1. CVSO Fall Training Who’s Next?

2. Arkansas Department of Veterans Affairs We are a state agency representing veteransWe are a state agency representing veterans We do not decide claimsWe do not decide claims We assist veterans in claims preparationWe assist veterans in claims preparation We assist veterans in claims appeal processWe assist veterans in claims appeal process We provide information on state benefits for veterans http://www.veterans.arkansas.govWe provide information on state benefits for veterans http://www.veterans.arkansas.govhttp://www.veterans.arkansas.gov You are our first line of defense and play a vital role in helping claimants secure their benefitsYou are our first line of defense and play a vital role in helping claimants secure their benefits Promote E-BenefitsPromote E-Benefits

3. Interview the Claimant Introduce yourself to the claimant.Introduce yourself to the claimant. Determine veteran status (DD214)Determine veteran status (DD214) Obtain/Confirm representation (VA Form 21-22)Obtain/Confirm representation (VA Form 21-22) Form 80 or NACVSO1Form 80 or NACVSO1 Ask what is it you can do for him/herAsk what is it you can do for him/her Listen!Listen! Determine eligibility of benefit sought; be specificDetermine eligibility of benefit sought; be specific Ask about medical records and other evidenceAsk about medical records and other evidence Do Not Smile and File!Do Not Smile and File!

4. Service Organization Arkansas Department of Veterans AffairsArkansas Department of Veterans Affairs American LegionAmerican Legion Veterans of Foreign WarsVeterans of Foreign Wars American Ex Prisoners of WarAmerican Ex Prisoners of War Marine Corp LeagueMarine Corp League Catholic War Veterans of the USACatholic War Veterans of the USA This is not an all inclusive listThis is not an all inclusive list

5. Eligibility A veteran who served in the active military, naval or air service, and wasA veteran who served in the active military, naval or air service, and was Discharged or released under conditions other than dishonorableDischarged or released under conditions other than dishonorable “VETERAN OF ANY WAR” means any veteran who served in the active military, naval or air service during a period of war as set forth in 38 CFR 3.2”“VETERAN OF ANY WAR” means any veteran who served in the active military, naval or air service during a period of war as set forth in 38 CFR 3.2” Proof of Service (DD Form 214 or equivalent)Proof of Service (DD Form 214 or equivalent)

6. Compensation & Pension The term “Compensation and pension” is the VA Monetary Benefit Programs paid on account of a veteran’s disability or death.The term “Compensation and pension” is the VA Monetary Benefit Programs paid on account of a veteran’s disability or death. Compensation is related to a service connected disabilityCompensation is related to a service connected disability Pension is an income based benefit for veterans who served during a period of war and is totally disabled not related to servicePension is an income based benefit for veterans who served during a period of war and is totally disabled not related to service

7. Service Connection Service connection for a disability requires proof that the injury/disease began during service (documented in medical records)Service connection for a disability requires proof that the injury/disease began during service (documented in medical records) Must have a current diagnosisMust have a current diagnosis Confirmation that current injury is linked to the injury that incurred during military service.Confirmation that current injury is linked to the injury that incurred during military service. If one element is missing, service connection is denied.If one element is missing, service connection is denied.

8. Service Connection Current Diagnosis Nexus linking in service event to current diagnosis Injury, Illness, Disease in Service

9. Service Connection Incurred during serviceIncurred during service Aggravated during serviceAggravated during service Presumptive Condition (Presumed to have begun during service if they manifest to a compensable degree within a specified time (generally one year) after service, even though there is no evidence of disease during service (Gulf War Illness)Presumptive Condition (Presumed to have begun during service if they manifest to a compensable degree within a specified time (generally one year) after service, even though there is no evidence of disease during service (Gulf War Illness) Secondary (a result of service connected disability)Secondary (a result of service connected disability)

10. Type of Claim Benefits Delivery at Discharge (BDD) 60-180 daysBenefits Delivery at Discharge (BDD) 60-180 days - Must have all documentation when submitted - Must have all documentation when submitted - Claim managed off site: UT, NC, CA - Claim managed off site: UT, NC, CA Quick Start: 1- 59 DaysQuick Start: 1- 59 Days Fully DevelopedFully Developed - Must have all documentation when submitted - Must have all documentation when submitted - Claim managed in Arkansas - Claim managed in Arkansas Fully developed recommended!Fully developed recommended!

11. Informal Claim Claimant must identify the benefit he/she is seeking Claimant must identify the benefit he/she is seeking All informal communications must be in writing or transcribed into written form All informal communications must be in writing or transcribed into written form The VA has NO “duty to assist” in development of such a claim The VA has NO “duty to assist” in development of such a claim Provisions of 38 CFR 3.155 are applied. Once filed and accepted as valid, VA has the initial responsibility to send a formal application Provisions of 38 CFR 3.155 are applied. Once filed and accepted as valid, VA has the initial responsibility to send a formal application

12. Formal Claim Application intended for the claim of specific benefit. Examples: Application intended for the claim of specific benefit. Examples: VA Form 21-526 – Initial Compensation, Pension or BothVA Form 21-526 – Initial Compensation, Pension or Both VA Form 21-527 – Initial PensionVA Form 21-527 – Initial Pension VA Form 21-534 – DICVA Form 21-534 – DIC VA Form 21-8940 – IU or UnemployabilityVA Form 21-8940 – IU or Unemployability Is the application substantially complete? What does that mean? 38 CFR 3.159Is the application substantially complete? What does that mean? 38 CFR 3.159

13. Formal Claim Substantially complete application means an application containing the claimant's name; his or her relationship to the veteran, if applicable; sufficient service information for VA to verify the claimed service, if applicable; the benefit claimed and any medical condition(s) on which it is based; the claimant's signature; and in claims for non-service-connected disability or death pension and parents 'dependency and indemnity compensation, a statement of income.

14. Original Claim First time an application is made for Compensation or Pension First time an application is made for Compensation or Pension Specific end products assigned for the original or (in this instance) first claim Specific end products assigned for the original or (in this instance) first claim Considerable development is usually required in original claims. Considerable development is usually required in original claims. Claims folders created Claims folders created Options for the specific effective date for the start of payments Options for the specific effective date for the start of payments

15. New Claim First time an issue is presentedFirst time an issue is presented It may include an original, reopened claim or claim for increase when a disability is identifiedIt may include an original, reopened claim or claim for increase when a disability is identified Nexus to military service?Nexus to military service? Evidence is determined once the purpose of the claim is known. For example – reopened NSC pension? Secondary service connection?Evidence is determined once the purpose of the claim is known. For example – reopened NSC pension? Secondary service connection?

16. Re-Opened Claim Previous denial of claim greater than 1 yearPrevious denial of claim greater than 1 year Requirement for new and material evidence addressing the previous deficiencyRequirement for new and material evidence addressing the previous deficiency Discourage immediate appeals without thorough reviewDiscourage immediate appeals without thorough review Get the claims folderGet the claims folder Controversy over “well grounded claims”Controversy over “well grounded claims”

17. Claim for Increase Need for supporting evidence – medical and layNeed for supporting evidence – medical and lay The “Proscelle” argument in the absence of medical evidenceThe “Proscelle” argument in the absence of medical evidence Detailed description of “credible symptoms”Detailed description of “credible symptoms” Absolutely no guarantee of a medical examinationAbsolutely no guarantee of a medical examination Secondary Service Connection for a new issue?Secondary Service Connection for a new issue?

18. Individual Unemployability (IU) Definition Individual Unemployability (IU) is a part of VA’s disability compensation program that allows VA to pay certain Veterans compensation at the 100% rate, even though VA has not rated their service-connected disabilities at the 100% level. A Veteran must be unable to maintain substantially gainful employment as a result of his/her service- connected disabilities. Additionally, a Veteran must have:

19. Individual Unemployability (IU) Criteria A Veteran must be unable to maintain substantially gainful employment as a result of his/her service- connected disabilities. Additionally, a Veteran must have: One service-connected disability ratable at 60 percent or more, OR One service-connected disability ratable at 60 percent or more, OR Two or more service-connected disabilities, at least one disability ratable at 40 percent or more with a combined rating of 70 percent or more. Two or more service-connected disabilities, at least one disability ratable at 40 percent or more with a combined rating of 70 percent or more.

20. Summary Determine Veteran StatusDetermine Veteran Status Obtain Representation or Review FileObtain Representation or Review File Complete / Review RepresentationComplete / Review Representation ADVA Form 80 or NACVSO1ADVA Form 80 or NACVSO1 Get a clear understanding of reason for visitGet a clear understanding of reason for visit Determine EligibilityDetermine Eligibility File a fully developed claim!File a fully developed claim! Urge Claimants to use E-BENEFITS!Urge Claimants to use E-BENEFITS!