How to Spot Predatory Claims Agents and Protect Your Disability Benefits
When it comes to tackling the adventure of filing a disability claim with the Department of Veterans Affairs (VA), veterans have a number of options.
If you have a knack for deciphering fine print and embarking on epic quests to track down paperwork scattered across various military and medical offices, you can file it yourself.
If that’s not your forte and you prefer a companion on this journey, you can call upon a registered Veterans Service Organization (VSO) for assistance. They’ll do it for free, but you might end up waiting a long time, and you may not get the personalized attention your claim deserves.
The VA also authorizes attorneys and accredited claims to assist with preparing initial claims and representing veterans who want to appeal an unfavorable VA decision.
Each of these representatives is subject to an accreditation process, to make sure veterans have access to responsible and competent representation on their VA benefits claims. The VSO certifies the competence and good character of its employees. An attorney licensed to practice law is automatically accredited. An accredited claims agent is someone who is not an attorney but who has undergone a character review by the VA’s Office of General Counsel (OGC), and has passed a written exam about VA law and procedures.
Unfortunately, there is one more way to file a disability claim: unaccredited claims agents.
These individuals or organizations typically promise to speed up the process and increase a veteran’s benefit amount. However, these renegade claims agents take a large cut of the veteran’s benefits up front, or may demand a percentage of future benefits, and may not ever deliver on their promises. Such practices have raised concerns about veterans getting misled and ripped off by predatory claims agents.
In this article we talk about the pitfalls of working with an unaccredited claims agent, and how you can make sure you’re getting the right kind of help with your VA disability claim.
Trajector Medical: A Cautionary Tale
As KFF Health News reports, Gulf War veteran Glenn Janssen was living in Portugal when he sought assistance in filing a VA disability claim for tinnitus and back and shoulder pain. A friend recommended Trajector Medical, an unaccredited operation that bills itself as a “private medical consulting and evidence-based company”.
When Janssen found that Trajector Medical — formerly Vet Comp & Pen — had done very little to assist him he decided to cancel his contract. He filed his claim on his own and ended up obtaining an award for the tinnitus claim. Trajector then contacted him to congratulate him on the rating and billed him for their supposed service. When Janssen refused to pay he faced threats of late fees. This veteran realized too late that he’d signed a misleading contract with a predatory claims agent.
How to Spot a Predatory Claims Agent
Trajector Medical is far from the only bad actor out there. Complaints about unaccredited claims companies have flooded the VA OGC in the past year. But veterans are far from powerless to protect themselves from scam artists. Here are some telltale signs that your claims agent isn’t on the up and up.
They call themselves a “benefits coach” or “medical consultant”
These terms are used by predatory claims agents to position themselves as an alternative to VA-accredited claims agents. Developing medical evidence is an important part of the claims process. However, companies purporting to be medical consultants are almost always scammers.
They charge a fee to prepare an initial claim
Charging a fee to prepare an initial claim is illegal. According to VA regulations, VA-accredited representatives are not permitted to charge a fee for assistance with an Initial claim. Predatory claims agents, on the other hand, may request that you sign a contract stipulating that you fork over a percentage of your back pay or future benefits in exchange for help with an initial claim.
Only VA-accredited representatives and VSOs are permitted to assist veterans with their initial benefits claims. No reputable organization will charge you a fee for their assistance on your initial benefits claim, or charge you up front for help with an existing claim.
They charge excessive fees
Accredited reps cannot charge more than 33.33% of your retroactive benefits for their services. Fees at or below 20% are considered reasonable according to the Code of Federal Regulations (CFR) section on payments to agents or attorneys who represent veterans before the Board of Veterans’ Appeals (BVA), which decides on appeals.
A reputable claims agent will never charge you up front for their services, and their fee structure is regulated by federal law. Those laws are in place to protect veterans from unscrupulous actors charging excessive fees or failing to deliver results for their clients.
Here at the Rep For Vets, all of our claims agents are VA-accredited. Our fee structure is simple and transparent and conforms with all VA regulations. Our fees are no more than 20% of any past due benefits owed to the veteran and their dependents, and we only collect fees if the veteran wins their claim.
They promise they can get you a faster claim decision
There is no slow track and fast track in the VA disability claims process. Claims are handled by the VA in the order in which they are received. Claims processing times depend largely on the VA’s current backlog, and what is being done to address it.
A VA-accredited claims agent may be able to get you a faster decision than on overburdened VSO in some cases, but there is no evidence supporting the promotional claims of unaccredited private companies that they can get you a claim decision faster than an accredited representative would. Those promises are empty marketing talk.
Sidenote: You may have heard that submitting a Fully Developed Claim can get you a faster claim decision. For some veterans the FDC option is attractive because it gives you more control over the evidence-gathering part of the process. We’ve looked into whether a fully developed claim can really help you get your disability benefits faster, and the answer is no. Submitting a fully developed claim will not get you a benefits decision any faster than a standard claim.
They aren’t accredited by the VA
This one goes without saying. You can check up on the accreditation status of an individual here.
VA Lags Behind Predatory Claims Agents
According to a February blog post by the Consumer Financial Protection Bureau and the VA, “unscrupulous actors have misled some veterans into paying hundreds of thousands of dollars”.
You would think it would be easy to shut these companies down, but the VA has limited authority to act against unaccredited companies, at least for now. They’ve sent cease-and-desist letters to private companies found preying on veterans, but that’s about all they’re currently authorized to do.
Veterans advocates are pushing for Congress to grant the VA more power to criminalize unauthorized and excessive fees for assisting veterans with disability benefit claims. Until then, veterans should be extra cautious in choosing a representative to assist with their VA disability claim. And be sure to report fraud when you encounter it. It helps protect the next veteran from getting ripped off.
PACT Act Expands Benefits to Hundreds of Thousands of Veterans; Scammers Flood the Zone
You might be wondering, Why are there so many scammers on the scene now? It has to do with the unprecedented scope of the PACT Act, which, when signed into law in August 2022, made it the biggest veterans benefits bill in U.S. history.
The Honoring Our PACT Act revolutionized the way the VA handles toxic exposure claims, expanding access to healthcare and screening and adding presumptive medical conditions for a range of toxic exposures, from burn pits in Iraq and Afghanistan to Agent Orange exposure linked to conflict zones beyond mainland Vietnam.
With tens of thousands of newly eligible veterans filing disability claims, it’s not surprising that unscrupulous actors have swooped in to take advantage of veterans. Scammers have aggressively targeted veterans with ads for their dubious services, making it hard to differentiate between legitimate claims agents and fly-by-night profiteers.
Make Sure You’re Working with a VA-Accredited Claims Agent
Make sure you’re working with a VA-accredited claims agent by entering their name here: Dept of Veterans Affairs Accreditation Search
After you’ve found a reputable claims agent, make sure you are seeking their assistance for the right reasons. There are two main reasons why a veteran can and should work with a VA-accredited agent.
- Your claim has been denied and you wish to appeal
- You believe your disability rating is too low, or you have new evidence that you want to present to the Board of Veterans Affairs
In both of these cases you’ll want an accredited claims agent in your corner to help navigate the complex appeals process. A claims agent can make a compelling case for increasing your rating. (If you need help filing an initial claim, see our resources on the Getting Started page.)
Having representation in the claims process makes a difference, and the numbers back this up. According to the Board of Veterans’ Appeals fiscal report for 2018, veterans represented by counsel had 45% of their claims granted, compared to the American Legion’s 35% success rate.
Since accredited claims agents and attorneys only get paid when you get paid, their goal is to reach the fastest decision at the lowest level of the appeals process, without leaving any compensation on the table.
Unaccredited claims companies like Trajector Medical say they fill a need not met by existing free resources and accredited agents, but these companies make misleading claims and their fees are not regulated by law. Stick to accredited claims agents and trusted resources!
Get In Touch with a VA-Accredited Claims Agent
The Rep For Vets is a team of accredited claims agents led by an experienced disability attorney. We are not a government organization or a VSO, but make no mistake – we don’t like to see vets get pushed around. We know the system inside out and are prepared to fight to get you the maximum compensation to which you are entitled.
How to Report Fraud
If you believe an individual or organization is misrepresenting themselves as a VA-accredited claims agent you can:
- File a complaint with VA’s OIG’s hotline
- File a complaint with VA’s Accreditation, Discipline, and Fees program
- File a report with the Federal Trade Commission
If you have an issue with debt collection, you can submit a complaint to the CFPB.