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                    Five Best Practices

by Jim Strickland
11/16/2010

I was fortunate to have been invited by my friends at Stateside Legal to attend and present at the annual NLADA conference.

I was on a panel...a team of advocates and attorneys who presented some varied information to an audience of other interested advocates.

Below is my offering for the meeting. “5 Best Practices” is written to introduce the novice to the Veterans Benefits Administration in anticipation of what they’ll find there. I hope these tips may help you to better deal with your VA as you work your own claim or help another vet with his or hers.

Stateside Legal is building to provide a wide range of legal help for veterans and active duty military.  http://www.statesidelegal.org  I’m honored to be on their web advisory board.

The National Legal Aid & Defender Association  http://www.nlada.org/About/About_Home is an organization “devoted to ensuring the delivery of legal services to the poor.” I met many wonderful people who deserve a smart salute and a ‘thank you’ for their dedication to the cause.



Meeting the Challenge of Providing Civil Legal Assistance
to Military and Veteran Households
2010 NLADA Annual Conference
Atlanta GA

               5 Best Practices

Jim Strickland, Veterans Advocate 

jim912@gmail.com
The A to Z Guide to VA Disability Benefits
http://jimstrickland912.com


Introduction

As a veterans advocate and columnist/writer, I have long supported the thought that most veterans are competent to file their own applications, claims and evidence when applying for their VA disability benefits.

It is my experience that most veterans can “DIY” a claim using information from VA and other data available on the Internet and successfully negotiate a fair disability compensation claim award with VA.

The process of beginning a disability benefits claim is non-adversarial and administrative. Veterans are not required to be represented by any authority. The VA system is designed to work directly with any veteran.

The Department of Veterans Affairs is required (“duty to assist”) to provide help to veterans who file claims. In any decision that may be close, the benefit of the doubt should be considered in favor of the veteran.

Having said that, we recognize that the VA makes errors. Veterans and advocates can often avoid common problems by closely adhering to the rules and regulations that VA will insist be followed.

Here I'll present my choice for the top 5 opportunities or “hints” for veterans and advocates to succeed from the start.


(1) Understand the VA Disability Claims Process.

VA is a business. Businesses large and small are similar in many ways. Each business has a product. Whether manufacturing widgets, caring for patients in a hospital or selling flowers, what a business does at the end of the day is its product.

One of the important products of VA is the fair and timely adjudication of a veterans claim for disability benefits. This occurs within the Compensation and Pension (C&P) division of the Veterans Benefits Administration (VBA). The VBA is one part of the Department of Veterans Affairs.

To build the VA product means that raw material (The VA Form 21-526 application and supporting evidence) enters via the mail room and through a defined process, the accumulated material is formed into an adjudicated decision. Subsequently a letter of award or denial is delivered to the veteran.

Businesses are often divided into categories that define how they operate. Some businesses are customer driven. In a customer driven business the customers largely define the end products that the business produces. This might be true of Ben and Jerry's ice cream, for example.

Other businesses are driven by a pre-defined, complex and rigid process. Companies or entities that are regulated by strict laws are often process driven; The IRS, medical device manufacturers and pharmaceutical manufacturers are oriented to numerous processes, laws, rules and regulations that control how they operate.

The VA is a process driven business. To the VA the process of adjudication of the claim is a goal unto itself. VA "customers" are paid scant attention. Crossing T’s and dotting I’s are seen as integral to accomplishing daily goals.

There is little room for “customer” error in the VA process. Mistakes in completing the process are not often overlooked or forgiven.

The process of getting the VA Form 21-526 from input to decision and notification is the driver for everything done at the VA Compensation and Pension service.

The veteran and/or advocate who may try to skirt around the process will do so at their own peril. If a notice received by mail tells the veteran that an adverse action is being proposed,  it also tells the vet that in order to disagree with the proposal the veteran must take certain actions. Usually the required actions involve a timely written communication to the VA from the veteran.

Many veterans ignore this step in the process and start a series of phone calls in hopes of finding a sympathetic ear who can fix the problem without all the fuss of letter writings.

This is always a mistake. The process must be followed or the veteran will lose.

The veteran or advocate who takes time at the start of the process to learn basic VA expectations and requirements will fare better than anyone who chooses to wing it.

(2) Read the Fine Print.

To begin a disability claim requires that the veteran complete the VA Form 21-526. This is an intimidating tome of some 26 pages of seeming gobbledygook and jargon.

When one reads it, you discover that only 3 of the pages are required to be completed. The rest is boilerplate and covers a great deal about options for claims other than disability compensation.

Most of the verbiage is included so as to meet the VA’s burden of the “duty to assist”.  VA provides many pages of detailed information in an attempt to avoid criticism by veterans that may begin with, “I didn’t know...”.

This same hint holds true throughout the rest of the process. Any mailing from VA may be critically important to the outcome of the case. There are numerous requirements regarding timeliness of replies and filings and to miss a deadline is to ensure that your case will be derailed.

Carefully reading, understanding and following through with every communication from VA will save a lot of time going forward.

(3) The Well Written Letter is Your Best Friend.

Veterans want to talk to someone. The thinking that, "If I can just get to that one individual who will listen to me, this can be resolved in minutes."

When vets call VA they may notice that a single toll free number is available to contact VA from anywhere in the U.S. The number does not connect to a Regional Office where files are located, it connects to a "call center". The call center staff do not have access to any files, they are not decision makers and can not take any actions on any aspect of the case.

(If you are an accredited attorney, VSO or agent, you may have access to internal phone numbers and systems not available to others. This hint may not apply to you.)

Once the veteran hangs up, the call is lost to history. There is no record of what was said or of any commitments made by the call center representative.

Any and all communication to VA should be made via certified letter, return receipt requested.

Letters should be brief and strictly factual. There should be no venting or any release of any frustrations. Letters to VA should be as respectful as any documents VA will send to the veteran. Always double check to ensure the accuracy of addresses, that the document is signed and that any reference numbers have been included on each page.

The veteran or advocate who communicates via certified mail, RRR and who carefully builds an organized paper trail is usually at the head of the race for benefits.

(4) State Your Claim Clearly and Precisely.

Although VA is often forgiving when the veteran isn't clear about what benefit they seek, the advantage always goes to the veteran who clearly communicates why they are making a claim and what they believe the outcome should be.

Consider:

"I want to claim my agent orange benefits because I am sick from that stuff. Also I need the money before I lose my house in the divorce."

"I am a Vietnam veteran. I claim that exposure to Agent Orange has caused my diabetes. I have read The Schedule For Rating Disabilities and according to the criteria set by VA, I am eligible to have a disability compensation rating of 40%. I have included my medical records."

If you were the "Rater" who opened those files on your desk at about the same time, which statement do you believe would get through the process of adjudication the quickest?

Note that the claim and expectation is in plain English. The veteran or advocate doesn't have to copy and paste in large segments of the law...that VA Rater already knows all that. Writing to the person at VA just as if you were speaking to them works well.

A brief but thorough written communication to the VA Regional Office is a prime ingredient to encourage VA to swiftly generate a fair award to the deserving veteran.

(5) Be Patient.

I have compared working with VA to a tennis match. There are two players, one on either side of the net and there is one ball.

The first player begins by hitting the ball to the other side. While the ball is traveling and while it's on the other side of the net, the first player is patient and prepares for the second player to send it back.

If player #2 is slow to react and seemingly isn’t paying any attention to the ball, player #1 may become impatient and lob another ball across the net. When this out-of-sequence play begins, the game is soon out of order and confusion reigns. Too many balls in play will bring about chaos.

Don't allow yourself to become  impatient. Don’t begin writing letters or making phone calls to try to move the claim along. Don’t start calling the local newspaper or your Senator or Congressperson.

Currently VA is thought be be significantly behind in processing claims...possibly as many as one million claims are languishing for weeks or months with no action. That figure is debatable but even if we agree to cut that in half, the backlog of work is enormous.

If you follow the hints here you’ll know that your claim is in process (the certified mail RR). When you submitted the claim you were sure it was well grounded and you made it easy for the Rater at VA to read and understand.

While the claim processes, take up a time-consuming hobby, read War and Peace, go for long walks and otherwise wait quietly.

The decision on your claim will be made when it is made, not a moment sooner.


In the final analysis, filing a claim for disability benefits at VA is simple. If done precisely and correctly from the beginning, the claim is likely to move through the process with no problems. Paying close attention to details and playing strictly by the VA rulebook will result in more favorable claims with fewer frustrations.