You selflessly completed your military service, but you have been left with a life-altering injury or condition. You disagree with the VA’s decision on your case and you have decided to appeal the decision and continue fighting for the benefits that you deserve. In addition to filing the appeal paperwork and submitting additional evidence, you have the right to request a VA appeal hearing.
DRO vs. BVA Appeal: What is the Difference?
The VA gives you the option of choosing a de novo review with a Decision Review Officer (DRO) appeal or a Traditional Review with the Board of Veterans Appeals (BVA). Both options give you the opportunity to request a hearing.
If you choose the DRO appeal, DRO will perform another review of your application and supporting evidence and make a new determination without giving any deference to the original decision. You do have the right to request a hearing with the DRO. This hearing will generally take place at your local regional VA office.
Once the DRO makes their decision, the VA will send you a rating decision, if they grant an increase or service connection and/or a Statement of the Case on those issues which they deny service connection or a rating increase. If you disagree with the rating decision, you can file an appeal and go before a different DRO. To file this appeal, you must complete a Notice of Disagreement within one year of the date on the rating decision. If you disagree with any portion of the Statement of the Case, you have the option of filing a substantive appeal with the BVA. To file this appeal, you must complete VA Form 9 within 60 days of the date of the Statement of the Case. You have the right to request a formal hearing before the BVA. You may request a hearing with the BVA via videoconference, travel board (when a judge from the BVA comes to your regional office, or in Washington (you travel to Washington D.C. for the hearing).
Should I Request a VA Appeal Hearing?
Most cases benefit from an appeal hearing because it gives you the opportunity to speak with the person who is making the decision on your case. This can be helpful for many reasons.
Human Element: The VA deals with many cases each day, countless applications for benefits, and thousands of pages of medical records. A face-to-face conversation allows the decision maker to see you as a human and gives you the opportunity to describe your impairments in detail and explain how these impairments affect your daily life. It is much easier for a decision maker to understand the extent of your impairments and limitations when they can see and speak with you, instead of just reviewing a pile of paperwork and medical records.
Opportunity to Answer Specific Questions: You’ll have the opportunity to answer the reviewer’s questions about gaps in the evidence or your medical record in real time. Many veterans are injured while serving, but they may not seek substantial medical treatment because they have other priorities or lack medical insurance. After 5 or 10 years, the injury gets progressively worse and now requires extensive medical treatment. If the decision maker were to rely only on the medical records, it is likely that your claim would be denied because it would be difficult to show service-connection. However, during the hearing, you have the opportunity to explain why you did not seek extensive medical treatment during your service. This information is invaluable to your claim and can often mean the difference between approval and denial.
Additional Supporting Testimony: At a hearing, you can bring in testimony from a spouse or family member, which can be helpful to your claim. Many times, it is difficult to remember all of the details of your service, injuries, and treatment for your injuries, especially in a slightly stressful situation like a hearing. A family member that witnessed your obstacles and treatment can provide details that you may overlook or not feel are important. It is helpful to discuss this testimony with your family member before the hearing to refresh your memory and to make sure that your information is consistent with your family member’s recollection of events.
The appeal process can be overwhelming. If you are undecided about requesting a hearing or would like assistance in preparing your appeal or getting ready for a VA appeal hearing, your representative (veteran service officer (VSO) or attorney) is an excellent resource.
In particular, your representative can help outline the critical issues and legal principles of your case during the hearing to ensure that the decision maker has all of the necessary information to make a decision about your claim. Additionally, your representative can help you determine if a hearing is appropriate for your case.
The VA disability benefits claim process can be lengthy and frustrating, but finding answers to your disability claims questions doesn’t have to be difficult. Take our free quiz to determine what resources are available for your specific needs.
Category: Disability Claims Information
After serving your country selflessly and completing your military service, you were left with a life-altering injury or condition. You completed an application for veterans’ disability compensation for your service-related injury, but you just received a denial or lower rating than expected. This can be incredibly disappointing, but it does not mean that you should give up! You can appeal the decision and continue to fight for the benefits that you deserve.
Reasons for Filing an Appeal
A denial or unfavourably low rating can seem like the end of the road, but there are many reasons that your claim could have been denied or under rated: missing information or evidence; incomplete forms; or the claim examiner may have missed something important. Do not take the VA’s decision as personal. Instead, read through the letter carefully and take note of the following:
Date: The date of the decision is very important! You have 12 months from the date on the letter to submit an appeal.
Reason for Denial: This part of the decision can help you determine the reason that the VA denied your claim. Often, the VA just puts standard language in this section, but there may be details about information that should have been included or evidence that was missing.
Effective Date and Rating: The date your benefits go into effect and the rating of your injury will determine the amount of benefits you receive. Take some time to review this information to make sure that it aligns with the date and severity of your impairments.
If you disagree with the VA’s decision or you believe that the effective date or the rating of your impairments is incorrect, you can appeal the decision. If you become overwhelmed as you are reading through the paperwork, or you are confused by the VA’s decision, make sure to contact your representative (i.e. veterans service officer (VSO) or an attorney); they will be happy to review the decision with you. Your representataive can also help you determine if an appeal is appropriate and assist you with filing a Notice of Disagreement.
How Do You File a Notice of Disagreement?
If you have decided to appeal the VA’s decision, you will need to complete a Notice of Disagreement (VA Form 21-0958). The Notice of Disagreement does not need to be a detailed list of all of the errors made in the decision. Use the form and answer the questions they ask as to why you disagree. You will also need to indicate if you would like a Decision Review Officer (DRO) appeal or a Traditional Review.
What is the Difference Between a Decision Review Officer and a Traditional Review?
The VA gives you the option of choosing a DRO appeal or a Traditional Review. The DRO option is generally a quicker process than the Traditional Appeal. Your VSO can help you determine which is the best option for you.
If you choose the DRO appeal the DRO will perform new review of your claim and supporting evidence and issue an independent decision. If requested by you, a hearing will be held prior to a decision. After review of all the evidence and information, the DRO will issue a Rating Decision on any benefits changed from the appealed decision and a Statement of the Case on any benefits in which the DRO agreed with the previous decision.
You again have the option to appeal the Rating Decision with a Notice of Disagreement. If you disagree with any portion of the Statement of the Case, you have the option to file a substantive appeal by completing VA Form 9. This will then send your appeal to the Board of Veterans Appeals (BVA) in Washington D.C.
Additionally, the VA allows the submission of new or relevant evidence during the appeal with a DRO and BVA, so you may submit new medical records or other supporting information. If you find the Notice of Disagreement or VA Form 9 difficult to complete, so feel free to ask your representative for assistance with this portion of the appeals process.
If you determine that it may be useful, at this appeal level you may also request a formal hearing in front of the BVA to explain your case. Once the BVA has reviewed all the information, a decision will be issued.
The VA disability benefits claims process can be lengthy, overwhelming, and frustrating, but finding answers to your disability claims questions doesn’t have to be difficult. Take our free quiz today to determine what resources are available for your specific needs.
Category: Disability Claims Information
Veterans who suffer from an injury that was caused or made worse during their active military service can make a claim to receive benefits from the Department of Veterans Affairs. These benefits are tax-free, paid to veterans on a monthly basis, and known as VA disability compensation.
The VA disability compensation process can be a challenging undertaking for veterans and their families, especially for those who have never gone through the process. That’s why having a veterans service officer (VSO) on your side can be extremely helpful.
VA Disability Compensation Decision
After you have applied for benefits, submitted paperwork to support your veteran’s disability claim, and completed your C&P exam, the VA must decide two things:
Was your disability caused or made worse by your service?
How does the disability affect your ability to obtain employment?
If the VA determines that your condition was not caused or made worse during your time in the military, then your claim will be denied. However, you can appeal the denial of your claim. See the section below on Appealing a Disability Claim Rating for more details.
When your claim is approved by the VA, it is assigned a disability rating. It is critical that you understand how your rating is calculated to ensure that your benefits are awarded correctly. A VSO can assist you with reading and interpreting your disability rating.
Accepting a Disability Rating
If benefits have been granted, you will receive a Rating Decision. This letter will state your disability rating, compensation amounts, and the date from which your benefits begin.
After carefully reviewing your determination letter, if you agree with the VA’s decision, you do not need to take any action to begin receiving your compensation. Your initial payment, which will include any past due amounts, should be mailed to you or direct deposited into the account number on your application within 15 days after you receive the notification letter. From then forward, your payments will be sent on the first day of each month.
Optional Next Steps After a Disability Claims Award
Sign-up for direct deposit with the VA. This enables you to receive your monthly compensation funds deposited electronically into your checking account, and it helps avoid complications from a lost or stolen paper check.
Consider registering for additional VA benefits. These include VA medical care, dental care, life insurance, and educational benefits, among others.
Research disabled veterans benefits available in your state. Many states also offer their own benefits for disabled veterans, which differ from state to state but may include reduced or exempted property taxes.
Appealing a Disability Rating
You can appeal the denial of your claim or a low rating by filing a Notice of Disagreement (Form 21-0958) with your regional VA office. The notice is a written declaration informing the VA that you disagree with their decision. Submitting this form will open an appeal to your compensation decision with the VA. You have one year from the date that you receive your determination letter to begin the appeals process.
Changing Your Rating at a Later Date
If your disability worsens after the one year appeal time is up, you can request an increase in your VA disability compensation using form 526EZ. You can support this request by enclosing medical evidence of your worsened condition. Generally, the VA will then schedule a new C&P exam to re-evaluate your disability. If the new evaluation increases your disability rating, your monthly compensation will also rise.
A claim for an increased disability rating can be more complicated than one might think. That is why it’s in your best interest to consult with your VSO before moving forward with a request for increased compensation.
The VA also has the right to re-examine your disability rating at any time unless you were deemed permanently and totally disabled in you rating decision. If you receive a letter scheduling you for a re-examination, then it is extremely important for you to attend or reschedule this appointment. If you do not, the VA can reduce or terminate your benefits.
While the VA disability rating system can be complex and hard to understand, finding answers to your disability claims questions doesn’t have to be difficult. Take our free quiz to determine what resources are available for your specific needs.
Additional ResourcesVA Disability Award Compensation Attachment
VA Guide on How to Appeal a Decision
Category: Disability Claims Information
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You applied for disability benefits through the U.S. Department of Veterans’ Affairs and, after a long wait, you have finally received a favorable decision, granting you veterans’ disability benefits. This decision should include a Notification Letter and a Narrative, explaining the reasoning used to determine your benefits.
For any impairments that have been deemed service-connected, the VA should include a disability “rating” and explanation for each of theimpairments listed in your decision, but what does it mean? How much compensation will you receive each month? Here are some answers.
Schedule for Rating Disabilities
The Rating assigned to your impairments is often the most confusing part of the decision. The VA created the Schedule for Rating Disabilities to identify what % should be applied to each impairment. This schedule is intended to reflect the loss in earnings that you may experience because of your impairments. Ratings range from 0% to 100%.
The Schedule for Rating Disabilities lists impairments by body parts affected and conditions/issues. Each diagnosis within the group of issues has a list of symptoms that the VA Rater will compare to your symptoms and the evidence in your medical record, including your C&P exam. Your symptoms are then rated according to the requirements listed in the Schedule. The more severe your impairment is, the higher the disability rating will be.
For example, if you were experiencing symptoms of post-traumatic stress disorder (PTSD) as a result of your time in the service, you would find the section titled “Mental Disorders,” which includes PTSD, Depression, Anxiety, and MST. The table for PTSD indicates that if you have occupational and social impairment in most areas resulting from symptoms such as spatial disorientation and suicidal ideation, you would receive a 70% rating for this impairment. If you have reduced reliability and productivity as a result of occupational and social impairment, you would receive a 50% disability rating, and occasional decreases in work efficiency would equal a 30% disability rating.
If you have multiple impairments, the VA will assign a separate disability rating to each one. Unfortunately, the VA does not add all of the ratings together when determining your overall disability rating. Instead, once all of the ratings have been assigned, the VA will use the Combined Ratings Table to determine the final rating.
The table has numbers on the left side and along the top. In order to calculate your combined rating (two impairments), you would take the first rating and find it on the left column of the table. Next, you would find your second rating in the top row of the table. The number that appears where the column and the row intersect will represent your combined rating.
If you have more than two disabilities, you would follow the steps, as stated above, for the first two impairment ratings. Once that number is determined, find the new number in the left column of the table and then find the third rating in the top row. The number that appears where this column and row intersect will represent the combined rating. This process would continue for the remaining disabilities. This combined rating is then rounded up or down to the nearest whole number. The highest overall disability rating is 100%.
If your disability is not listed in the Schedule, the VA will find a disability that is similar to your impairment and evaluate your disability based on the code for the related disability.
Monthly Compensation Rates
Monthly disability compensation amounts vary depending on your disability rating and the size of your family. Your family size is determined by your marital status, whether you have any children in the home, and whether you have any other dependents or family members.
You can review your compensation based on your disability rating and family size here. As an example, a veteran without dependents and a 30% disability rating would receive $408.97 per month. A veteran with a 100% disability rating who has a spouse and child would receive $3,197.16 per month. This amount increases based on Cost of Living adjustments.
What If You Disagree With The Rating?
Impairment ratings are an important part of the decision because they ultimately control how much you will receive in benefits each month. For this reason, you should take your decision to your Veterans’ Service Officer (VSO) for review. At this time you can also seek the advice of an attorney. The VSO or attorney can review the decision; answer your questions about your benefits or the decision; and then help you determine if the Rating in your decision is an accurate representation of your impairments. If you do not agree with the VA’s determination, you have one year from the date on your decision to submit more evidence or file an appeal (Notice of Disagreement), if necessary.
Finding answers to your disability claims questions doesn’t have to be difficult. Take our free quiz today to determine what resources are available for your specific needs.
Category: Disability Claims Information
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