A VSO Reveals the Most Common VA Claim Mistakes

0:02Leah Bucholz Hey, guys. It's Leah b here from Prestige Veteran Medical Consulting. I'm a US Army veteran, physician assistant, and former compensation and pension examiner. So today, we have Ray Herrera on again. He's a VSO here in Wilson County in Texas, and he's been on with us before.

0:17 But for our viewers that don't know you, Ray, can you kinda introduce yourself and and give them a little info about how you came to do what you're what you're doing?

0:26Ray Hererra Yes. My name is Ray Herrera. I'm the veteran service officer for Wilson County, Texas. I'm also a navy veteran. When I first got out of the service, I started working with veterans right away.

0:40 I started working with them in the education capacity at the university. I later transferred into small businesses for veterans, and then I rolled right into as a a veteran service officer. So I've been a veteran service officer since 2019, working with veterans since 2013. I've worked for three different counties as a veteran service officer, and now I am the director here in Wilson County.

1:03Leah Bucholz Awesome. Well, today, we're gonna talk about the biggest mistakes that veterans make when they're filing their claims. And I think this is a really great topic because, it can be kinda confusing out there for veterans. Right? So, if you if if you viewers haven't seen it, check out our last video, which is kinda like just basics on what VSOs do, and that might be helpful to you as well.

1:24 But, I guess, to launch right in, Ray, in your experience, what is the single biggest mistake that veterans make that you see veterans make when they're getting ready to file their claims or when they're filing their claims?

1:38Ray Hererra If I can pinpoint it to this a single one because there I think there's quite a few. I would say being familiar with the criteria for the condition that they are filing for.

1:53Leah Bucholz Sure. Yeah. That makes sense. Most definitely. Like, I just you saying that off the top of my head, I can think of, like, a million different ways that could go.

2:02 Right? Like, somebody's seventy percent for PTSD, and now they're filing for depression. And you're like, what's happening? Right? But that's another topic for another day. Right? So just understanding the criteria for what you're filing for, is a great one. So do you feel like veterans sometimes submit too little evidence, or too much evidence sometimes, or or is can it be more complicated than that type of one way or another?

2:30Ray Hererra That's that's a very good question. And, you know, I provide that exact detail at every one of my appointments with my constituents. I think when handling VA disability, when prepping, when filing, I think simplicity is the most important thing. Mhmm. What I mean by that is you don't wanna give the VA a thousand pages to just find one diagnosis.

2:59 Mhmm. So providing them the one page that they need to just confirm that you have a diagnosis, that's what you want. Providing them the, you know, one page or it can be a couple of pages of your statement revolving that condition is the best. So I think what I see veterans most of the time is not providing enough information. What I what I like to refer to as overwhelming and compelling evidence.

3:28 Right? And when they do, they do too much where they provide things that don't really apply to exactly what they're filing at that time.

3:37Leah Bucholz Sure. And I'm sure for the adjudicators that can get tough because they're just trying to sift through, like, a million documents that may or may not be relevant, and they could miss things that are really important instead of just putting it, like, bottom line up front. Right? Here it is. So do you think veterans misunderstand why they were denied in the first place frequently?

4:02Ray Hererra I've had I've had attorneys, non VA attorney accredited attorneys review documentations and letters, and and they've reached out to me and told me, Ray, you know, I'm a lawyer, and I I I still am not I'm not, you know, comprehending this piece. So if attorneys at times can be difficult to navigate this process, I would think a veteran who is not affiliated and no experience with this process is also gonna have a difficult time. So, yes, I do think it is is something to interpret, to understand the laws and and everything like that revolving those conditions. I do think they have a hard time.

4:47Leah Bucholz Yeah. I think it's really hard because I think VA does a really, really good job of giving, like, help documents on va.gov, and then also the rating decision letter, like, will tell you, this is what was missing, this is what was missing, and this is what was missing. Right? But people just don't know necessarily that that's where to look, or they don't know you know, for example, if you wanna file a claim, you know, obviously, VSOs can help, but va.gov actually has really great help documents that are, like, step by step on all these different processes on how to get enrolled in VA health care, how to file a claim, how to do burial, whatever. But people just don't know those resources that are available or how to, like they just get overwhelmed, I think, right, with where to look.

5:36Ray Hererra Most definitely, Leah. And I completely agree with you. One thing that bring comes to mind is when a veteran has filed something and has submitted a a diagnosis and the VA comes back and when they read the letter, they said, well, we we you don't you don't have a diagnosis. Right? And I try to help the veterans in interpret and navigate the letter itself because knowing there's a decision section and a narrative section, you know Mhmm.

6:03 And why that's important to understand. So one part on the narrative section is the evidence portion. Right? So VA should document everything that you you they utilize to process that claim. So I told her that's an important piece to really be familiar with because if you submitted a diagnosis and it's not listed on there and they're denying you for that case, well, there's your your your, standing for appeal there Right.

6:29 Or or vice versa. It's it's on there, but they're still saying that there's no no diagnosis. So was the evidence reviewed at that time? There'd be more of a duty to assist.

6:40Leah Bucholz Right. Yeah. And I see that on my end frequently. Right? Because, you know, I work with a lot of veterans, and I don't ever step in that lane.

6:48 Right? But if somebody gets denied and and they say, hey, Leah. I got denied with this letter that you wrote. Like, this is the extent of what I'll do. Even though I might understand some of these concepts, I look at the evidence section. K? Is the letter in the evidence section? If it's not, that doesn't necessarily mean it wasn't there. I understand that. Right?

7:06 But if I don't see it, I say, hey. I don't see the report in your in your evidence section, so you might wanna go check with your VSO or you know? Especially if they're like, hey, Leah. Can I get another letter? I'm like, I am not gonna advise you. Right? But if your first letter isn't in there, you know, so VA misses stuff or maybe people misfile things Correct. Or they it gets mishandled, and then it's not really, a denial. It's like like you said, it's a procedural error that, like so knowing where to look in those sections and navigate all the different little areas, it can be complex. But once if you're a really good VSO like you are, like, you're like, here.

7:46 I'm gonna hit step I'm gonna hit a, b, c. I'm gonna look at all these spots. Exactly. And then it's like boom boom boom. Right?

7:52Ray Hererra Yes. Definitely. Uh-huh. And that's why BBMS is so or working with a BSO or working with an accredited representative is important. Yep.

7:59 So they have the insight on those files, and they can pinpoint those dates from the C and P exams to the letter and and make sure you know, sometimes, like you said, mislabeled. I've, submitted something, and it was mislabeled under something else. So then it

8:13Leah Bucholz wasn't Like, correspondence. Correct. They might put it in as correspondence or something. Right? And so know?

8:20 And maybe they still even looked at it, but in the evidence section, they label it as you just never know, right, until somebody like you can get in the back end and look at what's going on in VBMS and all that kind of stuff.

8:31Ray Hererra Yes, ma'am.

8:33Leah Bucholz And for you guys out there that don't know, we're getting in the weeds a little bit, but that VVMS system is is the system that the accredited folks can look in to kinda see what's going on with your claim in in real time. Right? So this leads me to my next question, which we just kinda hit on. What kind of paperwork do you believe gets overlooked most often?

8:57Ray Hererra I I think statements are often overlooked so much. Statements because on the lower level of of initial claims and maybe the o nine nine fives, which is the supplemental claims

9:14Leah Bucholz Mhmm.

9:15Ray Hererra I've done them, and and they'll completely dismiss it, and they'll come back with the same decision. And I continue to pursue it, or or I'll do a a higher level review or clear unmistakable. And then until we get to the judge at times usually, you wanna handle it way way on the lower level. But if it gets there, you know, a lot of judges take testimonies a lot more into consideration. For some reason, I I I don't know why they have that that, discretion more maybe, but I do see it is taken or given more probative way in in regards to the claim.

9:53Leah Bucholz Or maybe they're just more well versed at applying the law correctly. Not saying that the that the lower levels are are not. Right? But, like, maybe there it's there's less subjectivity, and the and then the VA law judges are more like, okay. This is you know?

10:09Ray Hererra Which makes sense because at the at the b v, the the Veterans Law Judge's level, they got a team. Right? At the appeal level, lower level, it's it's a one person that's reviewing it and then maybe a a supervisor overlooking just to make sure dotting their

10:25Leah Bucholz team denies. Sure. So, speaking of personal statements, do you think that veterans, should always submit lay statements with their claims?

10:36Ray Hererra Yes. I encourage this every time, all the time, because nobody truly knows how veterans' symptoms are affecting them and impacting them. And I'm glad you asked that question, Leah. It's it's such it's such a key to this process. I tell veterans this.

10:55 When you go to an evaluation, this is a real human being that that you're being evaluated by. Right? And they might have a workload, so on and so forth. And, you know, there's so many variables when it comes down to it. If you express something, if you say something, if something happens in that exam and it was only their up to them to document it, maybe they got sidetracked for whatever reason, and it didn't get documented correctly.

11:21 Mhmm. At that point, it's gonna be that examiner's word against that veteran's word. And that can be go that can go both ways and take a long time to kinda iron out. But when you file a statement, right, when you provide a statement with a claim and you provide that same detail in person, I feel like that's a lot more something you can hold the examiner and the VA accountable to if Mhmm. Somehow that examiner did not document it or ignored it.

11:52 Right?

11:52Leah Bucholz Sure.

11:53Ray Hererra And they didn't reference it in the rationale as to as to why they they denied the veterans case. So it's definitely key. I always tell veterans, don't leave everything in in the VA's, pot, you know, to to Mhmm. Process your claim, understand your claim, and and assign you what you think you deserve. We should do our due diligence as veterans when when submitting these claims, and those treatments are definitely key.

12:20Leah Bucholz Yeah. Especially, I think, in in cases that are really subjective based. So, like, for the the example that comes to my mind the most is, like, headaches. Right? So I I've seen many times where veterans say they have let's say they have two or three headaches a month.

12:35 K? But the examiner puts that they get one headache every other month or, like, just it's so I mean, that's or they say, hey. I get 10 headaches a month, but they're just not document the examiner's not documenting that. And that's not like a that's not like a range of motion issue, which is

12:51Ray Hererra Correct.

12:51Leah Bucholz Up to their interpretation. That's what is the veteran telling you, and they're not documenting it. So it's like, that can be really frustrating. So I would imagine with personal statements, that's or, like, a headache log or whatever. It's like black and white.

13:06 Right? Are you having this many, or are you not? And so that late testimony or that personal statement can be very, like, supportive, I would imagine.

13:14Ray Hererra When when those statements are backed by medical evidence, I Mhmm. You can't go wrong. So having statements is is key to help the examiner, you know, and and maybe hold them accountable to you expressing those symptoms and stuff. But when it's backed by medical evidence, most examiners are are gonna follow suit and and aligned based off of the evaluation if they see the same thing.

13:38Leah Bucholz Sure. So what do you think tends to delay claims unnecessarily?

13:48Ray Hererra I think many things. But if if I can really just think about maybe two things, I think when the veteran is constantly submitting this and that and this, multiple multiple claims at at different times and then submitting different evidence at different times and pieces. You know, VA is getting all that, and and they're trying to interpret these things. Like, okay. Well, where does this go, and how does this you know, where does it fit?

14:16 So I always tell veterans, you just just if you wanna file a thousand claims at one time with all the evidence, do it all in one time. You know? That's that's the best. If you're not ready, do an intent to file. Alright? Save the date of your claim. Send your claim off when it's fully developed. I always encourage fully developed claims. So when it's not fully developed and you're submitting multiple claims, different lanes, different evidence at multiple times, and and evidence or or evidence that may not apply to those things, that's when I see things are delayed, to be honest.

14:49Leah Bucholz Sure. So what do you think what are one of the the biggest myths that you hear out there about the VA claims process that you would like to clear up?

15:01Ray Hererra One, I I don't believe the VA is against is is trying to purposely deny claims. I I don't I don't I truly don't believe that. I do think the VA has a lot on their plate to deal with. Right? So they're trying to find out different ways and, you know, evolving with the times.

15:26 But, yeah, I I don't think the VA is against us, and and we gotta do our due diligence to make it more streamlined for them. So that way when that VSR, VA representative gets that claim, every key everything's already streamlined them for just to just finish the process off. That that is the best. And, you know, I think in an ideal world, and I tell this to to my constituents is, like, VA is gonna process your claims, and they're gonna do everything to the t as best as they can, you know, and and it's gonna happen. But, you know, things happen.

16:02 The the it's a big organization. They have a big workload, and, we just need a help, throughout the process. And sometimes, it could be maybe lower level, limited trained people and, you know, a constant revolving door with the VA or or or their personnel, whatever the case may be. But if if that's the case, we just keep continuing. If if that veteran truly believes that this is due to the service, you know, and they can continue to provide standing to appeal, we continue to fight it.

16:33Leah Bucholz Well, if you could provide just one last piece of advice before these these veterans file, just generally. Right? Not we're not talking legal advice for their individual cases. But one general piece of advice for these folks, what would it be?

16:48Ray Hererra Invest in the process. And what I mean by that is do an intent to file. Even if you if you don't are not even sure you're gonna file a claim now or later, just do an intent to file because it ain't gonna it's not gonna hurt. You have a whole year to decide. And even

17:03Leah Bucholz if it expires, it expires. Like, whatever.

17:06Ray Hererra Yeah. Do another one after that. But gather your stuff. Get a fully developed claim. I would tell people, three main criteria the VA looks for.

17:15 They're looking for historical evidence, right, a current diagnosis, and how is this condition related to the military? Start answering those questions and get those evidence and statements before you even see a VSL because that's gonna make the the process so much more simpler.

17:31Leah Bucholz I I could not have expected a better answer from you. What a great answer. So those three key elements are so important. So, thank you so much for spending this time with us today, Ray.

17:43Ray Hererra Thank you.

17:43Leah Bucholz You know you know, what stands out the most for me always is, how you explain how these issues can be preventable, and getting that right guidance before filing can just make such a difference in that planning stage. So, again, thank you for being here. And if you guys out there have any questions or comments, Ray's gonna visit with us again in the future. So please drop some comments, and and we'll try to answer them. And, Ray, do you have any last words for our friends out there?

18:10Ray Hererra Not not at all. I just wanna say thank you. Go see your local VSO. Build a rapport. Even if they're not the the office that to service you, it's always good to just utilize the VSL, maybe in the near future.

18:24 You never know.

18:25Leah Bucholz Sure thing. Alright, Ray. Thanks again, and, thank you guys for watching.

18:29Ray Hererra Thank you. Bye bye.

18:30Leah Bucholz See you.