Informal Claims - Please read if you plan to apply

Discussion in 'General Discussion' started by Max, Mar 29, 2010.

  1. Max

    Max Hero Member

    Hello everyone,

    Here is a neat little VA policy of which you may be unaware:

    If you are considering applying for benefits within the next year, but are either not ready or are unsure of how the finances will play out after going into a nursing home/assisted living facility, it is best to submit an informal claim. An informal claim is any correspondence VA receives that requests benefits. For example, if you would like to apply for pension benefits, submit a signed statement that says something to the effect of "I would like to apply for pension benefits."

    Why would you want to do this?

    Say you submit an informal claim on March 29, 2010 and then submit an application on August 12, 2010. If VA can approve your claim for benefits, they will be able to grant the benefit retroactively to March 29, 2010.

    What's the time limit for this?

    One year from the date VA acknowledges your informal claim. For example, if you submit an informal claim on March 29, 2010, VA might review it on April 25, 2010 and send you a letter requesting an application. As long as you return the application to VA by April 25, 2011, VA will be able to grant the benefit back to March 29, 2010.
  2. vetadmin

    vetadmin Administrator Staff Member

  3. jpez

    jpez Full Member

    Here is a neat little VA policy of which you may be unaware

    Yes, Vetadmin had made us aware of this in the past.
    BUt why wouldn't the VSOs be aware of this "neat little VA policy". Or why isn't that clearly stated on the Pension site?

    We certainly appreciate your candor in sharing, but I am wondering what efforts are made to inform the Vets who don't come to this site.

    And I have to say that this flys in the face of benefit award letters that are not approved back to the date of the initial application but seem to be based on the 'DATE OF EXAMINATION' on form 21-2680.

    The secret really seems to be that the doctor state on that form that the condition or diognosis that created HOMEBOUND or A&A occured at some point in the past (what ever that point actually is). If the doctor just says the condition without a prior date, it seems that the person reviewing the case uses the date of exam as the date of the award.

    Even when financial costs are provided that do back to the date of the app.
  4. Max

    Max Hero Member

    Pretty much all of this can be answered by funding and law. The law stipulates the period for when VA can pay benefits. Technically, informal claims are classified as claims by the 38CFR so this allows VA to go back further. I'm assuming that the reason congress did not write the law so that VA could pay benefits based on the date that the physician performed an exam is because at that time, VA may not have had any claim received.

    Typically most VSO's are aware of this policy as the Texas Veterans Commission and American Legion will actually submit an informal the first time they talk to a vet about applying for benefits. That being said, many people do not go through their CVSO's so I thought it would be worth mentioning here, specifically to explain the time limits and to put it on the current front page of the forum.

    As far as outreach goes, we do make this policy known during outreach events, but with only 1 VA employee (including VAMC doctors and nurses) to every 100 veterans, VA simply doesn't have the resources to knock on every vet's door to explain all of the benefits available. At least the stimulus has gotten all of the VA offices some manpower to try to catch up on claims :)
  5. gt57

    gt57 Newbie

    I filed an informal claim almost two weeks ago (certified mail went out 8/26/10 and received the confirmation back with date stamp 8/31/10). It looks like I may have my formal claim ready to be filed in a few more weeks. I am assuming I will need to add the VA File Number to all the forms. How will I know when a VA File Number has been assigned?
  6. vetadmin

    vetadmin Administrator Staff Member

    You should get a letter of acknowledgement from the VA confirming that your informal claim has been received and informing you of the timeframe you have to provide additional information to complete the claim. That letter should have a claim number attached to it.
  7. gt57

    gt57 Newbie

    To recap:

    8/26/10 - filed informal claim via certified mail.

    8/30/10 - received certified mail reply for 8/26/10 mailing.

    9/24/10 - called VA to see if they assigned a file number. The VA rep did not understand what an "Informal Claim" was and advised me to file my claim as soon as possible.

    9/25/10 - filed all my paper work sans the file number via certified mail. Used the 3-ring binder with tabs format discussed in this forum.

    9/29/10 - received letter from VA defining the multiple conditions that constitute an informal claim. The letter had the assigned file number and included a blank form 21-534*.

    9/29/10 - received certified mail reply for 9/25/10 mailing.

    9/30/10 - received letter from VA stating they have received my application and to sit back and wait.

    I was very surprised to have received the 9/30/10 letter just days after sending in my application and that even though I filed an informal claim and then a formal claim without the file number, they were able to put the two together. I am hoping the informal claim date will be the start of eligibility.

    *The 21-534 I received back was printed two sides and two-hole punched at the top. The back side printing was upside down such that if the form was put into a two-ring folder, the back side could be read when flipped over. Based on this, those contemplating the 3-ring binder might want to consider a 2-ring folder with holes punched in the top instead.

Share This Page