Step-by-Step Guidelines

Dear Vets,

I received this guideline from a man that runs a County Veterans Affairs Office. The County Office is your first step, it is paid for by you and the county taxpayers. Their job is to help you! Each county in America has one. They will assist you in getting forms and your prior service health records. They will also guide you through the Federal VA process. I have begun to expand upon this instruction sheet and will continue to do so as I can. If you have any information that would help other veterans, please write to me so that we may post it for all to see.

In the event that you feel that you have not been properly treated or advised by the VA, then I request that you put into writing the situation and send it to your Congressman. They must and will respond. Congress controls the VA's purse strings. We live in a representative democracy. That means they represent you too!

The VA is in the business of delay and deny. However, politicians are in the business of wanting your vote. Do not forget what you served your country for- rights that you now are fully entitled to use. God bless America! The VA hospital has a chain of command for complaints. First there is a patient representative usually situated in the lobby or near the entrance. From there you should address complaints (That pertain to that Hospital) to the Chief of Professional Services (the top Doctor in the facility). If you are still not happy with their response then you go to the Hospital's Administrator. I have been told they have almost unlimited powers within their facilities. If you are still not happy then the VA has a separate investigator called the "Inspector General of Veterans Affairs". This person has almost unlimited powers to investigate complaints.

Your state also has a VA office that you may contact for assistance and help in dealing with the VA for medical care and the VBA in financial compensation.

The process should go as follows: You make an appointment to be tested at your local VA facility or hospital (170 in all across the nation). You are tested and a service connection determination is made by the physician evaluating you. The paperwork and doctor's advice go to the Regional Headquarters for Administration -paperwork processing. The VA will then schedule you for a Compensation and Pension Physical exam (C+P). The results of that exam and all the paperwork with the medical evaluation allows the VA to determine the level of your disability. Remember, they are trying to keep costs low so you must demonstrate disability and lost income from the disability. There are ways to do this.

Disability and Compensation are separate, but applied for with the same form (VA Form 21-526). Review carefully the instruction below.

Relax, I am here to assist you as needed.

Kevin Donnelly

Step by Step Guidelines:

1). Call, or visit your County VA office first! Try to speak with the Director of the Center. Have proof of service (DD 214) or similar evidence of qualifying service. Look in phone book, or call information for your county's phone number.

2). Starting point is to gather the medical facts. Try to obtain a copy of your service medical records by filling out a "Standard Form 180" requesting "all medical records and clinical reports". Two purposes for doing so:

- Assist current Medical Doctor in treating you
- Identify "in-service" first experience with illness, or related illness, to develop your claim.

3). Three parts to a VA claim for Disability Compensation: (VA Form 21-526)

- A). Something happened to you in the form of injury or illness while you were in the service.
- B). Problem has chronic and persistent aspects that continue to bother you, as evidenced by continuous medical treatment or clear medical evidence linking what happened in service with what you are experiencing now (called: RESIDUALS ).
- C). Disability impacts adversely on employment.

4). The VA pays disability compensation to close the gap in dollars between what you earn now and what you could earn if you did not have the disability (HCV in this case).

5). Seek qualified help in filling out VA Form 21-526 ! Qualified help can be obtained from your County VA Office.

6). Focus on BOX # 17, on VA Form 21-526, by carefully listing first sick call or treatment in-service for the illness.

- For example hepatitis infection (date of first awareness in service) and then see continuation sheet.
- Use plain bond paper to list chronologically each in-service treatment for all illnesses that may be related to Hepatitis.
- Attach photocopies of service medical records that support your outline.
- County director will help you fill out rest of the form omitting last sections dealing with pensions.

7). You are applying for disability compensation. Recommend discussing award of limited power of attorney to a service organization like VFW or American Legion to represent your claim at the VA regional office in your state. If not, you will have to go to the regional office whenever your paperwork is needed to be signed or initialed.

8). About 2-3 months after submitting your claim VA will send you a letter asking for medical evidence.

9). Through your County Director's Office send VA medical evidence - clearly linking HCV to Hepatitis. This allows a copy of your paperwork to be keep on file at your local office. This is a good idea for your protection.

10). About 2 months later you will be directed to go to a VA Med Center to be given a C & P exam (Compensation and Pension). You must make that

- Bring medical evidence of current medical problem and literature linking illnesses. Share these with your examiner.
- Stress affects of illness on your everyday life especially on your job.

NOTE: VA has no current rating table for HCV. We have no idea, yet, how the rating officers will rate HCV.

Important for you to keep all copies of every medical treatment for this illness for future requests for upgrades in disability comp.

You have rights as a veteran and you should not feel guilty asking for what you earned and deserve!

Subject: VA INFO: How to request copy of DD 214

Personnel at the Army Reserve Personnel Center in St. Louis, MO., had a major reorganization that affects your request for DD Form 214 (record of active duty).

SOURCE: Per telephone conversation with the National Personnel Record Center today, the following is the latest method for prior service members/retirees to request DD 214s:

Subject: Missing DD 214s
Author: deihll at gar1
Date: 6/12/98 11:14

REPLACING DD 214 (record of active duty training)
--prepare Standard Form, SF 180 and mail to--

National Personnel Records Center
9700 Page Ave
St Louis, MO 63132-5100

Was advised that for retirees, it takes 2 to 3 weeks others discharged - 8-10 weeks.
L. Deihl C, MPD/980612

Compiled by Kevin

Subject: VA INFO: VA Disability Payments
SOURCE: Handbook for Military Families, 6 April, 98

The Department of Veterans Affairs offers disability payments to former military members with injuries or diseases incurred or aggravated during active service. These are separate from the permanent and temporary disability payments made by the Defense Department (see disabled retirees).

VA disability pay is subtracted from any military retirement pay and is reduced by the amount of Defense Department severance pay.

The tax-free monthly income paid under VA disability to veterans with no children ranges from $95, based on a 10 percent disability rating, to $1,964, based on a 100 percent rating. Veterans with at least 30 percent disability rating get more money for their spouse and each child.

Congress usually provides an annual cost-of-living adjustments to all disability retirement paychecks to keep pace with inflation. Military retirees received a 2.1 percent cost-of-living adjustment Jan. 1, 1998.

Veterans who do not qualify for disability retirement must waive $1 of their military retirement pay for each VA dollar they get. VA payment is tax-free; most military retirement pay is not. The part of military retirement pay that is based on disability, however, usually is not taxed.

Veterans classified as 100 percent disabled are entitled to use military exchanges, commissaries and theaters. So are their spouses and any children living at home with them. However, they aren't eligible for military medical care. VA assumes that responsibility.

Subject: VA INFO: The Law and Health Care
SOURCE: Handbook for Military Families, 6 April, 98.

Military health care places some unique restrictions on those who use it. They do not have the same rights as patients who receive care from private health maintenance organizations or from civilian doctors in private practice.

Following is a brief discussion of the scope of patients' rights in military health care.

Privacy and Medical Records

As a rule, the services do not guarantee confidentiality of medical records. The nature of the military mission creates a powerful "need to know" about anything that would affect national security and the performance of duties.

As a result, the military can offer patients only limited confidentiality within the doctor-patient relationship. Military doctors have dual responsibilities: to their patients and their services.

Personnel not involved in a patient's care or in medical research are not suppose to have access to medical files, but exceptions are allowed. These include situations in which access is required by law, regulation or court proceedings.

Under the Privacy Act of 1974, patients have a right to see and have a copy of their health records, although a physician may resist if he or she believes such knowledge would harm the patient.

The Privacy Act also gives patients the right to challenge information and ask that incorrect or irrelevant entries be changed or deleted. Patients can ask a hospital administrator or commander to make the changes.

If the request is denied, the patient can appeal through medical channels. If the appeals is denied, the next recourse is to file a "statement of disagreement" for insertion in the file. A military legal assistance officer can help to correct records.

The Privacy Act also requires the military to keep an accounting of health records and information that has been released. This notation is usually logged into a person's medical file. The law allows patients to learn who, outside the medically community, has looked at their files.

Malpractice Claims

A U.S. Supreme Court ruling in 1950, known as the "Feres doctrine", forbids active-duty people from suing the government for medical malpractice or for any other injury they receive, no matter how justified their claims.

Congress has repeatedly turned down proposals to allow active-duty members to sue.

But active-duty people can be compensated in other ways for malpractice. For example, they can receive retirement on disability, or hospital care if they remain on active duty. If they are severely injured because of malpractice, they also are entitled to certain Social Security and VA benefits.

Technically, active-duty people also can ask congress to pass a so-called private relief bill to give them financial compensation. But such legislation is rare and almost always opposed by the Pentagon.

Family members and retirees are in a different category. They can sue the government.

As the sums asked in damages have increased, many states have placed ceilings on the amount of damages that can be paid in malpractice cases. Administrative claims must be exhausted before an individual goes to court with a lawsuit.

Filing a malpractice claim against the service is relatively simple, though it may take years before a final judgment is reached. To file a claim, family members and retirees file out a form at a base claims office. Stating their basis for belief that malpractice occurred and asking for a specific amount in damages.

A claim must be filed within two years of the alleged malpractice. Retirees can file only for malpractice that occurred after they retired. It is a good idea to have legal help when filling out the form, but a lawyer isn't required.

Most of the military's legal powers in such cases are on the government's side. Military lawyers can help an alleged malpractice victim file such claims but can not officially represent the victim.

Local lawyers for the military can settle claims for small amounts, but most malpractice claims are forwarded by base officials to the main claims office of the Army, Navy, Air Force, Marine Corps and Coast Guard.

The military has six months to review the claim. Settlement of the claim at this point avoids costly litigation, both for the injured person and the government. if the settlement offer is unsatisfactory, an individual can negotiate for more. If still unsatisfied, he or she can go to court. If the military makes no offer in six months, the individual can sue. In 1991, however, the U.S. Supreme Court ruled that military family members can not sue military doctors overseas.

Family members dissatisfied with a claims decision can appeal directly to the service secretary or judge advocate general, depending on the size of the claim. It is not unusual for a decision to be reversed, nor for a claim award to be increased. the decision in such an appeal is not subject to court reviews.

Subject: VA INFO: VA Pension
SOURCE: Handbook for Military Families, 6 April, 98

The VA also offers a pension for wartime veterans with limited income and permanent disabilities not traceable to military service. The pension varies according to the veteran's income, number of family members and capacity to care for himself, or herself.

The annual basic pension for a single veteran in 1998 is $8,665. A veteran with no income and one family member receives $11,349. For each additional family member; the pension increases by $1,476. Any income is subtracted from this payment. To find out more information send for, or visit the VA on the internet.

The VA publishes a comprehensive annual guide, Federal Benefits for Veterans and Dependents (Government Printing Office Stock No. 051-000-00212-1). It can be ordered for $5.50. make checks payable to Superintendent of Documents and send to US Government Printing Office, Superintendent of Documents, P.O. Box 371954, Pittsburgh, Pa. 15250. The handbook is also on-line on the World Wide Web ( To charge an order via telephone, call (202) 512-1800. Visa, MasterCard or Discover are accepted.

Disabled American Veterans (DAV), a private non-profit organization, offers assistance to ALL former service members with suspected disabilities. For information, write Disabled American Veterans, 807 Maine Ave. S.W., Washington D.C. 20024
Compiled by Kevin

Subject: VA - Rating Schedule
Source: 38 CFR (Codes of Federal Regulations) Chapter 1 (7-1-97 Edition)
S 4.114, page 400, 7345, Hepatitis, Infectious: (currently being used by the VA for HCV)

Note: Must be "service connected", or have had a "service connection determination" made by the VA. In short, the VA admits the military played a part in your acquiring the virus.

(Copied from the CFR)
100% Rating - ($1,964/month)
With marked liver damage manifest by liver function tests and marked gastrointestinal symptoms, or with episodes of several weeks duration aggregating three or more times a year and accompanied by disabling symptoms requiring rest therapy.

60% Rating
With moderate liver damage and disabling recurrent episodes of gastrointestinal disturbance, fatigue, and mental depression.

30% Rating - ($313/month)
Minimal liver damage with associated fatigue, anxiety, and gastrointestinal disturbance of lesser degree and frequency but necessitating dietary restrictions or other therapeutic measures.

10% Rating - ($95/month)
Demonstrable liver damage with mild gastrointestinal disturbance.

0% Rating -(no monthly payment)
Healed, nonsymptomatic.