Sign Colorado Claim Secure

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hi my name is James petit my veteran service officer with the state of Colorado its next section I'll be discussing the Supplemental claim process what it is and how best to prepare and submit claims with that process welcome to another presentation of tools for VSOs by the Colorado divisions of Veterans Affairs I'm James Burton the appeals and hearing specialist and we'll be discussing in this presentation the Supplemental claim process through this course we'll look at an overview of the veterans benefit administration supplemental claims process and learned some tools and tips to have a more successful outcome with the submission of a supplemental claim so the Supplemental clean win uses the be a form 2009 9 5 we can submit new and relevant evidence new evidence being evidence that the VA missed relevant means it addresses an aspect or part of the decision that could materially change the outcome of that the Supplemental clean lien is the only willing to reopen previously denied issues if the denial was over a year ago for example don't use the five to six days a to reopen they'll get a letter saying that you submit at the wrong forum to reopen this issue please submit something on the own i-95 for example claim was Smith was denied you know three years ago for missed examinations we can include we we submit the O 995 to reopen and the new relevant evidence is going to be that 41:38 that you know the better missed exam through no fault of their own and that they're willing and able to attend any and all examinations that the VA deems necessary so new and relevant evidence its defined by the VA sturdy 8 CFR 3.15 6 as new evidence as evidence not previously part of the actual record before agency adjudications this includes things like changes in federal law they count as new evidence so the most relevant example of that would be the blue water Navy veterans act so previously a veteran served in the Navy and they were out in the coastal waters of Vietnam they were denied the presumptive issues associated with Agent Orange exposure with the blue water Navy changes we can reopen that claim and say the blue the federal blue water Navy Act changed the evidence it's new laws that should be considered as new evidence so we can reopen these this claim for a service-connected disability relevant evidence means existing evidence that by sulfur were considered with previous evidence of records relates to an established fact necessary to substantiate a claim so rule simple this is say for example a decision was denied saying that a veteran didn't meet the diagnostic criteria for diabetes and that is like an a1c 6.1 or greater we can submit the wrote know numeral an evidence would be a bloodwork showing that the veteran met the diagnostic criteria with this new 8 1 C number and as long as it's submitted within that one year the decision the data claim should go back to that original denial so new and relevant something the VA hasn't seen before and that addresses one of the reasons why it was denied in the first place so what issues can be pursued through the Supplemental clean line well any claim that was previously denied regardless of when if it was the denial was 30 years ago five years ago or even three months ago it can be pursued supplemental cleanly now the date of claim is going to depend on when that did not was so any supplemental claim submitted within one year at that decision the date of claim will be the date of that decision anything on day 366 or later the date of claim is going to be when the VA received that supplemental claim documentation and form BVA decisions can be pursued through supplemental claiming so if the BBA judges said that you know we're going to deny this because the evidence doesn't exist to warrant granting of the issue we can submit that evidence that would warrant granting of the issue and send it through a supplemental claim lane in as long as it addresses the reason some rationale that the BBA provided for their denial the Supplemental claim lane can overturn that BBA decision as long as that evidence supports the rationale for that and higher lobe reviews can also be pursued through the Supplemental claim lien so if a high overview decision comes back and says that they record the evidence of record does not support granting the issue or a rating higher than X percentage we can submit evidence food supplemental claim Lane addressing those specific errors in addressing that particular decision so it's a very flexible process that we have when dealing with these appeals processes so some notes regarding the date of claim for the Supplemental claims so if the o95 and the evidence is received within one year of that decision if the decision the Supplemental claim review decision comes back as favorable then the date of grant will be based on that decision that we are appealing if the own i-95 in evidence is received one year or more after then the date the effective date will be when the VA got that owned i-95 one thing to note that the intent of file preserving an effective date does not apply for these supplemental claims and that's found in the 38 CFR 3.25 oh one point two point D so here's an example of a supplemental claim Lane air force event they served in Thailand they previously submitted a claim for prostate cancer due to Asian Orange exposure in 2018 Samoas they were a jet engine mechanic the claim was denied in October of 2018 saying that the veteran didn't meet the criteria for boots on the ground in Vietnam and that the only elements in Thailand that are assumed to have been exposed to Agent Orange are security forces personnel or those who either supplement at the security forces in working around the perimeter or those mo ices in which it's shown that the veteran at the time worked in and around the proximity of the perimeter so what are some of the evidence that we would need to submit to redress this question so one of the things I always ask you to do went before you submit any high-level review some of them are claim or appeal to the board of veterans appeals and is read the rating decision for supplemental claims look at the evidence submitted to see you know what was taken into consideration and what wasn't so here's everything that was submitted so in particular is the Memorandum of formal finding on a lack of information required to verify herbicide exposure in Thailand you know that's the VA saying that look unfortunately yes we do know that you served in Thailand we do know that you were a jet engine mechanic however because the rules that we have we can only concede herbicide exposure to Security Forces personnel those who argument is Security Forces personnel or individuals whose regular duties place them in or around the perimeter of the air bases in Thailand that Agent Orange and the other herbicides were used and here's part one from the narrative saying service connection result Reserve as a result of exposure to herbicides again note in here that it lists all the presumptive service-connected issues that is associated with exposure to Agent Orange and again here's the continuing of that narrative section where it addresses the elements so evidence does not show an advantage disease or injury and service that's that first element your service treatment records not can contain complaints treatment or diagnosis of this condition again that first element the evidence does not show that your disease developed to compensable degree within a specified time period after release again that first element it acknowledges that yes you have the second element but we just don't have that third element that connection so one thing to note with the implementation of the peel's Modernization Act is that decisions will have the favorable findings in that section so yes you were diagnosed with prostate cancer that's a fact that is binding on all future determinations so VA can't later come back and say well you were never diagnosed with prostate cancer it says favorable findings so anytime you have a decision with a favorable finding that's a win for us so in this case we just have to show the how the vet meets the presumptive elements so what evidence would be needed to have this be a successful supplemental claim again note the new and relevant evidence so in the example above the service connection was denied because of its MOS wasn't one in which the VA has acknowledged as operating along the perimeter or the fence line now is the evidence something needed by the VA is it and VA records or other federal records you know if it is for example if we can show the VA evidence which put them along with the fence or otherwise potentially exposed to the vet to Agent Orange pictures of the vet or even letters from home talking about walking the perimeter if that evidence is something that is needed or we have access to then let's go for a supplemental claim say for example we know or we have in elicited evaluations where the vets work was augmenting the security forces and that documented it documented in his evaluations then yeah let's submit that Evans say look you guys and didn't see this party didn't acknowledge it and here's clear documentation showing that you put him along the fence or otherwise potentially exposed him to Agent Orange or even pictures of the vet you know outside perimeter working along the perimeter you know pictures of the vet and a guard post on the perimeter or even litters from home where the vet talks about walking the perimeter or doing guard duty during his time in Vietnam if the evidence is something which requires a sworn statement or testimony that's something that we would have to address with the board of veterans appeals so if it's something that already exists then like a federal record or picture or otherwise existing document then let's go ahead and submit that as a supplemental claim if we have to rely on the vets sworn testimony then that's something that we really need to address through the BVA appeals process in particular having a hearing with an administrative law judge so here's some examples of things that are or could be considered as new and relevant evidence 41 42 or 42 alpha the release forms for the private medical records or even the reports themselves you know medical information that the VA didn't have access to at the time they made their determinations news articles news clips stories about the stressor event or search events themselves phrase say for example an issue was denied because the VA couldn't verify say a plane crash well if we submit a newspaper article saying yep on this date this plane crashed and the VA does know that the veteran was stationed at the base where the plane crashed but is a verifiable stressor event more 41:38 explaining through no fault of veteran's own the veteran missed the exam even if it was years or decades or decades ago or a 41:38 noting that laws or rules are changed for example PTSD in the easing fear standard that came about in 2013 where there had there were more strict requirements for stressor events and then 2013 the law has changed to a more easing standard or more commonly as we see today the changes with the Bluewater navies veterans actual week include in that supplemental cleanly 41:38 saying veterans served with a navy blue water Navy veterans Act past veterans ship operated within the coastal waterways of Vietnam please accept this as supplemental claim to reopen this issue or 41:38 noting relevant federal records that exist for example in a denial for for individual employability or IU if the veteran has a denial from vocational rehabilitation office or VR any showing that because it's veteran service-connected disabilities they're not a good candidate for VR any or that their disabilities preclude them from gainful meaningful employment that is something that new and relevant evidence that can be considered to overturn that denial for individual employability or even a 41:38 with new theories of service connection and by default the VA czars and RVs ours take into consideration a direct basis only by default unless we say otherwise they look at things on a direct basis but if we look at the exam and and the examiner says you know that there's no evidence that this is directly due to or caused by military service but we know that a secondary service connection could have been interest say for example if a veteran is service-connected for their right knee but because it's so severe and they've had to compensate by changing their gait has caused their other knee to go bad then we can request a supplemental claim lane saying you know this secondary service connection was not addressed it is something that we can also address through a high-level review but because a medical opinion would be Cerie I like to do things like that feuds supplement claims process just to cut out the step so some useful tips that I found help with more successful submissions of supplemental claims read the narrative the narrative is going to list all the evidence listed that the VA taken that the Raider took into consideration it's also going to list their various reasons and rationales as to why something was decided the way it was read the examination if the examinations fail to highlight a specific issue or failed to address something else you know read the examination read the narrative and don't rush this mission we have a year to preserve the date of claim when submitting these supplemental claims so don't rush the submission take your time make sure that everything we put together is good and thorough and complete and if you have any questions please feel free to reach out to either myself the appeal specialist or to any state veteran service officer remember our office is here to assist you in helping our brother and sister veterans receive positive outcomes