Let’s Explore if Low Value Claims Important

Are Low VA Claims of Value

Low-Value Claims Are Crucial for Veterans

Welcome to VeteransBenefitsHub.com! Today, we’re diving into an important topic: low-value claims. While there’s a wealth of information about high-value claims, it’s vital not to overlook the significance of filing low-value claims. These claims, even those warranting a 0% or 10% rating, play a crucial role in ensuring that veterans receive the benefits they deserve.

Why Low-Value Claims Matter

It’s easy to focus solely on high-value claims because they promise substantial compensation. However, low-value claims provide a foundation that can be leveraged in the future. By documenting and filing every service-connectable condition, even if initially rated at 0% or 10%, you establish a baseline. This ensures that all your service-related conditions are acknowledged, creating opportunities for future increases if your conditions worsen.

The Importance of Documentation

For every condition you believe is service-connected, gather all relevant evidence, including medical records, service treatment records, and supporting documentation. Proper documentation ensures you’re appropriately rated, whether that’s 30%, 50%, or higher. Settling for less than your deserved rating means missing out on crucial benefits.

Future Increases

One of the most significant advantages of filing low-value claims is the potential for future increases. Once a condition is service-connected—even at 0%—the VA has conceded the nexus. This means you won’t need to prove the connection again. As time passes and the condition worsens, supported by ongoing medical documentation, you can file for an increase. This process is typically much simpler than establishing a new service connection from scratch.

Secondary Conditions

Low-value claims often open the door to filing secondary claims. For instance:

  • Tinnitus (10%): Common secondary conditions include anxiety, depression, insomnia, migraines, hearing loss, and even somatic symptom disorder. With proper medical documentation, these conditions can compound your ratings.
  • Lumbar Spine Issues (10-20%): Secondary conditions might include sciatica, radiculopathy, degenerative arthritis, urinary issues, depression, and more. A 10% back rating could grow into 50% or 60% when secondary conditions are added.
  • PTSD: While PTSD itself is often a high-value claim (typically rated at 50-70%), it can lead to secondary conditions such as GERD, IBS, sleep apnea, migraines, hypertension, depression, and even coronary artery disease. These secondary claims can significantly increase your overall rating.

The Role of Medical Evidence

A well-documented nexus is essential for both primary and secondary claims. This means obtaining a medical opinion that links your secondary condition to your service-connected condition. A Disability Benefits Questionnaire (DBQ) filled out by a knowledgeable medical professional can help articulate the severity of your condition and ensure proper rating under the VA’s schedule of ratings.

If your doctor is unable or unwilling to provide the necessary documentation, consider reaching out to services like American Medical Experts for assistance. They offer consultations to help veterans navigate the complexities of nexus letters and DBQs.

Take Action

Don’t neglect low-value claims. They are building blocks that ensure your service-connected conditions are recognized, setting the stage for future increases and secondary claims. Treat your claims process as a critical investment in your well-being.

Thank you for visiting VeteransBenefitsHub.com. Remember, supporting one another is key to our success. If we don’t take care of each other, something has gone wrong.

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The U.S. Supreme Court recently heard arguments VA Handles Disability Claims

The U.S. Supreme Court

The U.S. Supreme Court recently heard arguments regarding how the Department of Veterans Affairs (VA) handles disability claims when the evidence for approval or denial is evenly balanced.

This case, Bufkin v. McDonough, involves the “benefit-of-the-doubt rule,” which mandates that when evidence is equally weighted, the decision should favor the veteran.

At the center of the case are veterans Joshua Bufkin and Norman Thornton, who filed separate disability claims that were denied, even though the supporting and opposing evidence was equally balanced. Bufkin, who served in the Air Force from 2005 to 2006, sought benefits for post-traumatic stress disorder (PTSD), but conflicting medical opinions led to his claim being denied. Thornton, an Army veteran who served from 1988 to 1991, was denied a higher disability rating for his service-connected injuries.

Their claims progressed to the U.S. Court of Appeals for Veterans Claims and later to the Federal Circuit, where the rulings were upheld. The veterans argue that the courts failed to consistently apply the benefit-of-the-doubt rule. Attorneys for Bufkin and Thornton pointed out that despite presenting equal evidence both for and against their claims, they were denied benefits.

The Supreme Court is now tasked with deciding whether the benefit-of-the-doubt rule should be uniformly applied in all cases, especially when evidence is closely balanced. A decision is expected next summer.

The veterans’ legal team contends that inconsistent application of the rule has harmed many veterans, with similar cases receiving contradictory rulings. They argue that this inconsistency has denied veterans the benefits they rightfully earned. The case raises questions about the fairness and consistency of the veterans’ claims process, especially for veterans who represent themselves in court.

On the other side, the VA’s attorneys have described enforcing the benefit-of-the-doubt rule as unnecessary, arguing that it could create redundant work for the veterans appeals court. However, advocates for veterans, including several organizations that filed supporting briefs, argue that this rule is a vital part of the VA’s review process, ensuring that veterans receive the benefits they deserve when the evidence is inconclusive.

The case underscores the ongoing debate over how the VA and the courts handle veterans’ claims, and its outcome could have far-reaching implications for veterans seeking disability benefits in the future.

Source: stripes.com



Veterans’ Medical and Health Records: Filing a Claim for Medical Benefits

Veterans Medical - Health Records

The Official Military Personnel Files (OMPF), housed at the National Personnel Records Center (NPRC), are administrative records that contain details about an individual’s military service history. While many OMPFs used to include both personnel and active-duty health records, this practice was discontinued in the 1990s by the various military branches.

In the past, all military services transferred a service member’s individual health records to the NPRC upon separation from service, along with the personnel records. The Army and Air Force retired health records with the OMPF, while the Department of the Navy (including the Navy, Marine Corps, and Coast Guard) sent these files separately to the NPRC until the 1980s.

Health records document outpatient, dental, and mental health treatment received during military service. They include induction and separation physical exams, routine medical care (such as doctor visits, lab tests, dental check-ups), but not inpatient records.

Clinical (hospital inpatient) records, which are created during hospital stays, are typically not filed with health records. Instead, they are retired to the NPRC by the facility that generated them. Medical records from the Department of Veterans Affairs (VA) are also not part of these files.

Changes in Record Handling

Starting in the 1990s, the military branches stopped including health records with the personnel portion of the OMPF sent to NPRC. The Army began sending most health records to the Department of Veterans Affairs (VA) in 1992, with other services following suit by 1998. By 2014, the practice of transferring these records to the VA was discontinued. To find out where your medical record is located, refer to the chart below:

Branch Status Date Record Location
Army Discharged, retired, or separated from any component 10/16/1992 to 12/31/2013 Department of VA, Records Management Center
on or after 01/01/2014 AMEDD Record Processing Center
Navy Discharged, retired, or separated from any component 01/31/1994 to 12/31/2013 Department of VA, Records Management Center
on or after 01/01/2014 BUMED Navy Medicine Records Activity
Air Force Discharged, retired, or separated from any component 05/01/1994 to 12/31/2013 Department of VA, Records Management Center
on or after 01/01/2014 AF STR Processing Center
Discharged or retired from Reserves or National Guard 06/01/1994 to 12/31/2013 Department of VA, Records Management Center
on or after 01/01/2014 AF STR Processing Center
Marine Corps Discharged, retired, or separated from any component 05/01/1994 to 12/31/2013 Department of VA, Records Management Center
on or after 01/01/2014 BUMED Navy Medicine Records Activity
Coast Guard Discharged, retired, or separated from Active Duty 04/01/1998 to 09/30/2014 Department of VA, Records Management Center
Reservists with 90 days active duty for training On or after 10/01/2014 USCG HSWL SC Medical Administration

VA Records Center and Vault

Secure, Reliable, Responsive Records Storage and Management Services

VA Records Center and Vault (RCV) provides short- and long-term records storage and records management services  for VA and other Federal government agency customers. Located in a subterranean, climate-controlled facility, RC&V provides storage for general, vital, and unscheduled records as well as records held pending litigation freezes. We are committed to providing our customers with the most secure, reliable, and responsible records storage services available at competitive rates.

Fast, Personalized Service

Storing critical records and being able to quickly retrieve them can be burdensome and costly. We understand the importance on providing timely and accurate retrieval of records. Documents stored at the RC&V can be in your hands next business day, or faxed to you within hours. At the RCV, we customize our service to meet your security and access needs.

VA Records Center and Vault  Source: https://www.rcv.va.gov/

Filing a Claim for Medical Benefits

Veterans intending to file a medical benefits claim with the Department of Veterans Affairs (VA) do not need to request their military health records from the NPRC. Once a claim is filed, the VA will obtain the original health record from the NPRC. Additionally, many health records were transferred to the VA prior to the 1973 Fire at the NPRC.

Veterans who have already filed a medical claim should contact the VA to verify if their records are on file. For assistance, veterans can contact the VA at 1-800-827-1000, which will connect them to the nearest VA office.

This information ensures veterans have access to the correct channels to retrieve their records and file claims for medical benefits.

Source: Archives.gov



Top 3 Conditions Claimed as Secondary to Service-Connected Sleep Apnea

VA Sleep Apnea Claim

 

In this article, we will explore the top three conditions that VA rating specialists often see veterans claim as secondary to their service-connected sleep apnea.

A Word of Caution:

Before diving in, it’s important to note that nothing is guaranteed in the VA claims process. If someone claims they can guarantee a favorable outcome, they are likely misleading you. There have been many cases where VA rating specialists thought a claim would be approved, only for it to be denied. On the other hand, claims that seemed far-fetched have sometimes been approved. Keep this in mind when submitting claims for secondary conditions.

For secondary conditions, it is essential to provide a Nexus statement—a document prepared by a medical professional that explains how your condition is linked to your military service. Veterans have the option of undergoing a Compensation and Pension (C&P) exam or having their private doctor complete a public Disability Benefits Questionnaire (DBQ), available on the VA’s website.

The Top 3 Conditions Claimed Secondary to Sleep Apnea:

VA Sleep Apnea Claims

 

1. Hypertension (High Blood Pressure)

The first condition commonly claimed as secondary to sleep apnea is hypertensive vascular disease, also known as hypertension. Let’s focus on the 10% rating criteria, as this often causes confusion. For a 10% rating, one of the following must be true:

  • Diastolic pressure is predominantly 100 or more
  • Systolic pressure is predominantly 160 or more
  • There is a history of diastolic pressure predominantly 100 or more, and continuous medication is required for control.

It’s essential to meet both requirements for a 10% rating in the third scenario: a history of diastolic pressure of 100 or more and the need for continuous medication. Veterans can track their blood pressure at home and keep a spreadsheet as evidence. If you believe you meet the criteria for a 20% rating (diastolic pressure predominantly 110 or more or systolic pressure predominantly 200 or more), providing your own records or notes from your doctor is crucial.

Additionally, hypertension or isolated systolic hypertension must be confirmed by readings taken on two or more occasions over at least three different days. So, whether you are monitoring your own blood pressure or having a private doctor or VA doctor take readings, proper documentation is essential.

2. Diabetes Secondary to Sleep Apnea

The second condition often claimed as secondary to sleep apnea is diabetes mellitus, particularly Type 2 diabetes. For these claims, you need a medical professional to provide a diagnosis and a rationale linking the diabetes to sleep apnea via a Nexus statement.

It’s not a bad idea to research medical studies or literature supporting this connection—sources like the Mayo Clinic often provide valuable insights. Additionally, you can refer to the Diabetes Mellitus Type 2 DBQ, which can guide your claim.

In this form, Section 3A asks if the veteran has any recognized complications of diabetes, such as:

  • Diabetic peripheral neuropathy (affecting the upper or lower extremities)
  • Diabetic nephropathy or renal dysfunction
  • Other complications

Section 3B asks if any of these conditions are “at least as likely as not” caused by diabetes, which constitutes a secondary medical opinion.

If you’re dealing with other conditions like hypertension, stroke, skin conditions, or eye conditions, these can also be linked through secondary conditions, sometimes referred to as “stacking.” In this case, the doctor completing the DBQ must provide a clear rationale in the remarks section explaining how they reached their conclusions.

3. Depression Secondary to Sleep Apnea

The third common condition linked to sleep apnea is depression. Veterans claiming depression secondary to sleep apnea must clearly explain to the C&P examiner how their sleep apnea contributes to their mental health condition.

For instance, you could describe how severe snoring or breathing issues force you and your spouse to sleep in separate bedrooms, which may impact your emotional well-being and relationship. It’s also important to familiarize yourself with the General Rating Formula for Mental Disorders to determine if you meet the criteria for a 0%, 10%, 30%, 50%, 70%, or 100% disability rating.

There are proposed changes to these criteria coming in April 2025, so be sure to stay updated if you’re pursuing a mental health claim.

Conclusion:

These are the top three conditions that VA rating specialists frequently see veterans claim as secondary to their service-connected sleep apnea: Hypertension, Diabetes, and Depression. Many veterans succeed in their claims by submitting private evidence or attending a C&P exam.

Disclaimer:

This article is for informational purposes and should not be considered professional legal or medical advice. While the author has had a successful VA rating outcome, veterans should conduct their own research and apply the relevant findings to their specific cases.



The 10 Most Common VA Disability Claims – 2024

VA Disability Claim

Here’s a list of the 10 most common VA disability claims for 2024, along with a brief explanation of each and links to more detailed resources, including examples of cases won by veterans on appeal:

1. Tinnitus

  • Description: Tinnitus, the most common VA claim, is the perception of noise like ringing or buzzing in the ears without an external sound. Often caused by exposure to loud noises during service, such as gunfire or machinery.
  • Rating: The VA typically rates tinnitus at 10%.
  • Appeal Example: Many veterans have successfully appealed for tinnitus claims, especially by providing detailed personal statements.
  • More Info: Tinnitus VA Claims | Case Example

2. Hearing Loss

  • Description: This condition involves difficulty hearing, often due to long-term exposure to loud noises in military environments. It includes conductive, sensorineural, or mixed hearing loss.
  • Rating: VA ratings for hearing loss range from 0% to 100%, with most veterans receiving a 10% rating.
  • Appeal Example: Hearing loss claims can be challenging to prove if filed more than a year after service, but successful appeals often include a Nexus letter from a healthcare provider.
  • More Info: Hearing Loss VA Claims | Case Example

3. Limitation of Flexion, Knee

  • Description: This condition refers to the limited range of motion of the knee, often due to injuries or arthritis. It’s common among veterans due to the physical demands of service.
  • Rating: Ratings are based on the degree of movement limitation, typically ranging from 0% to 30%.
  • Appeal Example: Veterans often appeal knee condition ratings, especially if pain is not fully accounted for in the initial assessment.
  • More Info: Knee Flexion VA Claims | Case Example

4. Post-Traumatic Stress Disorder (PTSD)

  • Description: PTSD is a mental health condition triggered by traumatic events during service. Symptoms include flashbacks, severe anxiety, and nightmares.
  • Rating: PTSD ratings range from 0% to 100%, based on the severity of symptoms.
  • Appeal Example: Successful appeals often involve detailed documentation of the stressor event and its impact on the veteran’s life.
  • More Info: PTSD VA Claims | Case Example

5. Scars

  • Description: Scars can result from injuries or surgeries related to military service. They are evaluated based on their size, location, and impact on daily life.
  • Rating: Ratings vary widely depending on the severity and visibility of the scars.
  • Appeal Example: Appeals may focus on the functional impact of scars, which might not be fully considered initially.
  • More Info: Scars VA Claims | Case Example

6. Sciatica (Paralysis of the Sciatic Nerve)

  • Description: Sciatica involves pain radiating along the sciatic nerve, often due to nerve compression. It’s common among veterans with back injuries.
  • Rating: VA ratings depend on the severity, from mild to severe paralysis.
  • Appeal Example: Appeals often include additional medical evidence showing the true impact of the condition.
  • More Info: Sciatica VA Claims | Case Example

7. Lumbosacral or Cervical Strain

  • Description: These strains involve the muscles of the lower back or neck, often due to physical strain or injury during service.
  • Rating: Ratings range from 10% to 100%, depending on the severity.
  • Appeal Example: Successful appeals often hinge on documenting how the strain affects daily activities.
  • More Info: Back and Neck Strain VA Claims | Case Example

8. Migraines

  • Description: Migraines are severe headaches that can be debilitating and are common among veterans due to stress and trauma.
  • Rating: VA ratings for migraines can go up to 50%, based on frequency and severity.
  • Appeal Example: Documentation of the frequency and impact of migraines is crucial in appeals.
  • More Info: Migraines VA Claims | Case Example

9. Ankle Conditions

  • Description: Ankle conditions often result from sprains, fractures, or other injuries sustained during service.
  • Rating: Ratings depend on the limitation of motion or instability of the ankle.
  • Appeal Example: Veterans often appeal for higher ratings if their ankle condition limits their mobility significantly.
  • More Info: Ankle Conditions VA Claims | Case Example

10. Asthma

  • Description: Asthma involves difficulty breathing and is often triggered or worsened by environmental factors encountered during service.
  • Rating: VA ratings are based on the frequency and severity of asthma attacks and the required medication.
  • Appeal Example: Appeals may involve additional medical tests to prove the severity of asthma.
  • More Info: Asthma VA Claims | Case Example

These resources and examples should provide a solid starting point for understanding and pursuing VA disability claims. If you need more specific case details or help with your own claim, legal professionals specializing in VA claims can be very helpful.

 

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Here’s a list of the 10 most common VA disability claims for 2024, along with a brief explanation of each and links to official VA resources:

1. Tinnitus

  • Description: Tinnitus is the perception of noise, like ringing or buzzing in the ears, without an external sound. It often results from exposure to loud noises during military service.
  • Rating: The VA typically rates tinnitus at 10%.
  • More Info: VA Disability for Tinnitus

2. Hearing Loss

  • Description: Hearing loss can result from prolonged exposure to loud noises, such as gunfire or machinery, during service.
  • Rating: VA ratings for hearing loss range from 0% to 100%.
  • More Info: VA Disability for Hearing Loss

3. Limitation of Flexion, Knee

  • Description: This condition refers to limited range of motion in the knee, commonly due to injuries or arthritis experienced during service.
  • Rating: Ratings typically range from 0% to 30%, based on the severity.
  • More Info: VA Disability for Knee Conditions

4. Post-Traumatic Stress Disorder (PTSD)

  • Description: PTSD is a mental health condition caused by experiencing or witnessing traumatic events during military service.
  • Rating: PTSD ratings range from 0% to 100%, depending on symptom severity.
  • More Info: VA Disability for PTSD

5. Scars

  • Description: Scars from injuries or surgeries related to service are evaluated based on their size, location, and impact on daily life.
  • Rating: Ratings vary depending on the severity and visibility of the scars.
  • More Info: VA Disability for Scars

6. Sciatica (Paralysis of the Sciatic Nerve)

  • Description: Sciatica involves pain along the sciatic nerve, often due to compression or injury, and is common among veterans with back issues.
  • Rating: VA ratings are based on the severity of symptoms, from mild to severe paralysis.
  • More Info: VA Disability for Sciatica

7. Lumbosacral or Cervical Strain

  • Description: These strains involve the muscles of the lower back or neck, often due to physical strain or injury during service.
  • Rating: Ratings range from 10% to 100%, depending on the severity.
  • More Info: VA Disability for Back and Neck Conditions

8. Migraines

  • Description: Migraines are severe headaches that can be debilitating and are often caused or worsened by stress and trauma experienced during service.
  • Rating: VA ratings for migraines can go up to 50%, based on frequency and severity.
  • More Info: VA Disability for Migraines

9. Ankle Conditions

  • Description: Ankle conditions often result from injuries such as sprains or fractures sustained during service.
  • Rating: Ratings depend on the limitation of motion or instability of the ankle.
  • More Info: VA Disability for Ankle Conditions

10. Asthma

  • Description: Asthma is characterized by difficulty breathing and is often triggered or worsened by environmental factors encountered during service.
  • Rating: VA ratings are based on the frequency and severity of asthma attacks and the required medication.
  • More Info: VA Disability for Asthma

These resources provide official VA guidelines and details on how these conditions are rated and compensated. For more specific information about how to apply or appeal, it is recommended to consult the VA website or seek assistance from a VA-accredited representative.



How Veterans Proved their Depression was Service Connected and WON their VA Claim

Service-Connected Depression

United States veterans deserve to be compensated for any new disabilities that arise from their service-connected conditions. One effective way to achieve this is by filing a VA depression claim. While winning a VA claim won’t magically solve everything, the additional compensation can significantly improve your quality of life. 

Two of the most common service-connected disabilities are hearing loss and tinnitus. These conditions may seem minor, but they can profoundly impact daily life. However, there is a cap on the compensation you can receive for them. So, what can you do? File a VA depression claim as secondary to your tinnitus or hearing loss. Don’t let the government overlook your needs. Mental health issues often develop as a result of tinnitus or hearing loss, and the Department of Veterans Affairs (VA) recognizes major depressive disorder as a compensable condition under the law. 

If you’re filing a mental health claim, you should aim for a diagnosis of major depressive disorder, which the VA can rate and compensate you for. But how do you prove that your depression is connected to your service? You do this through a secondary service connection claim, which means your depression is linked to an already service-connected condition, such as hearing loss or tinnitus. 

For example, if your hearing loss or tinnitus makes it difficult to work, communicate with friends and family, or carry out daily activities, you may develop depression as a result. To claim benefits for secondary service connection, you first need a medical diagnosis of depression. Then, a medical professional must establish a connection, known as a Nexus, between your depression and your service-connected condition. This Nexus links your depression to your hearing loss or tinnitus. A board-certified psychologist or psychiatrist must provide this Nexus, explaining how your depression was either caused or aggravated by your hearing loss or tinnitus. 

If you’re already receiving treatment from a VA psychologist or psychiatrist, ensure that your diagnosis of major depressive disorder is well-documented. You can ask your VA psychologist to write a Nexus letter linking your depression to your hearing loss or tinnitus. If your VA doctor is unwilling to provide this, citing a conflict of interest, you may need to find a private psychologist. 

To locate a doctor who can write a Nexus letter for depression, start by searching online. Look for psychologists who specialize in VA Nexus letters or Nexus letters for depression in your state. Be cautious of middlemen services, as they typically do not add value. It’s crucial to find a qualified doctor directly.

This author highly recommends Dr. David Anaise, who is both a medical doctor and an experienced, well-respected attorney. Dr. Anaise has helped many veterans, including myself, with excellent Nexus letters. He is also a skilled attorney who represents veterans in appeals with a strong track record of favorable outcomes.

Law Offices of David Anaise MD JD
1001 W San Martin Dr. Tucson, AZ 85704
Phone: 520-219-7321
Fax: 520-844-1452
www.danaise.com

Read my book, “Medical Evidence in Veterans’ Disability,” at http://www.amazon.com/dp/1542726581.
See also reviews:
www.AVVO.com – David Anaise – Lawyer in Tucson, AZ – Avvo
David Anaise MD JD LLC – Reviews (google.com)

Disclaimer: This recommendation is based solely on the Nexus letter Dr. Anaise produced for me, which contributed to my successful appeal. This recommendation is not promoted for monetary gain, nor am I affiliated with Dr. Anaise in any way.

The preceding article is a commentary and the views expressed are strictly the author’s own.