Matt Hill: Hello and welcome to another Hill and Ponton video blog. I’m Matthew Hill.
Carol Ponton: I’m Carol Ponton.
Matt Hill: And today we want to talk to you about a question we’ve gotten recently, which is a veteran asking us “if I have my own copy of my claims file, why do you have to go get one from the VA?” I think, first thing to discuss with this, is what is the claims file? The claims file is the form the VA benefits section keeps on you, not the VA health administration which has all of your medical records. The benefits section keeps a file that has any and every claim you filed since discharge and all the information and evidence that was included to go through those claims. It’s in the order in which those claims were filed.
Carol Ponton: I’ve had many veterans say “well, I have a copy of my claim file.” Sometimes, what they have is what they sent to the VA and what the VA sent back to them. That’s not a copy of their claim file, there would be a lot more evidence in there, compensation pension exams, the VA’s thinking on what they, why they did what they did with the case. Other times they do have, they have been sent a copy of the claim file but it’s been changed. As Matt said, there is a great significance in the order in which things are placed. What happens is when a veteran files a claim, you have the 526 that’s put in there, and then you have everything that is put in the file after that. But, they’re all put in in the date they’re received, there’s no organization, there’s no particular order. That allows us to see whether or not, for instance, there are old claims that are available to be reopened, it tells us a lot of things that allows us to get the maximum benefit for the veteran. If the claim file is mixed up, then we can’t be sure of what actually happened in the procedure from the day you first filed a claim to now. That is a real problem.
Matt Hill: When we represent veterans, our job is to do a competent and professional job, and so when our vets get frustrated on this note, you know, a claim is going to last, in all likelihood, anywhere from 18 months to 3 years, just on the way the VA’s processing cases. From the get-go we want to have the basis on which the VA is making their decisions and have made all past decisions. It’s a matter of just doing the job competently and professionally from day one.
Carol Ponton: A lot of times our veterans will say “I was in Vietnam, I have Diabetes, why aren’t they recognizing that? I keep showing them I was in Vietnam.” Once we get in to the claim file, we realize, the VA is not saying you weren’t in Vietnam, they’re saying “we don’t have a diagnosis of Diabetes.” Or “we don’t have a diagnosis of the Peripheral Myopathy or Heart Disease.” And so that tells me what the VA needs to win. I’ve had this happen so often with my clients, it’s really hard to figure out sometimes what the VA wants, and once you get that to them, then you win your case. But, you have to read the claim file. If we need an independent medical exam, we need to have our doctors, have read the important parts of the claim file. If they haven’t then the VA, when they get this opinion, is going to disregard it in most times, they’re going to say “our compensation and pension examiner read the claim file, your doctor didn’t, so this doctor, the VA doctor knows better than yours.” We don’t want that to happen, and we found when we get the claim file, and we have our doctor review that, that’s very hard most of the time for the VA to refute.
Matt Hill: Thank you for joining us today.
