Service Agreement Form


 Client Contract

 
 
Client Name:  
Client E-mail: 

 

  1. Our medical consulting fees are for “Pre-Filing VA Disability Claim Medical Consultation” relating to medical conditions that may potentially impact our Veteran Clients. Veteran Alliance Corp. provides our clients free-of-charge access to software to assist our Veteran clients in preparing and submitting various forms to the VA.
     

  2. All claim preparation assistance is provided exclusively via automated software that our clients utilize and we NEVER charge a fee for the preparation of a claim.  All claims must be reviewed by the Veteran for accuracy and signed prior to being submitted by the Veteran to the VA.  Veterans are solely responsible for ensuring that all fillings the Veteran makes with the VA are accurate and timely.  Veteran releases Veteran Alliance Corp. from any responsibility associated with the accuracy or timeliness of any filing made by the Veteran to and with the VA.
     

  3. Veteran Alliance Corp. will review your military and civilian medical records, C-File documents, and medical case history as Veteran Alliance Corp. deems necessary and will provide medical consulting services to you and/or your attorney/advocate if applicable.
     

  4. Veteran Alliance Corp. does NOT guarantee you or your attorney/advocate that we will accept your case and provide medical consulting.  Some cases are not appropriate for our services.
     

  5. Veteran Alliance Corp. does NOT guarantee that your case or claim will prevail and be approved by the VA.  Veterans must understand that Veteran Alliance Corp. makes no promises or representations as to what your case or claim will ultimately be worth and no employee or agent of Veteran Alliance Corp. other than the CEO has the authority to bind or commit or extend promises to a Veteran.
     

  6. Veteran Alliance Corp. has a team of medical and legal professionals who review your case and write Medical Opinions, Independent Rating Evaluations and assist you in preparing your Lay Statement in support of the claim.
     

  7. On a case-by-case basis, Veteran Alliance Corp. may assist a Veteran with any pending claims that have been filed prior to the signing of this agreement but have not yet been adjudicated by a VA REGIONAL OFFICE.  Veteran understands and agrees to compensate Veteran Alliance Corp. for any pending awards that the Veteran has filed with the VA if that award is adjudicated after executing this agreement.  Veteran Alliance Corp. STRONGLY PREFERS NOT TO WORK CASES THAT HAVE PENDING CLAIMS IN THE SYSTEM THAT HAVE NOT YET BEEN ADJUDICATED BY THE VA.
     

  8. Once Veteran Alliance Corp. assist you in getting a new claim service-connected, Veteran Alliance Corp. will help you protect that claim from being lowered FOR YOUR LIFETIME – AT NO ADDITIONAL CHARGE.
     

  9. Veteran Alliance Corp. is available to assist Surviving Spouses to receive approximately $15,000 per year for their lifetime in the event their Veteran spouse died from a service-connected disability.
     

  10. Veteran Alliance Corp. does NOT  charge you for the preparation of case files, such as copy fees, mailing fees, etc. nor does Veteran Alliance Corp. charge you any up-front fees for the work it does.
     

  11. Veteran Alliance Corp. NEVER charges you a fee unless you have a favorable outcome on your VA claim that leads to either an increase in your monthly disability award OR results in the protection of a previously granted award that the VA was attempting to reduce.
     

  12. In the event, you have a Mental Health Claim requiring an Independent Medical opinion by a specialized mental health professional who holds the specific VA required credentials (i.e. Psychiatrist), you may be given the option to use a private provider OR  use the VA staff doctors.  If you choose to use a private provider, that provider may charge you a fee for their services which is totally independent of Veteran Alliance Corp. and our medical consulting services.  The fee will be paid directly to the private medical provider and not Veteran Alliance Corp.  This is OPTIONAL and not required, however many Veterans have found the expedited processing times and convenience is more than worth the nominal expense paid to the private provider.
     

  13. Veteran Alliance Corp. does not file your claim for you; either you or your attorney/advocate are responsible for filing your claim with the VA and you are SOLELY RESPONSIBLE  for ensuring all time-sensitive responses to VA denials, notice, and rulings (Notice of Disagreement, Form 9, etc.) are filed within the appropriate timelines allowed by the VA.
     

  14. Veteran Alliance Corp. provides Medical Consulting Services and is NOT your VA Representative. Veteran Alliance Corp. does NOT represent you before the VA as an advocate or a legal representative and does not provide legal advice.
     

  15. Once you execute this agreement Veteran Alliance Corp. will begin expending significant resources on your case.  Since we do NOT charge any up-front fees, this agreement cannot be terminated by the Veteran without the express written approval to terminate by Veteran Alliance Corp.  Veteran Alliance Corp. will not unreasonably withhold approval to terminate this agreement once all pending casework has been fully adjudicated by the VA (including through the appeals process if applicable).

 

INDEPENDENT MEDICAL OPINION DISCLOSURE
 
The medical providers in our network:

  1. Provide CREDIBLE and UNBIASED Medical Opinions based upon the history that the Veteran provides the available medical-legal evidence, and the independent medical assessment.
     

  2. Every medical professional associated with Veteran Alliance Corp. has the sole authority and freedom to conclude that a claim lacks credible evidence to establish a service connection without fear of negative repercussions.
     

  3. Therefore, our Independent Medical Opinions carry significant weight before the VA and provide such value to our Veteran clients and their attorneys/advocates who may represent them.  It is a KEY to us helping you win ALL of your VALID CLAIMS.
     

  4. Veteran Alliance Corp. offers NO GUARANTEE that the medical opinion will be “favorable” to the Veteran’s VA claim.  If there is insufficient medical-legal evidence to support your claim, Veteran Alliance Corp. Independent Medical Opinion may be “inconclusive” or “unfavorable”.
     

  5. Thus, in summation Veteran Alliance Corp. DOES NOT  control or dictate what is documented by one of our associated medical professionals in their Independent Medical Opinions and we provide NO GUARANTEE THAT THE INDEPENDENT MEDICAL OPINIONS WILL SUPPORT YOUR VA CLAIM AND/OR APPEAL.
     

  6. At Veteran Alliance Corp., our mission is to continue to assist Veterans in uncovering legitimate service-connected disabilities and securing the necessary documentation that is formatted in proper medical-legal fashion for submission by the Veteran to the Dept of VA.
     

  7. This is accomplished through a large network of Independent Medical Professionals who provide CREDIBLE  and UNBIASED Independent Medical Opinions and documentation with a high professional standard of quality AND integrity. 

 
I understand the level of services provided by Veteran Alliance Corp. and acknowledge that I am SOLELY RESPONSIBLE  for ensuring all time-sensitive responses are filed with the VA within the appropriate timelines AND this contractual agreement overrides any verbal or written representations made by Veteran Alliance Corp. staff before and after the execution of this agreement unless those representations are in writing and signed by the CEO of Veteran Alliance Corp.
 

STANDARD PAYMENT AND FEES

 
Veterans Commitment & Representations

1. Veteran understands ALL interactions with the Department of Veteran Affairs on topics relating to disability claims could have a significant impact on the processing or award of any pending claims as well as the strategy developed by our proprietary system.
 
2. Veteran agrees to follow the strategic approach developed by the proprietary claims strategy algorithm that is built into our website and commits to refrain from filing claims that are not consistent with the proposed strategy until the Veteran completes the recommended approach that is provided to the Veteran.
 
3. Veteran understands that as his/her medical consultants, Veteran Alliance Corp. must be informed of all medical appointments, changes in health or medical conditions, VA Award Letters, and Rating Decision Letters as soon as the Veteran becomes aware of them.
 
4. Veteran will advise Veteran Alliance Corp. of any scheduled VA C&P exams as soon as the Veteran receives notice of the C&P exam
 
5. Veteran acknowledges that this contract is not cancelable once Veteran Alliance Corp. begins working on your Since Veteran Alliance Corp. does not charge the Veteran ANY upfront medical consulting fees, Veteran Alliance Corp. agrees to work in advance, based on your commitment to follow through with the claims process and pay a fee to Veteran Alliance Corp. after an award is received from the VA.  

6. In the event Veteran fails to follow through with this agreement, there will be a breach of contract fee owed to Veteran Alliance Corp. in the amount of $400 per hour Veteran Alliance Corp.staff has spent on the Veteran’s claims OR the full projected fee Veteran Alliance Corp. would have earned in this agreement, had it been honored, whichever is greater.

SUPPLEMENTAL FEES AND PAYMENT TERMS

NOTE: There are specific additional supplements to the standard fee charges noted in the  SUPPLEMENTAL FEES AND PAYMENT TERMS section below that apply to select Veterans.    

Veteran agrees to compensate Veteran Alliance Corp. according to the medical consulting fee calculation and schedule as follows:  Veteran Alliance Corp. will receive five times (5x) the monthly increase in the monthly benefits award the Veteran receives from the VA.   The monthly increase is defined as the difference between the Veterans pre-consulting monthly compensation benefits award (from previously awarded military service-connected disability claims percentage EXCLUDING any temporary rating increases such as convalescence) and the total newly awarded monthly compensation benefit and percentage awarded (from VA compensation and pension, special monthly compensation, concurrent retirement and disability pay, and combat-related special compensation awards). This is inclusive of VA compensation and pension, additional spouse/dependent award, concurrent retirement, and disability pay, combat-related, aid and attendance, DIC, and special monthly compensation awards.  
 
SUPPLEMENTAL FEES AND PAYMENT TERMS CONT

Veterans who fall into one of the following categories are responsible for the associated supplemental fees detailed below:    

1. Receiving military retirement pay and currently are being paid at a total disability rating of 10% to 40%. NOTICE: A Veteran collecting monthly military retirement is not eligible for Concurrent Retirement Disability Pay (CRDP) above their retirement pay until the service-connected disability rating reaches 50% or higher. As a result of the CRDP impact, your fees to Veteran Alliance Corp. will be dependent on whether we help you get up to that critical 50% rating threshold.  
 
If after working with Veteran Alliance Corp. you DO NOT obtain the 50% threshold, which allows you to receive both your retirement pay and your VA disability pay, then you WILL NOT owe Veteran Alliance Corp. anything for our services.  
 
If Veteran Alliance Corp. is able to help you obtain the 50% threshold, you will go from essentially receiving nothing for your VA service-connected disability (other than some favorable tax benefits) to receiving both retirement pay AND disability pay each month. Instead of paying the Standard Fee noted above, you hereby agree to pay Veteran Alliance Corp. five (5) months’ worth of the TOTAL VA DISABILITY CHECK paid to you each month by the VA when you reach the 50% or higher disability rating.  
 
2. Your case requires a specific Medical Opinion or other custom medical   NOTICE: Due to the significant additional work and expertise required for these documents, in addition to the standard five (5) months’ worth of the increased monthly benefit detailed in the above Standard Fee Charges and Payment Terms, you agree to pay Veteran Alliance Corp. 10% of the total gross retroactive (before any legal or other fees are deducted) award within two (2) business days of receiving payment on your claim.  

3. You want Veteran Alliance Corp. to protect an existing Service-Connected Disability Rating that Veteran Alliance Corp. did not participate in attaining.   NOTICE: Since Veteran Alliance Corp. did NOT participate in helping you secure the initial disability award rating, this claim is not covered by Veteran Alliance Corp.'s lifetime commitment to provide FREE medical consulting services to defend and protect your VA disability ratings that we previously helped you secure. Veteran Alliance Corp. will help you protect ratings that you had established prior to working with Veteran Alliance Corp. for the following fee schedule.   The VA letter that notified you of the VA's intent to reduce your rating will detail which service-connected disability rating is involved. Veteran Alliance Corp. will determine the impact losing that rating will have on your disability compensation and will advise you of such. If you choose to proceed and have Veteran Alliance Corp.S prepare the medical consulting package for you to present to the VA, you will be responsible for paying Veteran Alliance Corp. five (5) months’ worth of the protected rating no later than 90 days after Veteran Alliance Corp. provides you the complete consulting package. In the event that you are not able to pay that fee in full at that time, you agree to pay 10% of the total fee each month beginning the month after you file the response to the intent to reduce so your balance will be paid in full no later than 10 months after the response to the intent to reduce has been filed with the VA.    

4. You have a claim that has previously been denied and is on.   NOTICE: Since these cases often involve significant additional work to "undo" the previous unsuccessful attempts to secure an award for service connection, and they often require additional medical and legal evidence to be developed, in addition to the standard five (5) months’ worth of the increased monthly benefit detailed in the above Standard Fee Charges and Payment Terms, you agree to pay Veteran Alliance Corp. 10% of the total gross retroactive (before any legal or other fees are deducted) award within two (2) business days of receiving payment on your claim.  

5. You have a CUE or Clear and Unmistakable Error.  

NOTICE: Few Veterans have these claims in their files and even fewer still are aware of these claims. In the event we help uncover a CUE claim, the VA will be responsible for paying you retroactive pay to the initial date that the VA made the error. In these cases, you agree to pay us five (5) months’ worth of the highest monthly value of the CUE claim award PLUS 25% of the total gross retroactive pay (before any legal or other fees are deducted) due within two (2) business days of receiving payment on your claim.

6. You are receiving a temporarily increased rating (due to convalescence you are receiving 100% pay for 12 months while you recover from a surgery, stroke or heart attack, etc.).   NOTICE: The calculations for this agreement are based on the rating and pay level you had prior to the temporary increased rating since your temporarily increased convalescence rating will revert to the prior rating, or potentially even lower than that if the VA argues the condition has improved. You agree to pay Veteran Alliance Corp.'s fee based on the difference between the disability rating you were receiving prior to the temporary bump for the convalescence rating and the newly awarded rating you receive after Veteran Alliance Corp.'s medical consulting assistance. These cases generally require specific medical opinions so you will also be responsible for paying the additional 10% of the retroactive lump sum award detailed in #2.  

7. You have pending claims that have not yet been adjudicated by the VA or you file additional claims on your own.  

NOTICE: Any pending claims that have been filed prior to signing this agreement that has not been adjudicated by the VA, and additional claims that you file on your own without Veteran Alliance Corp's assistance can dramatically impact the viability of your case. These types of claims often add significant workload for Veteran Alliance Corp. and can adversely impact the case strategy etc. Due to this, Veteran Alliance Corp. would prefer NOT to work on cases that have pending claims that have yet to be adjudicated by a VA Regional Office and we would prefer to pass on cases where the Veteran intends to file additional claims on their own. HOWEVER, if the Veteran wishes to proceed and not wait for those claims to finish routing through the system, you hereby understand that Veteran Alliance Corp. will participate in ANY increased award from any pending claims the Veteran filed with the VA prior to executing this agreement or any pending claims the Veteran filed with the VA prior to executing this agreement or any new claims the Veteran files with or without veteran Alliance Corp.'s assistance after this agreement is filed up until the active claims Veteran Alliance Corp. is working on with the Veteran are fully resolved and Veteran Alliance Corp. advises the Veteran that no further case development is viable. We encourage you to NOT execute this agreement if you have any pending claims and are not comfortable with Veteran Alliance Corp.participating in the potential pending award. As of the effective date of this agreement, Veteran Alliance Corp.’s fee will be due regardless of whether the Veteran has a pending claim, or whether Veteran Alliance Corp. initiates the claim. History has proven that these cases are typically a mess and extremely time-consuming. Veteran Alliance Corp.'s fee for these cases is five (5) months’ worth of the increase in benefit for any previously filed claims or any claims the Veteran files on their own while still waiting for final adjudication on active claims Veteran Alliance Corp.is assisting with. Payment shall be sent to Veteran Alliance Corp. at the address at the top of this agreement within two (2) business days of receipt of the increased monthly benefits award from the VA every month until Veteran Alliance Corp.'s fees are paid in full.   For example, if you are currently getting paid at the 10% pay scale rate and you have a pending claim that Veteran Alliance Corp.'S did not assist you with that becomes approved, causing you to move up to the 50% pay scale level, you agree that you would be responsible for paying Veteran Alliance Corp. five (5) months’ worth of the increase in pay from 10% to 50% even though you filed that claim without Veteran Alliance Corp.'s assistance.  

8. In the event you are awarded a temporary convalescent rating.  

Since these ratings are temporary in nature, Veteran Alliance Corp. will NOT receive the standard five (5) months’ worth of the monthly increased award you receive. Instead, you agree to pay Veteran Alliance Corp. 20% of your gross total increased award during the temporary convalescent period.   For example, if your monthly VA disability pay increases from $1,500/mo. to $3,200/mo. for a period of 12 months, your gross total increased award during the temporary 12 month period is $3,200$1,500=$1,700 X 12 mo. = $20,400. You agree to pay Veteran Alliance Corp.20% of that gross total increased award which is equal to a fee of $4,080 payable to Veteran Alliance Corp.. Example
 

EXAMPLE OF HOW WE CALCULATE FEES – SCENARIO 1:  

A Veteran that is married and has no dependents and is currently rated at a 50% rating by the VA. He has applied for a new claim that has never been denied before, receives an increase to an 80% rating, and is also awarded Special Monthly Compensation (SMC) at $101.50 per month.    

Thus, the Veteran's total payment for services rendered is:  

Pre Veteran Alliance Corp. Consulting: 50% = $917.13
Post Veteran Alliance Corp. Consulting 80% = $1,680.48 + $101.50 for SMC = $1,781.98  
Difference in above (monthly increase) is [$1,781.98 - $917.13] = $864.85 x 5 months = TOTAL FEE OWED TO Veteran Alliance Corp. = $4,324.25    
The Total Fee Owed to Veteran Alliance Corp. can be Paid in Full (REQUIRED when Veteran receives a Retroactive Payment that is greater than Veteran Alliance Corp.’s fee) OR paid as follows:  

When enrolled in Veteran Alliance Corp.’s Automatic Monthly ACH Billing Program, this is payable over ten (10) monthly installments equal to ½ of the monthly increase or $432.43/mo.    

Not enrolled in the Veteran Alliance Corp.’s Automatic Monthly ACH Billing Program, this is payable over ten (10) monthly installments equal to ½ of the monthly increase $20 processing fee per payment or $452.43/mo.    

EXAMPLE OF HOW WE CALCULATE FEES SCENARIO 2:  

A Veteran that is married and has no dependents is currently rated at 50% rating by the VA. He receives an increase to 90% after the Veteran wins an appeal that was four years old.   Thus, the Veteran's total payment for services rendered: Pre Veteran Alliance Corp.'S Consulting: 50% = $917.13  

Post Veteran Alliance Corp. Consulting: 90% = $1,888.48  

Difference in above (monthly increase) is [$1,888.48 - $917.13] = $971.35 x 5 months’ worth of payment = $4,856.75  

Veteran also receives a retroactive gross award of $82,867.20 for the four-year-old appeal, before legal fees and other deductions: 10% of $82,867.20 = $8,286.72  

The TOTAL payment due will be $8,286.72 (10% of retroactive award) + $4,856.75 (5 months of  new monthly gain) =                                                                                                                                                  
TOTAL FEE OWED TO Veteran Alliance Corp.'S = $13,143.47  

The Total Fee Owed to Veteran Alliance Corp. MUST BE PAID IN FULL WITHIN 5 Days of Veteran’s receipt of payment from the VA since the Veteran’s Retroactive Pay is greater than Veteran Alliance Corp.’s fee.  
 

EXAMPLE OF HOW WE CALCULATE FEES SCENARIO 3:

A retired Veteran that is married and has no dependents is currently rated at 20% rating by the VA. He receives an increase to 90% after filing a claim assisted by Veteran Alliance Corp.  

Thus, the Veteran's total payment for services rendered:  

Pre Veteran Alliance Corp. Consulting: $3,200 retirement + (20% at $317.13) = $3,200  

Post Veteran Alliance Corp. Consulting: $3,200 retirement + (90% at $1,888.48) = 5,800.48  

Difference in above (monthly increase) is [$8,800.48 - $3,200] = $1,888.48 x 5 months’ worth of payment = $9,442.40 (plus 10% of retroactive pay)  

The TOTAL payment due will be $9,442.40 (five (5) months of new monthly gain)  
The Total Fee Owed to Veteran Alliance Corp. can be Paid in Full (REQUIRED when Veteran receives a Retroactive Payment that is greater than Veteran Alliance Corp.’s fee) OR paid as follows:  

When enrolled in Veteran Alliance Corp.’s Automatic Monthly ACH Billing Program, this is payable over ten (10) monthly installments equal to ½ of the monthly increase or $944.24/mo.  

Not enrolled in the Veteran Alliance Corp.’s Automatic Monthly ACH Billing Program, this is payable over ten (10) monthly installments equal to ½ of the monthly increase plus a $20 processing fee per payment or $964.24/mo.  

The above are examples to illustrate how Veteran Alliance Corp.’s fees are calculated and paid. There is a wide range of potential outcomes for the fees payable to Veteran Alliance Corp. that can range from zero to tens of thousands of dollars if you receive a substantial lump sum retroactive award. I understand and agree with the calculations for the supplemental fees owed to Veteran Alliance Corp. and the payment terms.
 
When you are approved from the VA a Payment Arrangement Letter will be sent from the Veteran Alliance Corp. Finance Department with options to pay the consulting fee over 5 months, or 10 months via ACH or Credit/Debit Card. If the Payment Arrangement is not signed within 3 business days the consulting fee will be debited via ACH using the information provided to VA over 5 months.   This is an Implied Agreement you agree to all stipulations in this agreement even if you don’t sign it if you accept the assistance of Veteran Alliance Corp. and receive an increase in your compensation.


Disclaimer of Warranties


1. Entire Agreement, Modifications, and Waivers. This Agreement contains the entire agreement between TrueVetSolutions Medical Consultants (Veteran Alliance Corp.) and Veteran with respect to the subject matter hereof. This Agreement may not be modified except by a written instrument signed by both Parties and referring to the particular provisions to be modified. If any provision of this Agreement is declared invalid or unenforceable, then the court shall replace the invalid or unenforceable provision with a valid and enforceable provision that most accurately reflects the Parties’ intentions and the remaining provisions of this Agreement shall remain in full force and effect. Failure by either Party to enforce any provision of this Agreement will not be deemed a waiver of future enforcement of that or any other Wherever the term “including” is used, it shall mean “including, but not limited to”. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original for all purposes, and together shall constitute one and the same agreement.  2. Headings, Advice of Counsel, and Drafting. Headings used in this Agreement are provided for convenience only and will not in any way affect the meaning or interpretation of each section. The Parties acknowledge that they have been advised by counsel of their own choosing or have had the opportunity to consult such counsel, and therefore waive any canons of construction that would construe this agreement more heavily in favor of one party over the other, and that its terms will be interpreted without any bias against one Party as drafter.  3. Governing Law, Disputes. This Agreement shall be governed and construed exclusively by and under the laws of the State of Florida, without regard to its conflicts of laws rules. The state and federal courts located in Duval County, Florida, shall have exclusive jurisdiction to adjudicate any dispute arising out of or relating to this. Each Party hereby consents to the exclusive jurisdiction of such courts. In any dispute arising out of relating to this agreement, the prevailing party shall be entitled to recover its attorney fees and reasonable costs. If the Veteran refuses to pay Veteran Alliance Corp. as agreed, the Veteran also agrees to pay Veteran Alliance Corp. the costs of collection of such debt, including reasonable court and attorney fees and costs.  4. Standard Forms 180, 4138, and Written, Electronic & Telecommunications with the VA. Veteran understands and agrees that to fully assist in the identification of all eligible benefits and to fully execute all aspects of this Medical Consulting Agreement; VetSuccess101 Medical Consulting will need access to private information regarding the Veteran’s VA claims file including pending, awarded, and denied claims. Veteran hereby agrees to provide, and or allow Veteran Alliance Corp. to verify any and all needed information to pursue the full execution of this contract and will provide an executed blanket VA SF180 or 4138 and will provide or request the delivery of the necessary records Veteran Alliance Corp. may request from time to time. Veteran authorizes Veteran Alliance Corp., for the purposes of medical consulting and full satisfaction of this agreement, to access all of the Veteran’s information and/or records at the Department of Veterans Affairs. Upon the full satisfaction of this agreement, the above authorizations will expire.  

I, VETERAN, PROMISE TO PAY Veteran Alliance Corp. the total sum owed for medical consulting services provided, as outlined above in the Standard and Supplemental Fees and Payment Terms sections of this document. My payment will be calculated based on the equation above. I understand that within five (5) business days following receipt of any additional benefit payment from the VA, I must either:  

a) Pay the Total Sum Owed in full (REQUIRED when Veteran receives a Retroactive Payment that is greater than Veteran Alliance Corp.’s fee)  
 
b) Enroll in Veteran Alliance Corp.’s Interest-Free Automatic Monthly ACH Billing program to make 10 equal monthly withdrawals commencing on the next VA monthly payment day  
 
c) Make 10 monthly payments via credit/debit card commencing on the first VA monthly payment day immediately following my award equal to 1/10 of the Total Sum Owed PLUS a $20 processing fee per payment.
 
Failure to make payments according to the above terms will subject the outstanding balance due to a 15% per month compounding interest rate, or the maximum permitted by law, whichever is less, plus all expenses of collection, for any unpaid balances. I agree to pay the aforementioned interest rate increase and expenses of collection if I do not pay Veteran Alliance Corp. in accordance with the terms and conditions above.  I hereby agree to hold Veteran Alliance Corp., Directors, Managers, and Staff, harmless for any losses or damages or any other liability whatsoever suffered or incurred by me or my heirs regardless of cause. I specifically understand that I am 100% responsible for ensuring that I file any and all claims and necessary responses, appeals, or disagreements in a timely manner with the VA and Veteran Alliance Corp. does NOT file any type of responses or documents on my behalf. I hereby authorize Veteran Alliance Corp. to contact me via phone and text messages, automated calling for reminders, etc., and authorize Veteran Alliance Corp. to discuss matters related to my claims with my family members, emergency contact person, or any referring or referred parties as Veteran Alliance Corp. pursues the complete satisfaction of this agreement.  
 
Confidentiality and Non-Disclosure. I hereby acknowledge that the medical consulting performed by Veteran Alliance Corp. or Veteran Alliance Corp. affiliated medical professionals, along with all copyrights, etc. are exclusively owned by Veteran Alliance Corp. and I am hereby restricted from publishing, reproducing, distributing, or sharing any of the documents produced with any party other than the VA unless specifically instructed to do so in writing by Veteran Alliance Corp. I hereby understand that breach of this confidentiality and nondisclosure may cause extensive financial damage to Veteran Alliance Corp. or other Veterans and I will be held liable for such breach.  

I, the undersigned client, hereby warrant that I am competent to contract in my own name. I confirm that I have read the herein agreement prior to its execution and I am fully familiar with the contents thereof. This agreement shall be binding upon me and my heirs, legal representatives and assigns.

Client

I agree to the terms and conditions of this contract.*

Sign Here

Veteran Alliance