The SEM Method

In filing for VA claims, there's a process that we use here at VA Claims Insider. It's called the SEM method. That's S-E-M, stands for Strategy, Education and Medical evidence.

This method works in a way to where it covers all the bases. It covers everything! When you follow this process, it’s gonna be easier and give you more confidence once you've got this down!

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Transcript

[00:00:00] VACI: If you are a veteran and have filed a VA disability claim, have been denied, have received a low rating, or you're unsure of how to get started, reach out to us. Go to docontheroad.com linked in our show notes and take advantage of a free VA claims discovery call. Learn what you've been missing so you can finally get the disability rating and compensation you deserve.

[00:00:31] Dr. John: Hello my brothers and sisters of the uniform. Yes, it's time again for Doc on the Road. There is a subject that we keep talking about but I want to go a little deeper into it and try to explain some of it. There's a process that we use at VA Claims Insider. It's called the SEM method. That's S-E-M, stands for Strategy, Education and Medical evidence.

This is a great [00:01:00] game plan, is the way I look at it. As you go through the process of, going for claims and putting together a packet perse of how you're going to prove that you deserve this particular condition to be service connected. Now let's start with strategy.

Strategy is actually one of those really cool things, I always say this, most of you that listen to this know what I say during the classes. You see me in the classes all the time, and I always say this strategy is very important. This is where you and your coach come up with a game plan to attack.

To get going in a manner that is really gonna put this together. It's like putting a puzzle together. That's what I always talk about. You're painting that picture. I've talked about this before too. You're painting that picture. Think about back when you saw Bob Ross. I know some of you might know who that is.

Some of you [00:02:00] might not, but it was this one guy. He was a vet. And he would paint these pictures that were just gorgeous, but he would do it on a TV show, and as he was painting, he's talking about how he's doing it. That's the same thing that you wanna do with your strategy. You wanna know your strategy inside and out because it will give you back doors.

If it doesn't go the way you want, because you've got already planned out what the next road is, it's like when you come to that fork in the road, you're already gonna know, okay, we're going right. If this happens, we're going left if this happens. So strategy is really cool. Now, if you're a member of VA Claims Insider, you know this because more than likely you've gotten with your coach and you guys have actually talked about the conditions that you think that matter to you.

And the conditions that might be tied off of that condition. So coming up with a strategy, we'll tie all that together and give you a [00:03:00] big battle plan, basically, is the best way to look at it. It will get you going in the right direction. Now, of course, when you have a well thought out strategy, you need to educate yourself.

You need to know exactly. What the VA is looking for in that particular condition. You need to look at how they rate it. You need to look at what are the symptoms of it. You need to look at how does it affect you in a manner to where it becomes cumbersome throughout the day for you. And I always say this too, during the classes, you wanna really look at three main areas when you're coming up with this is how does it affect you socially?

How does it affect you with your family, and how does it affect you with your work? Does it create situations where it creates negativities in those three main areas? Remember, painting the big picture, okay. Putting the puzzle pieces together at the right time. So when you're doing your [00:04:00] education, you wanna go ahead and get as much positive influence and positive input from people that have been there, that have done that.

And really understand how that condition gets service connected. You want to make sure that you're doing that and you tie that back into your strategy. Then you've got that, those two working for you. And then you come up with, okay, you gotta have medical evidence. Now again, Brian Reese is famous for this one line, and to be honest with you, when I came through the program, when I heard this line, I was like oh my God.

It's like common sense, but it's not because you don't think about it, but you need medical evidence. That's the M in the SEM method. You need medical evidence because you need to prove medically how this could be service connected. You need to have opinions, okay? And the opinions that matter are the ones that come from the doctors.

So your private [00:05:00] doctor or your doctor at the VA, you need to be talking to them. Now there's a couple of good ways to do this and again, I'm repeating stuff that I've said over the last three seasons, but I want you to remember, you gotta make sure that you do this. 

There's myhealthevet. That is the easiest way to start the paper trail for medical evidence. You write your primary care doctor and you say, Hey, look, I want to talk to you about this condition. They really, created a problem for me lately, and I'd like to get your opinion on 'em. Now that starts the ball rolling.

Okay. And then they set you up with an appointment. You go to the appointment and you talk about those conditions. You talk about how they hurt, how they flare up. How they do anything that can affect, remember the three main areas, social, family, and work, how that can happen. So let's just take it, for example, we're gonna be talking about migraines, [00:06:00] okay?

You gotta make sure that when you talk about migraines, you gotta talk about all the symptoms. Do you get nauseous? Do you get into a situation where you almost feel like you're getting caught up in vertigo? Do you have to lay down? Do you have to get away from light and sound? Whatever you have to do.

And also the methods that you do to try to cope with it. Does a cold shower work? Does medication work? Does, a cold compress on your head work? Just wearing shades so you can't see anything. Does that work? And you also gotta go ahead and say, because of this this is how I respond.

Because sometimes your response to a certain condition is also very important. 'cause that really ties in other areas. So let's say again back to the example of migraines. Okay. You're having migraine, you have to go through all these different steps that I've mentioned, and when you come out of it, Are you groggy?

Are you [00:07:00] unresponsive to your family? Are you having to take time off from work? Is there other things that causes also will play big time in, you being able to talk in the right manner to a practitioner and say this. Now when you get, use MyHealtheVet, what that can do is really open up the VA to help you out with this.

Create that medical evidence trail, create documents, create different opinions, create all kinds of different things that are gonna play for you as you go for your claim. And not to mention if you're doing this at the VA, it's going right into your blue button report.

That's the report that the VA holds and keeps on record of your complaints. All the conditions that you complained about and as well as all the treatments that they've done to help you with that. So more likely with the same example of migraines, you're gonna go see a neurologist. All of a sudden now you've [00:08:00] got one doctor's opinion where your primary care, then you're gonna get a neurologist that's gonna give you their opinion and treatment.

So as this builds, you're building a huge amount of paperwork, but it's paperwork that actually edifies what you're saying and what you're going through on a daily basis. This will really help. When you go ahead and you get your stuff together for your medical evidence, and it's sitting right there for the VA Rat ers to look at because it's right there at the VA.

Now, if you go to a private doctor, you do exactly the same thing. You talk about all this stuff and then you get a copy of that report. Then you take it to the VA and drop it off and say, Hey, I want this put in my medical record. That way you have it in two different spots. And when you come to the time where you're gonna do your claim, makes it a lot easier for the evaluator and the new practitioner [00:09:00] that you're gonna have to see for your C&P.

That's a compensation and pension exam. That's gonna help that out. Simply because they're gonna be able to find that in there. They're gonna see it and they're gonna say, wow, this guy, he's going through a lot. He's on medications. This has been affecting him for a long time. And it's gonna be a lot easier for them to make a positive decision for you and your case.

So remember strategy, education, medical evidence. Now as we talk about medical evidence, there's a number of different things you can do outside of the VA. You can actually get a private opinion. And that private opinion will also add on to the other doctor's opinions. So when you go to the VA for that comp and pension exam, That's just one practitioner, but that one practitioner is going against at that.

In that example that I'm giving you now is giving you the example of three other practitioners. If you can understand that, [00:10:00] how it would outweigh negative response from say, a C&P, because you have three positive ones there. That is gonna help you a lot with the rater because the rater's gonna say I've got three opinions from outside doctors that say this.

C&P practitioner, said something negative. But the main point to remember here is the C&P practitioner is also gonna see those three opinions, right? So that doctor's also gonna look at it and go you know what? This does sound right. I do agree with what you know, one says, two says three says, then all of a sudden you've got four practitioners that have gave their opinion and say that yes, this should be service connected.

That is an easy process of doing this. So again that SEM method works and works well because you are putting together a package and putting a bow on it so the rater can actually go ahead and make the [00:11:00] correct decision. Now every once in a while you will get a bad decision and like last week I talked about higher level reviews.

It'll go to a more senior rater. And that's really gonna help the case out if there is four positive opinions saying yes, we believe that this is service connected and he should be compensated. So when you're thinking about these claims, and I just use migraines for an example, but you can use that for any condition.

Okay? Now, when you do that, you wanna make sure that you're doing it in the right way. Use myHealtheVet. That's a real simple thing. You actually go to the VA. The way I signed up for it is I was walking out from having a doctor's appointment and I got stopped by somebody and said, Hey look we've got this program. Do you wanna sign up for it? And I asked 'em, what is it? And they go's myhealthevet. So you could actually message your doctors back and forth.

Without coming to the VA, they can get a message from you and they can also send a [00:12:00] message back and all your doctors that you see at the VA will be able to stay in contact with you. So I was like, yeah, that's crazy. And it's free. So it doesn't cost you anything, but it is a great tool to actually put all of this stuff together and build that paper trail.

To take you to the next level, to take you to the point where you have numerous doctors giving an opinion about what you're going through, and make sure when you're talking to those doctors that you talk about it just like you're going through what I call a C&P. Because what that'll do is get prompt them to actually write down little things too.

He's missing a lot of time from work because of these headaches. Patient complains of feeling nauseous during... it plays right into all the symptoms that go with migraines. And if you get all three doctors saying this it's gonna be a situation to where it's gonna be hard [00:13:00] to not concede it because, It's not doctors that are either related to the VA or can be related to the VA or outside doctors.

So there's really no difference because the doctor's a doctor, basically their opinion is their opinion. So you wanna get as many positive opinions for your case than say negative ones. That is a great tool and I'm already a hundred percent P&T. I still use this, myHealthEvet.

I still send him a message every once in a while saying, Hey, look, the work that I'm doing for my PTSD is going I'm still suffering from numerous symptoms and I still have really bad days. But the thing is I can say that about my knees. I can say that about my ankles. I can say that about my back, my neck, shoulder.

You get the point. The point of it is he's getting a continued report of what I'm saying that I'm going through, which goes straight into your blue button report, [00:14:00] which goes into your medical file. So if there's ever a decision to say, reevaluate or do anything like that, you've already got a ton of medical evidence that is sitting there saying, no, it's getting worse, or No, it's didn't get any better which can also help you later down the road.

But it's also great too because it keeps my doctor informed so he could keep giving me the therapies that I need or keep giving me recommendations to go see a different doctor to see if we could come up with some therapies that can help me with any of my conditions. So it really does pay off to actually have myhealthEvet.

And again, the thing I like more about or the most about myhealthEvet is that it goes right straight into your medical records. But now again, too, if you're going to a private doctor, all you have to do is get a copy and you throw that right in there too. And that does the same trick. The way I look at this is that method, the [00:15:00] SEM method, the strategy, education and medical evidence method works in a way to where it covers all the bases.

It covers everything. It covers that whole painting that Bob Ross would do for just you, but you're Bob Ross at the time creating this. And it's also gonna be easier and give you more confidence once you've got this down. And go and talk to a practitioner for that comp pension exam. Because you're gonna have so much evidence that you've gone through and you're gonna have so much experience talking to practitioners that this could become secondhand to you.

It could be a situation to where you just rattle off exactly how it's going and how it affects you. Again, in those three main areas social family and work. And it's gonna keep building that picture, keep building that picture in a way to where [00:16:00] everybody understands, and it's gonna be hard to say no to that kind of situation because you have every angle covered.

Also make sure while you do that, that you're getting diagnosis for things that will also pay off too. Because if you remember. A current diagnosis is very important to have. That way it gets carried back to your time in service where the event happened or where the trauma happened to where it created this situation where you're getting headaches and tying it all back together.

Like I said, You're making a big package, putting a bow on it. So the rater has no choice but to be positive and go ahead and accept what you're telling them because you're backed up by, 1, 2, 3, or four doctors in their opinions. So just remember that. Also, if you are not a member of VA Claims Insider the best advice [00:17:00] I can give you.

Is because I came through the program just like everybody else. I was nothing but just a veteran that was seeking answers. And I luckily met a coach that had the answers and taught me to be teachable and taught me that I needed to really listen to a simple program like the SEM method.

So I can actually put everything together and also to where I could be coached to do this. Now, as I did that, I ran into a number of different vets that I'm still buddy with buddies with today. We didn't serve together, some of us weren't even in the same branch. And I also have buddies that are coaches now that I got to meet when I first did this.

And the cool part about these relationships is we are learning from each other and we are learning as we're helping other veterans get through this. That is the one thing that [00:18:00] I started to really learn about this, is it's truly about the community. It's truly about veterans, helping veterans to get over those hurdles, but to do it in a manner to where the success rate is much higher. 

And doing it to where you're helping other veterans by displaying your positive attitude by displaying that this is awesome. This is how I got to 70, or this is how I got to 90, and you can actually help them because I can tell you right now, there's no more joy than when you go over a hundred percent.

But when you help, A number of veterans go over a hundred percent. It is like you're doing it all over again. I know every time I am lucky enough and privileged enough to actually give advice for a veteran, and the next thing I know, I get a call back from those saying, Hey, that worked like a charm.

I'm at a hundred percent now. Thank you so much. It's like I just won all over [00:19:00] again. So all of us can have that feeling. If we're helping our brothers and sisters of the uniform by doing the same exact thing, making sure that we're staying positive, making sure that we're working the process in a way to where it works not only for us, but for others to watch us do this.

And as that community builds, we're gonna be able to raise a lot of voices that are united just like we were when we were in the military. Just like you were with your squad. I don't know what the other branches called that. I don't know if it was called a squad, but in the army it was called a squad.

Just like your fire team. There was a point where you guys were so tight knit that no matter what you went through, you knew exactly what the other person's strengths were and what their weaknesses were. And you knew that you had to cover if you needed to. You also knew that they were gonna cover your back if you needed to.

That is the mentality that we need to [00:20:00] get back to as we're going through this. So using little programs like this, like the strategy, education and medical evidence, that SEM method really helps build not only that old feeling that you had about your fire team, but also builds new feelings because you're gonna meet a number of people.

Matter of fact I've met a number of Clients that have come through the program that I really gravitated to. And they're in different branches than what I was they're in different jobs than what I was. It's opened me up to realize that there was other things going on just besides me jumping outta airplanes.

There are people that took care of the airplanes. There are branches that took care of the airplanes that I was jumping out of. Because the Army doesn't have any airplanes, that tells me the Air Force was doing what they were supposed to do so we could actually do what we did. And not to mention, I got to train with a number of different situations because of some of the units that I was in.

That made me [00:21:00] feel really cool. I got to do some time at I'm gonna give up a couple secrets here, but I got to do some time here or there at Little Creek. some of you Navy guys will know exactly what I'm talking about. I really, truly enjoyed that because I got to see a different side the armed forces.

By doing that, I got to do some time at Paris Island for a sharp shooter school that they were holding that I got to go to. So I got to see some of that too. Got great stories about that. Maybe we'll go over that some other times. Because I really want you guys to concentrate on your claim, working with your coach.

And if you're not part of VACI, getting a coach and work with them, start coming up with a strategy, start coming up with the education, educate yourself completely. I remember when I was coming through the program, there wasn't a class that I missed. For about three months I was there for every one of them.

I learned from different coaches, different coaching styles, different kind of situations, the way they [00:22:00] talked about things or, and levitated to the ones that actually I related to. And helped me get through the process. I can tell you when I went through the process, I had some ups and downs.

But the downs weren't all that bad. Simply because I bought into the whole idea of veterans, helping veterans, so I could get through those downtimes and there's disappointments that I had and keep moving forward. So that's the best way to go through any program that you're doing to work on your claims.

So I hope a lot of this helped. I look forward to talking to you guys. Here in another week. And just remember we got some big changes coming for Doc on the road and we've got some big changes coming for a lot of things that are related. Love you guys. This is doc out.

[00:22:48] VACI: The VA claims process is a pain. Many veterans struggle for [00:23:00] years trying to increase their ratings or even getting rated at all. Most are not getting the compensation. They deserve. Here at VA Claims Insider, we've supported and educated more than 25,000 veterans to win their claims and increase their rating.

Now it's your turn. Schedule your free VA claim discovery call today by going to docontheroad.com linked in our show notes. You'll learn what gaps you need to fill and how to increase your rating.