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Claims Expert:  Make Official VA Appeal Your Last Resort

By Alex Keenan

July 20, 2018

       

The recent U.S. military (ret.) columns dealing with the Department of Veterans Affairs (VA) appeals process for benefits claims struck a nerve.  I’ve received many responses with valuable insights I feel are worth sharing. 


For example, retired Army Sgt. Maj. Jeff Howard, the veterans service officer for Adams County, Idaho, wrote in to point out that my advice on appealing a benefits decision might limit a veteran’s ability to use all tools at his disposal --- tools that may avoid the need to file a formal appeal.

  

  

  

  

  

  

  

  

 

   

 

   
“I am very careful when counseling a veteran,” Howard wrote.  “I rarely use the word ‘appeal.’  In fact, if the veteran chooses the appellate route first and loses his appeal, his options are limited.” 


Rather than formally appealing after receiving an initial denial of a claim from VA, Howard said, a veteran can choose a “Request for Reconsideration” a process that allows the submission of new information, such as doctors’ notes, physical therapy notes and/or required photos and statements from family members and friends who know of the veteran’s medical condition.


“I have found that photos and statements are the most effective when proving that a duty assignment confirmation was needed,” Howard said. 


If the reconsideration request is denied, the next avenue available is a request for a review by a decision review officer.


“My personal dealings with the DROs have been positive,” Howard said.  “For example, one veteran was denied an increase in rating on a hip replacement even though his primary care provider and orthopedic surgeon submitted additional evidence.


“Twice, he submitted a request for reconsideration and was denied both times.  He was eventually awarded 100 percent temporary disability for one year after the hip replacement but was denied a claim for permanent increase.”


At that point, Howard said, the veteran submitted a request to a DRO --- and won. 


The Code of Federal Regulations governs in black and white, he said, so it’s no surprise that the initial VA rater denied the claim, he “had no choice,” Howard said.

  

  

  

  

  

  

  

  

  

 

  
The bottom-line advice from a man who works VA cases on a daily basis on behalf of veterans “Only when the request for records consideration is denied and a DRO has denied the claim is it time to file an appeal to the VA Board of Appeals.”


If you intend to file a claim with the VA and have never used the services of a county veteran service officer, I recommend doing so.  I’ve written about these dedicated individuals before; their sole mission is to help veteran and retirees in the preparation, presentation, and prosecution of VA claims.


In fact, the National Association of County Veteran Service Officers has been officially recognized by the VA to perform that mission since 1993.


The NACVSO has a web site with a wealth of information on VA benefits, the claims process, legislative news, and many more links that could be helpful to veterans and retirees.