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From Pain to Purpose: VA Claims, Success Stories & the Truth About Claim Sharks · Military Broadcast Radio | MBR Talk

0:02
Welcome to the Propane to Purpose radio show.
0:05
I'm your host Viva Fulton. In this show, we explore the
0:08
incredible journeys of resilience, healing, and
0:11
transformation. In each episode, we will sit
0:14
down with individuals who have faced unimaginable struggles and
0:18
turn their pain into power, heartbreak into hope, and their
0:23
challenges into meaningful change and finding new purpose
0:26
in life. Through candid conversations and
0:29
inspiring stories, we will uncover how pain, whether
0:33
emotional, physical, mental, or spiritual, can be the catalyst
0:37
for profound growth and a deeper sense of purpose.
0:41
So if you are looking for motivation, insight, and real
0:44
stories of triumph over adversity, if you're in the
0:47
right place, let's get started on this journey from pain to
0:50
purpose. Let's give veterans a voice
0:53
through military broadcast talk. So my answer to going to college
1:05
was join the army. 1992 my life changed forever.
1:12
PCs to Germany with with my two boys and really try to take
1:18
advantage of the opportunity to travel learn another language.
1:23
The culture it was it was to me the dream coming true that
1:29
everything that I've been going through was worth it because I
1:32
was seeing another part of the world that I wouldn't have had
1:37
the opportunity if I hadn't been in the military.
1:40
Planned on getting out in 2000 and that was really kind of a
1:45
part of a joy in my life and getting married for the second
1:49
time and I looked forward to the future ended up kind of becoming
1:56
disillusioned and that was the whole housing bubble thing where
2:02
the mortgage jumped from bank to bank to bank.
2:06
My kids were counting on me to to take care of them, to ask for
2:11
that kind of help done to help other women is make sure that
2:19
they know what their resources are.
2:22
It it's for a long time I didn't understand that my service in
2:27
the military counted as a woman veteran, but nobody told me,
2:33
hey, Eva, you're a veteran too until I had that light bulb
2:36
moment and said my service counted too.
2:43
And I can tell you it's been a long road to learn how to dream
2:47
again. The community was the solution,
2:50
be it churches, be it nonprofits, be it veterans
2:53
service organizations or just people like myself.
2:57
We are the resources. We are the solution to help
3:01
keeping women off of the street our women veterans housed and
3:08
having the resources they need and not living in a car city of
3:12
the work that grows us as leaders for our second service
3:20
after the military to serve other people in our communities.
3:26
Hi everybody welcome to the from pain to purpose radio show.
3:32
Fair warning, this is prerecorded because I'm going to
3:35
spend some weekend time with my daughter and her new young
3:40
family. So I am adjusting my schedule
3:44
here on Monday and I'm super excited about having my guest
3:51
today because you saw my intro video that I just did.
3:56
It's the trailer for my documentary From Pain to
4:00
Purpose, her second service story.
4:03
It is international award-winning.
4:05
It has been in the Film Festival market for many years now, but
4:10
I'm still working on that parallel thing with my
4:13
dissertation, my PhD in public administration.
4:18
And you know, I love when I know that the people that I connect
4:25
with throughout the years have something that they bring to the
4:29
table that helps us, that helps me help somebody else understand
4:36
that one, they're not going through things alone. 2, that
4:41
chances are somebody else has been going through something
4:46
that has helped pave the way to make things a little bit easier.
4:53
Not a perfect process and the veteran world of things.
4:58
You guys all know that. I'm not telling you anything
5:01
that you don't already know, but you know my own, my own.
5:08
What are we talking about today? We are talking about claims in
5:11
the veteran world of things. And you know there's lots of
5:15
things that happened on that side.
5:17
I showed y'all the pictures for my car wreck in 1992.
5:21
I got out on a medical discharge in 2000 and it's been this
5:26
incremental process on getting help for my claim that took
5:35
years and years and years. You know, it was 20% then it was
5:39
30%, then it was, I think I finally got like the 70% and my
5:44
mind's a little fuzzy sometimes on did I get the 70?
5:49
But then I finally got the 100% in 2018.
5:53
It took 18 years after getting out of the military to get the
6:00
100%. And, you know, had it's, it's
6:04
been a journey, you know, but that's, but it's not easy,
6:09
right? And we all go through a whole
6:11
variety of things. I had years where I didn't, was
6:15
not able to work. But it wasn't until I sent in
6:18
the pictures for my car wreck that I think somebody had an aha
6:24
moment in the VA claims world of things and said, oh, this, Oh,
6:29
snap. This was not a normal car wreck.
6:32
No wonder why she has screws in her knees and a knee replacement
6:37
and so on and so forth. It's, it's not been easy.
6:41
And coincidentally, they gave it to me as a blessing and actually
6:46
awarded it on my birthday in 2018.
6:49
So, you know, it's it's it's been a journey my guest this
6:56
week to help us understand claims is actually from the Jag
7:02
world of things that Judge Advocate General in the Army.
7:05
I was a Jag paralegal, loved that work had many different
7:12
roles. And I I was talking with my
7:15
guest, Rick Russo just before the show and I thought we had
7:18
actually worked at the same place at the same time, but we
7:22
did not. But we crossed paths and, you
7:24
know, it's a a small world. So Rick's going to join us and
7:28
he's going to talk about his enlisted service in the Army
7:31
starting in 1988. That's when I started and he
7:36
served for 27 years and he retired in 2015 as a Colonel, as
7:41
an Army Judge Advocate General officer.
7:45
These experiences led and prepared him to represent
7:48
veterans with VA disability benefits and surviving spouses
7:52
for VA benefits. He also was in Operation Desert
7:57
Shield, Desert Storm, just like I was, and provided legal
8:01
assistance to surviving family members and later served as a
8:05
professor where he taught veterans and survivor benefits
8:08
at the Army Jag School in Charlottesville, VA.
8:12
I think I made it there twice. Since his retirement from active
8:16
duty in 2015, he's represented thousands of veterans and
8:21
surviving spouses as Ava accredited attorney.
8:24
And he's going to discuss some very painful cases that he's
8:28
been involved with and of course, some of those sex
8:32
success stories. So thank you much for joining
8:37
us, Rick. Let's see, he's our interview.
8:41
The interview of the week is brought to you by Jersey Mike's
8:46
A Sum above. Welcome, Sir, what Rick Russo,
8:52
thank you for joining the propane.
8:54
To purpose. Radio show.
8:56
You bet. I I'm glad to be here and share
9:00
what I can with with others as far as what we do and helping
9:04
veterans. I like to tell everybody in our
9:08
law firm every day is veteran's day because everybody that we
9:11
deal with is a veteran and everybody that works here in our
9:16
firm is either a veteran, a spouse of a veteran, a spouse of
9:21
a of active duty. So it's Veteran's Day every day
9:24
here. That is awesome.
9:26
You know, I think I started following you on LinkedIn and I
9:30
watched that you've added different members.
9:32
I think your daughter's a part of your firm as well.
9:35
She's a veteran, right? Not my daughter, but there some
9:40
of my employees have been here for quite a while.
9:42
Like I said, we, we started in 2015 right after I retired and,
9:47
you know, my senior folks have been here for 6-7 years now.
9:52
So it's, it's, it's quite a group that we have that brings
9:56
in a lot of experience. And like I said, I, I think even
10:00
even the spouses understand that we have, you know, what goes on
10:05
on the military side and understand, you know, the
10:08
purpose in the veteran world. So, yeah, we do what we can to
10:13
help out mainly with VA disability claims and appeals
10:18
and also a couple of our attorneys that as you mentioned,
10:22
you went through a medical board.
10:24
Two of our attorneys worked in the I DES process for medical
10:29
boards, one for 17 years, one for 18 years.
10:32
So they have a lot of experience in, in, in the medical board
10:36
process, which is another area where services are being cut a
10:41
lot on the active duty and reserve side and and we're kind
10:44
of seeing the pain and that as well.
10:49
Well, so where do we begin, if you know, I think the hardest
10:53
part is for a lot of veterans and they're just getting out, or
10:58
maybe they've been out for years.
11:00
You know, I can give you a great example.
11:02
Like my dad, he's 83, has never filed a claim.
11:07
I, I tried putting in for even a copy of all of his records,
11:12
zilch, nada. If he got something he never
11:14
told me, but he's got, you know, really bad tinnitus and, you
11:22
know, not major issues because he was Air National Guard.
11:27
But let's say somebody's been out for years.
11:31
Where's a good place to start? I always start by telling
11:35
everybody and kind of using a sports analogy.
11:39
If you hadn't filed a claim or you haven't filed a new claim,
11:43
you're kind of on the outside of the ballpark looking in and you
11:47
got to get in the ballpark and you get in the ballpark by
11:50
filing those claims, whether it's through a veteran service
11:53
officer or these days va.gov is very easy to file a
11:59
claimthroughva.gov and get it going.
12:03
So to me the first thing is get the claim filed or get an intent
12:08
to file a claim submitted while you get things together.
12:12
I will say in the VA process side things have speed up I
12:19
think a lot over the last 7-8 years in processing claims and
12:24
it's both good and bad. The good is if you file a claim,
12:30
it's not an uncommon, within about 30 days, the VA is
12:34
scheduling A compensation to pension exam.
12:38
About 96% of all compensation and pension exams these days are
12:45
done by contract examiners and those contractors have to get it
12:50
completed within 30 days to get paid the Max that they can.
12:54
So they want to move out on it. Kind of the downside is, you
12:59
know, what's the quality of the examiner and there's some great
13:03
ones and there's some that aren't very good.
13:07
And, and, and so, you know, to, we like to say at times, as you
13:12
mentioned, sometimes you got to go around the hamster wheel a
13:15
few times and it may take a few exams, it may take a few
13:18
appeals. But to go back to your question,
13:21
get the claim filed, get it going.
13:25
You know, if it doesn't turn out the right way, either not
13:29
service connected or rated too low, you have a one year period
13:33
of time to appeal it. And as long as you do that, it
13:36
can go back to the date that you filed that new claim or the
13:41
intent to file. So for those people that have
13:44
not done it, get it rolling. At least get your intent to
13:47
file, put in and then get things together.
13:50
That was huge for me, I think was getting the intent to file,
13:55
you know, started on va.gov. I mean, I think I'm, you know,
14:01
savvy enough about what those systems were.
14:05
I mean, they were pretty wonky when they first started getting
14:08
it online and then having to navigate, you know, some of
14:12
their drop down menus was a little difficult.
14:17
And how do you, you know, what's the difference between a
14:19
secondary versus, you know, a primary 'cause, you know, was
14:25
was the hardest part. But then what documentation was
14:31
necessary? I was very fortunate getting out
14:36
from the Jag Corps. I had plenty of people telling
14:39
me keep, you know, go get 2 full certified copies of your medical
14:46
records. And so, you know, no matter what
14:49
happens between DoD and the VA, those original files, you had
14:56
two full certified copies that could help supplement whatever
15:02
issues are. And then I had some very good
15:05
people, friends of mine, go through your medical records
15:09
file for pretty much anything that had happened, everything
15:12
from basic training to, you know, a deployment to what
15:18
other, you know, field exercises or whatever.
15:23
And I think the biggest one was having the line of duty on my
15:26
car wreck because that was that was very fully documented that
15:31
it was a line of duty and they couldn't argue that.
15:34
Right. That's important.
15:36
And you know, it's kind of unique when you talk about line
15:40
of duty because we don't see them that often on active duty
15:44
individuals unless there's some allegation that there may have
15:48
been some type of misconduct to take you out of the line of
15:51
duty. On the Garden Reserve side, we
15:54
actually see it more, but not enough because you know, if
15:59
somebody had an injury at a drill or I've had several cases,
16:03
believe it or not work, somebody's getting ready to
16:06
drive in the front gate for a drill or, or training and they
16:12
have an accident on the way in. And so it's helpful if we have
16:16
those line of duty investigations that took place
16:19
for our Garden reserve, but it's not totally crucial if it's not
16:23
there and a lot of units fail to put them together for the garden
16:27
reserve, we can kind of go back and and get documents and put it
16:31
together, not a lot of duty, but provide the evidence that's
16:35
needed for the service connection.
16:39
You know, it kind of a, if I can kind of loop back to something
16:43
that you said about I think it was your, your father individual
16:47
had never filed for a claim before.
16:50
A couple of interesting cases that I've had, I've found more
16:57
often than not a lot of our Vietnam Veterans never filed a
17:01
claim. And it was that mentality
17:03
somebody else had it worse than me or somebody didn't come back.
17:07
Why, why should I file that? You know it.
17:12
And unfortunately I've had that come up several times after the
17:16
veteran died and we were trying to get dependency indemnity
17:20
compensation for the spouse. And as you mentioned, we'd go
17:25
get the claims file and there'd be nothing in there.
17:28
They never filed a couple of cases that, that we had that
17:33
that kind of illustrate that one very, very recently.
17:38
I, I participate in, I'm in Bell County in central TX close to
17:43
Fort Hood. Bell County Bar Association does
17:46
a veterans legal clinic several times a year, pro bono legal
17:50
clinic. And I had a lady that came in to
17:52
see me that she was 94 years old.
17:56
Her husband had been a Vietnam veteran and he died in 1983 from
18:03
a cancer. Because he had was a retiree.
18:07
She was getting survivor benefit plan, which was good, and she
18:11
was getting survivor Social Security, which was good.
18:15
She had never filed for anything on the VA side because he had
18:20
never filed for anything on the VA side.
18:23
As we dug into the case, we found that the cancer that he
18:27
died from later on became a presumptive condition for Agent
18:32
Orange, and we were able to file for dependency indemnity
18:36
compensation for her. And it was not only granted,
18:42
even though it didn't, we didn't file for it till this year.
18:45
Surprisingly, we were able to get it granted all the way back
18:49
to 1983. What which hundreds of thousands
18:53
of dollars for her there there is a provision in the statute
18:58
that says if you file for Social Security survivor benefits, it
19:04
is basically noticed to the VA that you're a survivor of
19:09
veteran. They should consider that as
19:12
like a application for DIC. So this lady who had never
19:17
received anything from the VA since her husband died in 1983,
19:23
it was, it was a quite the moment to call her and tell her
19:27
you're going to not only be getting DAC each month and the
19:30
benefits that go with it, you're going to get several $100,000
19:33
going back to 1983. And, and we've had other, other
19:38
cases that are similar on DIC and I, I those cases, I mean, we
19:45
do a lot of disability, but the, the DIC cases, dependency
19:49
indemnity compensation, really, really, you know, pique my
19:53
curiosity because of that. And, you know, we put a lot of
19:58
effort, obviously, in those cases to get the survivors what
20:03
their spouses earned while they're on active duty.
20:06
Right, but that's, but that is, I'm glad you did that.
20:09
That is public administration one O 1 right, right.
20:13
If, if it's written there and these are the processes and it's
20:18
all documented. Well, I mean, I get it to a
20:21
certain point. Yes, it's putting the they put
20:24
the VA on notice way back when, but until you ask for it, you're
20:28
not going to get it. Yeah, but.
20:30
Use it, use it or lose it in a way and.
20:33
And it's interesting, you know, the history on this actually
20:36
goes back to a law or a status in the 1950s that told the VA
20:43
and Social Security to come up with a joint form for Social
20:48
Security survivor benefits and DIC.
20:51
And neither one ever came up with a joint form.
20:54
So over the years the courts have held well because of that.
20:58
If you applied for a Social Security survivor, it is like
21:01
notice of an application to the VA.
21:04
So it's it's kind of a little known provision that we go and
21:07
look for. Sometimes we get the DIC
21:10
granted, then have to go back and appeal to get that earlier
21:14
effective date. But those cases, you know, like
21:19
I said there, there's something special to me about the DIC
21:22
cases, my first experience with it.
21:24
You mentioned Desert Shield, Desert Storm.
21:27
I one correction, I didn't deploy in desert.
21:30
Shield Desert Storm. I was at Little Redstone Arsenal
21:33
in northern Alabama during Desert Shield, Desert Storm.
21:38
We deployed a lot of folks from that area.
21:41
But the interesting part is, as you, you're aware, there's a lot
21:44
of Garden Reserve units that are in the northern Alabama,
21:48
Tennessee area. Then we not only prep to deploy,
21:52
but we had four or five casualties that were from that
21:55
area that we assisted their survivors with benefits.
22:00
And we, you know, had a checklist in the Jag Corps where
22:03
you would go through these are the benefits.
22:05
And one of the, you know, very sobering moments was talking
22:11
with a surviving spouse who was 23 years old and telling her,
22:18
OK, you're getting this dependency and indemnity
22:21
compensation. You're 23 years old.
22:24
The last thing on your mind right now is getting married
22:28
again. But I'm telling you, I have, I
22:31
have an obligation to tell you if you get married before age 55
22:36
under I think at that time the law was probably 5755.
22:39
Now the DIC stops and you need to be aware of that.
22:45
And I wasn't telling her to go shack up with somebody.
22:47
I wasn't saying that, but I was telling her be aware because
22:51
what last thing I want you to do is go get married and then after
22:55
the fact realize you lost this benefit that you had.
22:58
So it was very much, you know, a sobering moment and, and letting
23:03
her know about the benefit, but then make sure she was aware of
23:07
the rules. So.
23:08
So on average, how much is DICI? Don't even know.
23:12
These days for a surviving spouse, it's right at $1700 a
23:17
month. It's tax free.
23:19
Just like disability income. There can be an additional
23:23
amount added on for each child. There can be an additional
23:27
amount that's added on if the surviving spouse is housebound
23:32
or needs aid in attendance. So normally it's between about
23:35
1700 to about 2122 hundred a month.
23:39
So it's not the full 100% that say a veteran may be getting,
23:44
but it's a significant amount. And with when the adept is
23:48
service connected, the DI sees payables.
23:51
The surviving spouse also qualifies for Champ VA insurance
23:56
and a lot of the other benefits that go along with it.
23:58
So, you know, it does kind of help fill in the gap that may
24:03
have been created by the deaf. Sure, so can they also get the
24:08
SSDI as well? Yeah, that that's completely
24:12
separate. So the VI mean now, now VA is.
24:15
Yeah. I know I lost my second husband.
24:21
He was not a veteran, but I lost him in 2015 and I got to collect
24:25
the SSDI for my, for our two youngest kids until they turned
24:31
18 or you know, when the school year finished.
24:35
So I didn't know if that was a like a dual benefit that you
24:40
it's one or the other not. Both.
24:42
No, the the only thing is that obviously for VA disability
24:45
benefits, the VA disability stops upon the death of the
24:49
veteran and the DIC can pick up. But if their Social Security
24:53
benefits 1 doesn't impact the other.
24:56
Now, there is some interplay in that VA and Social Security will
25:01
share some records. So like always tell everybody if
25:04
you're dealing with one, make sure you're consistent with what
25:07
you're saying to both, you know, because they do VA can pull
25:12
some, you know, some Social Security records and vice versa.
25:15
But yeah, they can qualify for both benefits.
25:18
I think a lot of the federal agencies are doing more of that
25:23
record sharing, just a matter of, you know, keeping things so
25:28
that people aren't getting more than what they're supposed to.
25:32
But in some ways it's actually beneficial to be able to apply
25:37
for things if it's due to you. I mean, I, you know, if I hadn't
25:43
been helping Mark with applying for SSDI for himself, I would
25:48
have known anything about my being able to get it when he
25:51
passed away. Because when they, when he
25:53
passed away, then it, it sent all of those payments directly
25:57
to me. And you know that that was such
26:00
a huge help raising to young kids, so.
26:03
Right. Oh, absolutely.
26:04
Absolutely. Well, before the show we were
26:07
talking about the whole concept about buddy statements and
26:14
spouse, you know, family member statements.
26:17
I think one of the biggest things that helped me reach my
26:21
100% in 2018 were pictures of my car wreck.
26:26
I think that that was a clear, hey, this was not like a Fender
26:29
Bender kind of thing. This was like, Hey, you know, I,
26:32
I would have, could have, should have died in that thing.
26:35
But I also, Mark had written me a spousal, you know, the impacts
26:41
of what the accident had done to me as his spouse.
26:45
And then also my mother had written a letter.
26:50
And I think that was huge. And coming from both of those
26:54
people, the impact of what my service was and, and how these
26:59
injuries had affected me by the service, you know, the, the
27:03
sickness, right? Because now even Desert Storm,
27:08
Gulf War veterans, we have a, what is it say it, is it 10 DSM
27:14
10? There's, we have a new code for
27:18
Gulf War veterans that is available for us.
27:21
But getting that applied is a whole another story.
27:25
But I think that these these spousal letters, the family
27:29
member letters were huge. And I agree, you know, as I like
27:35
to say as a recovering criminal defense attorney and prosecutor
27:40
that had to live by the rules of evidence.
27:44
You know, one of the things that I love in VA laws, VA, the rules
27:47
of evidence don't apply in VA law.
27:50
And and So what at what evidence can we get?
27:55
I mean, I use the term develop and I don't mean just dream up,
27:58
but go and get, you know, and, and statements is one of them.
28:03
And, and it's not uncommon with our veterans on the disability
28:08
side, I see a very common scenario.
28:10
Veteran gets off of active duty and for a period of five or ten
28:14
years, they may not have any insurance.
28:16
So they don't go to the doctor, they don't have medical records.
28:20
And five or ten years later, they get insurance somewhere
28:23
that they're working, They start going to the doctor, they apply
28:26
for benefits and the VA denies it and says, well, there's no
28:31
records for a 10 year period after you got out.
28:34
This must be some new injury that developed.
28:37
Well, if there's no records, one way we can fill in that gap is
28:42
with some lace statements like you mentioned.
28:44
You know, what was the veteran during that period of time?
28:47
My back was still hurting, my knees were still hurting.
28:51
You know, I, I would soak in the tub, I would rub on icy hot.
28:55
I took Motrin. What did I do to take care of
28:59
the The condition didn't go go away.
29:02
The condition continued. And even the VA gets this wrong
29:06
a lot because I see Virginia ratings and medical decisions
29:11
all the time that say there is no continuity of treatment of
29:16
the veteran. The law and the rule is
29:18
continuity of the symptoms. Did the symptoms continue that
29:22
the veteran had? And if there are no records,
29:26
let's get statements together. You know, can can a spouse write
29:30
up how you were suffering? Can a spouse write a statement
29:34
that when you have those migraine headaches, you have to
29:37
go to a room and turn off the light and you can't function?
29:40
And that's been happening ever since Active.
29:43
Duty so. With news, lay statements and
29:46
almost every case that we do and, and whether it's at the
29:51
supplemental claim level or going to the Board of veterans
29:55
appeals because it, it brings the case to life and it, it
29:59
helps to fill in the gap. So we use those all the time.
30:03
And I would, I would highly recommend that veterans and
30:06
whether it's filing initial claims or appeals, consider if
30:10
statements can fill in the gaps for them.
30:13
That's huge. I think the other two I think I
30:17
had to fill in doctors 1 was an ortho Dr. up in South Lake and
30:24
you know, saw me for my back and because that didn't ever stop
30:28
hurting and had to get some, you know, back treatments there.
30:33
And then I had a chiropractor that was very veteran friendly
30:37
and he was like, I'll be happy to write a statement for you and
30:41
help form that Nexus that yes, this was more than likely than
30:45
not. So I, I did lots of research.
30:48
I love the Internet when I was putting all of this together
30:51
because I was able to get the Nexus letter that helped paint
30:55
that picture, fill in the gaps of what the VA didn't know.
30:59
But I think the part of it was, you know, when I got out, I saw,
31:04
I got out in 2000. I went and I went and started my
31:08
identity as, you know, as a veteran at the VA, but like I
31:13
kind of talked about it in my trailer.
31:17
I family kind of coaxes you into not going and get your veteran
31:22
benefits right. And there's that dress trust
31:26
that we had in the whole VA system.
31:29
It was like, no, you don't want to go to the VA if you're sick.
31:33
Well, I didn't know where to go then, you know, and how could I
31:37
afford paying for insurance? I didn't, I didn't have that
31:42
option and I got, you know, when I had full time job and had
31:48
insurance, I could go. But when I got laid off, I had
31:52
no insurance once again. So my primary care still is
31:57
still the VAI mean I have even though I have Blue Cross
32:02
federal, I'm a federal employee for the continuity of the care.
32:07
I have kept it with the VA and I've had some I've been very
32:11
fortunate with some great doctors that treat me.
32:17
So that's that's pretty important.
32:19
Do you have any words of advice on how how people can get those
32:27
medical records? I mean, that's I.
32:28
Think probably the hardest part, yeah, getting, getting the
32:30
records. Yeah, a number of different
32:33
ways, you know, and, and just a little bit on our own process,
32:37
but it's also I think process any veteran could should do.
32:41
We always start off by doing a request for the official
32:44
military personnel file. You can go online and get the SF
32:48
180 and do the request on there. Do a request for the VA claims
32:53
file. In theory, your ONPF official
32:57
military personnel file, the service treatment records,
33:00
should all be in your VA claims file.
33:04
They're not always there. And it amazes me every day
33:07
because we have a whole section in our firm that that's what
33:11
their focus is, is getting records, is comparing what's in
33:15
the claims file, what's in the OMPF, and sometimes they're in
33:18
one and not the other. So get the records requested.
33:23
Unfortunately, on the claims side, getting the full claims
33:28
file takes a little bit of time. There's a VA form for that.
33:32
These days, it's running about 3 months to six months to get a
33:37
copy under the FOIA and Privacy Act.
33:40
That takes a little while if the veteran is represented by an
33:45
accredited agent, an accredited attorney or veteran service
33:48
officer, and we can get access to what's called VBMS, which is
33:53
the VA electronic claim system. So we can see in real time and
33:59
we can download in real time in effect what they call the E
34:02
folder electronic folder, which is like the claims file.
34:06
So as we take a new case in, we're going to go through that
34:10
and look at everything in there and more importantly, what's not
34:13
in there. I, I, I kind of jokingly tell a
34:17
lot of veterans that sometimes it may not even be something
34:21
magical on the legal side we need to do, but it's leaving
34:25
that trail of bread crumbs for the VA to follow to get to the
34:29
right answer. The VA process is not supposed
34:32
to be an adversarial system and there are different duty to
34:37
assist requirements that are on the VA.
34:42
I don't leave it the chance for the VA to go get everything.
34:45
I want us to go get it and compare what's in there and if
34:49
something's missing then provide it to them.
34:53
And then that that's helpful. And you know, and that can be
34:56
not only statements, pictures that you've mentioned, we've
35:00
used quite a bit. Sometimes we find medical
35:03
journal articles that are right on point about how a condition
35:07
may be service connected and we upload some of those.
35:11
So there's a lot of different things going back.
35:14
The rules of evidence don't apply, so if it's new and if
35:17
it's relevant, get it. Submit it to help support your
35:21
claim or appeal. So let's let's jump into, if you
35:27
want, let's go ahead and jump into this whole thing about what
35:31
is a veteran accredited agency like yours, right?
35:36
What what is you know, we've seen some things in the news
35:40
with, you know, our some of our favorite veteran service
35:44
organizations. And then there's the whole
35:49
gambit of claim sharks. And I've, I've seen some of my
35:54
friends who, you know, got got taken to the cleaners when they,
36:00
I don't know, let's can you spell all of.
36:01
That out, Sure. Well, I think the best way to
36:04
explain it is to go back in history with a little bit of
36:07
history lesson of why and how we got here today with the
36:11
unaccredited representatives. Believe it or not, until the
36:16
early to mid 2005, 2008 time period, the maximum anybody
36:22
could charge if they were accredited to assist a veteran
36:26
with a claim was $10. That was it.
36:29
And so there there was a statute that said if anybody did help,
36:35
you know, file an initial claim and charge somebody, there was a
36:40
criminal penalty for that. So the whole accreditation
36:43
process came into the statute. Statute and veteran service
36:48
organizations are accredited. There is an accredited agent
36:52
process where individuals can go through.
36:56
It's a lengthy background check, really similar to doing a a
37:00
clearance in the military that they have to take an exam and
37:03
they can become accredited and then attorneys go through a
37:07
similar process, but we don't take an exam.
37:11
That's the difference if you're an attorney versus accredited
37:13
agent. And that accreditation is done
37:16
by the VA Office of General Counsel.
37:19
Part of the accreditation is we have to play by the rules that
37:23
the VA sets up. One of the primary rules in
37:26
there is that I mentioned is that no one can charge a veteran
37:32
for filing and assisting with an initial claim.
37:35
The bottom line for accredited representatives or attorneys is
37:39
the way that we get paid is that we usually come in on the appeal
37:43
side. And if we went on an appeal and
37:47
the VA will calculate retroactive benefits and
37:51
accredited agents or accredited attorneys can be paid a
37:55
reasonable fee. And the the VA generally says a
38:00
reasonable fee is something at or below 33% of retroactive
38:06
benefits for attorneys. If the the attorneys want our
38:12
credited agents want the VA to withhold their fee from the
38:16
retroactive benefits, we have to do it at 20%.
38:21
OK, as as a credit attorney, I don't want to be a collection
38:24
agency with a veteran. I would rather get a direct
38:26
deposit from the VA than chase down a fee.
38:29
So if an accredited agent or attorney wants to charge 33%,
38:33
they have to go collect from the veteran.
38:35
OK, now let's go back to what I what I talked about.
38:39
When the law was first around, it provided for criminal penalty
38:46
if somebody was paid for an initial claim.
38:51
As this was revised in 2005 to 8 for accredited attorneys and
38:57
accredited agents to be paid a reasonable fee, somewhere along
39:02
the process, the criminal penalties dropped out of that.
39:06
I'm not exactly sure why, but it did.
39:09
With the increase in the Internet, particularly 2015 to
39:14
2020, some of these unaccredited companies begin to come up on
39:19
the Internet. Most of them do not want to go
39:23
through the accreditation process.
39:25
Well, why? Most of them make the bulk of
39:28
their money, and I'm talking millions of dollars, make the
39:32
bulk of their money on what I kind of call the low hanging
39:36
fruit, which is the initial claims filing for individuals
39:41
and then charging a fee when those initial claims are
39:45
granted. I file initial claims all the
39:48
time for veterans. A lot of most accredited
39:52
attorneys and agents do. I can't get paid on.
39:56
I don't charge on an initial claim, it's only on the appeal.
40:01
So this gap where there's no criminal penalties kind of got
40:05
these folks going, OK, well, if we operate and there's nothing,
40:09
they're going to go after us, let's go do it.
40:12
And that's kind of where they've, they've driven the
40:15
train through that gap in the process.
40:19
And so the, you know, the issue becomes, well, then who's
40:23
watching these folks who go? I'm laughing because I'm like,
40:27
this is public administration. What a what?
40:31
If I if I do something wrong then or an accredited agent, but
40:36
if we're credit attorney, they can go to VA Office of General
40:40
Counsel and complain against me. They could contest my fee and VA
40:44
Office of General Counsel will consider that.
40:46
They could go against my bar if they think I did something
40:49
unethical. Who do you go after for these
40:52
unaccredited reps? Well, you the VA Office of
40:56
General Counsel has said they have no authority over them
41:00
because they're not accredited and so they can't go after them.
41:04
So there is a. Double edged sneaky.
41:07
Sword it is. It is so this.
41:10
Reminds me of like the whole loan shark thing when we're in
41:13
active duty and, you know, yeah, that was.
41:18
So, so that's kind of the whole claim sharks thing.
41:21
And I don't want to, I don't want to name any of them.
41:23
I've actually, along with, you know, I think most of the
41:26
members and national organization of Veterans
41:28
Advocates, you know, we all got an e-mail cease and desist
41:32
letter from one of them at one point in time telling us to stop
41:36
calling them claim sharks. So, you know, I, I, I try to
41:41
avoid naming particular ones, but they're out there.
41:45
And the main thing I tell veterans is ask if the if the
41:49
organization they're going to is accredited, Are they accredited
41:53
VSO, are they accredited agent? Are they accredited attorney?
41:57
If they're not accredited, it's buyer beware.
42:00
I mean, who is going to go? I think that from what I can
42:05
see, the outsider looking in, I mean, I, I'm an insider, but I'm
42:09
also an outsider because I have my academic hat in public
42:13
administration that I can put on.
42:16
You have, you have risk of giving your records to somebody
42:21
and you don't know what they're going to do with them.
42:24
Well, I'll take, I'll take it a step further.
42:27
I told you as an accredited attorney, I get access to VBMSI
42:31
can look at the claims from accredited unaccredited
42:35
organizations. Can't do that.
42:38
This is even scarier. What do they do with the
42:40
veteran? They tell them give us your
42:43
login to va.gov and your password.
42:48
Yeah, they could. They could.
42:49
They could change the direct deposit for your monthly payment
42:54
and everything. If you're getting a disability,
42:58
you know, right now, wow, that's scary.
43:01
But if you're giving them paper records even, or sending them
43:05
electronically, that's all your PII that they're getting access
43:10
to and whatever your personal health issues are.
43:15
And, and then see on top of it, you know, anything that I
43:18
submit, it's got my name, it's got my VA accreditation number
43:22
coming with the 8th power of attorney on it.
43:24
When these unaccredited organizations file stuff, their
43:28
name and contact information doesn't appear anywhere.
43:32
It's as if the veteran did, but they're doing it a lot of them
43:35
on the veterans behalf, but their information appears
43:39
nowhere. They simply have a contract with
43:42
the veteran and I would argue it's probably an illegal
43:45
contract because I think it's in violation of the statute.
43:49
The best I would think that the VA could track these nefarious
43:53
individuals. Yeah, I'm going to use that
43:55
word. Nefarious is IP address.
43:59
If it's not, you know, if it's not the veteran's IP address,
44:02
but you don't know, you know, veterans could log in at the
44:05
library and it not be their IP address, right?
44:08
Man, scary stuff. But I.
44:11
Also think, isn't there also this risk that they would put in
44:19
a purposefully bad claim and and then appeal it afterwards in
44:28
order to get money? Most of them don't really want
44:32
to do appeals, they want to do the initial.
44:35
But to go to your point, let me kind of explain how a lot of
44:37
them are set up. I won't say all, but a lot of
44:41
these have both a claims consulting side, which is like
44:46
they what they hold themselves out and they have a medical
44:49
side. On the medical side, they sell
44:52
Nexus letters. What you know, in my world, it's
44:56
an expert medical opinion, but it's a Nexus letter and they're
44:59
making money on both sides. So as they're helping on the
45:02
claim, they say what you really need is a Nexus letter.
45:06
By the way, we have the sister company that you can get it
45:09
through. One of the things the VA is
45:12
started looking at is doesn't take that much effort in today's
45:17
world to figure out where some of these Nexus letters are
45:20
coming from and who's signing them.
45:22
The downside is going to be some of the veterans are going to pay
45:26
the price on this because computer programs probably with
45:29
the VA and AI these days can go figure out who got granted to a
45:34
certain level based on a Nexus opinion that may not really be
45:39
accurate or truthful by tracking who the provider was.
45:44
And my concern is some of these veterans are going to get caught
45:49
in the dragnet, that there's going to be some stuff that's
45:52
set in there that wasn't true. And I fear that some of them are
45:55
going to pay the price. That is scary to think.
45:58
I mean, I've heard about that, but that was just some trend
46:03
analysis of which doctors, which areas.
46:08
And you know, if we, if you put, I mean, data is data, you could
46:12
mine that data. Hey, Doctor John Doe, Doctor
46:16
Jane Doe from I'm, I'm, you know, I live up in North Texas,
46:21
but you have these same doctors and they've submitted, you know,
46:24
they've given Nexus letters for 500 patients up there.
46:31
It kind of makes you wonder, huh?
46:33
Yeah, now it's it's scary and, and, and I think the technology
46:38
is going to catch and some of them are going to be
46:40
unfortunate. I mean, one of the VA training
46:43
products I saw basically said question if a medical opinion or
46:49
disability benefits questionnaire was issued by a
46:53
physician more than 100 miles from the veteran.
46:57
Maybe if that was somebody across the country.
47:00
Well, you know, I have some individuals that are that are
47:05
professors at teaching hospitals that are very well credited that
47:09
do a complete review of records and give a medical thing in the
47:13
right way. Are they going to look at
47:15
they're located somewhere 100 miles more so so there's been.
47:21
A full second opinion that says, hey, I'm struggling.
47:25
I I'm not getting the answers over here.
47:28
I know there's something wrong with me.
47:32
Or maybe something happened and they go visit mom in
47:35
Pennsylvania and you know, something happens.
47:39
Yeah, wow. Yeah.
47:41
So that's how you know the term claim shark, and there's
47:45
activity on the legislative side.
47:47
Now, the problem is in Congress, there's competing bills there.
47:52
Historically, there's been what's called the Guard Act,
47:55
which is to put some regulations and criminal penalties back into
47:59
this, the claim charts, believe it or not, and you won't be
48:05
surprised. They have their own lobbying
48:07
effort going on, which they have a lot of money and they have
48:11
some individuals on their side with their legislation.
48:14
So, you know, I've gone two or three Times Now over the last
48:17
five years to do lobbying in Congress as part of National
48:22
Organization of Veterans Advocates for the Guard Act or
48:26
similar provisions. Because it's stalled on the
48:29
national level. These unaccredited organizations
48:33
have started to try to get legislation passed on the state
48:37
levels to get it approved. And obviously we have issues
48:41
there because this is a federal law.
48:43
Why should the states be involved in saying that
48:47
unaccredited agents can go act comply with the federal statute?
48:50
So you know, it for for listeners, I would say stay
48:54
tuned. You know, there's legislation,
48:57
you know, pending on, on different levels and hopefully
49:01
we'll get something that's favorable coming about.
49:04
So is so that's where you see things headed that that there
49:10
are some things in the works and is it, is it really just going
49:14
to be a matter of time, politics, money, all of the
49:18
above? Well, it first of all, is there
49:21
much getting done in Washington period right now?
49:23
That's one issue. And you have these two competing
49:26
groups. So I hold out hope that there
49:30
will be. And I just don't know after the
49:34
sausage is made what it's gonna end up looking like.
49:38
But hopefully there'll be some legislation.
49:42
A few of these companies have been sued in class action
49:46
lawsuits by and and some of them have filed bankruptcy to try to
49:52
get around the class action. How that goes?
49:56
I think some of them are ghosting the veterans, right?
49:59
I mean, I know a lady that she was just flat out ghosted once.
50:05
The whole process was, you know, the appeal process was pending.
50:09
She got ghosted at, you know, I don't even know what the status
50:12
was of her claim. So the sorry I have a guest
50:20
show. I tried texting him and let him
50:24
know hey come in the side doors. My guest for my Co host for the
50:28
other show We're recording here shortly.
50:33
I'm trying to texting. But anyways, what is something
50:36
that I could have asked, should have asked but didn't?
50:40
Do you have anything out there? Well, you know, one of the
50:44
things I think I would like to throw out, I've I teach a lot of
50:48
classes and a lot of continuing education for veterans law.
50:52
And periodically I get asked what's the most memorable client
50:59
or case that you've had? And there's no doubt there's one
51:03
that stands out in my mind. And I think it kind of goes to
51:08
the purpose of of your show. I represented a veteran that was
51:12
at 70% for PTSD. He was in a wheelchair.
51:18
He had lost part of a leg that was amputated and continue to
51:21
have medical problems with it. He had been represented by
51:24
somebody else. He wanted to get to 100% for his
51:27
PTSD. He was at 7.
51:29
It had been on appeal for several years when I took it and
51:33
then I continued it. We went to the Board of Veterans
51:36
Appeals. We did an in person hearing with
51:40
the veteran law judge and try to get him to 100.
51:44
And when you do your hearing, like most things, there's a
51:48
period of time where you're waiting for a rating decision.
51:52
So we were waiting and waiting for the rating decision.
51:56
While we're waiting, I got a phone call from his wife that
52:00
the veteran passed away. This happens sometimes.
52:04
Fortunately, there is a VA process where a surviving spouse
52:09
can be substituted into the claim to continue it.
52:13
And we did that. We got it in the right way.
52:16
So we got that done, and we're waiting for the decision to come
52:20
back. As we're waiting, I mean, and
52:24
months and months have passed by and I hadn't heard anything.
52:27
And this is almost 10 years ago. It was before we regularly had
52:32
electronic access to VA claims files.
52:35
So I had to depend on the mail to deliver the news.
52:39
I happened to come in on a Saturday afternoon and I picked
52:42
up my mail and the rating decision was there from the
52:46
Board of Veterans Appeals and the rating decision granted 100%
52:51
going back for a number of years, which was going to result
52:55
in hundreds of thousands of dollars in retroactive benefits.
53:00
So being Saturday afternoon, I went ahead and picked up the
53:02
phone and I and I called the surviving spouse to give her the
53:06
news. And, and in my business, there's
53:09
nothing better than calling somebody to tell them not only
53:13
you've won, but you're going to be at 100% and this is
53:16
potentially what you may receive.
53:19
So I told her that. And when you tell people that
53:22
there can be yelling, there can be excitement, there can be
53:25
crying, sometimes a little bit of silence.
53:28
So I told her and there was silence for a long period of
53:33
time on the other end of the phone.
53:35
And she said, I'm glad you called me.
53:39
I decided tonight I was going to end my life because the only
53:44
income we had was my husband's VA disability and his Social
53:48
Security and my little bit of Social Security.
53:51
I couldn't go on anymore. And that's what saved her.
53:57
That's what saved him that she went from within hours ending at
54:03
all that. Then knowing she was going to be
54:05
taken care of, she was going to have the VA benefits each month
54:10
and have a nest egg that she could depend on.
54:14
So when people ask me what case sticks out the most?
54:20
Why do you do what you do? Yeah.
54:23
Yeah. What a blessing, man.
54:26
You know, I know that when I got my disability because I, yeah,
54:33
it was like, you know, reading that paper, you know, there was
54:37
a certain validation, you know, that the injuries that I had
54:43
sustained were not, not imagined legendary.
54:47
I mean, you know, there's physical pain.
54:49
And you know, I built the show based upon 4 pillars of
54:53
physical, mental, emotional and spiritual pain.
54:56
When you get that kind of validation, it hits on all four
55:02
that you know, thank you, God, you know it because you're the
55:09
first thing that you're feeling is the physical pain, but it
55:12
starts affecting affecting the mental and the emotional and the
55:17
toll. And then it's your spiritual
55:19
because this lady, you know, you are such a blessing.
55:23
Rick, man, that's that's huge. So people need to know why.
55:30
Why are there good attorneys out there like Rick and how far do
55:37
you help people? Is it only in the state of
55:40
Texas? No, it's across the country.
55:43
We primarily do appeals that we call the agency level, the
55:47
regional office level and up to the Board of Veterans appeals.
55:51
I used to take cases all the way up to the Court of Appeals of
55:54
Veterans Claims, but we just got so busy.
55:57
So if we get to the point that we need to go to that level,
56:00
usually I engage with another attorney and we've probably got
56:03
a handful of cases at the Court of Appeals of Veterans Claims,
56:06
but VA practice is nationwide. I have clients across the world
56:13
in Germany and the Philippines, etcetera.
56:16
So it's a little bit different from the regular practice of law
56:19
and that you can represent anybody everywhere and, and a
56:23
lot of it can be done virtually. I mean, we, we have a physical
56:26
office because I like the interaction with my staff
56:29
because we can talk about cases, but no matter where the veteran
56:32
is, we can get the documents to them that need to be done, do it
56:36
virtually with them. I have a name for you.
56:39
I met this lady way back. Gosh, close to close to 10
56:45
years. Do you know Brene Brooks?
56:48
I think Brene Brooks. I don't think.
56:50
Is her name so she has she started her own practice.
56:55
I need to have her on. She used to work for the VA
57:00
Court of Appeals and she started her own practice.
57:05
So if you need a name, if you ever need a resource, let me
57:08
know. She's very sharp and she'll post
57:12
occasionally. Help somebody else, help
57:14
somebody else, you know? Wow, so incredible.
57:20
I thank you for the work that you do.
57:23
You know, I think that's the beauty and that, you know, as a
57:28
Jag attorney, you, you know, I think the career field that we
57:33
had in the military taught us some things.
57:36
Let us develop that after the military.
57:40
Mine has been on the public administration side.
57:42
So I may not be attorney, but it's all about that process out
57:47
of things. And you got to follow the
57:48
processes are there because otherwise if you're not crossing
57:52
those checking those check box to say we did that, we did that
57:57
in the process, then that's going to stump you through
58:02
everything. Well, thank you for joining us
58:06
you. Know.
58:08
This is going to air on Saturday so you are joy if if you ever
58:14
want to come back on because something new is changing in the
58:18
claims world. Upside you got an open door.
58:21
Feel free to reach back out and thank you for all you do.
58:26
Thanks. Stay on after the show and I'll
58:29
connect connect with you about something else.
58:31
So all right, folks, thank you so much for joining us today on
58:38
From Paint to Purpose radio show with military broadcast radio
58:42
letting our veterans voices be heard.
58:45
You know, the gamut of the things that we do in the veteran
58:50
arena is, is you know, we're here to help each other, right?
58:54
We are here to help support each other and wherever we're going
58:59
and the things that affect us. And don't ever let somebody
59:05
dissuade you from filing your claim because it's really
59:09
important to make sure that you take care of you.
59:12
And that's one of the best ways to help yourself.
59:17
That is one of the things that I think has been a big part of my
59:21
success journey is following my claim and taking care of me and
59:25
my family. So y'all have a great week and
59:27
I'll see you next week. Thank you.
59:30
Bye. Hi, I'm Beaker with Military
59:33
Broadcast Radio TV. We're your virtual MWR bringing
59:38
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59:43
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59:45
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