Dealing with the VA: Regional Office Appeals

Now that we have shed some light on the basic differences between claims and appeals, we can now focus more on the appeals process itself. To refresh, a veteran starts the process by filing a claim with the VA regional office (RO). Then, the VA issues a decision based on the evidence you have presented to them regarding your disability rating. If you disagree, you may then file a NOD, or notice of disagreement, officially starting the appeal process. But did you know that the RO develops appeals in addition to processing claims?

When the VA issues its decision, it will give you a Rating Decision, or RD. This decision will outline in detail why and how the VA determined your particular rating. And if you disagree with any part of that decision, it is important to remember that you have one full year in which to file a notice of disagreement with the VA. The sooner you file, the better.

Once you have filed your disagreement, you become entitled to new rights during the appellate process:

• You may submit new evidence in support of your disability,
• You can request to have your claim reviewed de novo, where a decision review officer (DRO) will look at your claim as if submitted for the first time, reviewing your file in its entirety; he or she may even requesting a hearing with you, a representative or attorney, or any witnesses to reach a new decision.
• You may request a traditional review.
• You may opt for a teleconference hearing with your DRO to speed up the process. In fact, the VA encourages teleconference hearings, and some appeals can be favorably resolved due to the faster scheduling and quicker processing of the appeal.
• Alternatively, you can choose to attend an in-person hearing, but it will be scheduled much more slowly than a teleconference. Either way, remember that it is ultimately your decision.

If you decide to file a NOD, you should submit any new evidence in support of your condition immediately. This will help speed up the process considerably. Another way to save time in the appeals process is to indicate on your NOD whether you want a traditional or de novo review. But don’t worry if you forgot to do it – the VA will mail you notification of this right, but you will only have 60 days to respond to their request. Time is of the essence when dealing with your VA appeal, so be sure to keep an eye on all deadlines!

So what is the difference between the traditional and de novo review processes?

A traditional review is much different than a de novo review. Traditional reviews are conducted by members of the RO’s appeals team, and they determine solely whether your claim was correctly processed. If the reviewing team member decides that your claim was processed correctly, the RO will issue you a Statement of the Case, or SOC. This will list all of the laws, statutes, and regulations that were used in determining your rating and how those laws applied to the evidence that the RO considered while making their decision. The SOC will be a very detailed explanation of the VA’s decision.

A de novo review, on the other hand, looks at all of the evidence you submitted in your claims file (c-file) and any new evidence that you provided. This process is carried out by a DRO, a highly experienced senior claims processor at the RO. The DRO has the power to grant or deny your appeal, issue a SOC, or request additional medical records or exams for further development of your case.

Whichever review process you choose, you will receive a SOC (unless the full benefit you are going after is granted). If you don’t receive the full benefit, however, you will still receive a SOC, which will allow you to continue with your appeal. Once you have received the SOC, you may still disagree with the decision of the RO. This is why, in our previous article, we said that the appellate process can have many layers.

If you still disagree with the VA’s opinion in the SOC, you have 60 days after receiving the SOC to file a Form 9, which is an Appeal to the Board of Veterans Appeals. If you submitted more evidence after you receive a SOC or before you file a Form 9, another review of your case – and another SOC, called a Supplemental Statement of the Case, or SSOC – must occur. This will include analysis of all of the additional evidence you submitted or a rating decision (if the new evidence helped the VA reach a decision in your case). This means that each time you submit new evidence, a new review must occur. It is like starting your appeal all over again, and every time the VA has to create a new SSOC for your case, another year can be added to the appellate process.

When you file a Form 9, you may also request to have a hearing with a judge, who will reach a decision in your appeal. This is not a mandatory part of the appeal, but it will delay a final decision. You can request a teleconference, wait for a judge to travel to your local RO, or you may choose to travel to Washington, D.C. to have a hearing. Again, like hearings with a DRO, teleconference hearings can be scheduled much more quickly and easily than either of the in-person hearing options, so you may prefer to choose this option. This is especially true if your disability makes travelling difficult or even impossible for you.

Whether you choose a hearing or opt to forego it, the appeals team at your local RO will ensure all of the required steps were taken so that it may be certified and submitted to the Board of Veteran’s Appeals (BVA). When all of the T’s are crossed and the I’s are dotted, the RO will transfer your appeal to Washington, D.C. for a decision by the Board.

Given all of the deadlines, formalities, and paperwork that can go along with keeping up with your appeal (or appeals, depending on your rating decisions), you may want to hire an attorney to help you keep track of everything. An experienced veteran’s disability attorney knows the ins and outs of the process, knows that you are as unique as your experience and your military service, and knows how to tailor their representation to get you the best benefit possible for you and your family. At George Sink, P.A. Injury Lawyers, we have a team in place should you decide to get help with your appeal.

Attorney George Sink and his entire team have a long history of helping injured and disabled people navigate their legal journeys, and we’re committed to providing personal service, passionate support, and strong representation. We have represented qualified veterans from all branches of the military whose service-related disabilities have affected their lives and ability to work. And as a disabled Marine veteran himself, George Sink knows the struggles that other disabled veterans face. If you think you may be entitled to a higher disability rating – or even total disability benefits – call George Sink, P.A. Injury Attorneys today for a free case review! Remember that at George Sink, P.A. Injury Lawyers, there is a team with 35+ years of experience that you can choose to fight on your side to help you get the veterans disability benefits you deserve.