CLEVELAND, Ohio -- What do you do when the VA says no?

That thematic question was posed for a discussion presented by the Cleveland Regional Veterans Affairs (VA) Benefit Office Thursday night at Cuyahoga Community College's western campus.

About three dozen people came to hear why veterans' disability claims are rejected and what to do next.

In listing some common reasons for rejections, Larry Zietlow, public contact coach for the regional office, matched the reasons with possible solutions that could resolve a problem and negate the need to appeal a decision.

"There are a multitude of things we can do before an appeal," Zietlow said. "We're doing a very good job completing initial disability claims. Appeals -- we're struggling."

Here are some things he said:

If a claim is denied because of failure to report for a VA medical examination, "don't appeal, call us. We'll re-open the claim and schedule an examination."

If a claim is rejected because there is no diagnosis from a VA exam, submit a diagnosis from a private physician for re-consideration.

If there is no link shown between a claimed disability and military service, submit a private medical opinion that connects the two.

If denied because military service could not be verified, "contact the VA to reconsider the claim and submit proof of service."

Zietlow also advised asking for a complete copy of the VA's claim file to see what might be missing and what evidence you can provide.

He cautioned that all of these steps must be taken within a year of the claim's decision date. He said if these steps fail, a veteran can file a notice of disagreement, but must use VA Form 21-0958 (available online).

"The VA grants disabilities when it can, and denies disabilities only when it must," Zietlow said.

Other factors in claims rejection were covered in this first of a new form of town hall meeting that will be hosted by the VA regional office, said Anthony Milons Sr. director.

These clinics will focus on specific topics, held quarterly, to help educate veterans and improve the VA's performance, Milons said. The next one will focus on the importance of submitting fully developed claims to reduce the chance of delay or rejection.

"People make it seem like it's us vs. veterans," he said. "We're here to support veterans. We really want to do as much as we can to make sure veterans get as much as they deserve.

"Our job is to make sure we educate folks about what they need to do to avoid filing an appeal."

The regional office handles an average of 3,200 claims a month from Ohio veterans. About 12 percent of the claims are appealed, not necessarily because they were rejected, but they might not have completely satisfied a veteran's request.

Milons said an effort planned for within the next three to six months is posting instructional videos on YouTube for how to file disability claims. Also in the works is a service for veterans living in remote or rural areas of Ohio to deal directly with benefits personnel in Cleveland via a Skype connection.

Zietlow observed Thursday that to understand why the VA says no, a veteran should know why the agency says yes.

He outlined four general areas of approval criteria. It included that a claim shows a direct link between a disability and a veteran's military service. Another covered vets who served in a certain area or performed certain duties while in the military that involved an accepted presumption of disability (such as exposure to Agent Orange in Vietnam).

A successful claim also can involve a secondary service connection in which a service-related problem created another disability. There are also claims showing that a condition that existed before entering the service was aggravated by military duty.

In all of these cases a current medical diagnosis or health assessment (either from the VA or a private physician) must be part of the claim, Zietlow said.

Case workers from the regional office were available Thursday to handle specific claims that came up. Most of the veterans who raised questions were referred to these workers who then met with the veterans in a separate room.

One veteran complained during the clinic that his physician did not have access to the VA's disability claim file and was unable to obtain information that could be used in a diagnosis. The vet said his claim was rejected.

"That's reason enough to re-open a claim," Zietlow advised. "Don't let that slide."

There were several complaints about repeated delays and denials of disability claims.

But there was also one bit of praise, from Rosie Palfy, 43, of Rocky River. The Marine veteran said she spent more than eight years fighting with the VA regarding her disability claim for post-traumatic stress related to being sexually assaulted while in the military.

She said with the help of Nicole Betts, an appeals coach at the Cleveland regional office who was one of the Thursday panelists, she recently got full, backdated benefits for her claim.

"I really want to thank you for your diligence and patience and help with my claim," Palfy told Betts.

Palfy, in turn, won praise and sympathy from VA officials.

"Thank you for not giving up. It takes courage," said Todd Weber, assistant director of the regional office. "I regret we ever handled this (claims regarding military sexual assault) the way we used to handle it."

Zietlow noted that many past VA policies and practices that led to rejections of disability claims have changed.

He encouraged vets who may have had a claim rejected to "please come back and talk to us again. We would like to take another shot at getting you what you deserve."

(The Cleveland Regional VA Benefit Office and the Louis Stokes Cleveland VA Medical Center will sponsor a town hall meeting Tuesday, June 30, 5-7 p.m., at the Parma VA Outpatient Clinic, 8787 Brookpark Road.)