VA Benefits Appeal. To win a VA disability claim, a veteran must prove all elements. Generally, VA will approve a VA benefits claim when a veteran proves the following:
In-service event, disease or injury,
Current disability, and
Medical nexus between the in-service event and the current disability.
After you submit your claim, VA is obligated to issue a decision. Based on the evidence, VA may decide to approve your claim completely. Alternatively, VA may either deny the claim outright, or grant your benefits at a low disability rating. Regardless, veterans have the right to appeal any VA benefits decision to a higher authority.
What is the point of an appeal?
VA decision-makers are not perfect. They often make mistakes. For a disabled veteran who is barely making ends meet, VA’s mistakes can be costly. This is why Congress created the appeals system. It gives veterans a fighting chance to correct VA’s mistakes without losing years of benefits.
VA benefits appeals are great because they preserve the earliest effective dates. Take the example of J. Stone, who filed a claim for PTSD in 2011. VA denied his claim in 2013 because they could not confirm the traumatic in-service event. His friends told him to just file another claim. Instead, he consulted the experts at Disability Help Group (DHG).
A DHG representative helped him file an appeal along with evidence of the in-service event. In 2015, VA decided the appeal in Mr. Stone’s favor. As a result, he received a 70% rating effective 2011, the date he filed his claim. He received
Appeals in the Legacy System
The Legacy system refers to the VA appeals structure for decisions issued prior to February 19, 2019. When VA first denies a claim in Legacy, the veteran may appeal with a Notice of Disagreement (NOD). The deadline to file a legacy NOD is 1 year from the date of the decision.
When you file a timely NOD, you are asking a senior VA officer to overrule the previous decision. If the VA agrees with you, then it will issue a new decision awarding benefits. If not, VA will issue a Statement of the Case (SOC) to explain why the previous decision should stand.
Fortunately, an SOC is not the end of the road. Using a VA Form 9, you can appeal an SOC to the Board of Veterans’ Appeals (the Board). Unlike the lower decision, you have only 60 days to appeal an SOC. A VA Form 9 is a request for a Veterans Law Judge to take a fresh look at your case. If the judge finds in your favor, he/she will award benefits effective the date you first filed. If the judge finds against you, then you can appeal to the U.S. Court of Appeals for Veterans’ Claims.
The Appeals Modernization Act changed everything
Any decisions issued on or after February 19, 2019 fall within the Appeals Modernization Act (AMA). If VA denies your claim, or approves it with a very low rating, you can appeal it by filing one of these forms:
VA Form 20-0995 Supplemental Claim, 20-0996 Request for Higher Level Review, or 10182 Notice of Disagreement to the Board of Veterans’ Appeals
Each lane has its pros and cons. Visit this link for more details [Link to the AMA article].
What’s the downside of an appeal?
First, a VA benefits appeal can take a very long time. Take a look at the search results when you Google “VA appeals backlog.” Prior to the AMA, VA took an average of 2.5 years to process appeals.
Second, you may have to appeal several times to get the job done. If your first appeal is not successful, then you should appeal to a higher tribunal (like the Board of Veterans’ Appeals). When you believe in your claim, you should never give up. Don’t let VA win.
Hire an expert to give yourself the best chance to win
Every VA benefits appeal is different. The best indicator of success is having an experienced representative. This is a very complex system. Most veterans are not equipped to force VA to change a decision. Some cases already have the evidence needed to win, but are lacking a good legal argument. Other cases lack both evidence and argument. An experienced representative can plug the holes in your case.
At DHG, our experts review each case with a fine-toothed comb. This is how we figure out the best path forward. We don’t just file a VA benefits appeal and then wait around for VA to act. Instead, we actively develop winning evidence and arguments to deliver for our clients.
Do you need help with your VA benefits appeal? Contact the experts at DHG for a free consultation.
Disability Help Group, Call Now for a Free Case Review, 800-700-0652
Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
Because memory deficits are common VA TBI residuals, a veteran should always have an advocate. Disability Help Group specializes in TBI cases and is here to answer your questions now.
VA Disability Remand. After a veteran applies for VA benefits, VA must decide to either
Grant the claim, or
Deny the claim.
Following a VA decision, the veteran has the right to appeal. If the first appeal fails, a veteran can request review by the Board of Veterans’ Appeals (the Board).
In addition to the first 2 decision options (to grant or to deny), the Board may decide to remand. When the Board issues a remand, it is ordering the VA Regional Office to take specific action to develop the claim. Unfortunately, most of VA’s appeals backlog involves remands.
For many veterans, it takes longer than 2 years for VA to issue a new decision after a Board remand. For most veterans, the goal is to turn a remand into a grant. That is exactly what we do here at Disability Help Group. Keep reading for more information on VA Disability Remands.
Which VA agencies are involved?
VA Disability Remands involve a maze of different decision-makers. To understand VA Disability Remands, one should first understand the different agencies involved.
VA Regional Offices. Claims start at the Regional Office level. There are 57 Regional Offices, most of which are based in the United States.At this level, VA Rating Specialists usually decide the claims. If the Rating Specialist denies the claim or grants it with an inappropriate rating, the veteran can file an appeal. More experienced VA decision-makers, such as Decision Review Officers, usually process these appeals.
Board of Veterans’ Appeals.If the first appeal is unsuccessful, then the veteran has the right to appeal to the Board of Veterans’ Appeals. The Board, which is based in Washington, D.C., is a superior tribunal of VA law judges. The Board reviews appeals of decisions issued by the Regional Offices. At this level, VA law judges (instead of local bureaucrats) make the decisions.
What is a Remand?
Put simply, a remand is an order from a superior agency to a lower one. The lower agency has no choice; it must comply with the remand order. In the VA disability system, the most common type is a remand from the Board to the Regional Office.
While it is not a final decision, a Board remand is binding on the Regional Office.
Why would the Board issue a Remand instead of a Grant or Denial?
There are 3 main reasons:
The Regional Office did a really bad job. Often, the Regional Office fails to meet its duty to assist veterans in accordance with the law. They may have failed to provide a medical exam, misinterpreted a regulation, or ignored favorable evidence. Because of these failures, the claim lacks evidence the Board could rely on to grant. To addressthese failures, the Board uses remands to spell out how the Regional Office can make up for them. After the Regional Office complies with the Remand, it must issue a new decision.
New evidence is introduced. Let’s say the Regional Office denied a PTSD claim because there was no medical nexus. During an appeal to the Board, the veteran submitted a private medical nexus opinion. Because the Board is strictly an appellate tribunal, it cannot consider new evidence in the first instance. In this situation, the Board must remand the case for the Regional Office to consider the new nexus opinion.
Your disability gets much worse. In an appeal involving a request for a higher rating, the disability may get worse while the veteran waits for the Board’s decision. The Board is likely to remand for a new VA medical exam if that last exam was over 2 years ago. Rather than rely on an old exam, the Board may order a new one that reflects the current disability.
What are the Pros and Cons of a Board Remand?
Pros
As a matter of law, veterans have the right to compliance with the Board’s remand order. This means that the Regional Office cannot ignore the order and issue another denial.
It preserves the earliest effective date for the claim. For example, let’s say a veteran filed a claim in February 2012. He appealed his case all the way to the Board, which issued a remand order in December 2019. If the Regional Office grants the case on remand, then the benefits will be effective February 2012.
Cons
Board remands represent the largest backlog of appeals at most Regional Offices. VA is slow to process them.
If the Regional Office issues a decision on remand without complying with the Board’s order, then the Board will likely remand the case again. This could drag the case out even longer.
Example
An experienced representative can make all the difference. Take the example of W.F., a DHG client who served in the Marine Corps.
In October 2012, he filed a claim for multiple orthopedic disabilities. In June of 2013, VA denied his claim for lack of a medical nexus. Although he met the criteria, VA failed to provide a medical exam. On his own, he appealed his case all the way to the Board. While he waited for a decision, W.F. submitted new evidence from his private doctor. In October 2017, the Board remanded his case with the following instructions to the Regional Office:
Associate the new medical evidence with the file,
Schedule the veteran for a VA medical exam, and
Re-adjudicate the claim.
Shortly after the remand order, W.F. hired DHG. First, we regularly urged the Regional Office to comply with the remand. Next, we developed a private medical opinion to satisfy the medical nexus element. As a result, the Regional Office granted the claim in full effective October 2012.
Do you need help with your VA disability remand? The experts at DHG are ready to help. Call for a free consultation.
Disability Help Group, Call Now for a Free Case Review, 800-700-0652
Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
Because memory deficits are common VA TBI residuals, a veteran should always have an advocate. Disability Help Group specializes in TBI cases and is here to answer your questions now.
Are thinking about or have already filed for Social Security disability benefits? You should consider hiring a SSDI disability lawyer for help. Many people think that applying for disability benefits is simple and fast. Unfortunately, this is not true. The initial application process requires a lot. It includes paperwork and medical records. Also, you must complete several forms. The process can become confusing and overwhelming.
You do not need to hire a SSDI disability lawyer to represent you. Although, hiring a disability lawyer can improve your chances of a successful claim. There are many reasons why you should work with a SSDI disability lawyer. Contact Boston’s trusted criminal defense lawyer in case of accident.
Advantages of Hiring a SSDI Disability Lawyer
There are many benefits to hiring an experienced SSDI disability lawyer. First, a SSDI disability lawyer will serve as your advocate. They guide you through the process. Social Security has very specific definitions of disability. This includes a Blue Book listing of medical impairments. These conditions qualify people for disability benefits. A SSDI disability lawyer can help you understand these listings. They will assist you in getting the right evidence to support your claim.
A SSDI disability lawyer reviews your initial application
Secondly, a SSDI disability lawyer reviews your initial application. They look for important missing information. Any mistakes or missing information can effect on your claim throughout the entire process. An SSDI disability lawyer can help you avoid making any serious mistakes.
A SSDI disability lawyer deals with Social Security
Third, your SSDI disability lawyer stays in touch with Social Security. They want to make sure your claim is moving forward. They can help you in completing important forms. Also, your disability lawyer will answer any questions that you have.
Lastly, a SSDI disability lawyer will file any necessary appeals. You don’t’ want to miss any deadlines. Social Security may make you start over from the beginning. An SSDI disability lawyer appeals your claim before any deadlines.
How A SSDI Disability Lawyer Can Increase My Chances
A SSDI disability lawyer knows the application process. They have gone through the process many times. They know why Social Security denies claims. A SSDI disability lawyer also knows what it takes to get a claim approved. They can get your claim on the right track. Also, providing the right information quickly helps your application go faster.
A SSDI disability knows Social Security’s rules
A SSDI disability lawyer presents your case in a way to give you the best chance of winning your claim. Social Security has special disability rules for people over age 50. They are called “grid rules.” The grid rules consider several factors when looking at your claim. They include your age, education and work background. An experienced SSDI disability lawyer can explain how these grid rules work. They can tell you if they apply in your claim.
Case study 1: applying the grid rules
For example, say you are over the age of 50 and previously worked as a cashier. You had to stop working because you have arthritis in your knees. Now, you can no longer stand or walk for long periods of time. A SSDI disability lawyer can tell you what records will help win your case. They can also provide you with forms for your doctor to complete to help support your claim. These are known as Residual Functional Capacity (RFC) forms.
Social Security Hearings
Working with a SSDI disability lawyer gives you a valuable advantage at the hearing level. SSDI disability lawyers are experienced appearing at hearings. They know the judges. Therefore, they can tell you what the judge is like at hearing.
Understand the hearing process
Generally, hearings are not like court on television. Social Security disability hearings take place in private hearing rooms. You do not sit in a witness box. There is not another attorney asking you questions. However, they still require you to follow certain rules. You do provide testimony under oath. Sometimes, there are medical and vocational or job experts that testify.
Be prepared for your hearing
An experienced SSDI disability attorney will get you ready for your hearing. They tell you the questions the judge will ask you. Typically, your disability attorney practices answering these questions with you. Additionally, they will also explain the roles of all the people present during a hearing, including any experts. Many times, the judges will have vocational experts testify. Vocational experts know about jobs. They help the judge understand how your past work is categorized. In addition, they will also testify how physical and mental restrictions impacts work in general.
A SSDI lawyer completes your file
Most importantly, your SSDI disability attorney reviews your file. They get any additional evidence or documentation that you may need to get your claim approved. They explain how the judge will review the medical evidence.
Disability Help Group: Winning case study
For instance, Sarah didn’t think she needed a disability lawyer. Her doctors told her that she was a good candidate for disability benefits. Unfortunately, Social Security denied her two times. At that point, Sarah turned to Disability Help Group. We reviewed her file. We discovered that some important medical evidence was missing from her file. Sarah’s advocate sent the missing records to the judge. The judge approved Sarah’s case. Her only regret was not hiring Disability Help Group sooner.
What is the cost of hiring a SSDI disability lawyer?
There are no up-front costs to hiring a SSDI disability lawyer. If you are not approved for disability benefits, you don’t pay any fees. Social Security has rules that decide how much a disability lawyer is paid.
Social Security regulates our fees
An SSDI disability lawyer cannot get more than 25% of your back pay up to $6,000 under Social Security’s rules. In other words, $6,000 is the most a SSDI disability lawyer can get paid. For example, if you were awarded $40,000 in back pay, then your SSDI disability lawyer receives $6,000 in attorney’s fees.
Social Security pays us directly
Social Security will automatically withhold your SSDI disability lawyer’s fee. Then, Social Security will pay your attorney. Social Security will send the rest of your back pay directly to you.
Costs associated with your claim
However, there could be costs associated with getting your medical records. These costs are separate from any attorney’s fees. You must repay these costs directly to your SSDI disability lawyer.
When should I call a SSDI disability lawyer?
Generally, it is better to contact an SSDI disability lawyer as early as possible. Especially if you are considering filing for disability, you should call a SSDI disability lawyer for a free consultation. They can look at the strength of your case. They can assist with the initial application process.
Get help now
However, all is not lost if you have already filed an application. Moreover, you can hire a SSDI disability lawyer during any stage in the process. They can answer any questions that you have about appealing your claim . An SSDI disability lawyer can also help you figure out what went wrong the first time around.
Disability Help Group, Call Now for a Free Case Review, 800-700-0652
Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
How Can I Check on My Disability Claim? It takes Social Security time to process your disability application. There are several steps that Social Security takes before making a decision on your claim. Checking your Social Security application status is an easy way to stay on top of your Social Security application. You can make sure there is no missing information slowing down your application.
However, there are different guidelines for checking the status of a claim. There are also different departments that handle your claim. It can be confusing and frustrating if you’re not sure who to contact for the status of your claim.
Ways to Check the Status of Your Application
There are several ways to check the status of your Social Security disability claim. These include:
Online at the SSA website at www.ssa.gov . If you are checking the status of your application online, you will need to create a “my Social Security” account.
Contact your local Social Security office
Contact Social Security’s national telephone at 1-800-772-1213
Contacting you Social Security disability lawyer
Information Needed to Check Your Claim Status
In order to provide you information about your claim, Social Security will ask for specific information. You should have this information available before speaking with Social Security. This includes:
Your name
Social Security number
Address
Email
A phone number for Social Security to reach you
Checking on Initial Applications or Reconsideration Claims
First, you send your disability claim to your local Social Security office. Second, the local office processes your application. Third, your claim is sent to Disability Determination Services or DDS. DDS assigns a claims representative to your case. The person assigned to your case is the claims adjudicator.
Even if you need to check the status of your claim at the initial application or on reconsideration (the first appeal), it is best to speak directly with the claims adjudicator assigned to your case. DDS often will include your claims’ adjudicator’s name and phone number on letters and forms that they send you. Your claims adjudicator will give you the status of your claim and tell you what information they are waiting for. However, the claims adjudicator cannot tell you Social Security’s decision on your claim. You will receive a decision letter in the mail.
DDS will assign a different claims adjudicator at the reconsideration level.
Especially if you have not received any letters or forms, you can also call your local office for additional information. Social Security recommends that you wait at least thirty days before checking on the status of your claim.
DDS mails you letters that tell you what information is missing from your claim. This generally includes a list of your doctors that Social Security has contacted. The letters state that they will make a decision within 10 days if they do not receive the requested information. Do not panic if you receive these letters. At times, you may receive this notice very shortly after your claims adjudicator sends a request to your doctors, giving them very little time to respond. It is best to follow up with your claims adjudicator or your disability lawyer to receive an accurate update on the status of your claim.
Checking on Hearing Level Claims
You can appeal at reconsideration level and request a hearing in front of an administrative law judge. Once a request has been filed, your claim is sent to the hearing office(OHO). Your claim will be assigned and scheduled for a hearing. It may take several months for OHO to schedule your hearing.
Speaking to the correct office
If your case is at the hearing level, it is best to contact the hearing office directly. The hearing offices are separate from Social Security. Therefore, your local office will not have much information about your claim at that point. At best, the local office will only confirm that your case is at the hearing office.
If You Have a SSDI disability lawyer
A disability lawyer will make these calls and check on the status of your claim for you. An experienced disability lawyer will perform regular status checks with Social Security. Since they are familiar with all aspects of the process, they will know who to call to get accurate information. A disability lawyer will also help you to complete all the paperwork. Overall, hiring an experienced disability lawyer can help to make the claims process easier.
Disability Help Group, Call Now for a Free Case Review, 800-700-0652
Make sure you start your claim the right way and apply for all the benefits you deserve. If you have already applied for SSI or SSDI, call immediately to make sure your case is still pending and was filed correctly. You may be entitled to significant compensation. Contact us now for a free consultation.
Osteoporosis is a condition that causes bones to be porous and fragile. This can cause the bones to break easily.
Osteoporosis happens when your bones become less able to make new bone as quickly as the old bone breaks down. Osteoporosis can be considered a disability if it prevents you from working.
Who Usually Develops Osteoporosis?
Anyone can develop osteoporosis. However, there are certain risk factors that can increase your likeliness to develop osteoporosis. These risk factors can include:
Sex – more women than men get osteoporosis
Age – you are at higher risk to develop osteoporosis the older you are
Diet – low calcium levels, anorexia and weight loss surgery can increase your risk
Lifestyle – you are at higher risk if you sit around a lot, drink a lot of alcohol or use tobacco
Medications
In early stages, osteoporosis often does not have any signs or symptoms. However, in more advanced stages, osteoporosis can cause:
Loss of height
Changes in posture
Back pain
Typically, osteoporosis alone will not qualify you for Social Security benefits. However, there are symptoms and related health problems that might affect your ability to work.
Evidence needed for your osteoporosis diagnosis
Medical evidence includes your doctor’s treatment notes, test results and imaging.
Difficulty or an inability to ambulate effectively, such as your ability to walk reasonable distances or to use stairs
The need for an assistive device such as a cane, walker, or crutches
Any pain with movement of your bones or joints
Problems using your hands
Difficulty traveling places without assistance
Difficulty performing activities of daily living such as shopping, cooking, cleaning, using public transportation, bathing or getting dressed
Specific tests related to osteoporosis include:
Bone mineral density test. This tests the strength of your bones. It can also be called a DXA scan.
Blood tests that include
Calcium levels,
Thyroid levels,
Vitamin D levels,
Alkaline Phosphatase,
Follicle stimulating hormone (FSH) or
Parathyroid (PTH)
Treatment for Osteoporosis
Treatment for osteoporosis can include medications and lifestyle changes.It is important that your doctor document side effects from medications response to medication surgeries or procedures related to fractures related medical complications
Listings of Medical Impairments
This is also known as the “Blue Book.” Osteoporosis is not one of the medical impairments included in the Blue Book. However, you might match a listing under another section.
Since osteoporosis can cause your bones to break easily, Listings 1.06 and 1.07 might apply. These listings provide specific criteria for fractures or broken bones in the upper and lower body.
osteoporosis due to other conditions such as cancer, thyroid disorders
If you have one of these conditions, you might match the listings under 9.00 for endocrine disorders.These include:
Pituitary gland disorders
Thyroid gland disorders
Parathyroid gland disorders
Adrenal gland disorders
Diabetes and other pancreatic gland disorders, including
Hyperglycemia (high levels of glucose),
Hypoglycemia (low levels of glucose) and
Diabetic ketoacidosis
What if your osteoporosis does not meet the Blue Book listings?
You can still qualify for Social Security disability benefits if you do not meet the Blue Book listings. However, you must show that your osteoporosis keeps you from working.
Social Security will need to assess your residual functional capacity (RFC.) Your RFC is what you can do despite your medical conditions. Your doctor can help clarify your RFC by providing certain information about your osteoporosis.
For example, you may need to use extreme caution performing certain activities due to a higher risk of breaking your bones, such as bending or lifting. You may have problems standing, walking or sitting for long periods of time due to joint pain, especially in your back, hips, knees or ankles.
You may also have difficulty reaching, grasping or holding items because of joint pain in your hands or arms.
Your doctor can help explain these limitations in an RFC form. Your doctor should be specific with any limitations related to these activities. They should include:
How long you can sit, stand or walk at one time or in an eight hour day
Maximum weight you can lift or carry
How frequently you can use your arms and hands
Your pain levels
Side effects from medications
You want to provide as much documentation and records as possible related to your osteoporosis. You should see your doctor consistently and continue to have regular testing for your osteoporosis.
Disability Help Group, Call Now for a Free Case Review, 800-700-0652
Make sure you start your claim the right way and apply for all the benefits you deserve. If you have already applied for SSI or SSDI, call immediately to make sure your case is still pending and was filed correctly. You may be entitled to significant compensation. Contact us now for a free consultation.
