VA Appeals Update 38: Choice, Control, Clarity: Appeals Modernization

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VA Appeals

Update 38: Choice, Control, Clarity: Appeals Modernization

The Appeals Modernization Act (AMA) of 2017 gave Veterans a greater choice in how to disagree with a VA claim decision. Giving Veterans more choice has been a top priority for VA. Cheryl Mason, the Chairman of the Board of Veterans’ Appeals, joined Ashleigh Barry on a special edition of VA News to take a deeper look at the modernized appeals process, discuss some early positive signs from the implementation of AMA, and to announce that Veterans can expect to see telehealth technology incorporated into the appeals process in 2020. “The Appeals Modernization system was designed to give Vets primarily three things: choice, control and clarity of their claim’s appeals process. And so that choice means they have options, they’re no longer stuck in a situation,” said Mason. Under AMA, Veterans can choose from one of three lanes to have their decision reviewed:

  1. Supplemental claim;
  2. Higher-level review; or
  3. Appeal to the Board of Veterans’ Appeals.

If a Veteran chooses to appeal to the Board, he/she can choose from one of three dockets:

  1. Direct review;
  2. Evidence submission; or
  3. Hearing request.

Which lane should Veterans choose? “We always advise Veterans to work with their representative…,” Mason said. “While we have made it easier, it’s still a little confusing to Veterans because it is different. Veterans representatives can really advise them on what they need to do.”

Nationwide availability of virtual hearing technology is on the horizon, too. Mason discussed how virtual hearings provide Veterans with increased access and improved customer service. “Much like you see with the telehealth process right now, where you see Veterans use their phones, their computers, their iPad to talk to a doctor, you’ll be able to talk to a judge–and that’s actually happening right now,” said Mason. The Board started testing virtual hearings in July. Its positive results showcase its need for 2020 and beyond. “You won’t have to travel 4-6 hours across the state to come to a hearing, or, if you’re not in a situation where it’s healthy for you to travel you don’t have to do that, you can do it at home,” Mason added.

Virtual hearings may also have an impact on the Veteran’s well-being, as it may take away some of the stress Veterans face when going through the appeals process. “It’s something that is very important to me personally. I’m very engaged in the mental wellness and suicide prevention process with PREVENTS… if [a virtual hearing] means making the hearing process comfortable for them, that’s what we want to do,” Mason added. For more information about the Board and its progress on appeals modernization:

FactSheet.pdf

VA News, and other engaging content, is available on televisions at select VA medical centers across the country and via simulcast on the Veterans News Network at https://www.youtube.com/watch?v=yA3X-ZxMTfg. [Source: Vantage Point | Ron Haskell | January 27, 2020 ++]

VA Appeals

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VA Appeals

Update 37: Progress on Resolution of Legacy Appeals

The U.S. Department of Veterans Affairs’ Veterans Benefits Administration (VBA) Appeals Management Office (AMO) significantly reduced disability compensation legacy appeals inventory during the last nine months as part of the department’s long-term legacy resolution plan. This inventory includes Notices of Disagreement (NOD) and substantive appeals filed in the “legacy” system – the appeals process in place prior to implementation of the Veterans Appeals Improvement and Modernization Act of 2017 (AMA). VBA lowered this inventory from a high of 292,452 in March 2016, to 96,350 on Dec. 31, 2019, despite receiving 770,571 new NOD and substantive appeals during that period.

“Veterans who have been waiting for their decisions can trust that VA is working towards getting them the benefits and services they deserve,” said VA Secretary Robert Wilkie. “Completing legacy Notices of Disagreement and substantive appeals will be an important step in meeting this obligation.” VBA is on track to eliminate its NOD and substantive appeals inventory by July 4. Information on the VA appeals process can be found at

https://benefits.va.gov/benefits/appeals.asp. [Source: VA News Release | January 21, 2020 ++]

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The Department of Veteran Affairs (VA) has implemented a pre-need eligibility program so that veterans, spouses and unmarried dependent adult children may better prepare for burial in a VA National Cemetery prior to the time of need. Interested individuals may submit VA Form 40-10007, Application for Pre-Need Determination of Eligibility for Burial in a VA national cemetery. The program details and the VA Form 40-10007 can be obtained here.  VA will review pre-need burial applications and provide written notice of a determination of eligibility. VA will store the pre-need application, supporting documentation, and the decision letter to expedite burial arrangements at the time of need.

https://www.usmcvta.org/wp-content/uploads/2021/03/va40-10007.pdf

VA Loan Refinancing Update 04:

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VA Loan Refinancing Update 04:

CARES Act Forbearance Effect on Eligibility In Loan Guaranty Circular 26-20-25, dated June 30, 2020, the U.S. Department of Veterans Affairs (VA) addresses the effect of a CARES Act forbearance, or some other COVID-19 credit relief, on the eligibility of a veteran for a VA purchase money or refinance loan. The guidance is effective immediately and applies to any loan closed on or after the date of the Circular, and will remain in place until further notice or when the Circular is rescinded. The VA advises that while lenders should continue to follow all applicable authorities regarding VA loans, the “VA is temporarily waiving certain regulatory and policy requirements in an effort to help Veterans and the private sector close essential housing loans.”

Purchase Money and Cash-Out Refinance Loans

The VA states that while lenders must continue to follow VA underwriting standards generally, “lenders should not use a CARES Act forbearance as a reason to deny a Veteran a VA-guaranteed loan.” However, when a Veteran has obtained a CARES Act forbearance, the Veteran, through the lender, must provide reasons for the loan deficiency and information to establish that the cause of the delinquency has been corrected. The VA will not consider a Veteran an unsatisfactory credit risk “based solely upon the fact that the Veteran received some type of credit forbearance or experienced some type of deferred payment during the COVID-19 national emergency.” The VA advises that while deferred payments may not be considered for credit risk purposes, the lender should consider the monthly obligation if the debt will remain active after the closing of the new VA loan.

Interest Rate Reduction Refinance Loan (IRRRL)

Although IRRRLs generally are not subject to standard VA underwriting requirements, if the loan being refinanced is more than 30 days past due, the Veteran must meet VA underwriting standards and the VA must provide prior approval for the IRRRL. The VA announces in the Circular that it will not require prior approval regardless of the delinquency status of the current loan if:

  • The VA has already approved the lender to close loans on an automatic basis;
  • The borrower has invoked a CARES Act forbearance relating to the loan being refinanced;
  • The borrower has provided information to establish that the borrower is no longer experiencing a financial hardship caused by COVID-19; and
  • The borrower qualifies for the IRRRL under specified VA credit standards (the standards set forth in 38 C.F.R. § 36.4340(c) through (j)).

When a borrower seeking an IRRRL has obtained a CARES Act forbearance on the loan being refinanced, for purposes of the maximum loan amount, the IRRRL may include the following:

  • Any past due installment payments, including those a borrower deferred under a CARES Act forbearance;
  • Allowable late charges, consistent with the note, the CARES Act, and all other applicable laws;
  • The cost of any energy efficiency improvements;
  • Allowable closing costs and discount points; and
  • The VA funding fee. With regard to the seasoning requirement for the current loan that applies when a Veteran is seeking an IRRRL, any periods of forbearance do not count toward the required seasoning. However, the mere fact that the current loan was subject to a CARES Act forbearance does not cause the loan to fail to meet the seasoning requirement. Pursuant to the Circular, a loan being refinanced is seasoned if both of the following conditions are met as of the date the borrower closes the refinance loan: 18 · The borrower has made at least six consecutive monthly payments on the loan being refinanced. For example, in a case where a borrower made five consecutive payments before invoking a CARES Act forbearance, such borrower would need to make six additional consecutive payments, post forbearance, in order to meet the seasoning requirement; and
  • The date of closing for the refinance loan is 210 or more days after the first payment due date of the loan being refinanced.

With regard to the consideration of a Veteran for an IRRRL and the imposition of fees on the Veteran, the VA makes the following statement: “VA encourages lenders to carefully consider whether an IRRRL is in the best financial interest of a Veteran. VA strongly supports and encourages the fee waivers that many lenders have adopted, including the waiver of origination fees, discount points, and premium pricing offsets, for Veterans affected by COVID-19.” [Source: JD Supra | Ballard Spah | July 4, 2020 ++]

Exercise Five Stretches to Do Everyday

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Exercise Five Stretches to Do Everyday

Every morning as you get out of bed or get off your desk in the evening, you know when you need a stretch. Now think of what this simple stretch does to your body. How it can loosen up your muscles, and you end up relieving the muscle stiffness in your neck and back that you experienced all day. Well, this is precisely what stretching can do to your body. It loosens up muscles, relieves tension, and improves joint mobility. These benefits are backed by research that also indicates that regular stretching can improve blood circulation. As a result, your muscles get more oxygen and nutrients to strengthen your muscles, improve body balance, and relieve stress.

On the other hand, if stretching is not a part of your daily routine, you are more prone to experiencing reduced joint mobility, affecting your body balance and risk of falls and injury as you age. So set up your morning alarm a few minutes earlier or skip the last part of your favorite late-night TV show and incorporate five easy and beneficial stretches in your daily routine. Performing these five stretches might only take a few minutes of your time during the day, but the results you get are bound to improve your overall health in the long run.

Toe Touch

Toe touch is an excellent stretch to get started. This simple stretch brings numerous benefits to your entire body, including arms, shoulders, back, and legs. All you have to do is to sit on the floor or stand upright. Then bend and reach out for your toes. Now hold the stretch for 10 seconds and return to your original position. Repeat this stretch a few times to loosen up your arm and leg muscles.

Downward Dog

This all-time favorite yoga pose is popular for good reasons. This stretch involves a wide range of muscles, including the back, hamstrings, arms, neck, and shoulders. It is an excellent stretch to improve blood circulation and get you started for the day. Even if you are not an expert yogi, you can do this simple stretch at home. Start with a plank position. Now push your legs forward and hips upwards to form a triangle. With your head between your arms, you will feel the blood flowing towards your upper body. Make sure your heels are tucked to the floor. Feel the stretch for good 10 seconds, move back to plank, and repeat downward dog stretch a few times.

Cat and Cow

Do you wake up with a stiff back? Then this stretch is for you. It boosts blood circulation, strengthens your back muscles, and enhances mobility. Get into the tabletop position (on your hands and knees) on an exercise mat. Your wrists should be in line with the shoulders and knees aligned with the hips. Now tuck in the pelvis, look down to the floor, and round your back. You should get an upward bend in your spine. Next, bend your spine inwards as you exhale. Look up with a full stretch in your neck. Repeat this pose a few times, and continue to inhale and exhale as you transition between cat and cow.

Spinal Twist

Want to strengthen the core and improve spine flexibility? Add a spinal twist to your daily stretching routine. Start by lying flat on your exercise mat and bend your knees such that the feet are flat on the floor. Then, with the upper body still, twist your left knee to the other side of the body in a way that you feel a stretch in your lower back. Hold the position and count till 10. Now repeat the position with your right knee. Complete 5-10 sets of spinal twists to get moving after a long night’s sleep.

Side Oblique Stretch

With this standing side oblique stretch, you get your hips and waist muscles working. Start by standing with feet shoulder-distance apart. Start by lifting your right arm overhead and your palm facing inward. Feel the stretch on your arm and side and bend towards the left side. Hold and count till 10, then switch sides.

[Source: https://aginghealthytoday.com | January 3, 2021 ++]

Prostate Cancer Update 18: Know Your Risk

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Prostate Cancer Update 18: Know Your Risk

Prostate cancer is the most common type of non-skin cancer in the United States. One out of every nine men will get prostate cancer in their lifetime. Unfortunately, there usually aren’t any early warning signs for prostate cancer. The growing tumor does not push against anything to cause pain, so for many years the disease may be silent. That’s why screening for prostate cancer is such an important topic for all men and their families. In rare cases, prostate cancer can cause symptoms. Contact your doctor for an evaluation if you experience any of the following: · A need to urinate frequently, especially at night, some- times urgently

  • Difficulty starting or holding back urination
  • Weak, dribbling, or interrupted flow of urine
  • Painful or burning urination
  • Difficulty in having an erection
  • A decrease in the amount of fluid ejaculated
  • Painful ejaculation
  • Blood in the urine or semen
  • Pressure or pain in the rectum
  • Pain or stiffness in the lower back, hips, pelvis, or thighs

Remember: urinary symptoms don’t necessarily mean you have cancer. Prostatitis or BPH (Benign Prostatic Hypertrophy, also known as enlargement of the prostate) are benign diseases but can cause similar symptoms and are very common. What about difficulty in having an erection? Again, this is most likely not caused by cancer but by other factors such as diabetes, smoking, cardiovascular disease, or just plain getting older. That said: Symptoms are symptoms, and no matter what’s most likely to be causing them, you should get them checked out by a doctor. Refer to https://www.cancer.va.gov/CANCER/pcf.asp   for more info on screening, the PSA Test, Prostate Exams, VA and PCF Partnership Videos, and special information for Veterans

VA has teamed up with the Prostate Cancer Foundation (PCF) to encourage men (and their families) to better understand prostate cancer risk and to take proactive measures to protect their health. 2021 will come with new ideas and goals, and there’s no better time to know your risk. Now is the time to make a plan to talk to your doctor at your next checkup about whether prostate cancer screening is right for you.

Gulf War Veteran Milton “Trey” Wilborn III, who lost his battle to an aggressive form of prostate cancer at the age of 49 in 2020, generously volunteered to share his story with other Veterans. Wilborn urged men to get checked, regardless of whether they are experiencing symptoms or feel they are too young. “I was diagnosed with prostate cancer at the age of 45,” Wilborn said. “I never even knew what a PSA (prostate-specific antigen) was. I didn’t know what a prostate was until I got sick … VA does take care of their Veterans. Their treatment is the best, you have all the newest, latest, greatest equipment and everything in all the treatments.”

VA partnered with PCF in 2016 to advance best-in-class research and care for Veterans at risk for prostate cancer. Oncologists at 12 VA PCF Centers of Excellence (COE’s) are collaborating to bring the latest breakthroughs to Veterans. To date, PCF has committed more than $50 million to this collaboration and recently publicly announced a commitment to help stand up 21 total COEs. So far, hundreds of 69 Veterans have been seen by a doctor for precision oncology at one of 12 COEs across the country. These centers are working to ensure every Veteran can access cutting-edge advances in prostate cancer research and treatment.

When PCF started working with the Washington DC VA Medical Center, Wilborn and his wife Shawni stepped up to work with PCF to champion prostate cancer awareness. You can read more about their touching story at https://www.pcf.org/c/love-story. Milton shared how the message of early detection, if it reached just one Veteran, could save lives. “God put me in a position to be able to tell my story,” he said, adding that he was grateful for the opportunity to help educate other men and their families.

Among those that VA and PCF hope to reach: African American men remain the hardest hit by prostate cancer. They are 79% more likely to develop prostate cancer than Caucasian men, and are more than twice as likely to die from the disease compared to men of other ethnicities. Precision screening is the best defense for men against prostate cancer. Awareness of your risk and talking to your doctor about screening are the next steps every man can take in 2021. Learn more at https://www.pcf.org/vets . In addition, PCF has a variety of resources to help.

[Source: Vantage Point Blog | January 1, 2021 ++]

VA Obesity Initiative Update 03: Just Released | New Overweight/Obesity Guidelines

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VA Obesity Initiative Update 03: Just Released | New Overweight/Obesity Guidelines

Forty-one percent of Veterans receiving care from VA have obesity. There’s a brand new eight-page booklet right here that can help bring that number down. The Management of Adult Overweight and Obesity booklet at https://www.blogs.va.gov/VAntage/wp-content/uploads/2020/12/Guidelines-Cover_r1.jpg   provides clear and comprehensive evidence-based recommendations. The updated guidelines booklet describe the critical decision points. It provides clear and comprehensive evidence-based recommendations to inform weight management practices throughout the DoD and VA Health Care systems.

This is not about trying to fit into your old uniform. This is about your health. There are important health benefits that result from weight loss. These include improvements in blood pressure, cholesterol,

the risk of developing diabetes and other chronic conditions, and even overall quality of life.   The new guidelines answer your questions.

  • What is consider overweight?
  • What is obesity? (Having a weight that is higher than what is considered healthy for a given height is described as overweight or obesity.)
  • What should you ask your health care team?
  • What is Body Mass Index? (There’s a great chart in the guidelines.)
  • What should be my weight loss goal? (For many people with overweight or obesity, an initial goal is to lose just 5% of their body weight.)
  • What is a Comprehensive Lifestyle Intervention? (Comprehensive lifestyle interventions are programs that combine changes to habits and behaviors as well as dietary intake, and physical activity, with support from a health coach or other member of a health care team.) Overweight and obesity are terms that describe different degrees of carrying extra fatty tissue – or body fat – above an ideal weight. Healthy eating is an important part of weight loss. Weight loss is achieved when you take in less energy (fewer calories) than your body needs to maintain your current weight, especially if you also increase your level of regular physical activity. A comprehensive lifestyle intervention (such as VA’s MOVE! Weight Management Program) is an essential aspect of any effective overweight or obesity treatment program. These programs help you to identify and make lasting changes in diet, physical 23 activity and other behaviors, like regular weighing, to help you stay on track. VA’s MOVE! program can help you reach a healthy weight.

The guidelines also emphasize the value of specific medications, as well as surgical procedures for treating overweight and obesity, though these treatments should always be combined with a comprehensive lifestyle intervention. Remember when you pushed back from the table and said, “Well, next year I’m going to get in shape?” Well, this is next year. If you need some inspiration, check out these success stories from Veterans who achieved significant weight loss after participating in the MOVE! program. Some are amazing and inspiring.

[Source: Vantage Point | Hans Petersen | January 8, 2021 ++]

VA Appeals Update 39: What to Expect During a Board of Veterans’ Appeals Hearing

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VA Appeals Update 39: What to Expect During a Board of Veterans’ Appeals Hearing

If you disagree with the initial decision VA made on your claim and decide to appeal the decision to the Board of Veterans’ Appeals (Board), you have a few different options to choose how your appeal proceeds. But many people don’t know what to expect, which could cloud their ability to choose the best option for them. In the video at https://youtu.be/UDI3C_ytJt8 Judge Tanya Smith, a Veterans Law Judge, explains to Veterans what to expect, what to prepare, and what happens after a hearing.

As explained in the video, one option is to have a hearing with a Veterans Law Judge (VLJ). Hearings are entirely optional and aren’t necessary to receive a decision from the Board. (Some Veterans elect to a potentially quicker decision and, to save time, they can choose one of the other options the Board offers. Instead of a hearing, the VLJ will simply review any evidence/statements you have submitted before deciding your appeal.) If you decide you want a hearing, consider choosing a virtual tele-hearing. Virtual tele-hearings are safe and secure, and they allow you to have your hearing from the comfort of your home instead of traveling to a VA facility. Virtual tele-hearings are a great option, especially during a pandemic. They do not negatively affect your appeal, so don’t postpone your hearing and delay your decision – choose a virtual tele-hearing.

What can you expect during a Board Hearing?

  • At the start of the hearing, the judge will ask you to raise your right hand, if possible, and swear you in. The judge will ask you to take an oath, or affirm that you’ll tell the truth during the hearing.
  • During the hearing, you, your representative – if you have one, and the judge will have a conversation about the issues on appeal. These hearings are an opportunity for you to tell your 21 story, and you should be comfortable in doing so. The judge will listen to your testimony and may ask you a few questions to better understand your appeal. What should you do during the hearing?
  • Tell the judge why you think you qualify for the VA benefits in your appeal.
  • Answer any questions the judge has about your appeal.
  • Share any new evidence with the judge: You can choose to add new and relevant evidence, either at the hearing or within 90 days after the hearing. Adding evidence is optional. What happens after your hearing?
  • Please understand that the judge will not issue a decision on your appeal the moment the hearing has ended.
  • When the 90-day time period for submitting new evidence after your hearing has ended, your appeal will be placed on the docket for a decision by a judge. · You will receive your decision in the mail and your representative will also receive a copy. You can track the status of your appeal by signing in at www.VA.gov.

[Source: Vantage Point | Cheryl L. Mason | January 5, 2021 ++]