Terms and Conditions
VA Claims Insider Elite Program – Additional Terms and Conditions
All members of the VA Claims Insider (VACI) Elite Membership Program understand, acknowledge, and agree to the following additional Terms and Conditions:
Client is solely responsible for the truth, accuracy, and timeliness of any claim he/she may submit to obtain VA disability benefits.
- Client hereby acknowledges that COMPLETELY FREE resources are available to assist with his/her VA disability claim.
- Because VACI does NOT assist Client with the preparation, presentation, and/or prosecution of his/her VA disability claim for VA benefits, and does not provide legal advice, VACI recommends that Client employ an accredited VSO, VA claims agent, and/or VA claims attorney to assist Client with the preparation, presentation, and/or prosecution of his/her VA disability claim. A list of accredited VSOs can be found HERE, and a list of accredited VA claims agents and/or accredited VA claims attorneys can be found HERE.
- Client agrees that he/she knows about, and has already explored, the FREE non-VACI resources available, and desires to become a member of VACI’s Elite Membership Program with the knowledge that the Client could achieve his/her desired VA rating and VA benefits for FREE and WITHOUT the use of the VACI’s resources and/or services. VACI encourages you NOT to become a member of the VA Claims Insider Elite Program unless you have already exhausted other FREE resources available to veterans.
- Client hereby understands that Client may obtain review of his/her medical records and condition from his/her own medical providers, possibly even FREE of charge, and that the services of VACI or other consultants are not required to obtain medical services in support of his/her VA claims.
- Client hereby acknowledges that VACI will NOT work on a claim that has already been filed. VACI will NOT work with or assist any VA-recognized or VA-accredited VSO, VA claims agent, and/or VA claims attorney. VACI will NOT ever refer Client to any VA-recognized or VA-accredited VSO, VA claims agent, and/or VA claims attorney.
- Client hereby acknowledges that VACI does NOT participate in any VA disability claim appeals. Additionally, VACI will NEVER receive any sort of retroactive back-pay compensation in connection with any disability claim appeal. VACI will NOT ever refer Client to any VA-recognized or VA-accredited VSO, VA claims agent, and/or VA claims attorney for the purposes of a disability claim appeal.
- Client hereby consents to receive emails, phone calls, and/or text messages from VACI, VACI team members (including VMCs), and independent medical providers in our referral network, for purposes of exchanging pertinent VACI Elite Membership Program information.
- Client hereby commits to maintaining an active eBenefits premium account and/or va.gov premium account (sign up for a free account at ebenefits.va.gov or va.gov). VACI will NOT have access to either of these accounts.
- Client hereby consents to using a HIPAA compliant Google Drive folder, which will be created for you freely after you execute this agreement, for purposes of the independent medical provider’s review purposes, DBQ reviews, Medical Nexus Letters, or any other health care service, if warranted.
- Client hereby commits to uploading a copy of his/her eBenefits Summary Verification Letter within seven (7) calendar days of signing a VA Claims Insider Elite Membership Program Agreement to his/her HIPAA compliant Google Drive folder, which will be created for all VACI Elite Program Members free of charge.
- For the purposes of calculating VACI’s Standard Membership Fee, the parties will use the Veteran’s current VA disability rating and current monthly payment inside their eBenefits and/or va.gov account, as of the date you executed your VA Claims Insider Elite Membership Agreement.
- Veteran agrees to notify VACI in writing within seven (7) calendar days of any change in benefits that Veteran receives following the effective date of the signed VA Claims Insider Elite Membership Agreement.
- Veteran agrees to upload a copy of the documentation of his/her new VA disability rating within seven (7) calendar days of receiving same to his/her HIPAA compliant Google Drive folder.
- Veteran agrees and consents to VACI contacting the VA to verify any change in benefits.
VACI NETWORK OF INDEPENDENT MEDICAL PROVIDERS:
VACI may offer to connect you with a medical provider (herein, a “VACI-Affiliated Provider”, who is empowered with the independent authority and freedom to exercise his/her own professional judgment. A VACI-Affiliated Provider may conclude that a claim lacks credible evidence to establish a “Nexus” for service connection without fear of negative repercussions.
VACI-Affiliated Providers charge for their services at reduced rates for VACI Elite Program members. Such services must be paid for by Client with a credit card and Client agrees not to submit such claims for reimbursement to any health care benefit program.
The VACI-Affiliated Providers have agreed to the following fee schedule as of May 1, 2020:
|VA Claims Insider Elite Membership Program – Independent Medical Providers Price List||Flat Fee|
|P&T Request Letter||$375|
|Independent Medical Opinion (IMO) + Nexus Statement||$375|
|Psychological Evaluation & Independent Medical Opinion (IMO) + Nexus Statement||$395|
If an in-person evaluation is required, such as a Range of Motion (ROM) test or a medical diagnosis of a disability/condition from a Medical Doctor (MD), the providers reserve the right to charge an additional fee for such services.
VACI-Affiliated Providers independently review and analyze your case. They are fully empowered to refuse service to any Client for any reason. Moreover, they may or may not agree to complete medical documentation for you.
VACI offers NO GUARANTEE that a VACI-Affiliated Provider’s opinion will be “favorable” to the Client’s VA disability claim. If there is insufficient medical evidence to support your claim, the opinion provided may be “inconclusive” or “unfavorable.” VACI-Affiliated Providers are not employed, engaged, or compensated by VACI in any way, nor does VACI control or dictate any Provider’s judgment or documentation.
STANDARD FEES AND PAYMENT TERMS:
VACI does NOT charge you any upfront fees for access and permission to use the VA Claims Insider Elite Membership Program. You NEVER owe a fee to VACI unless you receive an increase in your VA disability benefits.
Subject to any fee modifications or supplemental fees that may be set forth in Appendix A of the VA Claims Insider Elite Membership Agreement, Client agrees to pay VACI a Membership Fee (the “Standard Membership Fee”) in an amount equal to six (6) times the amount of the increase in Client’s Monthly Benefit Award following the Effective Date. For example, if Client’s Monthly Benefit Award increases by $1,000 per month, then VACI’s Standard Membership Fee is $6,000.
If Client owes VACI a Standard Membership Fee, Client has the following payment options:
- Option #1 – Lump Sum. If Veteran selects this option, VACI agrees to a 10% discount of the total fee owed. For example, if a Veteran owes VACI $6,000, a 10% discount would be applied to the total owed (10% of $6,000 is $600). Thus, the total owed would be calculated as follows: $6,000 – $600 = $5,400. The lump sum amount shall be paid via ACH electronic transfer (no fee), bank check (no fee) or credit card (2.9% processing fee added to the total owed) to VACI within seven (7) calendar days of the first month the veteran receives their new VA disability compensation payment(s) from the VA.
- Option #2 – Monthly Installments. If Veteran selects this option, the total owed to VACI will be paid in twelve (12) monthly installments equal to one-half of the monthly increase with no interest. For example, if a Veteran owes VACI $6,000, each month’s installment would be $500 for the next 12 months). The monthly installment shall be paid via ACH electronic transfer ONLY and to VACI within seven (7) calendar days of the first month the veteran receives their new VA disability compensation payment(s) from the VA, and each month thereafter, for a total of 12 months.
For the purposes of this Agreement, “Monthly Benefit Award” shall include all: (i) VA compensation and pension; (ii) additional spouse/dependent award; (iii) concurrent retirement and disability pay; and (iv) combat related, aid and attendance, DIC, and any special monthly compensation awards.
In the event that Veteran has not made payment to VACI within 30 calendar days following receipt of any additional benefit payment, the outstanding balance due to VACI will be subject to a 3% per month interest rate, or the maximum permitted by law, whichever is less, plus all expenses of collection, for any unpaid balances. Veteran agrees to pay the interest rate increase and expenses of collection if Veteran does not pay VACI in accordance with the terms and conditions herein.
Fee Cap. Under no circumstances will Client’s Standard Membership Fee exceed $15,000.
MEMBERSHIP TERMINATION POLICY:
VA Claims Insider, LLC reserves the right to terminate the VA Claims Insider Elite Membership Agreement with the client for any reason, including, but not limited to:
#1. VA Claims Insider, LLC feels the client is acting in an illegal, immoral, or unethical manner in an attempt to possibly defraud the Department of Veteran Affairs.
#3. The client fails to respond in a reasonably timely manner to request(s) from our team.
#4. The client fails to make timely payments upon services rendered.