How Due Process Works in Veterans Disability Compensation Claims

The entire thrust of the VA’s nonadversarial claims system is predicated upon a structure which provides for notice and an opportunity to be heard at virtually every step in the process.  The Secretary shall provide notice of a decision regarding a claim for benefits and “an explanation of the procedure for obtaining review of that decision.”  38 U.S.C. § 5104(a); see Rosler v. Derwinski, 1 Vet. App. 241, 249 (1991).  “Each appellant will be accorded hearing and representation rights pursuant to the provisions of [38 U.S.C. Chapter 71] and regulations of the Secretary.”  38 U.S.C. § 7105(a).  The VA regional office (RO) must provide notice of the right to appeal in regular and in simultaneously contested claims.  38 C.F.R. §§ 19.25, 19.100.

In simultaneously contested claims, the VARO must provide notice of appeal to other contesting parties.  38 C.F.R. § 19.102.  It must provide notification of the filing of an administrative appeal.  38 C.F.R. § 19.52.  It must furnish a Statement of the Case (SOC) to a claimant, 38 C.F.R. § 19.30, which “must be complete enough to allow … appellant to present written and/or oral arguments before the [BVA].”  38 C.F.R. § 19.29.  In simultaneously contested claims, each interested party must be furnished with an SOC.  38 U.S.C. § 7105A; 38 C.F.R. § 19.101.

A Supplemental SOC (a “SSOC”) is required when an appellant submits additional evidence to the VARO prior to the transfer of appellant’s records to the BVA, 38 C.F.R. § 19.37(a), and when a BVA remand of a case to the VARO results in additional evidentiary or procedural development and continuation of the denial of benefits, 38 C.F.R. § 19.38; see generally 38 C.F.R. § 19.31 (“a period of 60 days … will be allowed for response”); 38 C.F.R. § 20.302(c) (but only 30 days, in the case of a simultaneously contested claim, 38 C.F.R. § 20.501(c)).

If the BVA questions the adequacy of appellant’s substantive appeal, appellant is provided “notice … and a period of 60 days … to present written argument or to request a hearing to present oral argument.”  38 C.F.R. § 20.203.  The Board shall decide an appeal “only after affording the claimant an opportunity for a hearing.”  38 U.S.C. § 7104(a).  In connection with the right to a hearing, a claimant has the right to present evidence, testimony, and argument in support of a claim.  38 C.F.R. § 20.700.

A claimant has the right to notification of the time and place of the hearing on appeal.  38 C.F.R. § 20.702(b).  A claimant has the right to notification of the certification of appeal and transfer of the appellate record to the BVA.  38 C.F.R. § 19.36.  If a “Travel Board” hearing is held, a claimant must be notified of its time and place.  38 C.F.R. § 19.76.  When a “Travel Board” hearing is requested, a claimant must be furnished with an SOC if not previously furnished.  38 C.F.R. § 19.77.

“After reaching a decision in a case, the Board shall promptly mail a copy of its written decision to the claimant.”  38 U.S.C. § 7104(e).  A claimant is entitled to a hearing if a motion for reconsideration of a final BVA decision is granted.  38 C.F.R. § 20.1003.  The BVA may vacate an appellate decision which denies “due process of law” upon the request of appellant, or on the BVA’s own motion.  38 C.F.R. § 20.904.  Thurber v. Brown, 5 Vet. App. 119, 123-24 (1993).

As written, the due process provisions of 38 C.F.R. section 3.103 apply only to benefits and relief under part 3 of title 38 of the Code of Federal Regulations.  Part 3 is entitled “ADJUDICATION,” and is divided into two subparts: subpart A, which deals with compensation, pension, and DIC, and subpart B, which deals with burial benefits.  As written, section 3.103(b)(2) requires pre-termination/reduction notice only where there is a termination or reduction of an “award of compensation, pension or [DIC].”  Grovhoug v. Brown, 7 Vet. App. 209, 214 (1994).

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision!

Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims!

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VA Claims Corner: The Importance of VA Medical Exams

Remember when you were in the military and your commanding officer or staff NCO threatened to “write you up” because you failed to get your vaccination or resolve another medical issue near deployment time? Back then, you didn’t have to be as proactive with your medical appointments because safety nets were in place (thanks to your gunny/first sergeant/senior master sergeant/chief petty officer!) to make sure you made it to sick call.

The transition from military to civilian life can make remembering to attend your scheduled medical appointments a little tricky – especially if you’re in the middle of a job search or attending college for the first time. However, it’s important you know that making your scheduled VA exams is essential to accurately processing your claim. VA assesses your exam results when determining service connection for your claimed medical condition. These medical examinations are scheduled by VA and are performed by either a VA physician or contracted physician. It’s important to note these exams aren’t always required to evaluate your medical conditions; however, in instances when they are needed, it’s important that you make every effort to show up!

During my time as a Veterans Service Representative, I would periodically see cases where a Veteran failed to report to his or her medical appointment. While we certainly understand that life can get in the way, missing an exam can have huge ramifications to your benefits to include:

  1. Denial of your original or reopened claim, or claim for increase. When you fail to report for an exam, your claim will be rated based on the evidence available in your record. This could be detrimental to your original claim because the exam results could provide the necessary evidence needed to satisfy service connection. In reopened claims, the exam results may provide the new and material evidence needed to overturn a prior VA decision or, in the case of a claim for increase, show that your condition has worsened.
  2. Reduction or termination of your current benefits. When you fail to report for a reexamination of a running entitlement, VA, under law, is required to issue you a notice that proposes to either reduce or terminate your monthly benefit if an examination is needed to maintain a current rating.
  3. Delay in the decision of your pending claim. Examination requests are in high demand. Rescheduling can delay the processing of your claim and a final decision from VA.

In order to avoid these potential pitfalls, follow these simple tips:

  1. Keep your scheduled exam whenever possible.
  2. Can’t make it? Tell VA immediately by phone, online, or in person. We may be able to reschedule your exam date.
  3. Make sure your address and phone number is up-to-date in eBenefits. VA will attempt to notify you of an exam by letter and telephone. I’ve personally seen countless amounts of returned mail because applicants moved without notifying VA. The easiest and quickest way to update your address and telephone number is through eBenefits.

More information on this topic can be found in 38 Code of Federal Regulation 3.655.

As always, if you still have questions, a VA representative or a Veterans Service Organization may be able to help.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision!

Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims!

Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

VA Claims Corner: What to Expect at Your C&P Exam

When I attended my first compensation or pension (C&P) medical examination several years ago, I didn’t really know what to expect  — I had little information so I was unprepared, and a little anxious before and during my appointment.

I don’t think I’m alone. For some of us, attending a C&P exam for the first time can be stressful — they’re very different from the exams we’ve had in the military or private sector. So it’s understandable how going through an unfamiliar process like a C&P exam for the first time, or even the second time, may cause anxiety.

When I was in the Marine Corps, I found having a bit of intel before entering any situation helpful in alleviating my fear of the unknown.

Here’s what I found helpful:

  1. Your examiner doesn’t decide whether or not your condition is service connected – VBA claims processors do. C&P exams are tools used by claims processors to either collect missing evidence or clarify information in your claim. A complete C&P exam is just one part of the complete body of evidence from which claims processors must consider when making their decision.
  2. Keep in mind, that not all our contentions will require VA examinations. In some cases, claims processors may have enough evidence in hand to make a decision without the need for a C&P examination.
  3. If you’re scheduled for an exam, it’s important that you make every effort to show up! Missing a scheduled exam could adversely affect your claim. You can read more about this in my previous blog ‘Claims Corner: the importance of VA exams.’

As always, if you still have questions, a VA representative or a Veterans Service Organization may be able to help.

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision!

Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims!

Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency

VA Pension Provides Support for Qualifying Veteran Survivors

When Veterans and their family members think of VA benefits – the first thoughts that typically come to mind are VA’s educational benefitscompensation and health care benefits, or home loan benefits. Many don’t realize that VA also offers a benefit that can assist qualifying war-time Veterans and their survivors. As our country’s Veteran and surviving spouse population grows older and ailments worsen, it’s important for Veterans and their families to know about the benefits available to them from VA.

VA pension is an income-based benefit offered to qualifying Veterans and their survivors. The amount of pension payable is based on the Veteran’s or survivor’s family income. VA may be able to deduct out-of-pocket medical expenses from income, including but not limited to amounts paid to nursing homes, assisted living facilities, and for in-home care. Additionally, if VA determines a Veteran or surviving spouse is housebound or requires the aid and attendance of another person, he or she may be entitled a higher rate of VA Pension.

Qualifications

  1. With some exceptions, the Veteran must have served on active duty:
  • Veterans who served on or before September 7, 1980 must have 90 continuous days of service with at least one of those days during wartime
  • Veterans who served after September 7, 1980, must have served at least 24 months or the full period they were called up
  1. Veterans must either be:
  • age 65 or older or
  • permanently and totally disabled

***VA assumes a Veteran to be permanently and totally disabled if the Veteran is a patient in a nursing home or found disabled by the Social Security Administration. There are no disability or age criteria for survivors.

  1. Veterans and surviving spouses must meet income and net worth criteria.

Applying

Though there are various ways to apply for VA pension, the fastest way to apply is online through https://www.ebenefits.va.gov/ebenefits/vonapp.

If you still have questions, a VA representative or Veterans service organization may be able to help. You can also comment below!

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision!

Visit: VA-Claims.org

For Cases & Decisions that Could Save Your VA Service-Connected Claims!

Visit: VAClaims.org ~ A Non-Profit Non Governmental Agency