u/RedwoodDevotion

This is reposted from another comment where I responded to someone asking for the best advice for using AI tools to assist in claims filing:

I recommend stress testing your petition between two different AI’s. Personally, I use Claude and ChatGPT and give their responses to each other until they agree on the best method. Don’t speak in foregone conclusions.

Speak in a way that is persuasive by presenting your evidence and then making assertions based upon your evidence without demanding that relief has to be granted.

I also recommend looking up the specific applicable Code of Federal Regulations, as well as the M21-1 VA Rater Handbook Guidelines, that are most applicable to your claim (AI can help you figure out which ones are most applicable).

These are the ones that most apply to my case, since I am doing a supplement claim for a mental health disorder where there was missing evidence not previously considered (the entirety of my service department records pertaining to my mental health were never requested by the VA).

This is what I am asking my AI to apply when considering how to strengthen my argument: 38 CFR § 3.102 - Reasonable doubt 38 CFR § 3.156 — New Evidence, 38 CFR § 3.2501 — Supplemental Claims, 38 CFR § 4.1 — Essentials of Evaluative Rating, 38 CFR § 4.126 — Evaluation of Disability From Mental Disorders, 38 CFR § 4.2 — Interpretation of Examination Reports, 38 CFR § 4.3 - Resolution of reasonable doubt, 38 CFR § 4.7 — Higher of Two Evaluations

What these specify exactly can be pulled easily from the websites by AI.

M21-1, Part III, Subpart i, Chapter 2, Section C — Duty to Assist With Obtaining Records, M21-1, Part III, Subpart ii, Chapter 2, Section B — Procedures for Obtaining STRs, M21-1, Part IV, Subpart ii, Chapter 1, Section A — Review Examinations, M21-1, Part V, Subpart ii, Chapter 3, Section A - Determining the Issues, M21-1, Part V, Subpart ii, Chapter 3, Section B - Making Partial Rating Decisions, M21-1, Part V, Subpart ii, Chapter 3, Section C - Reviewing Diagnoses, M21-1, Part V, Subpart ii, Chapter 3, Section D - Evaluating Disabilities, M21-1, Part V, Subpart ii, Chapter 4, Section A — Effective Dates, M21-1, Part V, Subpart iii, Chapter 13 — Mental Disorders, M21-1, Part X, Subpart ii, Chapter 2, Section B — Revision Based on Receipt of Supplemental Service Records

These were a lot harder to get because the website is really wonky for mobile users, so I highlighted the entire page, copy and pasted into Google Gemini and asked it to keep all headings and information found in tables but to remove the table formatting.

Google Gemini is very sycophantic and overly agreeable (will get to saying you have over a 95% chance of success), so I would absolutely not trust anything it says and only use it as a tool to clean up sections you want to feed into other AI’s for compiling your evidence and asking what citations from 38 CFR or M21-1 Sections apply to your evidence/claim.

Just learned the hard truth from researching this issue. A veteran would ultimately be forced to have their case heard by the BVA as Decision Review Officers and even Senior Decision Review Officers at a Higher Level Review are instructed to follow the guidance of the M21-1 Manual instead of federal law.

Why do they do this? Because they have “sovereign immunity” from being sued by such bad faith instructions as they are classified only as “guidance”. Of course, it doesn’t hurt that it saves the government billions of dollars by denying veterans who often give up on their claims after being denied at the initial and higher level of review.

The Veterans Administration maintains a distinct operational divide between Service Treatment Records, known as STRs, and clinical records. Under the M21-1 manual, which serves as the internal procedural playbook for VA claims adjudicators, STRs are generally defined as the primary medical records generated during service, often accessible via the Healthcare Artifacts and Image Management Solution or the Joint Legacy Viewer. These are officially recognized as the certified and complete record of a veteran's military healthcare for the purpose of initial claim processing.

https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014119/M21-1-Part-III-Subpart-ii-Chapter-2-Section-B-Procedures-for-Obtaining-Service-Treatment-Records-STRs

Clinical records, conversely, are categorized by the M21-1 as a separate subset of medical documentation. This category frequently includes inpatient hospital stays, behavioral health notes, and other specific treatment documentation created at a military treatment facility. The manual explicitly notes that these records are rarely included in the standard STR bundle because they are archived by the treating facilities or the National Personnel Records Center rather than being automatically ingested into the VA’s primary electronic record systems.

https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014119/M21-1-Part-III-Subpart-ii-Chapter-2-Section-B-Procedures-for-Obtaining-Service-Treatment-Records-STRs

The invalidation of these records for the purposes of 38 C.F.R. section 3.156(c) reconsideration occurs when a claims rater adheres strictly to the manual’s narrow classification. When a veteran submits a request for reconsideration under 3.156(c) based on newly associated military records, the rater evaluates the evidence against the M21-1 definitions.

https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/subject-group-ECFR7629a1b1e9bf6f8.

If the rater determines that the newly provided documents are clinical records and not part of the certified STR file, they may conclude that the file was complete at the time of the original decision. This creates a bureaucratic loophole where the rater effectively disqualifies official Department of Defense medical records from the 3.156(c) mandate, arguing that the VA’s record was already complete based on its internal definition of an STR.

https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014119/M21-1-Part-III-Subpart-ii-Chapter-2-Section-B-Procedures-for-Obtaining-Service-Treatment-Records-STRs

This practice is technically legal and encouraged because the M21-1 acts as the authoritative internal instruction for VA employees. The VA defends this by asserting that the manual provides necessary procedural guidance to ensure consistency in processing. Because the manual is not a law, it does not supersede the Code of Federal Regulations, yet it dictates the daily workflow of the employees who make the initial and higher level review decisions. The VA is shielded from direct legal challenges to this manual, as courts generally view the manual as internal guidance rather than substantive law.

Consequently, the burden falls on the veteran to appeal these decisions to the Board of Veterans Appeals, where judges are not bound by the M21-1 and can prioritize the broad requirements of 38 C.F.R. section 3.156(c) over the VA’s restrictive internal policies.

https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/subject-group-ECFR7629a1b1e9bf6f8

Edit: Not sure why anybody but shitty VA raters trying to meet quotas would downvote this, but they are all over this sub.

It came to my attention last month that the VA was missing a substantial part of my medical records directly related to my mental health diagnosis. I had filed a VA Form 20-0995 under the impression that only my service treatment records from September 2010, and beyond (my last eight months of service) were missing.

However, a VERA representative recently confirmed in a virtual appointment I had on Friday that the issue is far more severe: the entirety of my behavioral and mental health clinical notes are completely absent from my original 2011 claim file.

These records were never transmitted to the VA, and they still had not been until I personally submitted them on May 12, 2026. This means that when I received my previous 30% and 70% ratings, the VA never had the full scope of my diagnosis available for review—despite my 2011 claim files explicitly listing “Service Treatment Records 2008-2011” as evidence considered.

Approximately 350 pages of clinical notes regarding my diagnosis (referred to as a “whole-category absence” by AI) were entirely absent from the claim files. Consequently, I was given a much lower rating at only 30% instead of the 100% P&T rating I was finally granted in 2019.

Because these are missing official military service department records that existed at the time of my discharge but were never associated with my file, this is explicitly a 38 C.F.R. § 3.156(c) issue. My goal is to use these newly associated records to backdate my 100% rating to my original effective date—the day after my discharge.

Here is where I am stuck procedurally:

I submitted the entirety of my service treatment records directly when I filed my supplemental claim last month. The rater completely failed to engage with the 3.156(c) issue I explicitly raised. Instead, the decision letter stated this didn’t meet the CUE (Clear and Unmistakable Error) standard because my C&P exams are what the rating was based on, and prior service treatment records wouldn’t have changed the outcome.

Because they completely ignored the 3.156(c) mandate and incorrectly viewed it through a CUE lens, I immediately filed for a Higher-Level Review (HLR).
I currently have that HLR pending, but I have a few questions for the sub:

Am I able to withdraw my current request for HLR and resubmit a new supplemental claim to explicitly trigger a proper 3.156(c) review based on this newly discovered, whole-category absence of records? Or will withdrawing the HLR mess up my timeline?

Do I have to wait for my current HLR request to finish processing before I can address the fact that these 350 pages of files were entirely missing from my record at the time of my 2011 claim?

Since HLRs don't allow new evidence, but the previous rater completely ignored 3.156(c), what is the fastest, cleanest way to force a rater to actually look at these 350 pages for the retroactive effective date without them lazily hiding behind "it doesn't meet CUE"? Should I argue this as a Duty to Assist (DTA) error during the HLR informal conference instead?

I have already reached out to my VSO (DAV) with these questions, but I wanted to see if anyone here has successfully navigated a rater completely ignoring 3.156(c), or switching gears from an HLR back to a Supplemental to fix a rater's incompetence.

Edit: When I filed my original Supplemental claim last month, I did so under the incorrect assumption that only my last 8 months of service records (September 2010 and beyond) were missing.

However, because of my VERA appointment last Friday, I now know the truth: the entire behavioral health category across my whole enlistment was missing from the 2011 file.

Because my closed Supplemental claim only explicitly called out the post-September 2010 timeframe, the pending HLR is technically bound by that scope. If I stay in the HLR lane, the Senior Reviewer might only look at the post-2010 gap and ignore the fact that the entire pre-2010 file was missing too, since that "knowledge" wasn't explicitly stated in the paperwork the previous rater looked at.

Simultaneously, the previous rater completely failed to engage with 3.156(c) at all, lazily stating it didn't meet the "CUE standard" because my C&P exams are what the rating was based on.

Given that I need the VA to look at the entirety of the 350 pages (pre- and post-2010) under the mandatory 3.156(c) framework to get my 100% backdated to the day after discharge, is it safer to withdraw the HLR immediately and file a brand-new Supplemental that explicitly defines the whole-category absence of my entire behavioral health file from day one of my service?

Or will withdrawing the HLR look messy and screw up my continuous pursuit timeline, even though the rater's decision was just last month?

I was planning to wait until August when my credit score would be over 800 (currently 785) to apply for a flagship card and then make a manual CLI right after on my Platinum card. Did they just completely screw up my timeline and now I have to wait 180 days for a second increase?

What’s worse is my car loan will be paid off in August (when I was planning to do the second card application and CLI before the loan is paid off), so that’s going to hurt my credit mix factor of my credit score and make it lower than it would have been by the time I’m able to apply for the CLI.