Documenting Your VA Claim Best Practices

Have a diagnosis from a doctor before applying for a claim, depending on what your VA claim is for the diagnosis may have to be from a VA doctor, such is the case with PTSD.

Request a copy of your military service medical records.
If you have had a previous VA claim, request a copy of your VA claims folder.

Documenting Your VA Claim Examining your military service medical records:

 This my system, but you may have a better one so use it. VA now sends out C-Files on CD’s so you can print out your pages.
  • The first thing I do after receiving a service medical record is number each page when I get to the end I go back and add 1 of # and so on.
  • Second I then make a copy of my service medical records on a different color paper, yellow or buff something easy to read, but it will distinguish it from the original.
  • I then put my original away and work off the copy.
  • Now if you know the specific date it’s fairly easy to find.
  • If on the other hand you don’t know specifically or you had symptoms leading up to it. Well, this may take some detective work and so Watson the game is afoot.
  • Let’s say it’s Irritable Bowel Syndrome (your diagnosis)
    • I would start page by page from page 1, if the first thing I run across an entry that supports my claim for IBS is on page 10, I number it #1, I Bracket it in Red, and then on a separate piece of paper, I start to compile my medical evidence index. So I would write Page 10 #1 and a brief summary of the evidence, do this as you go through all your medical records and when you are finished you will have an index and easy way to find your evidence. Study your diagnosis symptoms look them up. Check common medications for your IBS (your diagnosis) and look for the symptoms noted in your evidence that seem to point to IBS (your diagnosis), if your doctor prescribes meds for IBS (your diagnosis), but doesn’t call it that makes those a reference also.
  • I retype the index adding the exact quote from the reference for example Page 10 Item #1 “Dr prescribes Bentyl after complaints that seem to be IBS.” For our claim, this tells us the following: Bentyl is a common drug for IBS and though the Dr doesn’t specifically diagnose IBS he is treating you as if you had IBS. This typed index not only gives the rater an easy to read summary of your supportive fact it tells them exactly where to find that information.

Questions

Are you eligible?
     38 CFR 3.1(D) Veteran means a person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable. There’s more so make sure to read the regulations.
Can you link the aggravation to the illness/injury in the military service?
Information may be in your:
  • Military Service Medical Records
  • Hospital Records (Generally not included in Military Service Medical Records and may require on FOIA directly to that hospital.)
  • Performance Reports
  • After Action Reports
  • Journals
  • Letters Home
  • Conversations with buddies
  • Incident Reports you were involved in or witnessed