In the practice of law, there are a number of terms that are routinely thrown around that have meaning to the people using them, but to the casual observer are nothing more than gibberish. Today I want to talk about one of the terms that you will hear frequently when discussing your claim for benefits with your attorney, with the VA, and sometimes even medical experts. Today’s article is about the claims file; what it is, how to get it, and why it is so important to your VA claim.
To start at the beginning, what is your claims file? Your claims file is, at its most basic level, everything that the VA has in relation to your claim(s) for benefits and compensation. The claims file, also known as c-file, will (or is often the case “should”) contain all the records, medical and non-medical, that the VA has collected during the course of the claim. Examples of documents that are non-medical that the file will contain are employment records, service records, buddy statements, veteran statements and much more. Additionally, the c-file should contain any and all claims the veteran has filed since he or she was discharged.
So how do you go about getting the file? Again, this is fairly simple task. You ask the VA for it. The VA is required to provide a copy of a veteran’s c-file to the veteran. (How soon they get a copy of the file to the requester can vary greatly from one regional office to the next.) In our office, after we speak with a veteran and review their most recent decision, we order a copy of their c-file from the regional office. The c-file is the is the best way to find out what the VA has and has not done for a veteran, where there have been mistakes made, and how to remedy those mistakes to get the veteran his hard earned benefits.
As I said previously, the c-file contains everything relating to your claim (or claims) for benefits from the VA. When the c-file arrives, it can vary greatly in size from case to case. Some files that arrive at our office are only a couple hundred pages (which can be an indication that not everything was included) up to thousands of pages (some of this is due to numerous duplicates of documents). Upon arrival, we will send a copy to the veteran and go through page by page to create an index of the file. The index puts the file into order and creates a map so that we can plan our attack for the veteran.
If simply having a copy of everything the VA is using in your claim does not sound like reason enough to request a copy of your c-file, keep reading because it can reveal a number of things, most importantly, the evidence and reasoning the VA used to deny a claim for benefits. Veterans are often surprised by things that are in the file.
Oftentimes, when a claim is initiated, the VA will request a Compensation and Pension (C&P) examination. The veteran will attend this examination, answer a doctor’s questions, and can walk away feeling that the doctor understands them, their problems, and that the exam went well. The problem is that often the exams are lacking, or even worse simply negative. The veteran who thought that the exam had gone well is often shocked by this news.
Other times, the veteran believes that his or her treating physician is on board with their claim and supportive. However, when the claims file is obtained, the opposite turns out to be true. The records can show an entirely different picture than what the veteran thought was the case. Finding all of this helps in the planning of how to get the veteran his or her benefits whether that involves getting an expert opinion to rebut the VA doctor’s opinion, gathering additional private medical records or some other method.
Getting a copy of the claims file is the first step in winning your case and provides the guidance your representative needs to plan your case. It is not only important, but it is necessary to each claim. There may be negative evidence you are not aware of, positive evidence that was overlooked, decisions with appeals tolling, or old decisions that were clearly erroneous, but no one knows this for sure without having that file.
My hope is that after reading this, you have a better understanding of what the claims file (c-file) is, how you go about getting it, and just how important it is. The veteran, nor his representative, knows what type of case they have until the c-file is received and thoroughly reviewed. Once the file has been reviewed, all parties involved have a much better grasp of all the issues. The records in the file can be a game changer.
Thank you for your service.