9th District NEC DSO/CSO Update January 30, 2015 1 Welcome and Introductions Agenda TOPICS • Mandatory Forms • Fully Developed Claims (FDC) • Hearings • Proposed Reductions Standard Claims and Appeals Forms Effective March 24, 2015 Standard Claims and Appeals Forms Effective March 24, 2015: 1. All claims governed by VA’s adjudication regulations are required to be filed on standard forms prescribed by the Secretary. 2. All informal claims are required to be filed on a standard form. 3. All Notices of Disagreement are required to be filed on a standard form. Standard Claims and Appeals Forms Effective March 24, 2015: Compensation claims are required to be filed on form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits. Pension claims must be filed on form 21-527EZ, Application for Pension. Survivors claims must be filed on form 21-534EZ, Application for DIC, Death Pension, and/or Accrued Benefits. Standard Claims and Appeals Forms Effective March 24, 2015: The EZ forms were previously available on an optional basis. Under the new regulations, VA will mandate their use. Veterans and survivors do not have to file fully developed claims (FDCs) when using these mandatory forms, but VA is strongly encouraging FDC participation in order to help expedite delivery of benefits through the FDC program. Standard Claims and Appeals Forms Effective March 24, 2015: Informal claims must be filed using form 21-0966, Intent to File a Claim for Compensation and/or Pension, Survivors Pension, or Other Benefits. Because submitting an intent to file a claim protects an effective date of benefits for up to one year, individuals seeking compensation or pension benefits will have a full year to gather and submit evidence necessary to support a claim. Standard Claims and Appeals Forms Effective March 24, 2015: Form 21-0966 should be used by DAV Service Officers to protect an effective date of benefits while a claimant gathers evidence necessary to submit a Fully Developed Claim. After the evidence is gathered, then an EZ Form is used to submit the FDC claim. Standard Claims and Appeals Forms Effective March 24, 2015: A claimant or authorized representative may initiate an appeal by using mandated form 21-0958, Notice of Disagreement. Any claimant receiving a VA Form 21-0958, with their decision on a claim, who wishes to appeal that decision, must do so by completing and submitting that form. Appointment of Veterans Service Organization as Claimant’s Representative (POA) • Make sure your using the most current Appointment of Veterans Service Organization as Claimant’s Representative (VAForm 21-22). FULLY DEVELOPED CLAIM CHECKLIST • All, if any, relevant private medical treatment records which show treatment for the claimed condition(s), and identification of any treatment records from a Federal treatment facility such as a VA Medical Center. • No Release of Information (VAF 21-4142) • For pension claims, all necessary income and networth information. • For special monthly pension claims, a completed VA Form 21-2680, Examination for Housebound Status or Permanent Need For Regular Aid And Attendance. FULLY DEVELOPED CLAIM CHECKLIST • If claiming special monthly pension based on nursing home attendance, a VA Form, 21-0779 and 21-2680, Request For Nursing Home Information in Connection With Claim For Aid And Attendance. • If claiming dependents, a completed VA Form 21686c, Declaration of Status of Dependents MUST be included with the package. • The claimant must be available to report for a VA examination, if required. SCREENING QUESTIONS FOR FDC CLAIM Any item answered “No” disqualifies the claim from FDC Program, and a traditional claim process with be used instead. Yes Is this a claim for service-connected compensation, increased serviceconnected compensation, or a request for non-service connected pension, or DIC? Has the claimant fully completed and signed a VA Form 21-526EZ (compensation) or a 21-527EZ (pension) 534EZ (DIC) and is it attached? Has the claimant attached all relevant private medical records which show treatment for the claimed condition(s) – and/or – stated what VA treatment facility his/her records are located? Is the veteran claiming a disability which incurred during active National Guard or Reserve duty? (if “YES” disqualifies the claim from FDC.) unless he has copy of National Guard or Reserve Records. If this is a new claim that involves posttraumatic stress disorder (PTSD), has the veteran attached evidence of a diagnosis for PTSD; AND a combat award? OR a verifiable incident reported on fully completed VA Form 21-0781/0781a? OR a statement regarding fear of hostile military or terrorist activities while deployed to a hostile area? No Hearings • Personal hearing - A claimant may request a local hearing, with the office of jurisdiction at any time. The hearing may or may not be recorded. It is a right of the claimant, though not a requirement to process the appeal. The claimant may present witnesses and written evidence. • BVA hearing in Washington DC – The claimant may choose to travel to Washington DC and appear before the Board for this hearing. Any hearing before the Board will be recorded and transcribed. Requested on VA Form 9. 15 Hearings • BVA hearing at a local VA Regional office before a Board member – In-Person hearing – This is a face-to-face hearing with the claimant and the Board member at the local VA Regional Office. The hearing will be recorded and transcribed. Requested on VA Form 9. • Video Conference hearing – This is a hearing conducted between the claimant at the local VA Regional Office and a Board member in Washington DC, through a television satellite link. The hearing will be recorded and transcribed. Requested on VA Form 9. 16 Proposed Reductions/Severance • VA Rating Decision proposes to reduce an evaluation or sever service connection. • Due Process - The veteran has 60 day to submit evidence for rebuttal of the decision proposal and/or request a personal hearing. • End of the Due Process and after the hearing if requested. A final decision will be completed. • If the decision is upheld, a Notice of Disagreement can be filed at this time. 17 Questions? 19