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Training Agenda

Training Agenda. SOTS Annual Training 2012. Thomas Meadows TDVA Training Officer 615-441-3384 or tom.meadows@tn.gov. Welcome to the 2012 SOTS Training presented by the TN Department of Veterans Affairs. SOTS Annual Training 2012. DAY 1 TRAINING. Thomas Meadows TDVA Training Officer

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Training Agenda

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  1. Training Agenda

  2. SOTS Annual Training 2012 Thomas Meadows TDVA Training Officer 615-441-3384 or tom.meadows@tn.gov

  3. Welcome to the 2012 SOTS Training presented by the TN Department of Veterans Affairs

  4. SOTS Annual Training 2012 DAY 1 TRAINING Thomas Meadows TDVA Training Officer 615-441-3384 or tom.meadows@tn.gov

  5. DEVELOPMENT AND SECONDARY ISSUES Establishing a disability as service connected condition

  6. ESTABLISHING SERVICE CONNECTION • There are five ways of establishing that a disability is service-connected: • Direct: Service medical records show that the condition claimed was diagnosed during military service, and condition continues to affect the individual economic capacity. (38 CFR 3.304) • Aggravation: By demonstrating that a condition that existed prior to military service was aggravated beyond normal course – recently the VA has determined that a base be established.(38 CFR 3.306)

  7. Presumptive Illness: Means the veteran has contracted a condition/disease during his/her military service. (38 CFR 3.307 & 3.309) • Secondary: By demonstrating that a condition is caused or approximately the result of, or linked to an existing SC.(38 CFR 3.310) • Injury as a result of treatment: Where disease, injury, death or the aggravation of an existing disease or injury occurs as a result of having submitted to examination, medical or surgical treatment, or hospitalization in the pursuit of Vocational Rehabilitation. (38 CFR 3.800)

  8. MORE ON COMPENSATION • If a vet gets a disease or injury and it resolves without residuals, it is considered acute/transitory and service connection cannot be established. (38 CFR 3.4) • In the line of duty & Willful misconduct: An injury or disease acquired as the result of the veterans own willful misconduct. (38 CFR 3.1(m)(n)

  9. WHAT TYPE OF EVIDENCE WILL YOU NEED BASED ON THE FOLLOWING • A vet reports to you while on active duty he hurt his back, and both knees. He served with the 101st ABN; made many jumps but rarely sought medical attention or complained. • What type of evidence will you need to submit to prove an incurred condition?

  10. AGGRAVATED & PRESUMPTIVE CONDITIONS • While playing on his units baseball team during active duty, the veteran re-injured a pre-existing condition (ankle injury). The ankle today remains painful and effects locomotion. What type of evidence will you need to secure? (38 CFR 3.303 & 3.306) • L. Berman comes to you and indicates that he has diabetes and he is a Vietnam era veteran. What evidence is needed to prove Berman’s case? 38 CFR 3.309(e)

  11. SECONDARY DISEASE / CONDITION • A veteran was treated in the service for a right knee condition. After discharge he was granted 10% for impairment to his knee. Later on, he was crossing a street and was forced to run in order to avoid being hit by a drunk driver. His SC knee gave out and he fell and injured his other knee. What do you have to prove in order to SC the other knee? (38 CFR 3.310)

  12. CLAIMS DEVELOPMENT • The granting of veteran’s benefits is based on complying with congressional laws and regulations that are enforced by the VA. The VA must provide assistance to the veteran in the preparation and presentation of their claim. • As a veteran’s service officer(VSO) acting on behalf of an accredited organization chartered by Congress and recognized by the VA for claims representation, you have assumed the responsibility for providing direct assistance to the veterans, their dependents and survivors for any VA benefit.

  13. CLAIMS DEVELOPMENT (CONT) • One of the most important responsibilities of a VSO is to ensure that the claim receives due process under the laws and regulations of the VA. Once a POA is signed, there exists a legal obligation to ensure that all claims and evidence are properly and timely filed. • The claims process requires specific actions by all parties. The claimant must ask for benefits and supply information/evidence and participate at all stages. The VSO is responsible for informing the claimant what forms and documents are required to be submitted to VA and submit claims timely. Also, that VA follows its due process procedure and Duty to Inform and Duty to Assist.

  14. CLAIMS DEVELOPMENT (CONT) • The DVA is responsible for processing the claim in a timely manner and informing the claimant and the VSO of the results of his or her request. • Remember, you must file a Fully Developed Claim whenever possible.

  15. NON- FEDERAL & FEDERAL RECORDS • VA shall make reasonable efforts to assist claimant. Submit initial request with 60 days to respond and one follow up with another 30 days to respond. • VA will continue attempts until VA receives a response form the custodian of record that the records do not exist.

  16. QUESTION 1 • SMR’s for a KS vet show that he sustained a back strain during Active Duty in 1951, with one follow up treatment for low back pain. Vet was discharged in 1954; on separation report condition was noted as resolved. Private medical evidence dated 1981 indicates lumbosacral strain while lifting boxes at work. In 2000 a L4-5 discectomy is performed. Current medical evidence shows postoperative residuals of discectomy with DDD.

  17. QUESTION 2 • A recently discharged vet from the Army comes to see you. He is complaining of left hip pain. His DD 214 shows Airborne Ranger. He states he had multiple (jump record shows 20 jumps) parachute jumps. He claims on 3 jumps he landed awkwardly, injuring his hip but did not seek medical treatment. He used over the counter medications for continued pain. He submits spouses statement which indicates he complained in service to her and presently stopped doing yard work. SMR’s are silent. Examine/medical opinion?

  18. QUESTION 3 • SMR’s of a Vietnam era veteran show complaint of gastric distress and gastrointestinal complaints. Treated with Tagamet. SMR indicated condition resolved. Post service medical records contain several entries showing treatment for various gastrointestinal complaints over the past 20 years; with a current diagnosis of GERD. The vet wants you to file for SC for gastro condition. What would you say?

  19. PROXIMATE RESULTS, SECONDARY CONDITIONS • Under 38 CFR 3.310, disabilities due to or the result of a service connected disease or injury shall be service connected. When the condition is SC, the secondary condition shall be considered a part of the original condition. In this situation you must investigate the differences between conditions caused by diseases and ones caused by injury. Lets look at a couple of examples.

  20. CERTIFICATION OF DOCUMENTS • Certify copies of original discharge documents. • You cannot sign original, income or dependency claims. • Nor any other type of documents (dependency). • Original documents issued by the service dept. or a copy issued by a public custodian of records who certifies that a copy of the original document is on file. (County Clerk) • Certifications from war records are acceptable. • If veteran had multiple periods of service, needs 214’s for all periods if there were breaks.

  21. CERTIFICATION OF DOCUMENTS (CONT) • Responsible for detecting altered or fraudulent service documents. • 214’s issued from Korea forward, not for WWII. • For current discharges, need copy 4 of DD 214. • Discharge changes are made on form DD 215 • Different type or size print on same document. • Erasures or white out.

  22. CERTIFICATION OF DOCUMENTS (CONT) • Short period of Active Duty service with multiple decorations. • Combat decorations (Purple Heart) with no foreign service. • Short period of service with high rank, E-5 or above. • Lengthy periods of service with low rank, below E-3, suggests possible Court Martial. • Decorations not matching branch. • Inconsistent date of birth.

  23. CERTIFICATION OF DOCUMENTS (CONT) • Character of service not centered. • Cautions: • If you have doubt, submit but don’t certify • If you know that the document is fraudulent, do not assist the client. • Don’t submit SF 180 to verify service since VA will be attempting to do same. • Certification stamp must be exactly as sample. • You must purchase your own stamp.

  24. CERTIFICATION OF DOCUMENTS (HANDOUTS)

  25. FULLY DEVELOPED CLAIMS • The Fully Developed Claims (FDC) Program is the fastest way of getting your compensation or pension claim processed. • Participation in the FDC Program allows for faster claims processing while preserving great quality of service and your right to appeal a decision.

  26. Claim must be a rating related claim for live compensation • Original • Secondary • Increased service connected claims • Application form 21-526 EZ to include Fully Developed Claim Certification • VA forms available at www.va.gov/vaforms or on Vetra/Spec • You must submit all relevant private medical records for the disabilities you are claiming.

  27. You must identify any treatment records from a Federal Facility such as VA Medical Center, Outpatient Clinic, or Community Based Outpatient Clinic (CBOC) • For Guard and Reserve members you must submit any and all Service, Treatment, and Personnel Records in the custody of your Unit(s). • Medical can be in the form of letters from Physicians, Hospital records, or Disability Benefit Questionnaires. (DBQ’S) Located in Vetra/ Spec or VA site: http://benefits.va.gov/TRANSFORMATION/disabilityexams/

  28. If claiming dependents, must complete VA form 21-686c • The evidence must show injury in service, or a disease that began in service or was aggravated by service. • You must be diagnosed with a current physical or mental disability related to service. • A relationship or NEXUS must be established between claimed disabilities and an injury, disease, symptoms, or event in military service.

  29. PRESUMPTIVES 3.309: Example Agent orange, POW, and Radiation. • What if you don’t have all the evidence? • File an informal Claim Letter or a 21-4138; must clearly identify the disability being claimed: • “I intend to apply for compensation benefits for the following disabilities: __________________________________ under the FDC Program. This statement is to preserve my effective date for entitlement to benefits. I am in the process of assembling my claim package for submission”.

  30. NSC PENSION • Criteria: • NSC Pension Claims • 21-527EZ Original Claims • Fully Developed Claim Certification Form must be completed. • All necessary income and net worth in formation must be submitted • All private medical must be submitted. • Need for DBQ(see compensation instructions)

  31. Names and addresses of Federal facilities where you receive treatment to include dates of treatment • 21 2680 If Claiming Aid and Attendance 21 0779 If in a Nursing Home • Guard and Reserve records • Dependents 21-686c • What the evidence must show: • 90 Days service; one of Wartime • 24 Month Active Duty Requirement 9-8-80 Enlisted 10-16-81 Officers

  32. Permanent and Total Disability Single 60% or Combined 70% one disability being 40% or more. • Over 65 • Patient in a Nursing Home for long term care • Receiving Disability SS or SSI • Exception 3.321 B • Your Net Worth and Income must be within limits.

  33. Handouts #1, #2 & #3: Fully Developed Claims(Double click to open)

  34. ROLE OF THE VETERANS SERVICE OFFICER • History: Veterans need for assistance was realized shortly after the Civil War. • Attorneys seized the day and charged huge fees. • Congress passed legislation to recognize service organizations and to limit fees to $10.00

  35. ROLE OF THE VETERANS SERVICE OFFICER(CONT) • Attorneys could not represent veterans until they had exhausted all administrative procedures through the BVA process. • Currently attorneys can represent veterans for a fee at the time the veteran submits a Notice of Disagreement. • There are numerous Service organizations. TDVA employees represent 12 different Organizations.

  36. ROLE OF THE VETERANS SERVICE OFFICER(CONT) • The Accreditation Process: • You must be employed by a State County or Metropolitan Government. • Must be employed for at least 20 hours per week. • Must be an individual of good repute. • Must pass a basic skills test and continued testing annually. • Must attend training provided by TDVA.

  37. ROLE OF THE VETERANS SERVICE OFFICER(CONT) • The Accreditation Process: • You may be accredited by more than one organization. • VFW requires completion of VA sponsored TRIP training. • Point of contact Bette Carter Claims Office 615 695 6385 or Roger Harrell 615 695 6329. • Accreditation procedures provided as an attachment.

  38. ROLE OF THE VETERANS SERVICE OFFICER(CONT) • Privileges: • In order for you to represent a veteran VA Form 21-22 must be completed and signed by both you and the veteran. • POA must be for an Organization that you have accreditation for. • You can do almost everything for the veteran. • Cannot file Original claims or claims involving dependency or income.

  39. ROLE OF THE VETERANS SERVICE OFFICER(CONT) • Privileges: • You can check on claim status electronically or by phone. • You have access to Claims Office, Field Offices and State Training Staff. • Always remember the claim is the veterans claim, not yours: you must always act in his/her best interest.

  40. ROLE OF THE VETERANS SERVICE OFFICER(CONT) • Responsibilities: • You cannot submit information that is false or fraudulent. • You cannot release information to a third party without the veterans consent. • Identify the vet by questioning. • If you suspect the information given you to be fraudulent you must advise the claimant of the illegality.

  41. ROLE OF THE VETERANS SERVICE OFFICER(CONT) • Responsibilities: • You have the responsibility to report fraudulent activity to the VA. • Secure information in locked cabinets. Review and shred periodically. • Lock computers when you are not present. Do not allow someone else to use your computer. • Do not represent widow in an apportionment claim against the veteran.

  42. ROLE OF THE VETERANS SERVICE OFFICER(CONT) • TIP: If you take TRIP training you will receive more training in all these areas QUESTIONS ?

  43. CUSTOMER SERVICE HANDOUT

  44. SOTS Annual Training 2012 DAY 2 TRAINING Thomas Meadows TDVA Training Officer 615-441-3384 or tom.meadows@tn.gov

  45. FEDERAL BENEFITS IN ADDITION TO COMPENSATION • Life Insurance • 2 Year Window • Under 65 • Waiver of Premiums

  46. FEDERAL BENEFITS IN ADDITION TO COMPENSATION • Commissary & PX Privilege • 100% Disability includes TDIU • Doesn’t have to be PT New Change • Requires VA Letter and application • Obtain from Nearest Military Facility

  47. FEDERAL BENEFITS IN ADDITION TO COMPENSATION • Health Insurance for Dependents • CHAMPVA/No Cost • Vet 100% PT • Requires Application 10-10D • Widow 55 Remarries • Denver Colorado

  48. FEDERAL BENEFITS IN ADDITION TO COMPENSATION • Education Benefits for Dependents CH35 • VET 100% PT • Claim 22-5490 W and 22-5490 • St Louis • 45 Months Eligibility $957 monthly

  49. FEDERAL BENEFITS IN ADDITION TO COMPENSATION • Additional Benefits Other Than Monthly Compensation • Auto Grant • Specially Adaptive Housing • Clothing Allowance • Home Improvement and Structural Allowance • Home Loans

  50. STATE VETERANS BENEFITS • Services: State Veterans Cemeteries • 4 Total: Knoxville (2) Nashville (1) Memphis (1) • Planning stages for one in Jackson Area and one in Crossville Area • Free to Vet $700 for Spouse or Qualifying Child

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