WEEK ONE - VFW Department of Illinois Service Office

January 6, 2018 | Author: Anonymous | Category: Social Science, Political Science
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8 Week Course Week One

During these classes we will use or refer to:

VFW ByLaws and Manual of Procedure VFW Guide for Post Service Officers VA Handbook of Federal Benefits 38 Code of Federal Regulations Multiple handouts and other reference material. There will be a Quiz each week!

•The VFW Post Service Officer •VFW Representation

•Principles of VA Benefits •Definitions •VA Claim Process

•VA Appeal Process

Duties Responsibilities Authority Of the Post Service Officer

The Post Service Officer: Must be a VFW Post member in good standing

Is an appointed Officer of the Post, appointed by the Post Commander Unless restricted by Post Bylaws may also serve the Post in other elected or appointed positions

The duties & responsibilities of the Post Service Officer are generally defined in the VFW Manual of Procedure Section 218 (a) (12)

1.Shall assist members of the Post, their widows and orphans 2.Shall assist other worthy cases brought to their attention 3.Shall perform their duties in accordance with the instructions contained in the VFW Guide for Service Officers 4.Shall perform their duties under the general supervision of the Department Service Officer

The VFW Guide for Post Service Officers further provides that the Post Service Officer: 1. Should have access to the latest copy of the VFW Guide for Post Service Officers 2. Must route claims and supporting evidence and all inquires to the Department Service Officer

3. Should have an adequate supply of current VA Forms (either by hard copy or VA website) 4. Should keep members informed of veteran’s entitlements and benefits offered and administrated by local, state and federal agencies

5. Is not allowed to request or accept remuneration for their services 6. Shall not refuse to assist any claimant unless it is clear that the claim is fraudulent in which case the Department Service Officer will be the final authority as to whether the VFW will provide representation

7. Shall not refuse to assist any claimant because they do not feel the claimant is eligible for the benefit sought

8. Shall forward without delay all applications to the

Department Service Officer 9. Shall not keep original documents provided to them but are to transmit such documents to the Department Service Officer (may maintain records of claims prepared and submitted to the DSO only with the permission of the claimant and only under proper Post security, such records to be in the custody of the Post to be passed to the succeeding Post Service Officer and to be returned in full to the claimant upon request)

Note: Public Law 93-579 restricts the release of confidential information to parties other than the claimant. An accredited representative of a Veterans Service Organization may release only information necessary for development of a specific claim to a local Post Service Officer.

10. Shall not make direct contact with any office or representative of the Department of Veterans Affairs concerning a pending benefit claim or as a request for personal information regarding a claimant accept in the case of an emergent ill veteran to a VA Medical Center in which case the Department Service Officer will be informed when time permits

11. Must attend all training conducted within the Department in service work by the Department Service Officer, especially the annual Department Post Service Officer School and any service officer training conducted at District meetings or by the District Service Officer

When assisting a veteran in completing VA forms the Post SO may act as a recorder only, not as an advisor . This is an important issue due to potential liability.

Any VFW member may offer their assistance to a potential claimant. However only an appointed Post Service Officer may present themselves as such to either a claimant or government department or agency. Any VFW member offering their assistance to a claimant must accept the responsibility to act under the same rules as an appointed Post Service Officer.

What do we expect from a Post Service Officer? We expect that he has a desire to assist his fellow veterans without prejudice. We expect that he will establish a working relationship with other key Post and Auxiliary officers. Hospital Chairman Chaplain MAP Chairman National Home Chairman

We expect that he will establish a working relationship with key community service providers and agencies. Churches Shelters Funeral Directors State & County Social Workers Hospital Social Workers

We expect that he will establish a working relationship with key members of the veteran service network in his area.

County Veterans Assistant Commission Illinois Department of Veterans Affairs Other Veterans Service Organizations Other social agencies & organizations

Accreditation is awarded by the VA Organizations (VSOs) that are certified by the VA to do so may recommend individuals for accreditation.

VFW Policy: Individuals must be full time employees of the Department recommending accreditation, or under certain circumstances a Department may recommend a state or county employee for accreditation.

Accreditation requires annual training certified by the organization and approved by the VA. Accreditation has certain privileges: Access to VA records Permission to sign certain forms Accreditation has certain responsibilities: Continuing Education Representation of claimant during process

Who may assist a veteran?

An un-accredited representative: Family member Friend Attorney Access to information? VA Form 21-0845

Who may represent a veteran in a claim with the VA? An accredited representative: Attorney Individual Veterans Service Organization

Access to information? VA Form 21-22a VA Form 21-22

Your Questions!

Principles of VA Benefits The principle of VA benefits is to compensate the veteran, dependents or survivors for the hardship of military service through compensation for disability incurred in service or through other benefits intended to recognize the sacrifice and hardship of that service. Eligibility to VA benefits requires qualifying character, duration and time frame of military service.

Principles of VA Benefits Service Connected VS Non Service Connected?

The answer to this question governs eligibility to the full scope of benefits to which a veteran / dependents / survivors may be entitled.

Principles of VA Benefits Potential benefits include: Veteran Disability Compensation / Pension Survivor (DIC / Death Pension / other) Medical Benefits (veteran/dependent/survivor) Death Benefits (burial, headstone, flag) Education (GI Bill / Voc Rehab) Life Insurance (Conversion / RH) Home Loan Guarantee

DEFINITIONS Veteran - 3.1(a)(d) Types of Military Duty - 3.6 Active Duty Active Duty for Training Inactive Duty for Training Inactive Duty

DEFINITIONS Spouse - 3.50 Marriage - 3.1(j), 3.52 Surviving Spouse - 3.50, 3.52

Parent - 3.59

DEFINITIONS

Child (minor, disabled, school) 3.57 Natural Child Step Child Illegitimate Child

Adopted Child

VA Claim Process Claim Received by VA VA Development for Evidence VA Examination (if appropriate) Rating Board Decision Notice of Decision

VA Claim Process Formal Claim - 3.151 Received from claimant on proper form (directly of thru representative)

Informal Claim Statement Received from claimant or representative Claim not on proper form Incomplete claim on proper form VA medical care for SC condition

Claim Received by VA Original Claim Reopened Claim Claim for Increase Claim for previously denied condition Amended Claim Claim for new condition Claim for secondary condition

VA Development for Evidence VA has duty to assist the claimant (VCAA) Service Medical Records (SMRs or STRs) Service Personnel Records (as appropriate) VA Medical Treatment Records VAMC VA CBOC Non VA Treatment Records Vet Center Private Treatment Provider Records Lay evidence

VA Examination VA will order exams only for conditions deemed provable VA (VBA) will order exams at VA Medical Center closest to home of record capable of performing proper examination of disability claimed

Exam protocol is established by VBA Exam conduct is controlled by VHA

Rating Board Decision Rating Board evaluates all evidence in the context of claims made Rating Board reviews medical evidence and exams for Inferred Issues

Rating Board decides each claim granting or denying service connection Rating Board evaluates each disability assigning a percentage rating based on the VA Schedule for Rating Disabilities

Notice of Decision 38 CFR 3.103 - A VA Rating Board decision is not “official” until a Notice of Decision letter has been released which implements that decision. This notice is made to the claimant at the last address of record and is presumed to be received unless returned as undeliverable. The date of the Notice of Decision letter is the date from which the applicable appeal period begins. This letter and the attached documents will identify the claims (issues) considered and the basis for each decision made on those issues. It will also provide important information relative to the payment of benefits awarded and request any additional information needed to pursue additional aspects of the claim such as any inferred issues which have been identified or additional allowance for dependents. It will also give notice of appeal rights.

VA APPEAL PROCESS 38 CFR 20.200, 20.300, 20.301 The VA appeal process is very formal process. There are specific times frames within which the claimant must respond. The VA is not bound by any time frames during the appeal process. Almost any VA decision is appealable to BVA. (An example of a decision that is not appealable is a medical treatment decision.) The date of the notice of VA decision begins the appeal period.

20.201 - An appeal begins with the VA receipt of a Notice of Disagreement (NOD). 20.302 (a) - A NOD must be received with one year of date of notice of the decision being appealed. 20.201 - A NOD must identify the date of the decision being appealed, and A NOD must identify the issues being appealed. It is not enough to say “I disagree with the letter dated xxxx”. The NOD must identify the issues within the letter being appealed such as the denial of a benefit, the evaluation of a disability, the effective date of a benefit granted.

A NOD may include a request for a Decision Review Officer (DRO) review. Without such a request the appeal will be processed in the “traditional” process. The traditional process is that in response to the NOD the issues being appealed with be reviewed by another member of the Rating Board. Generally speaking they will review only the evidence itemized in the decision which may not include all historical evidence. Generally speaking a traditional review on appeal is much faster than a DRO review. When making a DRO request the claimant may also request a personal hearing before the DRO.

A DRO request is responded to by a full file review of the issue being appealed. In the case of a reopened claim for a condition previously denied, this may be useful. Following completion of the review by either method the VA will issue a Statement of the Case (SOC). The SOC may include a full or partial grant of the benefits sought on appeal or may continue the prior decision. The SOC details the evidence considered, the laws and regulations applied and reasons for each decision. The date of the SOC controls the next step in the appeal process.

20.202, 20.302 (b) - Following the SOC the claimant has 60 days to submit VA Form 9 or one year from date of decision whichever is later. The deadline for the Form 9 receipt is absolute, there is no extension of time. The VA Form 9 is the claimant’s opportunity to identify those issues from the SOC he desires to pursue on appeal. The claimant is also responsible to state why he believes the benefits sought on appeal should be granted.

Personal Hearing: The claimant may request a personal hearing before the BVA in one of three venues: In Washington, DC at the BVA, or

In Chicago before a travel board section of the BVA, or In Chicago at a video conference (televised) hearing before the BVA

Following the receipt of the VA Form 9 the RO certifies the appeal to the BVA. Certification of the appeal means that the Regional Office certifies that the issues on appeal have been properly developed and that all available evidence is in the claims folder. After VA certification the appeal is forwarded to the accredited representative if there is one. The rep completes a VA Form 646 which presents the rep’s arguments on the issues on appeal. Once the appeal has been certified to the BVA the case is held at the RO until it is called for by the BVA.

When an appeal is called up by BVA the file is reviewed by the appeals staff of the accredited representative if there is one. The rep makes a summary presentation of the appeal to the BVA. Following their review of the appeal, the BVA makes a decision which may include a grant, a denial or a remand or a mixture of all three. A remand decision refers certain issues back to the RO for additional development and return to the BVA.

An issue denied by the BVA may be appealed to the Court of Appeals for Veterans Claims (CAVC). The Court is not part of the VA process. An appeal to the Court is a judicial action. Appeals to the Court have very specific filing requirements. Appeals to the Court must identify a point of law which has been misapplied rather than interpretation of evidence.

Looking back at the appeal process it is important to know that at any time prior to advancement to the BVA the claimant may submit additional evidence which may be considered and may be the basis for a new decision which may either grant or continue to deny the issues on appeal. The submission of additional evidence does not extend any of the applicable periods mandated by regulation. Attention must always be paid to time limits during the appeal process. The VA will not send reminders!

QUESTIONS?

USE of VA FORMS 38 CFR 3.151 There is a VA Form designed for almost any purpose you may imagine in the claims process. The use of many forms are intended to be helpful guides in providing information to the VA and may be substituted by almost any submission of the required information. Other forms are REQUIRED to be submitted and may not be accepted by the VA in any other format other than the stipulated form.

USE of VA FORMS The use of proper VA Forms rather than generic forms is strongly encouraged because their use ensures that the proper information is provided to support the claim. The use of generic forms or letters to the VA may leave out required or useful information. This requires that service officers be familiar with the catalog of VA forms and their intended use.

QUIZ

Thank you for attending!

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