Understanding VA Decisions – Walsh Veterans Law

How to Read a VA Decision

Disability Claims, Understanding VA Decisions / Al Walsh

I’m going to talk about how I think Veterans should read VA Decisions, specifically decisions they don’t like. This is the third video in a series I’m making about VA Decisions. I don’t think you need to watch them all, but if there’s something in here that’s confusing, then maybe go check out the earlier videos.

This may seem like a weird thing to talk about, but the best way to start fixing a bad decision from the VA is to understand exactly what the VA said, and also what the VA didn’t say. That way, you can find errors and use them to your advantage as you continue to fight your claim. Now I know bad VA decisions can be very frustrating, but you have to get past your frustration and read the decision as objectively as possible. I recommend a pretty straightforward process to do that.

The first step is just to read the decision. And if that decision makes you mad, put it down and walk away. Give it at a few hours or a day or so, but give yourself time to calm down. Then, once you’re calm, read it again. And if it makes you mad again, put it down and walk away. Repeat this process until you can read the whole decision calmly and carefully, from start to finish.

Next, start making notes of whether the VA included everything they were supposed to. Write down whether each of those things was in the notice letter or the decision and what page it was on. This is where my earlier videos could come in handy, so if you don’t know what I’m talking about, go check those out.

Once you’ve done that, go back to the Rating Decision. First, look under the heading titled Decision and double-check that the VA listed every disability that you thought they were going to give you a decision on. By the way, later, you should go through your own files and make sure you can point to the specific document that proves you raised that raised each of those issues to the VA.

Next, skip the Evidence section for now and go to the Reasons for Decision section. We’ll come back to the Evidence section but stay with me. Here is where good notes are going to help you a lot. Go through each disability in the Reasons for Decision section. For those disabilities where the VA says you are not service-connected, write out the steps for what you have to prove to establish service connection for that specific disability.

Next, for every disability, Make a note of the specific things the VA looks for at each % level of disability rating. These are the things you have to prove to establish a specific rating. For those disabilities where the VA rates you too low, they should have done a good part of this for you in the decision, at least for AMA decisions, because they should describe what you need to prove for the next higher level of rating. But don’t stop there, look up the regulation, check the VA’s work, and also look at ratings higher than just the next one up.

Once you’ve made notes of everything you have to prove, and remember you have the obligation to prove your claim, then you go back to the Evidence section and make sure every piece of evidence you need to prove is listed somewhere in that evidence section. If something is not in the Evidence section of the decision, now you have a task. Go get that evidence, and file a supplemental claim. Or you may have to get the VA to fulfill their duty to assist. Or maybe the evidence was submitted and the VA missed it. Also, even if the evidence is there, think about whether that evidence as strong as it could be? You may need to get more and better evidence.

Once you’ve got the evidence sorted out, then turn to the law and start asking whether the VA applied the law correctly to the evidence in your claim. Now, the answer to that question can get very complicated, very quickly, depending on your claim. It’s more than I can get into here.

If this all gets to be too much, bring in some help. You don’t have to try and hire me, there are lots of attorneys and veteran service organizations out there who will help you. Make sure they are accredited by the VA, you trust them, and can work with them, because you’ll probably be working with them for a while.

This was a basic overview, there are other evidence problems and law problems that may pop up when you read your decision. Effective dates is one that immediately comes to mind but it is by no means the only one. Anyway, at a minimum, if you can carefully read a decision, you should know whether you need to add evidence to your claim, or whether you need to argue the VA got the law wrong. And it could very well be both.

So I hope you found this helpful. If you want me to help you with your VA claim, you can reach out to me through the contact information on my website.

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Where to Find What the VA Must Put in Every Decision

Disability Claims, Understanding VA Decisions / Al Walsh

In this video I talk about where to find all of those things the VA is supposed to put in their rating decisions. In a previous video, I talked about what those things are and for the sake of a quick review, I’ll walk through that list:

Identification of the issues adjudicated.
A summary of the evidence considered by the Secretary.
A summary of the applicable laws and regulations.
Identification of findings favorable to the claimant.
In the case of a denial, identification of elements not satisfied leading to the denial.
An explanation of how to obtain or access the evidence used in making the decision.
If applicable, identification of the criteria that must be satisfied to grant service connection or the next higher level of compensation.
Options for appeal, or review of a decision you don’t like.

In that video, I also mentioned that the VA is likely to include each of these in either the rating decision itself or a notice letter that they send with the rating decision.

Now, with that little review out of the way, let’s walk through the list of things the VA must include and talk about where to look for them.

For the identification of the issues adjudicated, by the way, the word adjudicated here, pretty much just means decided, you’ll want to go to the rating decision and look under the heading titled DECISION. In this section the VA will typically use a numbered list to state the claims they have decided and whether it was denied, granted, and if granted what percentage you were rated.

For the summary of the evidence considered, again go to the rating decision and look under the heading EVIDENCE. Pay attention to the list in this section. Make sure that everything needed to prove your claim is listed in there. But understand that sometimes it may be hard to tell if everything is there. For example, the VA will sometimes write in here something like all private medical records received on say, May 8^th of 2013. And you won’t know from looking at that list, what was included in those records. In that instance, you have to get a copy of your claims file to know what’s in there. But… you need a copy of your claims file anyway…

For the summary of applicable laws and regulations, you’ll most often find in the section titled REASONS FOR DECISION. It’s rare to see the VA reference statutes in here. In fact, I don’t think I’ve ever seen it. But you will see references to VA regulations, and usually, these will be spread out by each claim or issue. Does the VA provide a complete list? I think they could be a little more complete in some instances, but they probably provide enough to meet their obligation under the law.

Also under this heading, you will find favorable findings, if the VA makes favorable findings, again broken down by each claim or issue. And you’ll also find an identification of the elements not satisfied which lead to the denial, the criteria you need to satisfy to be granted service connection, and the criteria you need to satisfy for the next higher rating. Now not all of those will apply to every decision, or even in every claim or issue, so they won’t all be present every time.

In the case of denials, particularly when the VA denies service connection, I think the VA does a pretty poor job of explaining what you were supposed to prove but didn’t. Often it just a basic statement of the law, which I think again probably meets the bare minimum requirements for the VA, but it’s a far cry from what I think is the intent of the law, which is to actually help veterans understand exactly where and why their claim failed.

For the explanation of how to obtain or access the evidence used in making the decision, which is basically your claims file, you’ll have to leave the rating decision and turn to the notice letter. Somewhere in that letter, you’ll find a phrase which says something like: “If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain.”

That sounds ok, right? But if you actually pay attention to every phone number, email address, or mailing address listed in the rest of the notice letter you’ll see that none of them have anything to do with you getting copies of the evidence. None of them. I think the VA utterly fails on this one. It is a huge pain for a Veteran to get a copy of their claims file, and it’s something I wish the VA would fix.

Ok, now the last thing is your appeal or review options. The VA does a good job with this one. By that I mean they just include some standard forms at the end of every notice letter that talks about appeal options. So, not a lot for me to gripe about there.

I think that does it for how to find everything on that list, but before I wrap up I need to point out that the VA is not required to put any one thing in a specific place. So if you don’t find something where I just told you to look for it, before you get worked up about it, go back through everything the VA sent you and double-check to make sure it’s not hiding somewhere else.

I hope you found this helpful. If you did, please give it a like, that will help other Veterans find it. And if you want me to help you with your VA claim, you can reach out to me through my website.

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What the VA Must Include in Every Decision

Disability Claims, Understanding VA Decisions / Al Walsh

This video is the first of a series of videos about reading a VA decision, understanding it, and then what to do with a bad one. A good place to start is just a quick review of the things the VA is supposed to include in all their decisions.

38 U.S.C. § 5104 requires the VA to send you and your representative if you have one, notice of the decisions they make on your claim for benefits. And that notice is required to include some specific things such as:

Identification of the issues adjudicated. (generally each disability you’ve claimed)
A summary of the evidence considered by the Secretary.
A summary of the applicable laws and regulations.
Identification of findings favorable to the claimant.
In the case of a denial, identification of elements not satisfied leading to the denial.
An explanation of how to obtain or access the evidence used in making the decision.
If applicable, identification of the criteria that must be satisfied to grant service connection or the next higher level of compensation.
Your options to appeal the decision if you don’t like it.

The VA’s regulation, 38 C.F.R. § 3.103(f), restates all of these although slightly different.

So that’s the information the VA has to give you, but how do they go about it. As I’m sure you know, when the VA sends you a decision, you get a lot of paper in the mail, which can usually be broken down into two primary documents, the notice letter and the rating decision. All of that information needs to be somewhere in the notice letter or the decision.

The notice letter looks more typical letter, and it will usually start with the phrase “We made a decision on your claim….” Or “We made a decision on your VA benefits…” Also, the notice letters will include all the standard VA documents that describe your appeal options and other benefits that may be available to you.

On the other hand, the rating decision has a much different heading with a lot of the main information centered on the page and should have the phrase “Rating Decision.” And the rating decision, of course, is where the VA gets into the details of why they granted or denied your claim. Or at least they are supposed to, but they don’t always, which is very frustrating.

Now, I’m going to make more videos going into more depth on VA decisions, so watch for those coming up. I’m afraid if I did it all in one video, it would be much longer than I like these videos to be. But I hope that you found this quick overview helpful. If you did please give it a thumbs up, that’d help other veterans find it. And if you want me to help you with your disability claim, you can reach out to me through my website, walshvetlaw.com. Thanks for watching.

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