VA DISABILITY COMPENSATION

Transcription

1 VA DISABILITY COMPENSATION Greensburg Pittsburgh Latrobe

2 MICHAEL V. QUATRINI, ESQ. Accredited by Veterans Administration Sustaining Member of National Organization of Veterans Advocates (NOVA) Other practice areas: Workers Compensation Social Security Disability Pennsylvania Bar Institute faculty and presenter for Social Security: The Basics and Social Security Disability: Advanced Issues Quatrini Rafferty

3 WHAT IS VA DISABILITY COMPENSATION? Tax-free, monthly benefit to Veterans who Incurred injury(s) Incurred disease(s) Aggravated pre-existing conditions during active duty, active duty for training, or inactive duty training. Physical conditions (chronic knee, back, or gastro condition) and mental health conditions (post-traumatic stress disorder (PTSD), traumatic brain injury, etc) Compensation also paid for secondary disabilities Ex.: diabetes à peripheral neuropathy

4 WHO IS ELIGIBLE? * A veteran is eligible for disability compensation benefits when: * Served in the Uniformed Services on active duty or * Active duty for training or * Inactive duty training and * Discharged under other than dishonorable conditions

5 WHO IS A VETERAN? Who is a Veteran? Basic Eligibility for Veterans Benefits By: Christine Scott (Specialist in Social Policy)

6 HOW MUCH CAN A VETERAN RECEIVE? 10% $129 20% $255 After 20% there are variables: Spouse? Kids? How many? Dependent parents? How many?

7 FLOW OF A VA CLAIM Application to Regional Office (6 mths to 1 year wait time or more) Dept of Vet Affairs will gather service records and private medical records; Veteran entitled to medical examination; Ratings Decision (1 year to appeal) Decision Review Officer conference? Statement of Case (60 days to appeal) Board of Veterans Appeals Court of Appeals at Veterans Claims

8 REOPENING CLAIMS Claims that have gone un-appealed, or, have been negatively adjudicated can be reopened. Veteran will need NEW AND MATERIAL EVIDENCE New evidence means existing evidence not previously submitted to agency decision makers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an un-established fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. 156

9 HOW A VET GETS STARTED Regional Office Duq Univ School of Law Veterans Clinic Disabled American Veterans (DAV); Military Order of the Purple Heart

10 Nexus Presumptive vs. Direct

11 PRESUMPTIVE CONDITIONS * Depending on where a veteran served, certain diseases are presumed to have incurred as a result of their service Diagnosis + Service in Designated Area = Claim awarded

12 PRESUMPTIVE: AGENT ORANGE Exposure to Agent Orange is presumed if you stepped on land / served on certain ships in specific areas abroad and in the U.S. * AL Amyloidosis * Chronic B-cell Leukemias * Chloracne (or similar acneform disease) * Diabetes Mellitus Type 2 * Hodgkin s Disease * Ischemic Heart Disease * Multiple Myeloma * Non-Hodgkin s Lymphoma * Parkinson s Disease * Peripheral Neuropathy, Acute and Subacute * Porphyria Cutanea Tarda * Prostate Cancer * Respiratory Cancers (includes lung cancer) * Soft Tissue Sarcomas (other than

13 DIRECT CONNECTION Veteran must show that it is more likely than not that condition is result of service (51% versus 49%)

14 DIRECT CONNECTION Easy: Veteran injures right shoulder when IED explodes and overturns armored vehicle. Treatment is documented in service treatment records. In-service MRI shows torn labrum in the right shoulder.

15 DIRECT CONNECTION Hard: Veteran involved in IED blast which overturns armored vehicle. Although stunned, the veteran adjusts his helmet and - while under fire - makes his way behind the armored vehicle to grab injured friend. After a 30 minute gunfight, the veteran is evacuated by airlift to his remote FOB in provincial Afghanistan, where little or no treatment is available. Through the rest of his deployment, the veteran suffers from daily headaches, dizziness, and occasional double vision.

16 DIRECT CONNECTION Hard (continued): Eager to get out of the service and move on, the veteran skips through his exit examination; After a year of headaches and difficulty sleeping, following return to civilian life Veteran seeks treatment with primary care doctor.

17 DIRECT CONNECTION Hard (continued): Veteran eventually runs into a buddy that tells him to apply for benefits; veteran applies for headaches. VA reviews his claim and determines that there is no connection between his generalized headaches and his service.

18 UNFORTUNATE SERIES OF ERRORS Failure to have contemporaneous diagnosis: unrealistic? Culture of toughness? Lack of direction for initial claim? Thoroughness of VA examination? o disaster

19 POTENTIAL SOLUTIONS Repairing the narrative through throughout recollection: Review of in-service events; Review of compensation file; Supplemental materials: Buddy Statements; Letters home; Metals. Private evaluation

20 Exhibit A: TBI New Exam Letter

21 Exhibit B: TBI Examination