Category Archives: Types of VA Claims

Camp Lejeune Contaminated Water

The Department of Veterans Affairs (VA) amended its adjudication regulations relating to presumptive service connection to add certain diseases associated with Camp Lejeune contaminated water from August 1, 1953 to December 31, 1987:

https://www.federalregister.gov/documents/2016/09/09/2016-21455/diseases-associated-with-exposure-to-contaminants-in-the-water-supply-at-camp-lejeune

This new rule establishes that veterans, former reservists, and former National Guard members, who served at Camp Lejeune for no less than 30 days (consecutive or nonconsecutive) during this period, and who have been diagnosed with any of eight associated diseases, are presumed to have a service-connected disability for purposes of entitlement to VA benefits.

Presumptive Diseases Due to Camp Lejeune Contaminated Water

  • Kidney cancer
  • Non Hodgkin’s Lymphoma
  • Adult Leukemia
  • Liver Cancer
  • Bladder Cancer
  • Multiple Myeloma
  • Parkinson’s Disease
  • Aplastic Anemia
  • Other Myelodysplastic Syndromes

Eligibility

VA will presume exposure to Camp Lejeune contaminated water for all active duty, reserve, and National Guard personnel who served for no less than 30 days (consecutive or nonconsecutive) at Camp Lejeune during the period beginning August 1, 1953, and ending on December 31, 1987. VA will include both consecutive and nonconsecutive days in the calculation of the 30-day requirement for veterans who may have served at Camp Lejeune on multiple occasions that total no less than 30 days.

Camp Lejeune Contaminated Water

This proposed rule covers any veteran, reservist, or member of the National Guard, whose military orders or records establish their presence within the borders of the entirety of the United States Marine Corps Base Camp Lejeune border, which includes Marine Corps Air Station New River.

Pending VA Disability Compensation Claims

This rule applies to claims received by VA on or after the date of publication of the final rule in the Federal Register and to claims pending before VA for presumptive diseases related to Camp Lejeune contaminated water on that date. This proposed rule would not apply retroactively to claims previously adjudicated. A claim is considered to be adjudicated once a decision is made and the appeal period has expired. A claimant has one year from the notification date to appeal the decision before it becomes final.

 

 

Dependency & Indemnity Compensation (DIC)

Dependency & Indemnity Compensation (DIC) is a tax free monetary benefit paid to eligible survivors of military Servicemembers who died in the line of duty or eligible survivors of Veterans whose death resulted from a service-related injury or disease.

Bronze Star And Purple Heart

Eligibility (Surviving Spouse)

To qualify for DIC, a surviving spouse must meet the requirements below.

The surviving spouse was:

Married to a Servicemember who died on active duty, active duty for training, or inactive duty training, OR
Validly married the Veteran before January 1, 1957, OR
Married the Veteran within 15 years of discharge from the period of military service in which the disease or injury that caused the Veteran’s death began or was aggravated, OR
Was married to the Veteran for at least one year, OR
Had a child with the Veteran, AND
Cohabited with the Veteran continuously until the Veteran’s death or, if separated, was not at fault for the separation, AND
Is not currently remarried

Note: A surviving spouse who remarries on or after December 16, 2003, and on or after attaining age 57, is entitled to continue to receive DIC.
Eligibility (Surviving Child)

Not included on the surviving spouse’s DIC, AND
Unmarried, AND
Under age 18, or between the ages of 18 and 23 and attending school.

Evidence Required

Listed below are the evidence requirements for DIC:

The Servicemember died while on active duty, active duty for training, or inactive duty training, OR
The Veteran died from an injury or disease deemed to be related to military service, OR
The Veteran died from a non service-related injury or disease, but was receiving, OR was entitled to receive, VA Compensation for service-connected disability that was rated as totally disabling
For at least 10 years immediately before death, OR
Since the Veteran’s release from active duty and for at least five years immediately preceding death, OR
For at least one year before death if the Veteran was a former prisoner of war who died after September 30, 1999

Effective Date

For claims based on death in service, the effective will be the first day of the month in which the death actually or was presumed to have occurred.

  • If the death occurred after service and the claim is received within one year of the Veteran’s death, the effective date will be the first day of the month in which the Veterans died.
  • If the death occurred after service and the claim is received after one year of the Veteran’s death, the effective date is the date of receipt of claim.

Courtesy of www.va.gov

Filing a VA Disability Claim

Filing a VA disability claim? Here is what you need to know.

Service connected disability compensation is a benefit that is exactly what it sounds like: it’s compensation for a current disability that occurred as a result of your active duty service. In order to be successful and have your disability claim approved, you are going to have to satisfy three requirements:

  1. Diagnosis of a current disability
  2. An event or stressor that occurred during your active duty service
  3. A “nexus” or connection between the in service event and the currently diagnosed disability.

Diagnosis: you must have a condition that is currently diagnosed by a doctor in order to have a disability. A common mistake is to claim a condition that occurred during service, but currently is not disabling. For example, if you broke your ankle on active duty but it healed completely with no residual effects, then you cannot claim a disability for the ankle. Another one is Agent Orange. Although you may have been exposed to Agent Orange while serving in Vietnam, if you do not have a currently diagnosed condition that was caused by Agent Orange, then you do not have a VA disability claim. Exposure itself to Agent Orange is not a disability.

In service event: there must have been something that occurred on active duty service that caused the current disability, or the condition started while you were on active duty and has been chronic and continues to this day. For example, Post-Traumatic Stress Disorder (PTSD) is caused by a stressful event, or stressor, that happened while you served such as being directly involved in combat.

The complaint of the condition must be documented in your Service Treatment Records, or a stressor that is proven through other means such as witness statements.

Nexus: A nexus is the connection between the event that happened in service and the currently diagnosed disability. A nexus can be provided by a VA examiner from a C&P exam, or an independent medical opinion from a private doctor with specific knowledge of the diagnosed disability. For example, if you were treated for a knee injury in service and you continued to have chronic problems with it up until the present time, then you have a disability claim for a knee condition if it’s diagnosed.

Presumptive conditions: presumptive conditions are those conditions where you do not need to provide a nexus between the in service event and the current condition; the VA automatically presumes the event caused the disability.

Agent Orange is the biggest presumptive condition for a VA disability claim. If you set foot on the ground in Vietnam during the war, then you are automatically presumed to have been exposed to Agent Orange. If you are diagnosed with one or more of the presumptive conditions, such as ischemic heart disease, Parkinson’s disease, or Diabetes Mellitus, Type II, then the VA presumes that exposure to Agent Orange caused the disabilities.

For Gulf War veterans who served on active duty in the Southwest Asia theater of military operations, there is a presumption of service connection for certain medically unexplained chronic multisymptom illnesses. These conditions include: fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems. A complete list is also available at vetdisabilityaid.com.

For PTSD claims, if you were awarded a Combat Action Ribbon or Combat Infantryman Badge, then you do not need to provide a stressor, it’s automatically presumed because of your involvement in combat.

army-combat-infantryman-badge
Combat Infantryman Badge
Combat Action Ribbon
Combat Action Ribbon

NOD vs Reconsideration / Reopen

What route should you take with your denied VA disability claim: NOD vs reconsideration / reopen? Make sure that you know the facts before you make a decision.

First, I want to say upfront that I advise filing an NOD 99% of the time. Let’s start out by talking about the advantages of an appeal instead of a reconsideration or reopen. When you file an NOD, you also want to elect to have a “de novo” review performed by a Decision Review Officer (DRO). A DRO is an experienced supervisor who will take a fresh look at the claim and set aside the previous decision that was made. The DRO has the ability to approve the claim based on the evidence that was already submitted if he/she found that a mistake was made in the previous decision, and new evidence can also be submitted with the NOD for the DRO to consider. If the decision is favorable and the claim is approved, the effective date will be the original date of claim and the veteran will be paid retroactively to that date.

Now, let’s talk about the advantages of requesting a reconsideration / reopen of a previously denied claim instead of filing an NOD. There is only one advantage, and it is at best just a slightly better possible outcome: timing. We all know how long it takes the VA to do anything and chances are that you had to wait a very long time to even get the first bad decision on your claim. When you talk to an ill-informed VA representative or Veteran Service Officer about filing an NOD, they will try their hardest to have you file a reconsideration / reopen the claim at a later date. They will say that it will take several years for your appeal to go through and that a reconsideration / reopen is much quicker, but that may not necessarily be accurate. About 80-85% of the NODs that I submit get approved by the DRO at the Regional Office level within about a year, which is the same timeframe as a reconsideration.

This leads us to the disadvantages of an NOD. If the DRO continues the denial after conducting a de novo review, then the claim goes to the Board of Veterans Appeals (BVA) in Washington DC, and it may in fact take several years for the decision. One other factor to consider when filing an NOD is that you only have one year from the date of the decision to file a Notice of Disagreement. So as long as you are within a year from a denial, you should go ahead with the NOD. Otherwise, your only other option would be to reopen the claim if the denial is more than a year old.

When we look at the disadvantages of filing a reconsideration / reopen, the facts tell the real story. Probably the most important issue is evidence. If you have a claim that was denied, then you must submit new and material evidence in order for the claim to be reconsidered or reopened. What if the you submitted all of the necessary evidence with the original claim and it was still denied? If you file an NOD, the DRO may find that a mistake was made and the evidence that was submitted was overlooked or improperly evaluated, and the claim could be approved. With a reconsideration or reopen, you don’t have this option and unless you have something new and material to offer, you will not be successful and the claim will remain denied.

Most importantly, you stand to lose out on a significant amount of back pay when you file a reconsideration or reopen. If the claim is approved, the effective date will be the date that you submitted the new and material evidence. With an NOD, the effective date is the original date of claim. In some cases, this may be several years worth of retroactive pay.

An ill-informed VA representative or Veteran Service Officer (VSO) may try to discourage you from filing NOD, and they will try their hardest to have you file a reconsideration or reopen of the claim instead. They do not always have your best interests in mind.

I am working with a Veteran who was talked into withdrawing his NOD by a VSO and filing a reconsideration. As a result, it cost him over $46,000 in back pay!

Losing money with a reconsideration

Remember, don’t let anyone persuade you to do something that isn’t in your own best interests.

 

VA Aid & Attendance

The VA Aid & Attendance Benefit is a non-service connected pension available to wartime veterans and their surviving spouses to help with long-term care expenses including assisted living and in-home care.

Eligibility for VA Aid & Attendance:

1. Military:

Veteran had 90 days active of service with one day during a qualified war period:

a. World War II: December 7, 1941, through December 31, 1946, inclusive. If the veteran was in service on December 31, 1946, continuous service before July 26, 1947, is considered World War II service.
b. Korean Conflict: June 27, 1950, through January 31, 1955, inclusive.
c. Vietnam Era: February 28, 1961, and ending on August 5, 1964, in the case of a veteran who served in the Republic of Vietnam (“in country”). Otherwise, all inclusive from August 6, 1964 through May 7, 1975.

2. Medical:

Claimant (applicant) must be in need of aid and attendance (assistance) from another person with (2) Activities of Daily Living (ADLs) from the following: bathing or showering, dressing, eating, getting in and out of bed or a chair, and using the toilet.

3. Financial:

Each candidate is evaluated on a case-by case basis for qualification.

a. Income: the person must be spending a majority of their income to qualify for the benefit. Medical expenses may be deducted against income to qualify. Income includes: social security, any pensions, long-term care insurance benefits, annuity payments, and interest & dividends. A candidate must be spending all of their income on care expenses in order to receive the maximum benefit amount.

b. Assets: there is no specific limit for qualifying. Factors such as age, marital status, health condition, and income are used to determine the net worth limit.

4. Benefit Rates:

The VA Aid & Attendance benefit is paid on a tax-free monthly basis directly to the veteran or spouse. These rates may increase annually.

Married Veteran: $2,169
Single Veteran: $1,830
Unremarried Surviving Spouse: $1,176

VA Aid & Attendance Recipients

 

 

 

 

 

5. Required Supporting Documentation:

a. Original/certified copy of vet’s military discharge (DD214): www.archives.gov
b. Asset Verification: most recent bank & investment account statement(s)
c. Income Verification: Social Security, pension, disability income statement(s)
d. For Married Veterans and Surviving Spouses: copy of marriage certificate, documentation of previous marriages
e. For Surviving Spouses only: copy of veteran’s death certificate

For the Department of Veterans Affairs guide to pension and representation for VA Aid & Attendance claims click here.

Agent Orange Disability Claims

Agent Orange Claims: Were You Denied?

Veterans who served in Vietnam and “in country” even if only for a day, were exposed to Agent Orange. Brown Water Navy Veterans and Blue Water Navy Veterans who came ashore were also exposed to Agent Orange, as well as many others who served during the Vietnam Era.

Helicopter spraying agent orange

Presumption of Exposure to Agent Orange

If you served “boots on the ground” in Vietnam and you now have an Agent Orange presumptive disease, then you must be awarded service connected disability compensation. Period.

Know your rights when it comes to Agent Orange disability claims.

Veterans’ Diseases Associated with Agent Orange

VA assumes that certain diseases can be related to a Veteran’s qualifying military service. These are called “presumptive diseases.”

VA has recognized certain cancers and other health problems as presumptive diseases associated with exposure to Agent Orange or other herbicides during military service. Veterans and their survivors may be eligible for disability compensation or survivors’ benefits for these diseases:

  • AL Amyloidosis
    A rare disease caused when an abnormal protein, amyloid, enters tissues or organs
  • Chronic B-cell Leukemias
    A type of cancer which affects white blood cells
  • Chloracne (or similar acneform disease)
    A skin condition that occurs soon after exposure to chemicals and looks like common forms of acne seen in teenagers. Under VA’s rating regulations, it must be at least 10 percent disabling within one year of exposure to herbicides.
  • Diabetes Mellitus Type 2
    A disease characterized by high blood sugar levels resulting from the body’s inability to respond properly to the hormone insulin
  • Hodgkin’s Disease
    A malignant lymphoma (cancer) characterized by progressive enlargement of the lymph nodes, liver, and spleen, and by progressive anemia
  • Ischemic Heart Disease
    A disease characterized by a reduced supply of blood to the heart, that leads to chest pain
  • Multiple Myeloma
    A cancer of plasma cells, a type of white blood cell in bone marrow
  • Non-Hodgkin’s Lymphoma
    A group of cancers that affect the lymph glands and other lymphatic tissue
  • Parkinson’s Disease
    A progressive disorder of the nervous system that affects muscle movement
  • Peripheral Neuropathy, Acute and Subacute
    A nervous system condition that causes numbness, tingling, and motor weakness. Currently, it must be at least 10 percent disabling within one year of herbicide exposure and resolve within two years. VA proposed on Aug. 10, 2012, to replace “acute and subacute” with “early-onset” and eliminate the requirement that symptoms resolve within two years.
  • Porphyria Cutanea Tarda
    A disorder characterized by liver dysfunction and by thinning and blistering of the skin in sun-exposed areas. Under VA’s rating regulations, it must be at least 10 percent disabling within one year of exposure to herbicides.
  • Prostate Cancer
    Cancer of the prostate; one of the most common cancers among men
  • Respiratory Cancers (includes lung cancer)
    Cancers of the lung, larynx, trachea, and bronchus
  • Soft Tissue Sarcomas (other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma)
    A group of different types of cancers in body tissues such as muscle, fat, blood and lymph vessels, and connective tissues

Children with Birth Defects: VA presumes certain birth defects in children of Vietnam and Korea Veterans associated with Veterans’ qualifying military service.

Veterans with ALS: VA presumes amyotrophic lateral sclerosis (ALS) diagnosed in all Veterans who had 90 days or more continuous active military service is related to their service, although ALS is not related to Agent Orange exposure.

Source: U.S. Department of Veteran Affairs

38% Error Rate at VA

The VA acknowledges it makes mistakes on 14 percent of disability claims – an error rate the agency considers unacceptable and has pledged to all but eliminate by 2015.

A CIR analysis of 18 audits published this year by the VA’s inspector general shows the problem could be much worse, especially in high-profile cases. The analysis found a 38 percent average error rate for claims involving disabilities like traumatic brain injury and illnesses linked to the Vietnam-era defoliant Agent Orange…more

Exposure to Agent Orange by Location

Part of the United States’ strategy in Vietnam was to conduct an herbicide program to remove foliage providing cover for the enemy. Agent Orange was the most widely used of the herbicide combinations sprayed.

Agent Orange and other herbicides used in Vietnam were tested or stored elsewhere, including some military bases in the United States…more

Institute of Medicine Reports on Agent Orange

VA contracts with the IOM of the National Academy of Sciences, a nongovernmental organization, to scientifically review evidence on the long-term health effects of Agent Orange and other herbicides on Vietnam Veterans. IOM determines whether the evidence points to a statistically valid association that would suggest or establish a relationship between diseases studied and herbicide use…more