WEEK ONE - VFW Department of Illinois Service Office

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8 Week Course
Week One
During these classes we will use or refer to:
VFW ByLaws and Manual of Procedure
VFW Guide for Post Service Officers
VA Handbook of Federal Benefits
38 Code of Federal Regulations
Multiple handouts and other reference
material.
There will be a Quiz each week!
•The VFW Post Service Officer
•VFW Representation
•Principles of VA Benefits
•Definitions
•VA Claim Process
•VA Appeal Process
Duties
Responsibilities
Authority
Of the Post
Service Officer
The Post Service Officer:
Must be a VFW Post member in good standing
Is an appointed Officer of the Post, appointed by
the Post Commander
Unless restricted by Post Bylaws may also serve
the Post in other elected or appointed positions
The duties & responsibilities
of the Post Service Officer
are generally defined in the
VFW Manual of Procedure
Section 218 (a) (12)
1.Shall assist members of the Post, their
widows and orphans
2.Shall assist other worthy cases brought to
their attention
3.Shall perform their duties in accordance
with the instructions contained in the VFW
Guide for Service Officers
4.Shall perform their duties under the general
supervision of the Department Service
Officer
The VFW Guide for Post Service Officers further
provides that the Post Service Officer:
1. Should have access to the latest copy of the VFW
Guide for Post Service Officers
2. Must route claims and supporting evidence and
all inquires to the Department Service Officer
3. Should have an adequate supply of current VA
Forms (either by hard copy or VA website)
4. Should keep members informed of veteran’s
entitlements and benefits offered and
administrated by local, state and federal agencies
5. Is not allowed to request or accept remuneration
for their services
6. Shall not refuse to assist any claimant unless it is
clear that the claim is fraudulent in which case the
Department Service Officer will be the final
authority as to whether the VFW will provide
representation
7. Shall not refuse to assist any claimant because they
do not feel the claimant is eligible for the benefit
sought
8. Shall forward without delay all applications to the
Department Service Officer
9. Shall not keep original documents provided to
them but are to transmit such documents to the
Department Service Officer (may maintain
records of claims prepared and submitted to the
DSO only with the permission of the claimant and
only under proper Post security, such records to
be in the custody of the Post to be passed to the
succeeding Post Service Officer and to be
returned in full to the claimant upon request)
Note: Public Law 93-579 restricts the
release of confidential information to parties
other than the claimant. An accredited
representative of a Veterans Service
Organization may release only information
necessary for development of a specific claim
to a local Post Service Officer.
10. Shall not make direct contact with any office or
representative of the Department of Veterans
Affairs concerning a pending benefit claim or as a
request for personal information regarding a
claimant accept in the case of an emergent ill
veteran to a VA Medical Center in which case the
Department Service Officer will be informed when
time permits
11. Must attend all training conducted within the
Department in service work by the Department
Service Officer, especially the annual
Department Post Service Officer School and
any service officer training conducted at
District meetings or by the District Service
Officer
When assisting a veteran in
completing VA forms the Post SO
may act as a recorder only, not as an
advisor .
This is an important issue due to
potential liability.
Any VFW member may offer their
assistance to a potential claimant.
However only an appointed Post Service
Officer may present themselves as such to
either a claimant or government
department or agency.
Any VFW member offering their
assistance to a claimant must accept the
responsibility to act under the same rules
as an appointed Post Service Officer.
What do we expect from a Post Service Officer?
We expect that he has a desire to assist his fellow
veterans without prejudice.
We expect that he will establish a working
relationship with other key Post and Auxiliary
officers.
Hospital Chairman
Chaplain
MAP Chairman
National Home Chairman
We expect that he will establish a working
relationship with key community service providers
and agencies.
Churches
Shelters
Funeral Directors
State & County Social Workers
Hospital Social Workers
We expect that he will establish a working
relationship with key members of the veteran
service network in his area.
County Veterans Assistant Commission
Illinois Department of Veterans Affairs
Other Veterans Service Organizations
Other social agencies & organizations
Accreditation is awarded by the VA
Organizations (VSOs) that are certified by
the VA to do so may recommend individuals
for accreditation.
VFW Policy:
Individuals must be full time employees of the
Department recommending accreditation, or
under certain circumstances a Department
may recommend a state or county employee
for accreditation.
Accreditation requires annual training certified
by the organization and approved by the VA.
Accreditation has certain privileges:
Access to VA records
Permission to sign certain forms
Accreditation has certain responsibilities:
Continuing Education
Representation of claimant during process
Who may assist a veteran?
An un-accredited representative:
Family member
Friend
Attorney
Access to information?
VA Form 21-0845
Who may represent a veteran in a claim
with the VA?
An accredited representative:
Attorney
Individual
Veterans Service Organization
Access to information?
VA Form 21-22a
VA Form 21-22
Your Questions!
Principles of VA Benefits
The principle of VA benefits is to compensate
the veteran, dependents or survivors for the
hardship of military service through
compensation for disability incurred in service
or through other benefits intended to recognize
the sacrifice and hardship of that service.
Eligibility to VA benefits requires qualifying
character, duration and time frame of military
service.
Principles of VA Benefits
Service Connected VS Non Service Connected?
The answer to this question governs
eligibility to the full scope of benefits
to which a veteran / dependents /
survivors may be entitled.
Principles of VA Benefits
Potential benefits include:
Veteran Disability Compensation / Pension
Survivor (DIC / Death Pension / other)
Medical Benefits (veteran/dependent/survivor)
Death Benefits (burial, headstone, flag)
Education (GI Bill / Voc Rehab)
Life Insurance (Conversion / RH)
Home Loan Guarantee
DEFINITIONS
Veteran - 3.1(a)(d)
Types of Military Duty - 3.6
Active Duty
Active Duty for Training
Inactive Duty for Training
Inactive Duty
DEFINITIONS
Spouse - 3.50
Marriage - 3.1(j), 3.52
Surviving Spouse - 3.50, 3.52
Parent - 3.59
DEFINITIONS
Child (minor, disabled, school) 3.57
Natural Child
Step Child
Illegitimate Child
Adopted Child
VA Claim Process
Claim Received by VA
VA Development for Evidence
VA Examination (if appropriate)
Rating Board Decision
Notice of Decision
VA Claim Process
Formal Claim - 3.151
Received from claimant on proper form
(directly of thru representative)
Informal Claim
Statement Received from claimant or
representative
Claim not on proper form
Incomplete claim on proper form
VA medical care for SC condition
Claim Received by VA
Original Claim
Reopened Claim
Claim for Increase
Claim for previously denied condition
Amended Claim
Claim for new condition
Claim for secondary condition
VA Development for Evidence
VA has duty to assist the claimant (VCAA)
Service Medical Records (SMRs or STRs)
Service Personnel Records (as appropriate)
VA Medical Treatment Records
VAMC
VA CBOC
Non VA Treatment Records
Vet Center
Private Treatment Provider Records
Lay evidence
VA Examination
VA will order exams only for conditions
deemed provable
VA (VBA) will order exams at VA Medical
Center closest to home of record capable of
performing proper examination of disability
claimed
Exam protocol is established by VBA
Exam conduct is controlled by VHA
Rating Board Decision
Rating Board evaluates all evidence in the context of
claims made
Rating Board reviews medical evidence and exams for
Inferred Issues
Rating Board decides each claim granting or denying
service connection
Rating Board evaluates each disability assigning a
percentage rating based on the VA Schedule for Rating
Disabilities
Notice of Decision
38 CFR 3.103 - A VA Rating Board decision is not “official” until
a Notice of Decision letter has been released which implements
that decision. This notice is made to the claimant at the last
address of record and is presumed to be received unless returned
as undeliverable. The date of the Notice of Decision letter is the
date from which the applicable appeal period begins.
This letter and the attached documents will identify the claims
(issues) considered and the basis for each decision made on those
issues. It will also provide important information relative to the
payment of benefits awarded and request any additional
information needed to pursue additional aspects of the claim such
as any inferred issues which have been identified or additional
allowance for dependents. It will also give notice of appeal rights.
VA APPEAL PROCESS
38 CFR 20.200, 20.300, 20.301
The VA appeal process is very formal process. There
are specific times frames within which the claimant
must respond. The VA is not bound by any time frames
during the appeal process.
Almost any VA decision is appealable to BVA. (An
example of a decision that is not appealable is a medical
treatment decision.)
The date of the notice of VA decision begins the appeal
period.
20.201 - An appeal begins with the VA receipt of a
Notice of Disagreement (NOD).
20.302 (a) - A NOD must be received with one year of
date of notice of the decision being appealed.
20.201 - A NOD must identify the date of the decision
being appealed, and
A NOD must identify the issues being appealed. It is not
enough to say “I disagree with the letter dated xxxx”.
The NOD must identify the issues within the letter being
appealed such as the denial of a benefit, the evaluation
of a disability, the effective date of a benefit granted.
A NOD may include a request for a Decision Review
Officer (DRO) review. Without such a request the
appeal will be processed in the “traditional” process.
The traditional process is that in response to the NOD
the issues being appealed with be reviewed by another
member of the Rating Board. Generally speaking
they will review only the evidence itemized in the
decision which may not include all historical evidence.
Generally speaking a traditional review on appeal is
much faster than a DRO review.
When making a DRO request the claimant may also
request a personal hearing before the DRO.
A DRO request is responded to by a full file review of
the issue being appealed. In the case of a reopened
claim for a condition previously denied, this may be
useful.
Following completion of the review by either method
the VA will issue a Statement of the Case (SOC). The
SOC may include a full or partial grant of the benefits
sought on appeal or may continue the prior decision.
The SOC details the evidence considered, the laws and
regulations applied and reasons for each decision.
The date of the SOC controls the next step in the appeal
process.
20.202, 20.302 (b) - Following the SOC the claimant
has 60 days to submit VA Form 9 or one year from
date of decision whichever is later. The deadline for
the Form 9 receipt is absolute, there is no extension of
time.
The VA Form 9 is the claimant’s opportunity to
identify those issues from the SOC he desires to
pursue on appeal. The claimant is also responsible to
state why he believes the benefits sought on appeal
should be granted.
Personal Hearing:
The claimant may request a personal hearing before
the BVA in one of three venues:
In Washington, DC at the BVA, or
In Chicago before a travel board section of the BVA,
or
In Chicago at a video conference (televised) hearing
before the BVA
Following the receipt of the VA Form 9 the RO
certifies the appeal to the BVA. Certification of the
appeal means that the Regional Office certifies that
the issues on appeal have been properly developed
and that all available evidence is in the claims folder.
After VA certification the appeal is forwarded to the
accredited representative if there is one. The rep
completes a VA Form 646 which presents the rep’s
arguments on the issues on appeal.
Once the appeal has been certified to the BVA the
case is held at the RO until it is called for by the
BVA.
When an appeal is called up by BVA the file is
reviewed by the appeals staff of the accredited
representative if there is one. The rep makes a
summary presentation of the appeal to the BVA.
Following their review of the appeal, the BVA makes
a decision which may include a grant, a denial or a
remand or a mixture of all three.
A remand decision refers certain issues back to the
RO for additional development and return to the
BVA.
An issue denied by the BVA may be appealed to the
Court of Appeals for Veterans Claims (CAVC). The
Court is not part of the VA process. An appeal to the
Court is a judicial action. Appeals to the Court have
very specific filing requirements.
Appeals to the Court must identify a point of law
which has been misapplied rather than interpretation
of evidence.
Looking back at the appeal process it is important
to know that at any time prior to advancement to
the BVA the claimant may submit additional
evidence which may be considered and may be the
basis for a new decision which may either grant or
continue to deny the issues on appeal.
The submission of additional evidence does not
extend any of the applicable periods mandated by
regulation. Attention must always be paid to time
limits during the appeal process. The VA will not
send reminders!
QUESTIONS?
USE of VA FORMS
38 CFR 3.151
There is a VA Form designed for almost any purpose
you may imagine in the claims process. The use of
many forms are intended to be helpful guides in
providing information to the VA and may be
substituted by almost any submission of the required
information.
Other forms are REQUIRED to be submitted and
may not be accepted by the VA in any other format
other than the stipulated form.
USE of VA FORMS
The use of proper VA Forms rather than generic
forms is strongly encouraged because their use
ensures that the proper information is provided to
support the claim. The use of generic forms or letters
to the VA may leave out required or useful
information.
This requires that service officers be familiar with
the catalog of VA forms and their intended use.
QUIZ
Thank you for attending!
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