foreign
welcome to another edition of cck live my name is Mike lestritto and today I'm
joined by Michelle dettori and Elise Phillips to discuss common mistakes veterans make when
filing VA claims for increased ratings so to begin with an overview of va ratings when a
veteran applies and is ultimately granted VA service connected disability benefit
s science a disability rating for the condition based on the severity and impact on the veterans
earning capacity these ratings are assigned based on va's what's known as schedule for
rating disabilities which assigns a particular rating VA rating based on specified symptoms that
the VA is looking for um to assign a particular rating these ratings can
range from a zero percent what's known as a non-compensable rating all the way up to
the max scheduler rating of a hundred percent and typically um the increments range in uh
at 10 increments um so a rating from 0 to 100 qualifies the veteran for monthly compensation
um zero percent obviously being um a service connected condition that unfortunately does
not result in any multi-compensation but is nevertheless service connected or related
to service and 100 rating uh providing the max rating allowed at least for a scheduler rating
ultimately as I'm sure you can suspect a higher rating equals more monthly compensation
so with that very brief background in mind uh Michelle I'm going to turn it over to you can you
talk to us a little bit about what our claims for increased ratings of a service connected condition
so anytime that veteran believes they are underrated they can either file or appeal
for an increased rating for their condition so how you do that is you essentially it depends
on kind of where you're at with your case so if you're within a year of a reading decision that
denied denied or granted service connection and you didn't think that the rating was high
enough you would appeal at that point in time you can either usually in the AMA system which
is the appeals modernization act you can file a supplemental claim Appeal on a VA form 0995
you can file a higher level review Appeal on a VA form
0096 or you can file directly to the board on a Nosa disagreement which is a VA form 101.82
if you're outside the one-year window then you're going to be filing a new claim for an
increased rating which is typically going to be the VA form 526 however sometimes it still
might be the supplemental claim form just depends on kind of the case and scenario
um again it gets a little confusing with the forms um but you would be filing there for an
increased rating um for the condition so kind of what do you need to support it or you know what
do you need to do in order to file is you typically would want to be submitting
evidence that supports that your disability has worsened or was underrated um it can be
treatment records it can be statements it can be even a VA examination that supports that
keep in mind anytime you usually submit a claim or appeal for an increased rating VA will typically
always schedule a VA examination so a lot of times you will have that going on well it just depends
also on what type of Lane that the appeal has gone in because keep in mind the duty to assist is not
in every appeal Lane in the appeals monetization act so if you went higher level review or certain
board uh review Lanes unfortunately it doesn't always um require an examination or examination
will not be submitted but if you do have evidence in your election for appeal does allow for you to
submit evidence those are some things that you would want to do is you know get maybe a private
medical opinion or you could go out and get your medical records or something that supports your
increased rating yeah and so this is this is a big change from the old appeals processing system
potentially right so in the old system prior to February 19 2019 uh commonly referred to as
the Legacy appeal system veterans could submit evidence at any point in time to support their
increased rating claim or appeal um and Michelle now in the new appeal system the the AMA system
that you alluded to they're very specific periods when veterans can submit uh you know lay us lately
statements as you alluded to medical records or other evidence um and so I think it's right
it's it's really worth veterans understanding the different appeal options that they have in ama and
when and then when they cannot submit evidence in support of their increased rating claim or appeal
yeah it's very confusing and it's it it's limiting in a lot of ways but
um this is when it's with this appeal system we always find that it's very helpful to reach out
to somebody that knows you know when and how and what's the best course of action um based on you
know especially something like this where you're trying to demonstrate that your disability has
worsen do you want to be able to submit evidence and so sometimes you want to be able to talk to
somebody to see what's the best way to go in order to be able to do that yeah exactly and that leads
into our our next topic here uh at least common mistakes veterans make when filing for increased
ratings um you know so there are a number of different potential pitfalls that veterans can
unfortunately fall into can you walk us through um a couple here to start absolutely so the first one
is gonna actually kind of off what Michelle was talking about and it's going to be not appealing
um and increased trading decision whether you're granted an increase rating that you
think you should be granted hire one or you're just denied an increased rating
um you do have a right to an appeal an unfavorable decision from the VA um and it's important that if
you are still within a certain time period which is you know under the year in most cases that
you should file an appeal rather than a new claim the reason for that being that you'll be able to
preserve your claim stream your effective date will go back to when you initially filed your
volume if you file a new claim it might mess up your effective date sometimes it can really
map up your whole claim stream um if things you know aren't filed on the proper form so
going back to what we're talking about really important to have um assistance there uh and
you know sometimes we'll see veterans file things on the wrong forms they'll be intending to file an
appeal but they're actually filing something on a new claim form VA will accept that as a
new claim and change their effective date so it is really important to be careful with the forms that
you're using and if you are within the appeal period to actually appeal not file a new claim
um going off that another thing that we see is people will wait to file their claim so
um basically they'll miss that date that effective date uh be very careful when you do have either
um but when you're appealing just make sure that you are filing that within the one year again like
I said if you don't it will mess up your effective date yeah and so it seems in my mind to be you can
break it down into two ways of thinking about it right if there's a decision that a veteran
receives that is you're still within the one year period to appeal the increased rating
veterans should file the appeal rather than submitting a new claim for that same condition
um if veterans are outside of the one-year period to appeal either a denial or a grant
that they're not satisfied with for the increased rating plan
um so they unfortunately cannot appeal then they would file a new claim and I think what we have
all seen in our practice is that the sooner you file the better and in order to lock in that
effective date and one mechanism in order to do that is to file an intent to file form which is
a specified form that VA has veterans or veterans Advocates can can file the form they don't have to
necessarily even specify the type of claim that they're going to file at that time but that form
in and of itself locks in the effective date as of the date that the veteran files the intent to file
so long as the veteran ultimately ends up filing the claim within one year of the intent to file so
you know waiting to to file the new claim if that's what is in fact is needed uh could
result in a loss of retroactive benefits for for months or years potentially um even if
the veteran ultimately has their claim granted so that's a very common you're right police that's a
very common mistake that we unfortunately see all the time in our practice here um another
common mistake that I see is the failure to obtain sufficient medical evidence or a medical opinion
so VA often denies increased rating claims or appeals based on the fact that it finds that
there's a lack of medical evidence specifically demonstrating the severity of the condition and
or how the disability has worsened so therefore a medical opinion from either an independent
expert or even a letter from a private health care provider that the veteran can obtain in
that submit can really make a huge difference in helping to support and ultimately have your claim
granted veterans often make the mistake of relying on the results of Simply a compensation and
pension examination so in other words a VA exam it's really important to rebut any unfavorable
findings that may exist in a compensation and pension examination with your own medical evidence
again whether that's you know a private treating physician that can write a letter for you maybe
that individual has known you and examined you for a long time they can State as much in the letter
um or you know an independent expert in some situations can really be helpful as well
um those individuals particularly Private health care providers often know the veteran and can
speak to um all the the reviews and examinations that they provided to the veteran in the past and
oftentimes VA uh at least we would argue should find that that evidence is much more probative
much more important to consider when examining the veterans condition or the severity of the veterans
condition then one compensation and pension examination that occurs at One Moment In Time
perhaps for 10 to 15 minutes um you know without a thorough review of the file
in a similar vein another mistake that we see very frequently unfortunately is that veterans do not
attend their compensation and pension examinations so although we want to rebut unfavorable findings
if they do occur in compensation of pension examinations like we were just talking about
it is ultimately very important that veterans do attend these exams why because if a veteran
doesn't attend a compensation and pension examination it's very low hanging fruit for
V8 to swoop in and deny on the sole basis that the veteran did not attend the exam oftentimes in a
lot of decisions that I've seen the VA won't even cite any other evidence they'll just say nope you
know we scheduled for an exam you didn't attend I'm sorry we're denying your claim so don't let
that happen to you we want to make sure that we're attending all of our all of our CMP exams um and
then even if it's unfavorable we will have ways or your representative will have ways to potentially
address those unfavorable findings but it is important that veterans attend in the first place
another thing um on the topic of compensation and pension exams is veterans are entitled to a
copy of the exam and so the report may not be done the same day even the same week perhaps
even the same month unfortunately um as the date of the exam but ultimately veterans are
and Veterans Advocates representing the veteran are entitled to a copy of the exam and I would
I really recommend that veterans or accredited agents or attorneys request a copy of the exam
so that they can see specifically what the findings were and how to how to report them
uh Michelle turning turning back to you um can you tell us a little bit about the submission
of evidence that either is unhelpful or is just irrelevant to a veteran's claim
yeah so I think sometimes we see where
it the evidence isn't submitted that supports the increase rating or showing that the increase
rating and I think sometimes the confusion is what is the issue at this point so sometimes
you know you've been fighting so long for service connection you get service connection and I think
it's hard to realize that at this point now you're switching like Ba's granted service
connection now the issue is no longer whether or not the conditions related to service the issue is
the severity of the condition so sometimes clients will be resubmitting service records resubmitting
all this evidence showing that the condition is related to service one at this point in
time that's no longer va's problem or va's issue with the claim or appeal their issue is that they
don't believe the increased rating is warranted or they believe that they've given the proper rating
so at that point in time the issue now becomes finding records that show that increased rate
um I think sometimes you also see where clients submit all their medical records where you end
up submitting hundreds and hundreds of pages of medical records that maybe don't have to
do with this condition so you know you'll say I trade here here's all my VA medical records and
like that that's great and that's definitely what you should be doing in some cases but sometimes
it varies the relevant evidence in thousands and thousands of pages of unrelevant evidence
so it's hard to find those pieces of evidence that support the increase rating in those circumstances
what I would usually tell a client is let's find the doctor let's find the records that
show the increase rating and that's what we want to be submitting we don't we can also obviously
tell them where you're treating tell them to get those records but we want to highlight
the records that support the increased rating so we want to make sure we're submitting that
I also think that sometimes going along with you know submitting the proper evidence it's
also knowing what actually entitles them to an increased rating which can be difficult because
now you're talking VA regulations VA rating critiators and sometimes that information is
not always very comprehensible sometimes they're talking about ejection fraction rates and medical
terms and stuff that maybe you know people aren't as familiar with so it's very hard to know
um so I think that it's also going along with the finds of you know what evidence to submit
is also knowing kind of how you're going to get to that increased rating and unfortunately some cases
you know the condition might be worse and you might feel worse than you know the 10 rating or
the 20 rating that you got but unfortunately these rating criteria is very strict in the sense that
you're just not going to get that increased rating um up to you know 30 or the 40 you know based on
you know the additional pain because they require you know X Y and Z instead so I think that that's
something also to be very mindful of is you know ing if you are entitled to the next highest rating
based on the rating criteria and that's again when you know reaching out to somebody you know
reaching out to their credit representative an attorney a vso somebody that could help you you
know understand if you're unclear on the reading criteria as well yeah and so the bad news is that
the rating criteria is often complex it changes frequently it's difficult to understand and then
difficult to to apply the good news though Elise is that there's help out there for veterans right
absolutely and that brings us to our last common mistake which is failing to seek assistance from
a representative um we see especially now with a new implementation of the AMA the
VA disability claims process is just it's such a complex system with regulations procedures forms
um you know requirements that are expected of a veteran to be able to get their increased rating
that it is um very helpful to have someone who is knowledgeable um and can help you kind of just
guide through uh the weeds a bit um help you with knowing which forms to file whether you should be
filing an appeal or a new claim um help you gather the medical evidence that you might need or lay
evidence that you might need to get that increase rating and also just what type of evidence really
VA is going to be looking for um so a accredited representative can help you gather all of that
um and their experience is going to help ensure that you get the benefits that you deserve
all right um well thank you both that's all that we have for you today for more information
on increased ratings um and increased rating claims and appeals check out our other YouTube
videos and as always be sure to subscribe to our Channel and follow us on social to keep up
to date with the latest veteran related news as always thank you for joining us
foreign