The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your...

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The Life Cycle of a VA Claim and the VA forms we see in-between

Transcript of The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your...

Page 1: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

The Life Cycle of a VA Claim

and the VA forms we see in-between

Page 2: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

Standard VA forms and what they mean General overview of the VA claims process General overview of the VA Appeals

process RAMP Questions

Page 3: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

21-0966: Intent to File 21-526EZ: Compensation 21P-527EZ: Pension 21P-534EZ: Survivors Benefits 21-0958: Notice of Disagreement VA Form 9: Appeals process

*Type into Google: VA Forms*Scroll down to Search: Form Number

Page 4: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

Getting out of the military

Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA

form 21-526EZ).

Under review Claim has been assigned to a VSR and is being

reviewed to determine evidence needed. If evidence isn’t needed (i.e. FDC, DRC) claim

moves to the Preparation for Decision phase.

Page 5: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

Gathering of Evidence Any evidence you may have Medical professional Government agency Lay/ buddy statements (common for claims to return to this stage)

Review of evidence Once all evidence has been received, the VSR will

review and determine if that is enough If more evidence is needed, claim will be sent back

to the Gathering of Evidence phase.

Page 6: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

Preparation for decision VSR has recommended a decision, and is

preparing required documentation detailing decision (Narrative).

If more information is required than claim will be sent back to Gathering of Evidence phase.

Pending Decision Approval Recommended decision is reviewed If more evidence is needed send back to GoE.

Page 7: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

Preparation for Notification Entire claim decision is being prepared

Completion VA has sent your packet to the mailing address

in their database. ******

Page 8: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

I disagree with my decision!!! Complete Notice of Disagreement within

one year of Notification Good idea to get new evidence, or a

diagnoses from a care provider

Or;

Page 9: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

New and Relevant Evidence Takes months instead of years Have to do it within one year of your

Notification

Page 10: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

Submission of Notice of Disagreement Statement of the Case (SOC) VA Form 9 Supplemental Statement of the Case

(SSOC) VA Form 9 (if you have New and

Material Evidence: repeat) Off to Board of Veterans Appeals

Page 11: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

Your three options: Travel Board Teleconference* Trip to DC (non-reimbursable)

De Novo Review (claim will be reviewed with new eyes)

If required. Possible Remand (your claim gets sent back to new examination)

Finalized.

Page 12: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).
Page 13: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

Higher Level Review You’re all in. Meaning, you have all necessary

evidence and supporting documentation to complete your claim. Also allows for a telephonic conference with your Service Officer to discuss your claim.

Supplemental Review VA assists in gathering of evidence. If you

need a new examination the VA will set one for you, if you have additional documentation to submit, the VA will allow you to submit it.

Page 14: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).

RAMP opt-in election needs to be submitted to the VA. You can opt-in the moment you receive a

unfavorable decision. Submit an NOD, followed by your opt-in

letter to the VA. RAMP is an ALL-IN decision. You cannot

choose which issues you want. Everything goes! 120 days

Page 15: The Life Cycle of a VA Claim - Life Cycle of a VA... · Getting out of the military Submitting your claim, or Claim received When a veteran applies for benefits (e.g. VA form 21-526EZ).