Military vets who are denied veterans disability compensation will receive a form from the VA after they file their Notice of Disagreement (also known as the NOD). The form offers veterans the choice between a "traditional" appeal to the Bureau of Veterans Affairs (BVA) or a "de novo" review of their claim by a Decision Review Officer (what is called a DRO, throughout this article).
Veterans considering an appeal usually have two questions: What is the DRO (de novo review) process, and should I choose it? My answer is always direct: I cannot think of a situation where a veteran challenging the VA's denial of disability benefits for injuries incurred in military service would not choose the DRO review.
I will explain this in a minute, but first, let me explain the initial steps of the VA appeal process, so that my reasons make more sense.
The VA Regional Office will issue a decision to a U.S. veteran when the veteran is seeking disability compensation for an injury, medical condition, or disability that results from the veteran's military service. The decision letter from the VA will either partially or completely deny the claim. To challenge the VA's decision, the veteran has to file what is called a Notice of Disagreement (NOD) with the VA Regional Office that issued the Ratings Decision (typically, no later than one year after the Ratings Decision).
After filing the NOD, the VA will send the veteran an election form, asking him or her to choose between a "de novo" appeal or a more traditional appeal. The "de novo" review is the DRO process I write about here.
Now that I've explained the general appeal process, why is a DRO review different from the traditional BVA appeal that veterans are most familiar with, and why should the veteran choose the DRO review?
First, the DRO is a senior claims examiner. The DRO is authorized to reverse the VA's initial denial, in whole or in part, without needing any new or additional documentation from the veteran.
Second, the DRO process has pretty good odds for the veteran. If the DRO review results in even a partial reversal of the VA's initial ratings decision, the veteran will get their benefits a lot faster than if they appealed to the VA.
Third, because the DRO is a senior employee, he or she is far more experienced than the average VA claims representatives that denied the veteran's claim. They have seen more medical issues and more claims, know the law better, know the process better, and understand that they have two roles: to make sure that the veteran is getting a "non-adversarial" decision on their claim and to ensure that the VA is protected from expensive and time-consuming appeals resulting from poor decisions from junior VA employees.
Fourth, the DRO will review the case without giving any legal weight (or legal deference) to the VA's initial decision. In other words, the DRO review is "de novo", a Latin phrase that means "from the beginning", or "with fresh eyes." The VA's initial ratings decision is given no deference -- no legal weight -- by the DRO.
Fifth, in some cases, the veteran or his or her representative can ask to meet with or discuss the facts or medical evidence with the DRO.
Finally, even if the DRO doesn't reverse the VA's initial decision (or only partially reverses it), the veteran can still appeal to the BVA without any significant delay. Now, the average wait time for a BVA hearing can be 500 days or more, so when I say "significant delay," I mean that in the context of the cumbersome and byzantine appeals process that is the BVA.
In short, the veteran doesn't lose an appeal right, has a chance of reversing the VARO's claim denial, often doesn't have to provide new evidence, and can sometimes interact directly with the DRO. What's not to like about the DRO process?
Here is a success story to illustrate the value of the DRO process. I recently represented a Vietnam veteran with PTSD - a medical condition known as Post Traumatic Stress Disorder. Initially the VA denied the claim - saying that there was no evidence that the veteran had been diagnosed with PTSD. I can't repeat the words I used to express my shock when I read this decision. After all, the VA diagnosed the veteran's PTSD themselves, the VA doctor's diagnosis appeared about a dozen times in the Claims File and treatment records, and the VA Doctors had formally written opinions that the PTSD was the result of my client's horrific experiences in the Vietnam War.
I immediately sought review by a DRO. Within months, the veteran was evaluated by a local VA Medical Center to see how much his PTSD impaired him. Within 30 days of that visit to the VA Medical Center, my client received a check for over $10,000 in past due benefits. Had the veteran used the traditional BVA appeal, he would have waited over two years for a BVA hearing. Even if he won at the hearing, the VA would still have had to evaluate and assess the degree of his impairment, a process that could easily have taken 1-2 more years. Instead, within a few months, my client was getting monthly compensation for the PTSD that he suffers because of his experiences in the Vietnam War.
Now, let me be clear. The DRO process is no guarantee that the veteran will win, reverse the VARO decision, or get any benefits. But, it's a good chance to change a bad VA decision, and is usually a lot quicker than the traditional appeal process. In my mind, the DRO process should be used to start the challenge to any Initial Ratings Decision from the VA Regional Office.
Here's more information about dealing with a DRO to get disability compensation.
Written By: Attorney Chris Attig