Transcript 2015 9th District NSO presentation

9th District NEC
DSO/CSO Update
January 30, 2015
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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.
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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.
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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.
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Questions?
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