can take anywhere from 6 months to a year or more. This phase is where VA gathers and develops the medical evidence, service medical and administrative records, and schedules the C & P examinations.  The more evidence the veterans and the VSO provide the VA the less time it takes.   The claim will not move to ratings unless all of this data is collected and the veteran signs off on the VCAA notice, or one year from the date the claim was filed if the veteran is unreachable.

When the claim is finished with development it may still take 30-90 days or longer to be assigned a rater.  This is because they are busy rating other claims and the VA waits until a rater becomes available to assign the claim. The rater then assigns a percentage for the disability.

Lastly is the authorization phase. This is the shortest process and usually takes one to two weeks for completion.  This prompts the rating decision and award letter to be generated to the veteran and the claim then goes to finance if an award payment is necessary.  Being proactive on your claim and acquiring all the evidence suggested by the service officer or county and VA will help your case.  If you wait for VA to tell you what they need you should probably understand that your claim will sit on a shelf and not get touched for 60 day increments at a time or until evidence arrives.

Another solution, and quite frankly a must, is to be clear, concise, and patient with the people who are helping you.  I love my job and work very hard to bring you the greatest amount of benefits one deserves. Please remember that our job as DVSO’s includes a variety of functions other than claims processing. We perform legal research to help various claims, counsel veterans with employment issues, homelessness issues, and try to answer as many phone calls as we can in an 8 hour period. DVSO’s represent veterans claims in appeals to judges and VA employees at the regional office in Detroit and assist National for an claims being appealed in Washington D.C.  Lest we forget the currently serving military who need our assistance while still serving.  We attend training and giving training to be more knowledgeable officers and exchange ideas on improving the process.  Please, be patient with us because you are our purpose and the reason we do all that we do.  If I have not said this to you while speaking to you on the phone or in person, THANK YOU for your service, WELCOME HOME and please continue to support the your veteran service organization.

The Fully Developed Claim Process

The FDC Cuts the time to a decision

Talk to just about anyone who has been working in the veterans benefits industry for more than 8 years and they can give you plenty of stories of applications for benefits taking a long time.  It is still the case to for some, depending on the complexity of the claim being made.

IMPORTANT NOTE: It is up the to veteran to prove they have a service connected disability, not the VA.  The VA will determine whether it is service connected and how much the veteran is disabled.

Just a few years ago the VA Back log received quite a lot of attention and it still is today.  I am not speaking of the backlog to receive healthcare, but the benefits side.  Over the last 15 years, in my opinion, there has been a traffic jam of several interchanging events that have made a bottleneck at the VA.

1.  Information sharing and awareness of Agent Orange and the diseases it  causes was finally receiving attention in Washington and more presumptive diseases were added to the list for Vietnam Era Veterans.

2.  World War II and Korean Veterans were applying for VA benefits late in their years. 

3.  We entered the Global War on Terror

4.  VA personnel who had been hired in the 1980's to help with backlog then were reaching retirement and some contracts required they be forced to retire, leaving an experience gap.

5.  The new personnel did not have the experience.

6.  The bureaucracy of the system itself was fully exposed for it inefficiencies.

7.  Funding

I am sure the list could go on and on, but the system was choking itself, so the VA came up with the Fully Developed Claim process, where veterans could compile ALL of the information required by the VA on their own before submitting it.  With the help of a VSO a veteran then could be placed in a different pile for processing and the process has proven to be much faster then not submitting a FDC.

Is it working?  According to 2013 testimony by The American Legion to Congress, yes it is. http://www.legion.org/veteransbenefits/217119/are-fully-developed-claims-helping-veterans

The VA has a short video about the FDC.

Don't attempt to file a claim or FDC alone, you have help from VSO's.

 

What's a Power of Attorney Good for with Veteran Claims?

Veterans Administration Form 21-22

This is the official form that allows a Veteran Service Organization or VSO to represent you and the claim you are filing to the Veterans Administration.  see form here 21 -22

Don't Face the VA Alone

Organizations like The American Legion, Disabled American Veterans, and the Veterans of Foreign Wars have Veteran Service Officers trained and certified by the Veterans Administration to assist you in submitting the claim, reviewing the claim, and following the claim through the process.

The veteran is encouraged to sign up for e-benefits at the VA to track the benefits they are applying for, but the portal may not have all the details with the claim.  A VSO representative can explain and look into any questions the Veteran has about their specific claim.

Using a VSO ensures accuracy when submitting a Fully Developed Claim.  Claims made through the FDC process are awarded quicker and more efficiently.

To learn more about the VSO and POA please watch the following videos produced by the VA.

Bring the right information to the Veteran Service Officer

Don't Face the VA Alone #3

 

When visiting a veteran service officer it is important to bring certain documents to the meeting.  Not every document is needed for every claim or benefit application, however, having more information at the initial meeting helps begin the process faster.

Please bring the following information:

(  )  Original or certified copy of the Report of separation or your discharge papers (DD214 or member 4)

(  )  Copy of Marriage certificate

(  )  Copy(s) of birth certificate(s) for each claimed dependent to include spouse

(  )  Copy(s) of death certificate(s)

(  )  Copy(s) of divorce decree(s) for veteran and spouse

(  )  Copy of Guardianship Document/Court Letters

(  )  Copy of Social Security award letters showing current benefit rate

(  )  Copy of pension or annuity award letter showing current benefit rate

(  )  Statement from doctors, showing current medical condition that is being claimed

(  )  Doctor’s name, address, and phone number to include fax numbers

(  )  Medical evidence indicating that the disability was caused by or arose during your active duty service

(  )  Medical treatment records

(  )  Any correspondence from the Veterans Administration

(  )  Collateral statement(s) – eyewitness accounts

(  )  Social Security numbers for each claimed dependent

(  )  other evidence you believe will assist in supporting your claim.

Gather as much information as possible, before seeing a veteran service officer.  The more information they have the sooner they can file your claim.