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How Hard Can it Be to Make a Claim? You'd be surprised!

Understand your options

If you’re to believe the Veterans UK website, in which they advise you that you really do not need to seek professional help from a Claims Management Company to make a claim, you’ve got nothing to worry about if you attempt to submit a claim by yourself – or have you?

PTSD Claims

You’ve been diagnosed with PTSD by your GP after several consultations and numerous sessions with a counsellor. Your condition is well documented in your medical records and on that basis you make an AFCS claim for PTSD

Result – Declined. The problem with your claim is that your diagnosis was not made by the appropriate grade of clinician, but nowhere will you find that advice on the Veterans UK website. You are now in the appeals process, which is far more difficult than your original application, and your chances of having the decision overturned are now much more difficult.

Sports Injury Claims

You follow orders and take part in a routine sports afternoon on your base playing football during which you suffer a serious knee injury.  You are medically downgraded for 6 months and might need surgery to reconstruct your knee. This has an adverse effect on your promotion prospects and you’re struggling to return to full fitness. 14 months after the incident you make an application for an award under the AFCS and submit your claim directly to Veterans UK. 

Result – Declined. The problem with your claim was that you were not representing your unit in that football match; there is nothing in Routine Orders confirming that you took part, no Calling Order was raised for the match, and no-one is in a position to draft an Executive Factual Report. You won’t find advice about Calling Orders or Executive Factual Reports anywhere on the Veterans UK website and any appeal is now much more difficult.

Slipping & Tripping Claims 

It’s a cold winter’s morning and you’re walking from your accommodation block to your place of work. You’re in uniform, you’re on duty, and there is snow on the ground.  Walking along one of the paths, your right foot catches a slightly raised drain cover which you cannot see because it is covered by snow and you fall onto your right side. You sustain a serious injury to your right shoulder which keeps you off work for 7 months during which time you need surgery on your rotator cuff. You submit an AFCS application directly to Veterans UK on the basis that you were on duty and were injured in circumstances that were caused by your service.

Result – Declined. You were not aware of the Regulations under Part 2, Injury and death: exclusions relating to travel, sport and slipping and tripping, Article 11 (3) ‘except where paragraph (4) and (9) apply, benefit is not payable to or in respect of a person by reason of an injury sustained by a member, the worsening of an injury, or death which is caused (wholly or partly) by that member slipping, tripping or falling’. These Regulations were not written to give you the benefit of the doubt, so if you slip or trip going to work you’re in for a difficult time when claiming.

Advice

These are just three examples of how ‘Going it Alone’ will put you in a position where you have wasted 4 months of your time waiting for a decision by Veterans UK that was always going to be a rejection.  The Regulations are complex; they are interpreted by the Medical Advisers at Veterans UK subjectively, which means it is what they think and not what you think about whether your circumstances fit into the right box.

You absolutely can go directly to Veterans UK to make these claims, but Veterans UK is not there to make sure that you have all the necessary advice on how to understand and use the Regulations to strengthen your application.

The best advice we could give you is to take advice from people that know. You wouldn’t expect a civilian to have the first idea on how to strip and clean an SA80 and we wouldn’t expect a serviceman or woman to understand the complexities of the Regulations that govern Armed Forces Compensation Scheme or War Pension Scheme applications.

Take Advice. Understand your options. Make the right choice!