Veterans Administration – Claims 101

 In Veterans
Veterans Administration - Claims 101

Recently a veteran said, “Claims should be simple!” Sometimes they are. Other times a claim to the Veterans Administration (VA) is not only difficult, but is often intimidating!

I enjoy helping veterans make disability claims to the VA. As a Veterans Service Officer (VSO), I’m an “advocate of veterans to the VA.” I believe the VA “intends” to make the process simple, but that is not always the case. Fortunately there is hope!

Every claim for disability compensation is based on three things: a current chronic condition, a situation or event during a veteran’s military service and a link between the service and the current condition.

The first factor is a current chronic condition. Let’s say you have a condition, such as Diabetes Mellitus type II, or Peripheral Neuropathy of the lower extremities (numbness in the feet or sometimes tingling). The best way to ensure verification of the condition is to have your doctor make a written diagnosis. While the condition is very real to the veteran, the VA works off objective evidence, not subjective claims. Hence, you need a written diagnosis from an expert in the medical field, such as an Endocrinologist, or Neurologist, in the above examples. So, the first requirement is a current condition that is chronic (persistent) rather than acute (sudden or short duration).

The second factor required for every claim is that there must be a situation or event during military service that “triggered” or aggravated a health condition. Exposure to Agent Orange, acoustical trauma (noise exposure) from combat as an infantryman, or Traumatic Brain Injury (TBI) from an Improvised Explosive Device (IED) are all examples of situations that “trigger” chronic conditions either immediately or manifested later in life. These triggers can be verified by orders or noted on the DD 214, Military Occupation Specialty (MOS) and deployment on the battlefield, or written in service medical records (SMRs) substantiating treatment for a concussion, in the above examples. There must be situation that occurred while on active duty.

The third factor is a link between the two above items. The link can be established in a number of ways. For example, Diabetes Mellitus type II (DM2) is “presumed” to have come from exposure to Agent Orange. DM2 is one of over twenty presumptive conditions related to Agent Orange. The link for noise exposure is confirmed by a good write up in the claim, the military occupational specialty and military conditions that cause acoustical trauma. The link for TBI is the note in military records that records the IED (or otherwise) event and the accurate diagnosis of the brain concussion by a qualified medical person. Without a good link, the claim will be denied. This link is just as important, if not more, than the other two factors. Let me explain.

I provide a six page handout on the “Nexus Letter.” The word “nexus” can mean many things in different contexts. In this context it means the “link” between the military trigger and the current chronic condition. The handout explains how there must be irrefutable evidence for a disability claim. A nexus letter must be brief, written by a medical expert (e.g. oncologist for cancer related conditions) and the doctor must have reviewed all available and pertinent service medical records.

The doctor does not have to use absolutes or that the “trigger” caused the current condition. He/She must, however, record his/her opinion of whether the condition is “more likely than not” (probability greater than 50%) or “at least as likely as not” (probability of 50%).

This is a broad brush summary of the three essential ingredients for making a claim and the possible need for a Nexus Letter. There are many exceptions to a simple claim that can make the process frustrating, but there is hope. Give me a call and I’ll be happy to walk through the details of your claim.

by Bryan Hult, Bonner County Veterans Service Officer

Bryan Hult is the Bonner County Veterans Services Officer. He enlisted in the infantry, graduated from Officer Candidate School and Jump School from Fort Benning, Georgia and Flight School from Fort Rucker, Alabama. He then flew helicopters at Fort Hood, Texas. His military education included the Army War College in Carlisle, PA. After seminary, he served at every level of the Army chaplaincy in the Indiana National Guard and retired in 2010 as the Assistant Chief of Chaplains.

Recommended Posts

Leave a Comment

Ask Us!

What are you seeking? How Can we help? We will contact our experts for answers. Watch our Facebook for replies*. @thewiseguideonline *We will not post any names/email addresses/or contact information. We will also carefully edit questions and answers to protect your privacy.

Not readable? Change text. captcha txt

Start typing and press Enter to search