deny your claim.  Write back and state the evidence was previously provided or that you do not have the required information.  Emphasize to the VA that you think the evidence already provided is enough to allow your claim -- if you and your VSO believe that to be the case.  When writing to the VA, be sure to use your claim # and the VA's reply # on all correspondence.

Step 6: Be Prepared to Wait:  Currently the back log of claims waiting for adjudication is enormous.  Gulf war claims have been sent back from one of four major regional centers to the local regional centers for adjudication -- and there is a big backlog of claims.  Your claim may take up to a year or more to adjudicate -- especially if you have not done good work up-front providing the necessary documentation.
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Step 6: Be Prepared to Appeal:   As of March 1996, only 12% of environmental exposure claims and 5% of undiagnosed illnesses claims of Persian Gulf veterans had been granted compensation.  The odds are that your claim will be denied.  When the VA denies your claim, they must notify you and tell you what additional rights you have for appeal.  Don't be discouraged - request a reconsideration, or appeal, within the deadline.  Often the appeals are denied as well, but don't despair.  At this point you get to go to a Medical Review Board - in person if you desire.  This is where you may well have success, and you can bring in expert medical and technical testimony to bolster your case.
 

Non-Service Connected Pensions

Disabled veterans who lose their claims for compensation should consider applying for pension.  Pension benefits are available to veterans with war-time service, who have limited incomes and assets and who are totally and permanently disabled for reasons primarily not related to their military service.  VA Form 21-526 can be used to apply for a pension.

A pension usually provides much less money than compensation, but for many veterans it is a necessary means of support.

Denials

If your claim is denied, you and your advocate should promptly do two things: file a notice of disagreement (NOD) and request a copy of the rating decision.

An NOD can be as simple as a letter to the VA Regional office saying that you disagree with its decision.  The notice should include the date of the adverse decision and the claim number (C-number).  The NOD must be postmarked within one year of the date on the denial letter or you will lose your right to appeal.  There are no extensions.

Once you file a NOD, two important things happen.  First, the VA will respond to your NOD with a statement of the case (SOC).  The SOC should describe in some detail the laws that apply to your claim and why your claim was denied.

Second, once you file an NOD you can request a hearing in front of a VA hearing officer at the regional office.  If the hearing officer determines that you have presented new and relevant evidence, he or she can make a new decision.  If the decision of the hearing officer is unfavorable, you can still appeal to the Board of Veterans' Appeals.

Appeals

Along with your SOC, the regional office will send you the VA's Form 9, the substantive appeal form.  You and your advocate must complete and return this form to the VA if the Board of Veterans' Appeals in Washington, DC is to consider your case.  You have 60 days from the date on the SOC or you have the remainder of one year from the date the VA first denied you claim, whichever deadline is later, to file the VA Form 9.

The Form 9 asks if you wish to appear at a hearing before the BVA in Washington, DC or before a traveling BVA member at the regional office.  At a hearing, a BVA member will listen to arguments and permit you to submit evidence about your appeal.  In most cases, if you are at all able to appear in person at a hearing before the BVA, you should do so.  Even if you do not request a hearing, however, the members of the BVA will review the evidence in you case and make another decision about your claim.

If you disagree with a BVA decision, you might appeal to the US Court of Veterans Appeals in Washington, DC.  You could also file a motion for reconsideration with the BVA or, if you have new and material evidence about your claim, you can reopen your claim at a regional office.

Rules for Undiagnosed Illnesses

The VA has issued a regulation to compensate veterans of the Gulf War for illnesses that have not yet been diagnosed.  (See Appendix C for a copy of the VA Regulations.)  Congress has never before directed the VA to pay compensation benefits for illnesses that can not be diagnosed and for which a specific cause has not yet been identified.  This regulation is called "Compensation for Certain Disabilities Due to Undiagnosed Illnesses".  This regulation applies only to illnesses that cannot be diagnosed.  If your condition has been completely and adequately diagnosed, the rules explained below do not apply to you.

The new regulation permits the VA to pay compensation benefits for a disability caused by chronic illnesses or symptoms (that exist for at least six months) and that cannot be diagnosed (identified).  Before the VA will grant you compensation benefits as a Gulf veteran with undiagnosed illnesses, you must:

• Show that you served in the Southwest Asia theater of operations during the Gulf War (8/2/90 -

(Continued on page 16)

Second Edition - Fall 1997          Page 15