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Your VA Rating


U.S. Navy Member. Istock photo by Willowpix
Reprinted from PN/Paraplegia News August 2016

The Department of Veteran Affairs (VA) claims process can often be confusing and frustrating.

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Once a veteran has received his or her rating decision letter, many don’t know all of the information it provides. Obtaining a better understanding of your rating decision and how to effectively read the letter will help in seeking the benefits to which you’re entitled.  

The top of the rating decision letter consists of the VA regional office crest and address of the office that rated the claim, followed by the veteran’s name, Social Security or VA claim number, the name of the service organization or representative of the veteran, followed by the date of the rating decision.  

Introduction

The rating decision’s introduction section describes the veteran’s period(s) of service, the era of service, the years of service and the branch of service. That’s followed by the date the VA regional office received the claim.

If you filed your claim before the date listed in the introduction section, contact your Paralyzed Veterans of America (PVA) National Service Officer (NSO) or service organization and discuss the issue with them.

It’s always best to verify your date of the claim because you may be entitled to additional benefits or other compensation.

Decision

The decision section briefly explains whether you were granted service connection or denied service connection.

If you were granted service connection, the rating would provide you with the percentage granted for that particular condition and the effective date of the granted condition. If your claim was confirmed and continued, that means your service-connected percentage will continue at its current rate.

If your claim was denied or the previous denial was confirmed and continued, that means your claim has remained denied.  

Evidence

The evidence section should list all of the medical information that was submitted to support the claim and should list the dates of that data, as well.

It’s critical to check this section to make sure all of the information submitted is listed. This will ensure that all of the evidence was considered in making a decision on your claim.

Reasons For Decision

This section explains the rating in greater detail.

If your claim was granted, it would tell what percentage was given, why you were granted that particular percentage and what warrants a higher percentage for that condition. 

If you believe you deserved a higher percentage, then review what justifies the higher percentage and check your medical evidence to make sure you met those criteria.

If you fulfilled the criteria for the higher percentage, contact your NSO and have him or her review your medical evidence and discuss your options.

The VA looks for specific medical evidence to grant service connection. It’s looking for a definitive diagnosis of a chronic medical condition and chronic treatment for that condition while in service. It’s also looking for continuity of medical care once you have retired or separated from the service.

If your claim was denied, this section will explain why your claim was denied. One of the more common reasons for a denial is “medical evidence does not show that you are clinically diagnosed with this condition.”

Another common reason for denial is “your service treatment records do not show any complaints of, treatment for, or a diagnosis of claimed condition.”

These statements are saying the search of your service treatment records doesn’t show a medical diagnosis or treatment for the alleged condition. Often, veterans may have been treated for back pain or knee pain, but those aren’t a diagnosis because back and knee pains are symptoms of a condition.

A ruptured disc or a torn knee ligament is a diagnosis and pain is a symptom of those conditions. If you’re missing a diagnosis, you’ll need to seek a medical opinion to connect your current condition to the treatment you received while in the service.  

Locate Your Records

Remember, before the VA can grant service connection, the condition must be a diagnosed condition.

If you were denied service connection because the VA couldn’t find medical records documenting your diagnosis, it’s in your best interest 
to locate and provide those records to the VA.

If a civilian doctor saw you, seek out that doctor and request your medical records. If you don’t have a copy of your service treatment records, you can ask for them using form SF180 (Request Pertaining to Military Records). The easiest way to locate the SF180 is to perform a Google search.

If you don’t have a computer or need assistance requesting your service treatment records, contact your NSO or service organization.

For more information, visit pva.org or contact your local PVA NSO from the roster on page 56.

Todd Jones is PVA’s East-South Area Manager in St. Petersburg, Fla.

 

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