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What You Need to Know About Expediting a Claim

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There are very certain circumstances that the VA will consider expediting a claim, and they are often confusing as each regional office can sometimes offer expedition for a claim that may fall outside of the parameters based on special circumstances. However, the basic rules for expediting a claim are laid out in the VA regulations below. We will also discuss some ways to help make sure your expedite is reviewed with the minimal possibility for errors.

Reasons the VA expedite a claim when:

Regulations require the following to be expedited:

  • Any claimant who is
  • diagnosed with Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s Disease
  • a participant in the Fully Developed Claim (FDC) Program
  • experiencing extreme financial hardship, or
  • a survivor of a former Prisoner of War (FPOW).
  • Any current or former member of the Armed Forces who
  • was very seriously injured/seriously injured (VSI/SI) in service and is not already receiving Department of Veterans Affairs (VA) disability benefits
  • is an FPOW
  • is homeless
  • is terminally ill
  • is more than 85 years old, or
  • received the Medal of Honor.

However, there are some guidelines and exceptions, as well as some confusion and irregularities in the regulations that Veterans need to pay close attention to.

Homelessness

Under 38 CFR § 61.1; the VA will consider a Veteran homeless if they meet the criteria set forth under the legal definition of homelessness per 42 U.S. Code § 11302:

  • an individual or family who lacks a fixed, regular, and adequate nighttime residence;
  • an individual or family with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings;
  • an individual or family living in a supervised publicly or privately operated shelter designated to provide temporary living arrangements;
  • an individual who resided in a shelter or place not meant for human habitation and who is exiting an institution where he or she temporarily resided;
  • an individual or family who—
  • will imminently lose their housing, including housing they own, rent, or live in without paying rent, are sharing with others, and rooms in hotels or motels not paid for by Federal, State, or local government programs for low-income individuals or by charitable organizations, as evidenced by—
  • a court order resulting from an eviction action that notifies the individual or family that they must leave within 14 days;
  • the individual or family having a primary nighttime residence that is a room in a hotel or motel and where they lack the resources necessary to reside there for more than 14 days; or
  • credible evidence indicating that the owner or renter of the housing will not allow the individual or family to stay for more than 14 days, and any oral statement from an individual or family seeking homeless assistance that is found to be credible shall be considered credible evidence for purposes of this clause;
  • has no subsequent residence identified; and
  • lacks the resources or support networks needed to obtain other permanent housing

Any individual who is fleeing domestic violence or other life-threatening situations and no other housing options are available is also considered homeless

  • Age: Here is where irregularities sets in. The VA regulation M21-1, Part III, Subpart ii, Chapter 1, Section D states that the eligible age for expediting a claim is 85. However, 38 CFR § 20.900, which is the Federal regulation set forth by legislation states that the age of 75 years or older is eligible for expedition. Many regional offices use the age requirement of 85 years of age to reduce the number of claims they are backlogged. However, the federal regulation clearly states 75 years of age so if an RO is stating a Veteran does not qualify because they are under 85, please refer to this regulation.
  • Extreme Financial Hardship: Financial hardship is granted on a case-by-case basis and a Veteran must have documentation to prove their case. There are specific situations where the VA will consider a financial hardship and these include home foreclosure, bankruptcy, inability meet daily living expenses such as food and electric, or having utilities being turned off; past due mortgage or rent payments. Preventing homelessness is often a priority in financial hardship cases.
  • Poor Health: 38 CFR 7107 states that a case may be advanced based on poor health. This is usually defined as terminal illnesses or injuries that will lead to a person’s eventual death. These types of illnesses or injuries include terminal cancers, heart failure, or injuries that are deemed by a physician to lead to death.

To file an expedite request, a Veteran will have to ensure they have documentation to support any claim they are making. For example; shut off notices for utilities, diagnosis and treatment records for illness/injuries; a statement from a social worker or other official identifying the Veteran as homeless (medical professional, DFCS, non-profit organization provider, etc.).

Is Getting a Claim Expedited Worth it?

Filing an expedite request on a claim will speed up the clock and will help your representative or attorney push to get a decision made on your case. Most of the time it does speed up the process, but there are never any guarantees that it will get a decision in time to prevent the loss from happening. The VA’s new program is attempting to work faster and more efficiently, in all cases, to prevent more Veterans from becoming homeless or passing away before their benefits are awarded, but in any case, your representative knows exactly which forms you need to get the expedite approved and moving.

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