How to File a Claim For VA Disability, Part IV

Part IV

You now know that you need to have a current medical condition, a in service event, and a nexus that links the two in order to obtain VA disability compensation. You have also learned what kinds of evidence is needed to prove your claim, and how to get it. You have, hopefully, made an appointment and reviewed your C-file, and you know what forms are necessary to file your claim. What do you need to do now? You need to compile all of your information in a meaningful, orderly fashion and send it to the VARO.

Marking the Evidence

The absolute first thing that must be done once you have gathered all of your evidence is separate it into different categories. What seems to work best is to break them up by medical condition. You will want one stack of records for each disability that you suffer from. Then you should put these stacks in chronological order, with the oldest records first and the newest records last. Once this is accomplished, we can begin to highlight the most important parts of the medical records so that it stands out clearly to the rater.

If you have read my blog titled "My Philosophy on VA Claims," Then you recall that I wrote the following passage:

"The next thing that we all must realize is that our fight with the VA is a war of words. They operate under laws, regulation, and manuals. All of these items are written in specific language that must be closely adhered to in order to win your claim. Contrary to popular belief, these things are not written in secret code, but in ordinary, everyday language. Some of the words may not make sense to many, but if the reader takes the time to look up the words he does not understand, the education he gets in return can be completely empowering. It's time to dust off those dictionaries and bookmark Google in your web browser."

You may also recall from this blog that I briefly explained some of the different laws, regulations and manuals that the VA uses to adjudicate veteran's claims. Knowing this, we should all seek to learn the rating criteria from 38 CFR 4 which applies to our specific disabilities. In this criteria, there is very specific language for each rating. Let's look at a specific set of rating criteria. Almost everyone I have known who served in the military developed some form of knee problems due to the physical stresses of military life. We'll look at one of the rating criterion for a knee disability:



5257 Knee, other impairment of:

Recurrent subluxation or lateral instability:
Severe 30
Moderate 20
Slight 10

This may seem simple enough to some, but it may look like Greek to others. Don't let words you've never seen before scare you, though. Not even medical terms, because all words have a definition. You can look in a good dictionary to find this definition, or better yet, you can use the internet to find that word much quicker. Let's break this criteria down.

Recurrent is a simple enough word that means something happens repetitively. Instability is pretty straight forward as well; the knee is not stable. What about subluxation lateral, though? If we do a quick Google search of the term "subluxation," it returns about 879,000 hits. The very first one just happens to be a Wikipedia entry on the term. While I would not use Wikipedia for hardcore research, or as a reference for writing a college paper, it is fine for our purpose. In this instance, it tells us that the word subluxation means "an incomplete or partial dislocation of a joint or organ."

If we use the search term "lateral," we come up with over 55 million hits. Again, the first one is Wikipedia. When we click on that, it shows several different options. The one that makes the most sense for us, though, is marked "human anatomical terms." When we click on that we learn that the definition of the word lateral is "...[describes a sctructure that is] away from that [midline of the body]." This may still not be very clear to some readers, so a continued search finds that Merriam-Webster's Online Dictionary gives the definition as "1. of or relating to the side." You should keep searching until you find a definition that makes sense. If you never find one, it is ok to ask for help.

Now that we have these definitions, we can re-write the sentence "Recurrent subluxation or lateral instability," to read like something that is more understandable. "Repetitive, incomplete or partial dislocations of the knee or the knee is unstable to one side or the other." That makes a little more sense. Our next mission is to scour the medical records that relate to the knees for the key terms, "subluxation or lateral instability," or any of the words that we found, or any other words that have the same meaning. Not all doctors are the same, and each one uses different language in their notes. This will take some time.

When you find words that are similar to that listed in the rating criteria, you should highlight it. I have always found it beneficial to highlight other key pieces of information on each record, also. This information is things such as the date, the doctor's name who wrote the record, and any kind of prescription that was given (medicine or otherwise). Do this for each stack of records that you have.

Putting it all Together

Now that you have all of your records neatly organized and highlighted, it is time to put them all together and send them to the VARO. If you are like me, this can be a daunting task. When I filed a claim in 2007, it had 13 separate issues on it. I had over 350 pages of evidence to turn in. I have heard from some VARO employees that this is not wise, because it frustrates raters to have so much information to pour through. I say hogwash to this! Records and the laws and regulations are the only things that we have to win our claims with. If you have a mountain of evidence in your favor in your possession, send it in. Don't worry about some whiner at the VARO.

The first thing that you will want to do is buy a three-ring binder, a three-hole punch, and a package of tabbed dividers. You need to hole punch each page so that it will neatly go into the binder. Be sure the binder you buy is big enough to fit all of your evidence in. There is nothing worse for the person preparing the evidence, or the person trying to read the evidence than a binder that is so full it flies open when it is just looked at the wrong way.

Next you want to lay out your evidence in a meaningful order. It needs to be in a order that flows smoothly for the rater, so as to make it as simple as possible for them. The order I have always used is:

1. VA Form 21-4138
2. Addendum to VA Form 21-4138/personal sworn statement
3. Sworn Statements (buddy letters)
4. DD 214's
5. Reference material, such as VA Training Letters or peer reviewed journal articles
6. Medical evidence by condition

You can use this order, or find your own method. So long as it makes sense and makes the rater's job easier is all that matters. Once you have the evidence in the order you want, you can hole punch each page and place it in the binder. You should place a tabbed divider between each section, and label each tab with what that section contains (i.e. Sworn Statement, Knee Condition, Spine Condition).

Now you can label each page with some very important information. The very first thing that you MUST ensure is on every single page is your name and C-file (social security) number. This way if some of the pages fall out, they will know who it belongs to. I always put this information in the top right corner of the page. Some of your medical records may have this information on it already. Even it that was the case, I still put it at the top of each page.

The next thing that you should put on each page is the page number, and how many pages are in the entire packet (i.e. 1 of 100, 2 of 100, 3 of 100). This way, if some pages fall out, the reader can put them back in the correct order. It will also serve to show you how conscientious your VARO is the next time you review your C-file. Chances are when you do review it, the pages will be horribly out of order. I always put this information in the bottom right corner of each page.

Next you should assign a exhibit number to each record. I always keep it simple, and number them E-1, E-2, E-3, and so on. The first exhibit number should be the VA Form 21-4138. This is done to make it easier for the rater to refer to individual records. Since some pieces of evidence will have multiple pages, you should also place page numbers and how many pages are in that exhibit under the exhibit number.

Lastly you should make a table of exhibits. The way I did this was to create a word document with two columns. The left column was titled Exhibit, and the right column was titled Page. On the left column, give the number of each exhibit followed by the name of exhibit (example: E-1 VA Form 21-4138, E-2 Personal sworn statement, E-3 Sworn Statement of M.Y. Buddy). When you get to the medical records, don't over think it. Simply call it VA Progress Note, or Midtown Medical Center Record. In the right column give the page number of the corresponding exhibit listed in the left column. Leave a space between each section of evidence. This would be where the tabbed dividers were placed in your binder. This will make it easier for the rater to read. Place this table of exhibits in the very front of the binder.

Now the whole packet is together. I strongly suggest that you take the time to make a exact replica of it for your on records now. That way if there is some kind of a question, or if the VARO says they did not get a piece of evidence, you can go to your copy and find it easily. You may now send your claim and packet of evidence to the VARO. Be sure to place it in a sturdy box and wrap it well in shipping paper. I always suggest using the US Postal Service's certified mail, return receipt requested for any correspondence that you need to send to the VA. This is one of the only times that I make a exception. While this packet can still be sent this way, I chose to send mine through UPS because of the size of the package. You can also insure your package and request a signature confirmation this way. The ability to track the package is nice, too, although you can have this feature through the post office these days, too.

There it is in a nutshell. I know it seems like a lot of work just to file a claim for disability, but you will be glad in the end that you took the time to do it right the first time. The alternative is to get a denial letter and start all over. I hope this helps someone, and remember; no one cares more about your claim than you do (I really need to remember where I found that line so I can give credit when I use it).