To: 16198196828 ome eee T2AS2023 21:40:22 UTC From: US Veterans Affeire US. Department of Veterans Affairs VA FAX TRANSMITTAL TO: Clarence Hill SUBJECT: FAX #: 16198196828 FROM: US Veterans Affairs DATE/TIME: 12/19/2023 21:39:44 UTC NUMBER OF PAGES: 55 Please find the attached documents as requested. Information provided herein may be protected by federal law, e.g. Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA), etc., such that unauthorized disclosure may be prohibited by federal law. This transmission is intended only for the use of the person or office to whom it is. addressed and contains information that is confidential and may be privileged or protected by law. All others are hereby notified that receipt of this message does not waive any applicable privilege or exemption from re-disclosure, If you have received this communication in error, please notify us immediately at the telephone number shown above. Receipt of information in error does not negate requirements to maintain confidentiality as required by law. Thank you.To: 16198196828 Page: 2 of 55 T2AS2023 21:40:22 UTC From: US Veterans Affeire DEPARTMENT OF VETERANS AFFAIRS: Febmary 14,2019 CLARENCE L. HILL PO BOX 441782 In Reply Refer To: 345/DM DETROIT, MI 48244 CSS 367 66 9369 HILL, Clarence L Dear Mr. Hill: ‘You have chosen to participate in the Rapid Appeals Modernization Program (RAMP). VA completed your Supplemental Claim Review received on May 15, 2018. ‘We made a decision regarding your entitlement to VA benefits. This letter tells you what we decided. It includes a copy of our rating decision that gives the evidence used and reasons for our decision, We have also included information about what to do if you disagree with our decision, and who to contact if you have questions or need assistance. What We Decided ‘We determined that the following condition(s) was not related to your r service connection remains denied: litary service, so ‘Medical Description ‘cervical spine condition ‘We have enclosed a copy of your Rating Decision for your review. It provides a explanation of our decision, the evidence considered, and the reasons for our decision. Your Rating Decision and this letter constitute our decision based on the Supplemental Claim Review request that we received on May 15, 2018. It represents all claims we understood to be specifically made, implied, or inferred in that review. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you should write and tell us why. You have one year from the date of this letter to file one of the following options: For review of a Supplemental Claim decision, you may: + file a Supplemental Claim, or + request a Higher-Level Review, or + file an Appeal to the Board of Veterans’ Appeals. For review of a Higher-Level Review decision, you may:To: 16198196828 Page: 3 of 55 T2AS2023 21:40:22 UTC From: US Veterans Affeire 2 CSS 367 66 9369 Hill, Clarence L. + file a Supplemental Claim, or + File an Appeal to the Board of Veterans’ Appeals. You must use the attached pre-populated VA Form 21-4138, Statement in Support of Claim — RAMP Selection, to notify us of your decision to seek further review. The VA Form 21- 4138, RAMP Selection is the only form accepted by VA during RAMP. Please note: You may not request a Higher-level Review of a decision on a Higher-level Review or a decision on an appeal to the Board of Veterans’ Appeals. If you elect to file an appeal with the Board of Veterans’ Appeals, your Notice of Disagreement (NOD) will be assigned a docket number based upon the date of receipt. The Board will begin processing these appeals in the new, more efficient appeals process no earlier than October 2018. ‘The enclosed RAMP Review Rights explains your options in greater detail and provides instructions on how to request further review. If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.eBenefits.va.gov. What Is eBenefits? Benefits provides electronic resources in a self-service environment to Servicemembers, Veterans, and their families. Use of these resources often helps us serve you faster! ‘Through the eBenefits website you can: Submit claims for benefits and/or upload documents directly to the VA. Request to add or change your dependents Update your contact and direct deposit information and view payment history Request a Veterans Service Officer to represent you Obtain verification of your military service, civil service preference, or VA benefits ‘And much more! Enrolling in eBenefits is easy. Just visit www.eBenefits.va.gov for more information, If you submit a claim in the future, consider filing through eBenefits. Filing electronically, especially if you participate in our fully developed claim program, may result in faster decision than if you submit your claim through the mail.To: 16198196828 omar T2AS2023 21:40:22 UTC From: US Veterans Affeire 3 CSS 367 66 9369 Hill, Clarence L. If You Have Questions or Need Assistance If you have any questions, you may contact us by telephone, e-mail, or letter. Ifyou Here is what (0 do. Telephone Call us at 1-800-827-1000. If you use a Telecommunications Device for the Deaf (TDD), the Federal number is 711. Use the Internet | Send electronic inquiries through the Internet at hitps:/itis.va.gov. Write VA now uses a centralized mail system, For all written communications, put your full name and VA file number on the letter, Please mail or fax all written correspondence to the appropriate address listed on the attached Where to Send Your Written Correspondence chart. In al cases, be sure to refer to your VA file number 367 66 9369. If you are looking for general information about benefits and eligibility, you should visit our website at https://www.va.goy, or search the Frequently Asked Questions (FAQs) at hitps:/firis.va.gov. We sent a copy of this letter to your representative, Disabled American Veterans, whom you can also contact if you have questions or need assistance. Sincerely yours, Regional Office Director Enclosure(s): Rating Decision VA Form 21-4138 Statement in Support of Claim RAMP Review Rights Where to Send Your Written Correspondence ce: DAV DVA Detroit Regional Office Attn 14th Floor Mailroom 477 Michigan Ave RM 1400 Detroit MI 48226To: 16198196828 ea aee ee T2AS2023 21:40:22 UTC From: US Veterans AffeireTo: 16198196828 Page: 6 of 55 T2AS2023 21:40:22 UTC From: US Veterans Affeire DEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office CLARENCE HILL VA File Number 367 66 9369 Represented By: DISABLED AMERICAN VETERANS Rating Decision 02/06/2019 INTRODUCTION As aresult of the enactment of the Veterans Appeals Improvement and Modernization Act of 2017 Public Law 115-55), the Department of Veterans Affairs (VA) is required to change its current appeals process. Under the authority of Public Law 115-55, VA created the Rapid Appeals Modemization Program (RAMP) io provide Veterans with the earliest possible resolution of their claims, You have chosen to participate in RAMP, and you selected to have your claim reviewed under the Higher-Level Review lane option. However, additional evidence ‘was required and your claim was moved to the Supplemental Claim lane option, ‘The records reflect that you are a veteran of the Peacetime, You served in the Marine Corps from September 12, 1978, to March 30, 1979. We received your Higher level review on May 15, 2018. Your claim was moved to the Supplemental Claim lane option on December 17, 2018. Based on the review and the evidence listed below, we have made the following decision, DECISION ‘The previous denial of service connection for cervical spine condition is confirmed and continued,To: 16198196828 eae ener T2AS2023 21:40:22 UTC From: US Veterans Affeire CLARENCE HILL, 367 66 9369 20f4 EVIDENCE ‘+ Deferral From Higher Level Review, received December 17, 2018 * VA, VA Exam (Medical Exam for Disability Evalation), exam conducted, August 24, 1979 * Previous Rating Decisions, dated September 27, 1979, May 16, 2014, April 1, 2015, March 16, 2016 and September 7, 2016 VA Treatment Records, Detroit VAMG, for the period August 18, 1998 to February 1, 2019 VA Form 21-22 Appointment of Veterans Service Organization as Claimant's, Representative, received September 5, 2014 * VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits, received January 29, 2015 * Service Treatment Records, received March 4, 2015, for the period of September, 1978 to March, 1979 © Private Medical Records, Spine Specialists of Michigan, received June 24, 2016, for the period of August, 2015 to August, 2015 + DD Form 214 Certificate of Release or Discharge from Active Duty, received January 7, 2016, for the period of September, 1978 to March, 1979 + VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits, received June 24, 2016 © VA Letters, sent to you, dated September 12, 2016, October 21, 2016, December 14, 2016, January 5, 2017, April 1, 2018, May 15, 2018 and January 14, 2019 VA Form 21-0958, Notice of Disagreement, received September 30, 2016 Statement of the Case dated, October 28, 2016 VA Form 9 Appeal to Board of Veteran Appeals received, November 30, 2016 Correspondence, statement in support of claim from Veteran received, November 30, 2016 VA Form 8 Certification of Appeal dated, January 4, 2017 VA Form 21-4138 Statement in Support of Claim, received June 14, 2017 VA Form 27-0820 Report of General Information, in regards to, BVA hearing scheduling, dated December 22, 2017 * VA Form 27-0820 Report of General Information, in regards to, RAMP request to opt in, dated January 31, 2018 ‘Rapid Appeals Modernization Program (RAMP) op-in election, received May 15, 2018 * Rapid Appeals Modernization Program (RAMP) letter, appeal withdrawal, dated August 28, 2018 * VA Form 27-0820 Report of General Information, in regards to, DRO informal conference scheduled, dated December 13, 2018 © VA Form 21-6789, Deferred Rating Decision, dated December 17, 2018 * VES, VA Exam (Neck (Cervical Spine) Conditions ), exam conducted, January 22, 2019 © VES, VA Exam (Medical Opinion), exam conducted, January 22, 2019 Service connection may be granted for any disease or injury that is considered to have resulted in aperiod of war or service. To establish direct service connection for a claimed disorder,To: 16198196828 earner ee T2AS2023 21:40:22 UTC From: US Veterans Affeire CLARENCE HILL, 367 66 9369 30f4 objective evidence must show a diagnosis of a current disability that is related to a disease or injury incurred in or aggravated during "active " service; or that manifested itself to a compensable degree within one year from the date of discharge (specified under 38 CER. § 3.303). ‘We have denied your claim for service connection for cervical spine condition because the evidence continues to show this condition was not incurred in or aggravated by military service, ‘The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition, We reviewed your service treatment records, private medical evidence, and your VA Medical Center treatment reports. We received your medical evidence which discusses the symptoms of your medical condition. We reviewed your private medical evidence from Dr. Louis N. Radden dated August 31, 2015 which discusses the medical condition and the opinion which attempted to link this, condition to your military service; however, the rationale provided was not based on objective evidence and review of your military records to explain/support a link of the condition to military service, The VA medical opinion found no link between your diagnosed medical condition and military service. On VA exam dated January 22, 2019 the VA examiner opined "Mr. Hill's service treatment records does not contain complaints, treatment, or diagnosis for cervical condition during military service. During the veteran's enlistment examination dated August 17, 1978, he reported a history of being involved in a car accident in 1972, prior to service, where he struck his head against the windshield sustaining a laceration. Although the veteran claims that he re-injured his neck during military service, itis not supported by objective medical records, He contends that he fell during active military service while carrying another service member, aggravating his cervical spine condition, however there are no miedical records to support this ciaim." There was no continuity of symptoms from service to the present, First complaint of neck pain in Detroit VAMC records not noted till October 26, 2007. A pre-existing injury or disease will be consider to have been aggravated during service when there is an increase in disability during service, unless there is a specific finding that the increase disability is due to the natural progression of the disease. Temporary or intermittent flare-ups of preexisting injury or disease are not sufficient to be considered “aggravation in service” unless the underlying condition itself, as contrasted with mere symptoms has worsened (specified under 38 CER, § 3.322) On your enlistment examination dated August 17, 1978, you reported a history of being involved in a car accident in 1972, prior to service, where you hit your head against the windshield sustaining a laceration which was shown to be healed. You denied any residuals from this accident, You were not shown to have been treated for any complaints of a neck injury in service. Therefore, service connection due to aggravation of a preexisting injury is denied. In addition, the medical evidence fails to show that the disability became compensable (severe enough to be evaluated at least 10 percent disabling) within the time period specified under 38 CFR 3.307. Although a VA examiner made range of motion notes on your VA exam dated August 24, 1979, there was no diagnosis and no complaints of pain, Therefore, service connection on a presumptive basis must be denied.To: 16198196828 earner T2AS2023 21:40:22 UTC From: US Veterans Affeire CLARENCE HILL, 367 66 9369 40f4 Favorable findings identified in this decision: Evidence of current diagnoses of displaced cervical intervert disc with disc herniation, cervical facet syndrome, sprain/strain, and disc bulges shown in private records from Spine Specialists of Michigan dated August 2015, received September 15, 2015, November 3, 2015, January 7, 2016, and June 24, 2016, Current VA exam dated January 22, 2019 has a diagnosis of cervical strain, degenerative arthritis of the spine, spinal stenosis, degenerative disc disease, and radiculopathy bilateral upper extremities, Laws and regulations applicable to this issue: 38 U.S.C. 1110 & 1131 Basic entitlement. 38 U.S.C. 5107 Claimant responsibility; benefit of the doubt. 38 CER. §3.1 Definitions. 38 CER. §3.6 Duty periods. 38 CER. §3.102 Reasonable doubt. 38 CER. §3.103 Procedural due process and appellate rights. 38 CER. §3.104 Finality of decisions. 38 C.F.R. §3.156 New and material evidence. 38 CER. §3.159 Department of Veterans Affairs assistance in developing claims. 38 CER. §3.303 Principles relating to service connection, 38 CER. §3.304 Direct service connection; wartime and peacetime. 38 CER. §3.306 Aggravation of preservice disability. 38 C.F.R, §3.307 Presumptive service connection for chronic, tropical, or prisoner-of-war related disease, disease associated with exposure to certain herbicide agents, or disease associated with exposure to contaminants in the water supply at Camp Lejeune; wartime and service on or alter January 1, 1947. 38 CER. §3.309 Disease subject to presumptive service connection, 38 CER. §3.322 Rating of disabilities aggravated by service. Pub. L. No. 115-55 Veterans Appeals Improvement and Modernization Act of 2017. REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans’ Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov.To: 16198196828 Poge: 10 of 55 AZAG2023 21:40:22 UTC From: US Veterans Affaire WY department of Veterans Affairs RAMP REVIEW RIGHTS After careful and compassionate consideration of your claim, we have reached a decision. This document ‘outlines your rights to seek further review of our decision as part of the Rapid Appeals Modernization Program (RAMP). If you choose to do so, you may ONLY SELECT ONE review option for all issue(s) for which you are seeking review under RAMP. If you are satisfied with our decision, you do not need to take any action, including any of the actions listed below. VA must receive your request to proceed with a review of the issue(s) you disagree with within one year of the date VA sent you notice of our decision to maintain your eligibility to receive the earliest possible effective date for benefits. Choosing one of the review options described below does not exclude you from choosing another review option after completion of VA's review and issuance of a decision. ‘You must follow the application requirements outlined below to seek further review until the new decision review system becomes effective on or after February 14, 2019, at which time you may select different lanes for each issue and will have to follow the application requirements of the new system. VA will provide additional information to RAMP participants once the new system is operational. ‘You may select one of the following review options for continued review under RAMP: * Fie a Supplemental Claim + Request a Higher-Level Review + File an Appeal to the Board of Veterans’ Appeals (Board) (Note that the Board will not be able to begin to process your appeal until no earlier than October 2018) ‘The following is an overview of each option to help you select the most appropriate course of action. You can find more information on the review options at htips//benefits.va.gov/benefits/appeals.a: File a Supplemental Claim * Use this option when you have additional evidence that is NEW AND RELEVANT to support granting the benefit(s) sought or you can identify existing relevant records that you would like VA to obtain. (NEW evidence means information not previously considered by the local VA office, and RELEVANT evidence means information that tends to prove or disprove a matter at issue.) To be a complete application, you must submit evidence with your application or identify evidence that VA can assist you in gathering to support the Supplemental Claim. Request a Higher-Level Review * Use this option when you have NO additional evidence to submit, or that you would like VA to obtain, in support of any of the previously decided issue(s), and you would like VA to conduct another review of the issue(s) with only the evidence of record at the time of the last decision. The designated reviewer will conduct a brand new review of the issue(s) based on the evidence that was previously considered by the local VA office, but any factual or legal finding in the decision that was favorable to you cannot be changed unless there is evidence to the contrary that is clear and unmistakable. VA WILL NOT consider any new evidence submitted after VA issued the decision under review or assist you in obtaining new evidence. ‘The designated reviewer may find that VA did not fuffil its duty to assist you in the original claim process With respect to obtaining documents or providing an examination. The reviewer will retum the claim on that basis for further development and readjudication. ‘An informal conference is available to you and/or your representative, if you choose to exercise this option. The purpose of this telephonic contact is to point out specific errors in the case. VA will not receive new evidence during an informal conference. This option may cause some delay in the processing of your higher-level review. ‘You MAY NOT request a higher-level review after receiving a decision on a higher-level review or an appeal to the Board. I to the Board Use this option to appeal to the Board for consideration by a Veterans Law Judge. The Board will not process your appeal until NO EARLIER THAN OCTOBER 2018.Uitte eae eee eee a ‘+ When appealing to the Board, you have three options. By selecting one of these options, the Board will place your appeal onto a list for consideration in the order it was received. — Direct Review. Choose this option if you do not have additional evidence to submit and you do not want a hearing. Evidence Submission. Choose this option if you DO NOT want a hearing, but you do have additional evidence to submit. The Board will review the issue(s) in your appeal considering the ‘evidence that the local VA office considered, along with any additional evidence that you submit within 90 days of the date that the Board receives your request. After 90 days, any additional evidence added to your claims file will not be considered by the Board. Hearing, Choose this option if you want to testify before a Veterans Law Judge, and have the ‘opportunity to submit additional evidence. This option may cause some delays in receiving a decision by the Board. The Board will contact you regarding the scheduling of your hearing NO EARLIER THAN OCTOBER 2018. After your hearing has been held and you have had the opportunity to submit adlitional evidence, the Board will review the issue(s) in your appeal, considering the evidence that the local VA office considered along with your hearing testimony and any additional evidence that you submit within 90 days of your hearing. After 90 days, any additional evidence added to your claims file will not be considered by the Board. How do | request review by VA of my decision? To select a review option during RAMP, you must submit the attached VA Form 21-4138, Statement in Support of Claim, “RAMP Selection” form to the appropriate office for review. For a Supplemental Claim or a Higher- De ENC INCARE coe ne Level Review, complete and mall or fax Peete VA Form 21-4138, “RAMP Selection" and . JANESVILLE WI 53547-4444 the provided coversheet to: FAX: 844-531-7618 For an Appeal to the Board, complete BOARD OF VETERANS' APPEALS and mail or fax VA Form 21-4138, P.O, BOX 27063 “RAMP Selection,” to: WASHINGTON DC 20038 FAX: 202-495-6803 If requesting the opportunity to submit evidence without a hearing before a Veterans Law Judge, you may submit evidence to the address or fax number above within 90 days of your Appeal to the Board. Can I get someone to help me with my request for review? Yes. You can have a Veterans Service Organization representative, an attomey, or an “agent” help you with your request. You are not required to have someone represent you. It is your choice. You can have a Veterans Service Organization representative help you with your review free of charge. ‘An attomey or agent can also represent you but may require you to pay for their services. VA cannot pay any attomey or agent fees. VA only recognizes attomeys licensed to practice in the United States or in one of its territories or possessions. An agent is a person who is not an attorney, but who VA recognizes as being knowledgeable about veterans’ law. If you do hire an attomey or agent to represent you, a copy of any fee agreement must be sent to VA. You can find more information on accredited representatives (VSOs, attomeys, and agents) and fee agreements at: https/ww.va.qov/ogc/accreditation.asp. How long do I have to request a review of my decision? You must act within one year of the date VA sent you notice of our decision to preserve your right to receive the earliest effective date for benefits. Upon the conclusion of RAMP, if you are still within your one-year period, you may seek review by filing under the new claims and appeals system. What happens if I do not submit my request for review on time? If you do not request a review option within the required time limit, you may only seek review through the following options: + File a request for review based on a clear and unmistakable error in our decision or, * File a Supplemental Claim along with new and relevant evidence to support your issue(s).To: 16198196828 Page: 12 f55 V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: Se aes STATEMENT IN SUPPORT OF CLAIM "yor hus interes, ddrsusetion of VA Tropa tnd delivery of VA ene, veratin of ety ard sty cma amon) a Letiied ia te VA sats of cond SOVAZI(2 75, Compensation, Peon, Fenton and Veco Robs sed nef Rass” VR, [lake ibe Foe Ragser, You bgann eapondtoqced we cana or nn Cnet, VA sun yur SSN only yon i le Povaiog yor SN wil ep en nk ‘Van ie ay alent ig pn irr Se eda oh SS yeaa Sut fy cl oy 0 ed {lin edet Tbe round nor cotter va nd nace oor nian Sewer lv, Th repose ou ote ee calred cotta GY USC. ‘TOD, beso ube settee ecuph cour cg pograns WEN Goce [RESPONDENT BURDEN: We ned hi infmsion bain eins in spe of yours fr boa (38 USC $01) and). Ti 8, Ud Snes Cod sw ak fe his fre tl re leon eae reir: in erin, nro frm YA cn a cpt er onthe OM tere Ps tm recon dayPANaiy H dese yu can cll -3008Y7-1000 40 pet sfonnation on where fo se comments sega son ths FIRST NAME MIDDLE NAME “LAST NAME OF VETERAN (pe or prin ‘SOCIAL SECUATTY NO. VAFIENO, cress "Ths folowing Satencal i made nconnevion wilh a lai fe Delis i eis oe above-named Wtean RAMP SELECTION Use this form to seek additional review under RAMP until the new system becomes effective on or after February 14, 2019, at which time you will have to follow the new application requirements outlined in the new appeals system. Filing instructions will be available at https:/www.benefits.va.gov/benefits/appeals. Instruction: Please list the issues you are seeking review of below and on the next page select the type of review you would like from the choices provided. Note that you may select ONLY ONE type of review for all issues identified on this form. See the "RAMP Review Rights" document for information on each review: option and mailing instructions. I would like to seek further review of the following issues (use additional page if necessary): BEE oi} | TERT THAT be scrans ois om re ead caret to et of my Rrowlaige and ck eo ‘DRTESGNED 7ODRESS TELEPHONE NUMBERS (nce tee Cab) ‘BAYT EVENING, PENALTY: Th law provides sever penalis which inclade fe or ipesonment,o bat, for te wilful sabmiision of ay Satement or evidence oF a aerial fact, knowing ittohe fase varonit SUPERSEDES VA ronit21-4198, UG2011, shia 21-4138 Whicl WALNOTBEUSED. CONTINUE ON REVERSETo: 16198196828 Page: 13 f55 V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: Jelect to have all Issues reviewed under the following option (Check ONLY ONE of the boxes below): D Iam filing a Supplemental Claim. I understand that | must submit or identify new and relevant evidence that was not previously considered by the local VA office. 1 1am requesting a Higher-Level Review based on the evidence of record at the time of the Prior decision. 1 Lam requesting a Higher-Level Review based on the evidence of record at the time of the prior decision and | am requesting a one-time informal conference with the Higher-Level Reviewer. If you have an accredited representative (VSO, attorney, or agent) please include his or her contact information below. (This option may cause some delay in the processing of your higher-level review.) Representative/Org. Phone Number. 1am appealing to the Board of Veterans’ Appeals (Board). | understand the Board will nol process my appeal under the new system until no earlier than October 2018. I would like the following review option: 1 Direct Review (Based on the evidence of record at the time of the prior decision; NO ‘evidence submission or hearing request) 11 Evidence Submission (Evidence submission within 90 days; NO hearing request) 1 Hearing (Hearing with evidence submission allowed) (This option may cause some delay in receiving a decision by the Board.) VAFORM2-#930, sa 2015,To: 16198196828 Page: 14 of 55 V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: DEPARTMENT OF VETERANS AFFAIRS Where to Send Your Written Correspondence In order to properly determine where to send your written correspondence, please first identily your benefit type (Compensation, Veterans Pension, or Survivor Benefits); then, locate the corresponding address based on your location of residence. For correspondence relating to all Compensation claims: Address Location of Residence All United States and Foreign Locations *Note: For foreign Veterans Pension and Survivor Benefits please refer to the below addresses, Department Of Veterans Affairs Evidence Intake Center P.O. Box 4444 Janesville, WI, 53547-4444 Or fax your information to: Toll Free: 844-531-7818 Local: 248-524-4260 For correspondence relating to all Veterans Pension and Survivor Benefit claims: Countries outside of North, Central or South America Location of Residence Address ‘Alabama Kentucky Missouri Department Of Veterans Affairs ‘Arkansas Louisiana Ohio Claims Intake Center Mlinois Michigan, Tennessee Attention: Milwaukee Pension Indiana Mississippi Wisconsin Center P.O. Box 5192 Ianesville, WI 53547-5192 ‘Alaska Montana Texas Arizona Nebraska Utah Department Of Veterans Affairs California Nevada Washington Claims Intake Center Colorado New Mexico Wyoming Attention: St. Paul Pension Center Hawaii North Dakota Mexico O. Box 5365 Idaho Oklahoma Central America Ianesville, WI 53547-5365 Towa Oregon South America Kansas South Dakota Caribbean Minnesota Connecticut. New Hampshire South Carolina Delaware New Jersey ‘Vermont Department Of Veterans Affairs Florida New York Virginia Claims Intake Center Georgia North Carolina West Virginia | _Attention: Philadelphia Pension, Maine Pennsylvania District of Center Maryland Rhode Island Columbia P.O. Box 5206 ‘Massachusetts Puerto Rico Fanesville, WI 53547-5206 CanadaTo: 16198196828 Page: 15 of 55 V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: DEPARTMENT OF VETERANS AFFAIRS September 12, 2016 CLARENCE L HILL In reply, refer to: PO BOX 441782 351/SC DETROIT MI 48244 File Number: 367669369 Clarence Hill Dear Mr. Hill: ‘We made a decision regarding your entitlement to VA benefits. Your claim was processed in the Fully Developed Claims program. This letter tells you what we decided. It gives the evidence used and reasons for our decision, We haye also included information about what to do if you disagree with our decision and who to contact if you have questions or need assistance. What We Decided ‘We made the following decision(s): Tssue/Contention [cervical spine condition [>The claim Tor service connection for cervical spine condition Ts considered reopened. However, the evidence continues to show this condition was not incurred in or aggravated by military service. le The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. On your enlistment examination dated August 17, 1978, you reported a history of being involved ina car accident in 1972, prior to service, where ‘you hit your head against the windshield sustaining a laceration which was shown to be healed. You denied any residuals from this accident, You were not shown to have been treated for any complaints of a neck injury in service.We received your medical evidence which discusses the symptoms of your medical condition. We received your private treatment record from Dr. Louis N. Radden dated August 31, 2015. Dr. Radden's record indicates you are diagnosed with displaced cervicalTo: 16198196828 Page: 16 of 55 V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: Page 2 File Number: 367669369 HILL, CLARENCE L. intervertebral disc. You reported to Dr, Radden that you sustained cervical dise bulges as a result of a military accident in the early 1970's, Based on your reported history, Dr. Radden provided a statemient this condition could have been causéd by the military accident as relates to failure segmentation of the cervical spine, He further stated failure segmentation of the cervical spine is a congenital disorder that is a pre-existing condition, which could have been potentially aggravated and exacerbated by your injury in the early 1970's. We did not find a link between your medical condition and military service. Although Dr. Radden provided a statement linking your current cervical spine condition to your military service. His opinion is based solely on your reported history. Without evidence of an injury in service, we are unable to grant service connection for this condition, Are You Entitled to Additional Benefits? Did you know you may be eligible for a VA guaranteed mortgage with no down payment (potentially exempt from a funding fee depending on your rating)? For more information about this benefit, or to determine and print your Loan Guaranty Certificate of Eligibility, please visit the eBenefits website at htip://www.ebenefits.va.gov. If you served overseas in support of a combat operation you may be eligible for mental health counseling at no cost to you at the Veteran's Resource Center. For more information on this. benefit please visit https://www.myhealth.va.gov/mhv-portal-web/. ‘The VA provides Blind Rehabilitation services to eligible blind, low vision, or visually impaired Veterans to help them regain their independence and quality of life. The Veteran’ s blindness, Jow vision, or vision impairment does NOT have to be related or caused by military service. If you need help with your vision loss, please contact your nearest Visual Impairment Services ‘Team Coordinator (ViST) at the eye clinic at your nearest VA Medical Center. For more information, go to www-va.gov/blindrehab/. Evidence Considered Tn making our decision, we considered: VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, Received June 24, 2016 Service treatment records, received March 4, 2015 «Private treatment records, Spine Specialists of Michigan, P.C., received September 15, 2015, November 3, 2015, January 7, 2016 and June 24, 2016 © DD Form 214, Certificate of Release or Discharge from Active Duty, from September 12, 1978 through March 30, 1979 «Rating Decision, dated April 1, 2015 with notification letter dated April 1, 2015To: 16198196828 Page: 17 of 55 V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: Page 3 File Number: 367669369 HILL, CLARENCE L. What You Should Do If You Disagree With Our Decision For Compensation Claims: If you do not agree with our decision, you must complete and return to us the enclosed VA Form 21-0958, Notice of Disagreement, in order to initiate your appeal. You have one year from the date of this letter to appeal the decision. The enclosed VA Form 4107, “Your Rights io Appeal Our Decision,” explains your right to appeal. What is eBenefits? Benefits provides electronic resources in a self-service environment to Servicemembers, Veterans, and their families. Use of these resources often helps us serve you fuster! Through the eBenefits website you can: Submit claims for benefits and/or upload documents directly to the VA. Request to add or change your dependents Update your contact and direct deposit information and view payment history Request a Veterans Service Officer to represent you Track the status of your claim or appeal Obtain verification of military service, civil service preference, or VA benefits And much more! Enrolling in eBenefits is easy. Just visit www.eBenefits.va.gov for more information. If you submit a claim in the future, consider filing through eBenefits. Filing electronically, especially if ‘you participate in our fully developed claim program, may result in a faster decision than if you ‘submit your claim through the mail. If You Have Questions or Need Assistance If you have any questions or need assistance with this claim, you may contact us by telephone, e- mail, or letter.To: 16198196828 Page: 18 of 55 V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: Page 4 File Number: 367669369 HILL, CLARENCE L. Tryou Here is what to do, {Telephone [Call us at 1-800-827-1000. If you use a Telecommunications Device for| the Deaf (TDD), the Federal number is 711. (Use the Internet [Send electronic inquiries through the Internet at hitps:/iis.va.gov. Write: }VA now uses a centralized mail system. For all written lcommunications, put your full name and VA file number on the letter. [Please mail or fax all written correspondence to the appropriate address listed on the attached Where to Send Your Written Correspondence Jchart, below. In all cases, be sure to refer to your VA file number 367669369. If you are looking for general information about benefits and eligibility, you should visit our web site at hitp://www.va.gov, or search the Frequently Asked Questions (FAQs) at http:/iris.va.gov. We sent a copy of this letter to DISABLED AMERICAN VETERANS, who you have appointed as your representative. If you have questions or need assistance, you can also contact your representative, Thank you for your service, Regional Office Director Enelosure(s): VA Form 4107 VA Form 21-0958 Where to Send Your Written Correspondence cc: DISABLED AMERICAN VETERANSTo: 16198196828 Page: 19 of 55 V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: CEs Pen YOUR RIGHTS TO APPEAL OUR DECISION After careful and compassionate consideration, a decision has been reached on your claim. If we were not able to grant some or all of the VA benefits you asked for, this form will explain what you can do if you disagree with our decision. If you do not agree with our decision, you may: « Start an appeal by submitting a Notice of Disagreement. Give us evidence we do not already have that may lead us to change our decision, This form will tell you how to appeal and how to send us more evidence. You can do either one or both of these things, How CAN I APPEAL THE DECISION? How do I start my appeal? To begin your appeal, you must submit VA Form 21-0958, "Notice of Disagreement," if that form was provided to you in connection with our decision. If we denied more than one claim fora benetit For example you claimed compensation fr thre disabilities and we denied two of them), please tell us in Part IIT of VA Form 21-0958 each of the claims you are appealing, A filed VA Form 21-0958 is considered your Notice of Disagreement. If you did not receive VA Form 21-0958 in connection with our decision, then write us a letter telling us you disagree with our decision or enter your disagreement on VA Form 21-0938 in questions 10 or ILA. If you did not receive VA Form 21-0958 in connection with our decision, then either your statement or VA Form 21-0958 is considered your Notice of Disagreement. Send your Notice of Disagreement to the address included on our decision notice letter. How long do Ihave fo start my appeal? You have one year to start an appeal of our decision. Your Notice of Disagreement must be postmarked (or received by us) within one year from the date of our letter denying you the benefit. In most cases, you cannot appeal a decision after this one-year period has ended. ‘What happens if1 do not start my appeal on time? 1f you do not start your appeal on time, our decision will become final. Once our decision is final, you cannot get the VA benefit we denied unless you either: « Show that we were clearly wrong to deny the benefit or ¢ Send us new evidence that relates to the reason we denied your claim. ‘What happens after VA receives my Notice of Disagreement? We will either grant your claim or send you a Statement of the Case. A Statement of the Case describes the facts, laws, regulations, and reasons that we used to make our decision, We will also send you a VA Form 9, "Appeal fo Board of Veterans’ Appeals," with te Statement ofthe Case. I'you want to continue your peal fo the Board of Veterans! Appeals the Board) after receiving a Statement of the Case, you must complete and return the VA Form 9 within one year from the date of our letter denying you the benefit or within 60 days from the date that we mailed the Statement of the Case to you, whichever i ater. Ifyou decide to complete an appeal by fling a VA Form 9, you have the option to request a Board pearing. [earings often increase wait time for a Board decision. It is not necessary for you to have a hearing for the Board to decide your appeal. It is your choice, ‘Where ean I find out more about the VA appeals process? * You can find a "plain language" pamphlet called "How Do I Appeal,” on the Internet at: http/Awww.bva.va.gov/How_Do_I_Appeal.asp. # You can find the formal rules for the VA appeals process in title 38, Code of Federal Regulations, Part 20. You can find the complete Code of Federal Regulations on the Internet at: http://www.ecfr.goy. A printed copy of the Code of Federal Regulations may be available at your local law library, YOUR RIGHT TO REPRESENTATION Can I get someone to help me with my appeal? Yes. You can have a Veterans Service Organization Fepresentative, an atlomey-at-law, or an "agen" help you with your appeal. You are not required to have someone represent you. It is yout choice. « Representatives who work for accredited Veterans Service Organizations know how to prepare and present claims and will represent you. You can find a listing of these organizations on the Internet at: htp://www.va.govivso. AO A407 (Please continue reading on page 2)To: 16198196828 eeeeare V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: ‘* A private attorney or an "agent" can also represent you. VA only recognizes attorneys who are licensed to practice in the United States or in one of its territories or possessions. Your local bar association may be able to refer you to an attorney with experience in veterans’ law. An agent is a person who is not a lawyer, but who VA recognizes as being knowledgeable about veterans’ law. Contact us if you would like to know if there is a VA accredited agent in your area. Do | have to pay someone to help me with my appeal? It depends on who helps you, The following explains the differences. © Veterans Service Organizations will represent you for free. * Attorneys or agents can charge you for helping you under some circumstances. Paying their fees for helping you with your appeal is your responsibility. If you do hire an attorney or agent to represent you, one of you must send a copy of any fee agreement to the following address within 30 days from ihe date the agreement is executed: Office of the General Counsel (02D), 810 Vermont Avenue, NW, Washington, DC_ 20420. See 38 C.F.R. 14.636(g). Ifthe fee agreement provides for the direct payment of fees out of past-due benefits, a copy of the agreement must also be filed with us at the address included on our decision notice etter. See 38 C.F.R. 14.636(h)(4), GIVING VA ADDITIONAL EVIDENCE ‘You can send us more evidence to support a claim whether or not you choose to appeal. NOTE: Please direct all new evidence to the address included on our decision notice letter, You should not send evidence directly to the Board at this time. You should only send evidence to the Board if you decide to complete an appeal and, then, you should only send evidence to the Board after you receive written notice rom the Board that they received your appeal Ifyou have more evidence to support a claim, it is in your best interest to give us that evidence as soon as you can, We will consider your evidence and let you know whether it changes our decision. Please keep in mind that we can only consider new evidence that: (1) we have not already seen and (2) relates to your claim. You may give us this evidence either in writing or at a personal hearing with your local VA office, In writing, To support your claim, you may send documents and written statements to us at the address included on our decision notice letter. Tellus in a letter how these documents and statements should change our earlier decision. Ata personal hearing. You may request a hearing with an employee at your local VA office at any time, whether or not you choose to appeal. We do not require you to have a local hearing. It is your choice. At this hearing, you may speak, bring witnesses to speak on your behalf, and hand us writien evidence. If you want a local hearing, send us a letter asking for a local hearing, Use the address included on our decision notice letter. We will then: # Arrange a time and place for the hearing « Provide a room for the hearing. « Assign someone to hear your evidence e Make a written record of the hearing WHAT HAPPENS AFTER I Give VA EVIDENCE? ‘We will reyiew any new evidence, including the record of the local hearing, if you choose to haye one, together with the evidence we already have. We will then decide if we can grant your claim, If we cannot ‘grant your claim and you complete an appeal, we will send the new evidence and the record of any local hearing to the Board. BACK OF WA FORN A107, JONBOIS ‘SUPERSEDES VA FOR 4107, EBON, ‘WnIGH WILL NOT BE USED.To: 16198196828 eee V2A82023 21:40:22 UTC ‘From: US Veterans Affairs: Department of Veterans Affairs INFORMATION AND INSTRUCTIONS FOR COMPLETING NOTICE OF DISAGREEMENT (NOD) IMPORTANT: Please read the information below careful to help you complete this form quickly and accurately. Some pats of the form also contain notes or specif instructions for completing that part “The use of this form is mandatory to initiate an appeal from the decision on disability compensation claims you received. This form hos several oy components, which, when fled out compltoly and accurately, wil decrease the emount of me it takes to procass your NOD, FREQUENTLY ASKED QUESTIONS How do | use this standard Notice of Disagreement (NOD) form? You must use this form if you wish to indicate that you disagree with a decision you received regarding your claim for disability ‘compensation. Examples of these decisions may inclide entitlement to service connection, percentage of evaluation assigned, and ‘effective date among ather things. This form Is the only way that you can initiate an appeal from 2 decision on your claim for disablity compensation. Should Ifill out this form? You must il out this form if you disagree with a decision issued by the VA regional office (RO) about your disability compensation claim. This includes an inital decision, a decision for an increased rating, oF any other decision with which you disagree. Only those issues that ‘you list on this NOD will be considered on appeal. For those Issues you do not ist on this NOD, you wil stil have one yeer from the date ‘of the decision notification letter to fle an appeal for these Issues, Where can get help? You can ask the Department of Veterans Affairs (VA) to help you fill out the form by contacting us at 1-800-827-1000. Before you contact Us, please make sure you gather the necessary information and materials, and complete as much ofthe form as you can. You can also contact your representative, if applicable, for assistance with completing this form. If you do not already have a representative, you can find a Ist of approved Veterans Service Organizations at wwnv.va.govivsa. You can be represented by a Veterans Service Organization representative, an attomey-atlaw, or ‘agent’. Contact your local RO for assistance with appointing a representative (or visit yewwebenefis.va.gov. ‘What should I do when | have finished my NOD? You should provide your signature in Item 134 and the date signed in item 138. Be sure to sign every form you fil out before you send it tous. If you don't sign the form, VA will return it for you to sign, and it wll ake longer to process. ‘Attach any materials that support and explain your NOD. ‘Mail your NOD to the address included on the VA decision notice letter or take your NOD to your local RO. Do | need to keep a copy of this NOD form? Itis important that you keep a copy of all completed forms and materials you give to VA. ‘What constitutes a complete NOD form? Generally, VA wil consider your NOD "complete" i the following Information is provided on the form: lease note that it would assist VA if you provice all the personal Information in Part |. However, i you provide certain information specific ‘o tho claimant such as tho claimant’ last name and Social Security Number or VA file number, VA will be able to Identify the claimant in ‘our system and would not necessarly consider this NOD incomplete if other Information In Part I, such as the claimants address and telephone number, is exchided. Please list the issues or conditions for which you seek appellate review in Item 11 of Part lV. At a minimum, please indicate the specific Issue of disagreement in Item 11A such as “right knee disabiliy" or “Post Traumatic Stress Disorder (PTSD)" and indicate the area of disagreement in Item 148 by checking the appropriate box. If you disagree with an evaluation of a disability, you may tell us what percentage evaluation you seek in Item 1 1C; however, you are not required to Indicate the percentage of evaluation sought in lem 11C in ‘order to complete this form, Please be sure to sign the NOD, certifying thatthe statements on the form are true and correct fo the best ofthe claimant's knowledge and belief. IMPORTANT: If you do not provide the above information on this NOD, VA will consider your form incomplete and wil request clarification from you. You must respond to this request for clarification either 60 days from the date of VA's request for clarification or one year from the date of mailing of the notice of decision of the RO, whichever is late. If you do not provide VA with a completed form within that time ‘frame, the decision will become final, and you will have to file a new claim, VAFORM Paget ecpaoe 21-0958 7