so
welcome to cck live my name is kayla dinofrio i'm an accredited claims agent here with the
agency practice at the firm i'm joined today by frank padula and matthew fusco who are also
accredited claims agents working in the agency practice today we're going to be reviewing some
of the biggest mistakes that veterans make when they're filing va mental health claims
as just sort of a general overview for va ratings for mental health veterans can receive disability
compensation for both physical and mental health conditions that are caused by their
military service va rates mental health conditions differently obviously than physical ailments and
not all psychiatric disorders qualify for service-connected disability compensation
for example personality disorders will not qualify so today we're really just going to be
focusing on those disorders that would qualify for compensation and the types of claims and
how to go about doing so um just some examples of some eligible mental health conditions would
include things like anxiety or panic disorders trauma and stressor related disorders like ptsd
psychotic disorders like schizophrenia schizophrenia cognitive disorders like add or adhd
eating disorders such as anorexia or bulimia mood disorders such as major depressive disorder or
residual psychiatric effects from traumatic brain injuries or tbis aside from eating disorders va
rates all mental health conditions using the same diagnostic criteria
those conditions are going to be rated at either a 0 10 30 50 70 or 100 rating using va's general
rating formula for mental disorders these ratings are based on the level of social and occupational
impairment caused by service-connected mental health conditions so meaning how that condition
affects your ability to interact with other people and your ability to work
just one thing that we want to note is that va has recently proposed to change the way that
they rate mental health conditions as of right now it is still just a proposal nothing is finalized
but we do have some other videos on our website that talk a little bit more in depth about
those proposed changes and how they can affect veterans who are going through the claims process
specifically for mental health conditions um so once you determine that you have a mental health
condition and you think it's related to service the next thing that you're going to want to do
is file a claim um so matt what are some common mistakes that veterans might make when filing
claims and what can they do to avoid it one of the more common mistakes we see being made when
filing claims for mental health conditions is not submitting all the necessary forms the va requires
generally veterans should download and fill out a va form 21-526 ez
when they're applying for specifically benefits and mental health benefits as we're discussing
this can be submitted via mail to the claims intake center in person at your closest va
regional office or even electronically through va's website it's important to know here that
if your claim for mental health condition was previously denied and you're outside of the one
year mark needed to appeal that decision you're going to need to file a supplemental claim which
requires a different form than this initial claim form that we're discussing we have some
other videos posted to our website that get into the specifics of supplemental claims and filing
supplemental claims but just just something that we felt it was important to note here
if you are specifically seeking ptsd benefits va requires that you fill out some additional forms
you're going to want to submit either a va form 21-0781
which is a statement in support of claim for
service connection for post-traumatic stress disorder or a va form 21-0781a
which is a statement and supportive claim for service connection for post-traumatic stress
disorder secondary to a personal assault so those are some additional forms you'll need
to fill out if you're specifically seeking ptsd benefits as a part of your mental health claim
and i think something that's important to note with those specific forms is that they're really
asking for information about what your stressor is details about your stressor what happened
when it occurred where you were stationed or where you were located when it occurred
you can also submit that statement just using kind of general lay evidence without the forms but in
order to make sure that va has all the information especially if you don't have a representative the
form is probably your best option to make sure you have all the information that va is looking for
so if you have more than one mental health condition frank how should you go about
filing for those and what is va going to do with all of your different diagnoses
when you submit a claim for a particular mental health condition va should process your claim as
a claim for any mental health condition this means that va is not supposed to limit its consideration
to the particular mental disorder identified on your claim form so it may be beneficial to keep
your claim in a more broad sense and claim any mental health condition additionally veterans with
more than one mental health condition should be aware of pyramiding pyramiding is the va term for
rating the same disability or same manifestation or same symptom of a disability twice you know
for example veterans who suffer from ptsd might also have a diagnosis of major depressive disorder
if va has conceded that both of these conditions are attributed to the veteran's service
the vendor is not going to receive a rating for ptsd and a rating for major depressive disorder
instead the veteran may receive a combined rating under the diagnostic code for only one of those
conditions so overall va does not consider the number of mental health disorders but instead the
severity and impact of each in order to assign a single comprehensive rating great thank you
and when you are looking for va to make a decision on your claim the other thing
that they're looking at outside of just what you submit is the evidence that's included
one common mistake that we see happen both on the veteran and va's end is relying solely on cnp or
compensation and pension exams um the problem with that is that compensation and pension exams
are often not really an adequate picture of the true nature or extent of the veterans conditions
so instead there's other things that we want to do to maybe supplement the record especially when
it's not the most comprehensive or it is a negative opinion
expert opinions or nexus letters can be particularly helpful in these circumstances they
can provide a much clearer picture of the veteran symptoms and counter any negative va examiner
findings the veterans physician or medical provider can provide a nexus letter as long
as they're a qualified expert in the area that you are seeking benefits for so for example a
psychologist or a psychiatrist for mental health claims if you have an accredited representative or
an attorney that represents you they may also be able to obtain an expert medical opinion
through one of an through an expert that they may work with um to serve as a nexus letter they would
be responsible for looking through your claims file in its entirety and in some circumstances
conducting an interview with you um if they would need it to supplement the record you can also get
additional medical evidence within the file so if you do treat for a mental health condition
especially if it's outside of a va through a private treating physician um adding those records
to the uh to your claims file can be particularly helpful for compensation and pension examiners to
look at and for va adjudicators to look at when they're making a claim they can provide
a lot more context to your disability including the onset and the severity of those symptoms
in addition you can also have your treating physician fill out a disability benefits
questionnaire form or a dbq form this form is essentially the same set of questions that va
examiners are filling out when they're conducting those exams it allows veterans or their healthcare
provider to answer questions about different aspects of their disability including their
symptoms the severity of their symptoms the onset or the possible cause of their symptoms as well
as any relation to any other service-connected disabilities if that's something that's applicable
in the case matt is there any other evidence that might be helpful for these types of claims
sure so something we really wanted to discuss and suggest is submitting lay evidence in your case so
veterans will often think that their medical records alone are sufficient to win disability
benefits however in our experience this is not always the case mental health conditions
specifically can be really difficult to quantify and medical records alone may not be able to
capture the full scope of a disability and how it really impacts a veteran's day-to-day life
along those lines it's important and we want to underscore that veterans should submit written
statements describing how their mental health condition impacts their day-to-day functioning in
their everyday life another type of late statement that you can consider submitting is statements
from family members friends or co-workers with whom you may spend a portion of your time these
accounts can help to corroborate your statements and paint a fuller picture of your condition in
the way that it affects you and others around you it's important to know however that submitting too
much evidence that is not particularly relevant to your claim can make it difficult for va to kind
of sift through that information and locate the pertinent evidence that is most relevant to the
condition you're claiming along those same lines it's important to ensure consistency in the lay
evidence that you are submitting in your case to make sure that the evidence you are submitting is
following the same kind of timeline story symptoms being reported that you've submitted along the
life of your claim so that's another thing that veterans want to make sure that they are doing
is ensuring consistency to avoid any negative credibility findings from the va
that's a really good point thanks matt um so with the different rating criteria va kind of
outlines the social and occupational impairment and they also list a number of symptoms that
might be associated with a particular rating so frank does a veteran need to have every symptom
that's listed in the rating criteria to get that particular rating or what should they do
in order to prove a severity it's important to understand that veterans do not need to exhibit
every single symptom listed in the rating criteria to receive that particular disability evaluation
since mental health conditions can manifest differently per individual va's rating formula
for mental health conditions is not binding and symptoms listed in each level of the rating
formula are simply examples meant to demonstrate the types and levels of impairment commonly found
at that assigned percentage rating and if you're not happy with the rating that they
assign or if they just deny your claim for service connection what options do you have so it's also
important to understand that veterans have the right to appeal unfavorable decisions from va
in other words if your mental health claim is denied or you receive a disability rating that is
lower than you deserve you can disagree with va's decision and continue to seek service connection
or that increased rating you know for instance when a veteran files an initial claim va might
grant a service connection but assign a lower rating than you want and instead of filing a new
claim for increased rating it is more beneficial to file an appeal for that increased rating
and under the new va appeals system veterans can choose from three different review options or
lanes when filing an appeal the first being a higher level review lane the second being the
supplemental claim lane and third is the notice of disagreement lane otherwise known as an appeal
to the board of veterans appeals and continuing to pursue a claim through the appeals process
allows veterans to preserve their effective date and could entitle them to a larger sum of
retroactive benefits down the road great and one important thing to note is those different appeal
options some are applicable with certain decisions while others are not and the different appeal
options do have sort of different rules for when you can or can't submit evidence and what he's
going to consider we have a lot of other videos dedicated to this specific topic on our website
um and on our other socials so i do recommend checking those out for more information about
the different appeal options and sort of the rules that go along with each of them but with
that i think that's kind of a good place for us to close out today matt or frank do you have any
sort of closing thoughts or any other things you want veterans to keep in mind when filing these
types of claims just i guess one tip that you kind of mentioned earlier kayla is seeking the
help of an accredited representative is really can be a really useful tool when it comes to
this type of thing to avoid mistakes in the claims filing process especially for mental health claims
because they can of course get a bit complicated um as with many other things with filing va claims
so i think that one thing we would suggest is that seeking out the help of an accredited
representative or attorney can be super useful to avoid any any pitfalls in the claims process
great yeah i have to second what matt says it can be very complicated with these types of claims
so if you need help at all i would definitely seek out an accredited representative or attorney to
help you out agreed thank you both so much thank you all for tuning in today be sure to subscribe
to our channel and check out our library of videos for more information about the va cleans process
you