Veteran Disability Benefits
VA Disability Benefits are given to disabled veterans who have a “service-connected” condition. Disability Benefits are meant to compensate a veteran for any decrease (or perceived decrease- a veteran does NOT need to still be working to qualify) in income that may be caused by their disabilities and to provide health care for these conditions. To receive VA Disability Benefits, the veteran must go through the VA Disability Process.
There are countless factors and details that go into the process, which could take up its own website, let alone one page. We’ll try to outline some of the major events and suggestions we’ve seen while assisting veterans with their claim. For more detailed information, please check out our Resources page for additional links regarding how claims work and what forms are required.
The first step is to file a claim. This is something that is commonly done by either the veteran alone, or with the assistance of a Veteran Service Officer (VSO). Attorney’s typically do not get involved until there’s an appeal of a decision. Here’s where we will offer the biggest suggestion that may help prevent the need for an appeal (thus not requiring an attorney).
When making your initial claim, be sure to include the information you would require if you were the one making a decision. As Jami handles cases at the Court of Appeals for Veteran Claims, she’s noticed a trend of “incomplete” files. This doesn’t mean VA has screwed up and not included the needed records, it’s more a situation where there could be information, but it was never included by the veteran. The best example? A Personal Statement from the veteran and their support network who have witnessed the medical issue. We’ll be writing blog articles on what to include in these letters, so be sure to check back often!
So then, just include a personal statement and your claim will be granted? Nope. Another issue we’ve seen is that submissions will include a form that says something along the lines of “all medical records are part of the file”, usually meaning a veteran only goes to the VA for medical care (no private doctors) and the thought is that since VA has the records, VA will of course review the file and see exactly what they need to, in order to reach to the right decision. Okay, we agree, that would be logical. Do not, we repeat, do NOT try to apply logic to VA.
A better way to think about putting your submission together is to think of a courtroom trial. Imagine for a moment that you are sitting on a jury for a murder case. The judge is on the bench, the prosecutor is sitting at their table, and the defendant and their defense attorney are sitting across from the prosecutor at their table. The defendant looks nervous and you notice someone that might be the defendant’s mom sitting in the courtroom trying not to cry. You understand what’s at stake and intend to take your role as juror very seriously- considering all evidence and testimony. After the formalities the judge looks to the prosecutor and says make your opening statements. For anyone who’s seen a TV court show, this is where the foundation for the entire case is laid out. While no evidence is presented at this point, you know it’s coming. Now, imagine as you’re sitting there knowing you’ll decide the fate of the person accused of the crime that the prosecutor stands up and says, “your Honor, members of the jury, we thank you for your time. All of the evidence needed to convict the defendant is in the record. The State rests.“ In other words, you and the other jurors are going to be handed boxes and boxes of evidence, witness statements, and a bunch of stuff you don’t even know what it’s supposed to be, and you are all supposed to put the argument together yourselves- no guidance from the Court. After all, all the details are in those boxes so you should have no trouble arriving at the proper decision- right?
Well, that’s essentially what’s happening when a claim is submitted (okay, there’s no judge or attorneys, but you get the idea) and you only note that "everything’s in the file". The people making the initial decisions are not doctors and they have to get through so many files a day that reading each page of your file is absolutely impossible. One case Jami worked had over 13,000 pages! Just how fast can YOU read?
Another issue, since again we’re not talking about medically trained people making decisions, is the use of different terms in a medical file. For example, Jami had a case where VA claimed veteran did not suffer from knee instability. Yet, veteran had tons of medical reports noting subluxation and a specific medical diagnosis- both of which when researched actually mean that the veteran suffered from extreme knee instability. The decision maker looked for the term “knee instability” only, with no time to research every medical condition noted in the file to make the connection themselves, didn’t see it, and denied the claim.
Having hopefully painted you a clear picture of what mindset to have when making your submission, we feel it important to note that even if you take all the steps we suggest and connect all the dots for the decision maker, there is no guarantee VA will get it right. But at least you have the evidence to build your claim on already in the file for your appeal.
While we cannot typically get involved until you’ve been denied and have filed your first appeal, we will be writing different articles on this topic that may help you in preparing your first submission. Be sure to check out our Resources page and blog often for the most up to date information.
Aid & Attendance
Aid and Attendance is a benefit paid by Veterans Affairs to veterans, veteran spouses or surviving spouses. This benefit helps those who need financial help to cover in-home care, assisted living facility costs, or nursing home costs. Unlike standard Veterans Benefits which require a service connection, Aid and Attendance is a non-service connected benefit and the disability is not required to be service related.
This benefit is available to wartime veterans and spouses of wartime veterans who have very little or no income, who are at least 65 years old, or, if under 65, are completely and permanently disabled. Further requirements include a discharge under conditions other than dishonorable, having served at least 90 days of continuous active duty with at least one day during an active wartime period. It is not a requirement that a veteran have served in combat though.
Part of the medical requirement is that the Veteran and/or Veteran’s spouse require the aid of another person in order to perform basic functions of everyday living like bathing, dressing, feeding, protecting themselves from normal hazards in the home, or that they be bedridden, or they require nursing home level care. These tests may seem like an obvious yes or no, but VA can seem challenging in their determinations.
While the application can take months before an approval is issued by VA, it is imperative that all requirements are met before the application is submitted. Similar to Medicaid, there are Income, Asset, and Medical tests that need to be analyzed prior to applying. Like Medicaid, VA in 2018 imposed a 36 month look-back for asset distribution. We can discuss what this means for you and your family when we meet.
This description barely touches on all the steps and requirements of the Aid & Attendance process. It cannot be stressed enough though that if you or someone in your family was a servicemember and are needing assistance for the conditions noted above, that you contact a VA Accredited attorney to determine what options you or your family may have. Jami Worley is a VA Accredited attorney and has experience working in the area of Veterans Benefits at multiple levels including Regional, Board of Veterans Appeals, and the Court of Appeals for Veterans Claims. Message or give us a call today!