Service Officer Training. Structure. Benefits Appeals Hearings Resources

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1 Service Officer Training 1 VA Structure VA Law Benefits Appeals Hearings Resources 2 Veterans Benefits Administration (VBA) Veterans Health Administration (VHA) Board of Veterans Appeals (BVA) Court of Appeals for Veterans Claims (CAVC) National Cemetery Administration 3

2 Responsible for all VA payments Includes; Compensation, Pension, Education, Burial, Home Loans, & Life Insurance ALL monetary benefits from the VA are non-taxable Many claims are completed at the VA Regional Office (RO) of jurisdiction. Texas has 2 ROs. 4 5 Primary areas: Compensation Pension Education Home Loans Insurance Burial 6

3 Compensation is for injuries that were incurred or aggravated during military service Compensation ratings represent the impairment in earning capacity from such diseases and injuries in civilian occupations 7 Pension is a monetary award granted to low-income, wartime Veterans who are disabled or over 65 Low-income; Income must be below the amount set by the VA Wartime; Must have served during a time of war (Not necessarily a Combat Veteran) Disabled; Unable to obtain gainful employment 8 Compensation Special Monthly Compensation (SMC) Dependency Indemnity Compensation (DIC) Injury due to VA Hospitalization / Treatment Line of Duty / Misconduct Combined Ratings Bi-Lateral Factor Presumptive Conditions Pre-existing Conditions Reductions Secondary Conditions Independent Medical Opinions Pension Computation of Income Exclusion from income Unreimbursed Medical Expenses Evaluating Net Worth Special Monthly Pension Overpayments Waivers Death Pension Eligibility Verification Reports 9

4 VA Education Programs include: Post 9/11 GI Bill Montgomery GI Bill Vocational Rehabilitation Reserve Education Assistance (REAP) Survivors & Dependents Assistance (DEA) Veterans Educational Assistance Program (VEAP) 10 VA Home Loans help eligible service-members, Veterans, reservists & un-remarried surviving spouses to obtain homes Uses: Buy / build a home Buy a residential condominium Buy a residential cooperative housing unit Repair, alter or improve a home owned by a Veteran Refinance an existing home loan Buy a manufactured home and/or lot Install solar heating / cooling system or energy-efficient improvements 11 Provides health care to Veterans & eligible dependents Responsible for Medical Centers, Outpatient Clinics, Community Based Outpatient Clinics and Vet Centers Set health care priority & eligibility 8 Priority groups balance eligibility & resources (Priority group dependent on Service Connection, Pension, or Income) 12

5 Independent from VBA Decides appeals regarding Veteran s benefits Located in Washington DC Jurisdiction on decisions made on any NON-MEDICAL decisions. Have Traveling Boards that are scheduled at the ROs 13 Not attached to VA Title II Court with narrow jurisdiction Only take cases finalized by BVA 14 Responsible for establishment & construction of new cemeteries Responsible for care & maintenance of existing cemeteries Provide burial flags and Presidential Memorial Certificates 15

6 The Constitution of The United States of America Established The Congress passes bills about veterans which when signed into law by The President Are codified as Title 38 United States Code (U.S.C.) Which is interpreted by VA in 38 Code of Federal Regulations (C.F.R.) from which policy & procedural instructions are given in Directives Manuals VBA Fast Letters / (M 21-1 MR) VBA Training Letters CFR Part 3, Adjudication Adjudication expands on the definition of a veteran, dependent and survivor. This part also provides guidance concerning claims, evidence and ratings. 38 CFR Part 4, Schedule for Rating Disabilities The rating schedule is primarily a guide in the evaluation of disability. The percentage ratings represent the average impairment in earning capacity resulting from such diseases and injuries and their residual conditions in civil occupations. 38 CFR Part 17, Medical This part explains basic enrollment provisions and patient s rights. Additionally, charges, waivers and collections are covered. 17 ALL Decisions made by the VA Service Center may be Appealed Medical decisions should be appealed to the VAOPC / VAMC Director or Patient Advocate Compensation / Pension Decisions are appealed to the Regional Office of Jurisdiction Most Pension claims from Texas are completed in St. Paul, Mn. Most Compensation claims are completed in the Houston or Waco Regional Office 18

7 Comp & Pension Appeals must be made within one year of the decision letter Appeal is initiated by a Notice of Disagreement (NOD) There is no standard VA form for a NOD Claimant may request the type of appeal on the NOD If the type of appeal is not requested, VA will sent the Claimant letter requesting type of appeal desired Two types of appeals: De Novo Review Traditional Appeal 19 Complete review of the claim by a Decision Review Officer (DRO) Conducted at the RO of jurisdiction DRO has authority to grant, continue denial or request additional information / evidence If denial is continued, Claimant will receive a Statement of the Case (SOC) and VA Form 9 20 A traditional appeal is initiated if Claimant does not request a De Novo review Claimant will receive a Statement of the Case (SOC) and VA Form 9 21

8 Claimant must complete & return the Form 9 within 60 days of the SOC Claimant may request or decline a BVA hearing If a hearing is declined, the designated service organization completes a Form 646 and the Claimant s file is sent to the BVA in Washington Note: It is almost always best to advise the client to request a DRO review 22 Any time prior to the appeal being sent to BVA in Washington, a Client may request a hearing at the RO For De Novo reviews the hearing is conducted at the RO by a local hearing officer For BVA hearings a Judge from Washington will preside over the hearing at the RO or by video conferencing A Counselor from the organization the Client has POA with will be present during the hearing 23 For VA purposes POA must be designated in writing on a VA Form Usually Client designates an Organization with their POA. (TVC, VFW, American Legion etc.) The POA allows a representative from that organization access to the Client s VA file POA also allows representative access to Client s VA electronic files 24

9 Veterans Organizations in Texas Other State and Federal Agencies VA Facilities Regional Offices (RO) Vet Centers National Cemeteries Medical Centers / Outpatient Clinics Questions????? 27

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