Military Veterans' Lawyer Blog
CUE Claim Denials?
If you or I made a clear and unmistakable error which had a huge price tag, we’d expect some consequence. Like, we might get fired. Or demoted. Or something else undesirable would happen. That’s not at all the case with “Clear and Unmistakable Error” (CUE) actions by claims examiners at the Department of Veterans Affairs (VA).
Far from any remedial or disciplinary action for committing a CUE, as far as we can tell, nothing happens at VA. No training, no discipline. In fact, we’ve been informed that CUEs aren’t even tracked, making it impossible to tell what’s going on. If for no other purpose than training claims examiners to avoid making the same mistake over and over again, one would think CUEs should be tracked by VA.
This internal lack of basic administrative quality assurance might merely be interesting except for the fact that it has a direct impact on your benefits claims. How so? Well, based on VA’s own guidance in its M21-1 Manual, VA appears to look for “clear and unmistakable error” when it thinks it has been too generous in assessing your claim. The M21-1 guidance specifically talks twice about preparing a CUE decision to “reduce an SC evaluation, or sever SC for a disability.” (“SC” = “service connection”) There is one instance of preparing an allowance on the basis of a CUE, but no discussion of increasing an SC evaluation on the basis of a CUE.
Given the Manual’s biased guidance in favor of reducing or severing benefits, it is clear that claims examiners are taught to err on the side of denying claims. They may even be rewarded on the basis of a higher denial rate. What this means for you is that VA’s system is set up to figure out ways to deny you your earned benefits. Of course, VA has a vast team of examiners, managers, doctors, and attorneys to tell you why your cancer, heart disease, joint pain, mental trauma, or diabetes is the result of bad luck, old age, your terrible lifestyle, or anything else except your military service and sacrifice.
Well, since VA has a team dedicated to denying you your benefits, you should have your own team too. Fair is fair. It hasn’t always been the case, but since June 2007, Federal law obligates VA to let you have representation from an accredited individual or organization. Can you imagine? Before Congress passed Public Law 109-461 on December 22, 2006, it was even more difficult to get VA to let someone help you challenge its intense bureaucracy!
Your ability to have an informed representative on your side can level the playing field immensely. An accredited representative understands how to challenge VA’s denial of your claims and might even identify additional claims to which you are entitled. Probably the most important way an accredited representative helps you, though, is simply by dealing with VA paperwork and bureaucracy on your behalf.
Whether you are the Veteran, or the Veteran is your spouse, domestic partner, parent, or child, if you are experiencing any difficulties in getting through to VA to ensure benefit claims are properly assessed, don’t hesitate to contact a VA-accredited representative.
If you have any questions regarding service-connection benefits, please contact The Law Firm of Robert B. Goss, P.C. at: https://www.attorneyforveterans.com/contact-us.html