The Rating Board & Their Decision
The Rating Board
There are usually three members to a Rating Board. Two individuals are Rating Board Officers and one is a Medical Doctor. They do not meet as a team, such as in one room together to decide your Claim.
Your file is reviewed by one member at a time. First your file will be reviewed by one of the two Rating Officers. He or she will make a determination and recommendation about your Claim. Your file, along with the first Rating Officers’ recommendation is then given to the second Rating Officer. This person reviews your file and the recommendation of the first Rating Officer. The second Rating Officer to review your Claim will either agree or disagree with the recommendation of the first Rating Officer. Your file is then given to the Doctor. He or she will review your file, especially the medical evidence. The doctor will either agree or disagree with the findings of the first to Rating Officers.
If all three persons on the Rating Board are in agreement about their findings then a decision has been reached. If they do not all agree, they will have a reason for not agreeing. If they do not agree, they may compromise on a decision or they may request more information from you. They may send you Form 13075, “Questionnaire About Military Service” (found in Chapter 21 “Forms Completed”). Complete the Form, make a copy of it and the letter which accompanied the Form. Return the completed Form and Letter, Certified Mail Return Receipt Requested.
There is always the possibility they may send you a letter stating they need more evidence or information. They will be specific about what evidence or information they need. Sometimes they are simply trying to put you off and discourage you. If you have put together the information which is outlined in this booklet, they should not need any further evidence to process your Claim.
Should you receive a letter stating they need more information and you feel you have already provided them with sufficient information you do not have to comply with their request. You must, however, write the Adjudication Officer a letter (in third person). State you have supplied him with sufficient information as outlined in Title 38 of the Code of Federal Regulations and at this time you have no new evidence to present. Tell them to proceed with their decision based on the information you have already submitted.
At any time during the process you can telephone the Regional Office which is handling your Claim. Most Regional Offices have a Toll Free Number. You can find the telephone numbers for VA Regional Offices at www.va.gov . When you telephone a Regional Office have your Claim Number at hand. Tell the Operator that you are calling to inquire as to the status of your Claim. Most of the time the VA Operators are not vary sympathetic, so they won’t volunteer any information. They tend to answer your questions as direct as possible.
Do not be afraid to ask the Operator any questions you may have about your Claim. If you don’t understand their answers, tell them and ask them to help you by explaining their answer again. Sometimes these Operations can get a little put out if a Veteran persists with a question. But, remember, those Operations work for you! They would not have a job if it were not for people filing Claims. If the Operator irritates you to the point where you want to reach through the phone an smack them just say good-bye and hang up. Call again a few minutes later. Usually there is more than one Operator working the telephones.
The Rating Board Decision Within 12 weeks the Rating Board should reach their decision. You will most often be unofficially notified by a Service Representative (DAV, PVA, etc) before the official notification from the VA arrives. The Service Representative usually will write you a letter informing you of the decision the Rating Board has reached, especially if it is a favorable decision. Within a week or so after the Service representatives notification you should receive the official notification from the VA. You will receive an Award Letter as well as the Rating Decision. Copies of these type of letters can be found in this Chapter.
The first letters is a computer printed letter which tells you how much money you will be receiving each month (MONTHLY RATE), the EFFECTIVE DATE, as well as the disability (CONDITION) and the PERCENTAGE of disability you are Rated at. A copy of this letter is hand labeled “Example of Rating Board Decision”.
The second letter is a copy of the actual Rating Decision. It will explain the Issue, Evidence, Decision and Reason & Basis for the decision. This letter is on VA Form 21-6796. An example of this type of letter is hand labeled “Example of Details from Rating Board Decision”.
You will also receive a VA Form 21-8764 (Compensation Award Attachment Important Information). This is a Form Information Letter which informs you about VA Benefits. We like the first part of this Form Letter.... “VA Check Delivery”. Remember the back pay we told you about and why it was important to file your Claim as soon as possible? You will note this sentence says, “the back pay check will be in your hands within fifteen days”!” You will find a copy of this Form in this Chapter.
As you review the example letters notice the Award Date of 04-01-92 and note the date the Rating Board made their final decision.... September 22, 1993. The Claim was filed on April 1st of 1992 and the final decision was made on September 22nd 1993. They ended up paying this Veteran 18 months back pay, pus he began to receive his full 100% disability check on November 01, 1993.
This is the kind of Rating Decision we would like every Veteran who believes he is 100% disabled from PTSD to receive. If you follow this booklet, put together the evidence needed, you too will receive your award letter for disability for Post Traumatic Stress Disorder.