The Fine Tooth Comb Approach To Disability Claims


Trust Shinseki

Over the past week, I’ve been revisiting my own disability claims to be sure VA did it properly.

No matter how many years that go by, and how many issues they miss, I am still able to find new issues VA skipped, or omitted, or manipulated to fit their denial.

Here is what this means to you, and I’ll explain what happened to my own claim later. When you read your own file, read both your initial claim to VA and VA’s actual response to you.

What you may notice is that VA will fail to adjudicate all conditions you write down. This seems to be especially true with older claims.

Let’s not forget that VA has been caught intentionally lowballing veterans at least once a decade. So, if you happened to be one of the unfortunate majority of veterans who got screwed, you need to be ready to read your own claim very carefully.

The first step is getting a copy of your file through a Privacy Act request or a Freedom of Information Act request.

Once you get your file, start to read it through, end to end. Be sure VA examiners properly noted conditions. Be sure, if the condition or symptom was noted, that VA’s adjudicator actually included the data in their decision.

Case in point.

In my situation, I have an adjudicated Form 9 in my file from 2003. VA cannot seem to figure out what to do with it. In addition to the Form 9, there are many symptoms of conditions in my claims that VA also did not adjudicate.

Specifically, I noted to VA that I was suffering from fatigue in a Statement in Support of Claim. I thought the fatigue was related to Sleep Apnea, which is a condition VA denied in 2003 and again in 2012. While fatigue could be related to Sleep Apnea, it can also be connected to many other things, such as TBI.

As chance would have it, I do have a current diagnosis for TBI in 2009.

Here’s what this means. When a claim is unadjudicated, it could result in VA being on the hook for an earlier effective date. Now get ready for the dip and hook.

Instead of VA connecting fatigue to TBI, they connected it to Sleep Apnea. And since I don’t have a service connection for Sleep Apnea, VA is off the hook for the earlier effective date.

And, best of all, the VA adjudicator did this without consulting a doctor. Instead, the nonmedically trained VA employee rendered a medical decision when they could not do so based on medical training.

This kind of decision is contrary to many decisions from the US Court of Appeals for Veterans Claims. Regardless, VA continues to defy logic and law to deny veterans benefits.

Of course, in my situation, I won’t stop until I win. And you shouldn’t either.

The sad fact is that the American people need to be accountable for their decision to fight many wars across the country. If we let VA get away with scamming veterans out of their benefits, the American public will not know how much war really costs when it comes to cleaning up the mess.

Without a full understand of the cost and impact of war, many more “Chicken Hawks” in Congress will be able to lead us into senseless wars.

So, my charge to all of you is to be sure to read your claims file very carefully. Be sure to not let VA off the hook without fairly adjudicating all of your claims.

Look for any instance where a VA adjudicator dimwit rendered a medical opinion with no medical proof or sound reasoning.

I can assure you that VA probably does this in at least half of the claims they deny. In fact, I believe 60 percent of all claims that are denied are denied on unsound reasoning last I checked.

After I’m done with the MN State Bar, I’ll be breaking down my own claim and the process I go through to fight for my own justice. Check back in from time to time to see if you can gain some insight.

Most importantly, if you can, never give up.

VA is a past master of the “deemed denied” claims philosophy. You report. We ignore. I filed in 1994. Denied (of course). I sent in new evidence and they foolishly said “Roger, we got it. Will get back to you soon”. They never did. I won in 2008 and they refused the earlier date until we got to the CAVC. Nineteen years later, on the courthouse steps five minutes before showtime they expressed their mea culpas. Remember, Vets. If you… Read more »

Well-written. Best of luck on the EED. If they give you the “I can’t hear you” treatment, don’t continue pro se. I finally got a law dog when i approached the Court. VA had their ears plugged up and refused to even acknowledge what was in the C-file.

Stanley Smith
Stanley Smith

This is a very motivational article. I too will use this insight to educate the american people on the cost of war.

I stumbled upon this article when I was searching for information on lost medical records. I just submitted an application to reopen a claim because the VA’s decision to deny me was based on my diagnosis. What I mean by my diagnosis is that they reviewed my file and noticed that I had complained of tinnitus during allergy season. My tinnitus is continuous and was caused by chemotherapy. During allergy season I am congested and the ringing is “louder” or… Read more »

*I meant based on self-diagnosis not a doctor’s.

Izk Einsein
Izk Einsein
there are people within the veterans administration that are using their job positions to process claims for themselves and friends and getting paid for things like getting water up their nose when jumping in water ,while swimming. also for their feet hurting because they where made to march. I was up in northern Michigan on the 4th of July in a bar with friends and a man named Mike Wise, who said he works for the V.A. Adminastration Office in… Read more »
Bonnie G
I plan to read my husband’s paperwork. He is 100% now for the past 7 or 8 years, but it took 4 or 5 years to get there with gradual increases as we submitted more claims. However, I’m sure they underrated his heart condition in earlier years as they later awarded the rest of the 100% based on the same heart condition we reported earlier. My question is what about the year time frame for appeal? We’ve long since passed… Read more »
Bonnie G

As an clarification to the comments I just submitted, my husband is rated for diabetes which the doctors say his kidney failure was caused from, so the relationship between the two conditions does mean the kidney condition would have been an acceptable rated condition if he hadn’t been already 100% when it occurred.

Gary Phillips
Gary Phillips
I walked into a VA Regional Office and was told to have a seat. The VA employee pulled out a form and with the help of my discharge physical proceeded to fill it out. I mentioned my head injury and was asked if it was in my record. I told him the Navy lost my record. He said…… “Can’t prove it, don’t waste my time”. Just out of service, intimidated and suffering from undiagnosed brain injury, I signed the form… Read more »