<aside> 1️⃣

Step #1 - BEFORE DOING ANYTHING ELSE ALWAYS CHECK Current Combined Rating - eligible for TDIU and not working? Confirm employment if needed

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<aside> 2️⃣

Step #2 - CHECK VBMS BEFORE DIVING IN - Anything pending? (client file their own claims, etc? update the case since the last VBMS Update Note). Even if you checked VBMS last week you want to check before you start working on appeals incase something was filed since.

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<aside> 3️⃣

Step #3 - Service Tab - a. Periods of service correct? b. Toxic Exposures Filled out including Date of TERA Memo? If not correct/not filled out you need to update this before you dive into the claims.

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<aside> 4️⃣

Step #4 - Review Case Tab - Synopsis/Claims Tab to confirm nothing else pending. A case should only be in the AOJ class code when decisions on all claims filed have come in. If additional things are still pending, update the case to reflect that and put in correct class code, but keep an eye on any deadlines!! If client has filed their own claims, help them develop the evidence needed etc.

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<aside> 5️⃣

Step #5 - Strategy Tab - Initial Blue Print section filled out? If no, before reviewing claims for appeal, at the very least, copy & paste Active Problem List from most recent CAPRI / or Private Treatment records in VBMS. You will want to keep these active problems in mind when reviewing appeal strategy (identify potential secondary claims/missed claims).

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<aside> 6️⃣

Step #6 - Copy and paste the Synopsis Notes (to include all decisions you are reviewing) in an Appeal Review Note in the Notes Tab - you will keep going back to this note as you go through the claims for appeal to make sure you are addressing all the claims in the decisions from the past 1 year. Once you are done with your AOJ workup you will just go back to that note to update it and put something like “will appeal in HLR, see claim tab/ or no appeal, see claim tab” after each RD

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<aside> 7️⃣

Step #7 - Claims Tab - go through EACH ONE and address ALL claims that are not marked “final no appeal” or “not pursuing (explain)” already. there may be additional claims listed that you need to address here that are not in the decisions identified in the synopsis tab - but before you are “done” with your AOJ workup, each claim must be marked “______[claim/appeal -Filed]”, “Final No Appeal”, or “Not Pursuing -explain”.

• was service connection DENIED: if so, why? look to kailey’s notes

  • SUPP (No C&P Ordered or missed C&P exam)

    • Missed C&P Exam - client missed the CP, submit good cause statement w/ Supp Claim
    • No C&P Ordered - confirm if client’s statement was sufficient to get to C&P (see kailey notes on service-connection statements). Additionally, look for the REASON the claim was denied (not related to service, no diagnosis/treatment?)
      • If not/the original statement was lacking (especially continuity of symptoms, did not adequately describe MOS duties when claiming chronicity, etc) - get a new & better statement from the client and submit in SUPP. Also check to see if any other evidence can be submitted to support claim (REP statement(s), buddy statement(s), medical records).
      • MH claims denied w/ no C&P Ordered (PTSD*)

        • Did we submit a sufficient stressor statement /VA Form 21-0781? Did the VA request a stressor statement/VA Form 21-0781 and we did not respond (check in VBMS for this as well as review the rationale).

          • If no - get stressor statement/VA Form 21-0781 from client (see kailey’s lunch & learn when completing this with client) & submit in SUPP (also consider getting any additional evidence to verify stressors if necessary buddy statements, etc);
          • If yes - was the stressor statement/VA Form 21-0781 properly filled out (see kailey’s lunch & learn), if not/missing info complete better new one with client & submit in SUPP (also consider getting any additional evidence to verify stressors if necessary buddy statements, etc).

          -When we submitted a sufficient stressor statement/VA Form 21-0781 to the VA, review the denial reasons in the decision, was VA able to verify stressor? If not, is there additional evidence NOT ALREADY ON THE RECORD that we could get from the client to confirm (buddy statements, photos, outside trt recs not previously submitted, etc). If so, submit in SUPP w/ that evidence.

  • HLR (No C&P ordered):

    • Denied w/out ordering C&P when statement was adequate to establish in service event/chronicity, continuity of symptoms & cl has diagnosis on record: argument: see text expander (@1 +DTA) -“DTA Error; please order C&P as veteran not afforded one. Vet has diagnosis of claimed condition & statement submitted connecting/suggesting condition related to service. The VA must provide a medical examination where there is competent evidence of a current disability or persistent or recurrent symptoms of a disability, evidence establishing that an event, injury, or disease occurred in service, and a suggestion that they may be related. See McClendon v. Nicholson, 20 Vet. App. 79 (2006); see also VA Adjudication Manual, M21-1MR, Part I, Chapter 1, Section C, Subsection 3(b). See McClendon v. Nicholson, 20 Vet.App. 79 (2006); see also VA Adj. Manual, M21-1MR, Part 1, Ch. 1, Sec. C, Subsec. 3(b). “
    • Denied w/out ordering C&P when statement was adequate to establish in service event/chronicity & cl had continuous symptoms but no diagnosis: argument: see text expander *(@DTA +dx) -”*The evidentiary standard for requesting examination does not require that a disability be diagnosed. Competent lay or medical evidence of current symptoms may be sufficient to raise a medically answerable question that warrants the ordering of a VA examination. See VA Adjudication Manual, M21-1MR, Part I, Subpart i, Chapter 1, Section C, Subsection 3(d) Direct SC: Reviewing for Evidence of Current Disability or Symptoms (May 17, 2019). DTA Error; please order C&P as veteran not afforded one. Vet has provided evidence of current symptoms related to claimed condition and statement submitted connecting/suggesting condition related to service. See McClendon v. Nicholson, 20 Vet.App. 79 (2006); see also VA Adj. Manual, M21-1MR, Part 1, Ch. 1, Sec. C, Subsec. 3(b).”
    • *Denied w/out ordering C&P due to no evidence of claimed toxic exposure (*where we are claiming a condition due to TE at a non-presumptive location -ex. cl claims has diabetes due to agent orange exposure at a Base that stored AO but the VA has not yet conceded that location and the VA failed to order a C&P due to same -negative TERA Memo).
      • First, confirm we submitted enough evidence including an MOS statement from cl discussing frequency/duration/etc of claimed exposure, as well as any available news articles, photos, buddy statements etc to confirm that AO was at this location.

        • if YES, then:

          HLR - argument: see text expander (z +ow) “DTA error; RO needs to concede actual exposure to [enter toxic exposure] based upon his active duty service in [list non-presumptive TERA location] from [years]. Veteran has raised issue that he was exposed to [TERA] during active duty service in [location]. Relevant evidence was submitted regarding this issue with [claim/date filed]. This issue was not addressed by RO in [denied decision]. This issue is essential as client has [dx] which is known to be caused by [TERA exposure].”

        • if NO, then:

          SUPP - w/ evidence described above that should have been submitted on initial.

</aside>

<aside> 8️⃣

Step #8 - Once you develop your plan for each claim/update the CHECKLIST to reflect what needs to happen (add aux checklist for whatever will happen next, SUPP, HLR, BVD, multiple). Once everything is FILED update the checklist including “Done” on the deadlines when those issues were appealed, and “Done” on the aux checklist once the Supp, HLR, BVD etc is submitted (an OPEN EP Code checklist should pop up for Supp & HLR filed.

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<aside> 9️⃣

Step #9 - Once you submit any appeals make sure you put a “DRC” note with the confirmation # for each filed (sometimes multiple HLR, SUPP, etc). make sure to note what was appealed (you can use the text expander [~ + drc] to help remind you what to put in the notes)

• STEP #9 ABOVE - WHEN S/C IS DENIED. MORE DETAILS </aside>

<aside> 🔟

Step #10 - Update the rest of the Case in NEOS - Case tab: update the class code, synopsis, AOJ workup date; Checklist (see #8 above); Treatment tab (if applicable, aka did we file a new PMR, point to any new VAMC recs not already in the trt tab); Claims tab: Make sure each claim appealed/not appealed is properly labeled, the theory of service connection accurately reflects what theory you are currently pursuing, any notes in the claim tab are updated (delete anything that is no longer relevant), and any new evidence submitted for that claim is linked to that claims tab. Confirm that the statement from the cl that was submitted is linked to the claim tab. It should be very easy to understand why we are claiming this condition just by looking at the claim tab.

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<aside> ➕

Step #11 - NOTIFY THE CLIENT (PHONE OR EMAIL) ABOUT WHAT WAS APPEALED/WHAT TO EXPECT (AKA NEW EXAMS, WAIT TIMES FOR BOARD APPEALS, ETC). Make sure there is record of this in the Notes tab.

</aside>

<aside> ➕

Step #12 - Strategy tab- Fill out the “Appeal Blueprint” section in full to reflect what is currently going on. Make sure you update the dates (AOJ Plan updated and Client notified AOJ plan). IF PAGE AI IS USED - MAKE SURE YOU MARK YES ; IF NOT; MARK NO - DO NOT LEAVE ANY OF THESE BOXES BLANK.

</aside>

<aside> ➕

Step #13 - Do one final check by clicking down each applicable tab before moving on (Case tab, checklist tab, notes tab, treatment and medications tab if applicable, claims tab, service tab (if any updates are applicable), employment tab (if updated when assessing for TDIU), and Strategy tab.

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