The VA disability application process is a lot more complex than just filling out a form for someone to read through and approve.
If you’re a veteran and you have a disabling condition, you may know that you’re entitled to compensation from the VA. At first glance, applying for VA disability compensation may seem straightforward enough. You have to have a diagnosed condition, a precipitating event in your service record, and a medical nexus connecting the two – easy enough, right?
But the VA review process can get complicated in a hurry. Read on to learn more about this process and what you can expect after you file your disability claim.
In this article about the VA disability application process
- Your Claim Is Received
- The Initial Review
- Evidence Gathering
- The C&P Exam
- Review and Decision
- Preparing the Claim Decision Packet
- If You Agree with the Decision
- Appealing a Low Rating
- Appealing a Denial
- VA Rating Schedule
- Disability Compensation Rates
- Requesting a Higher-Level Review
- Filling Out the Form
- Additional Appeals
- Tips for a Successful Claim
- Learn More About the VA Review Process
Your Claim Is Received
After you file your claim for VA disability benefits, you’ll get a confirmation that your claim was received. It’s a good idea to save this confirmation in case something goes wrong and your claim gets lost. Make sure you get evidence of the date you submitted your claim in case any question arises with your case deadlines.
If you submit your application online, you’ll get an on-screen message after you hit “submit” that you can screenshot. Through eBenefits, a notice from the VA should show up in your claims list within an hour. If you mail in your application, the VA will send you a letter within a week letting them know they received your claim.
The Initial Review
After the VA receives your claim, it will move into the initial review stage. The VA will review your medical diagnosis and make sure the doctor who provided it meets their criteria. They will also take a look at your service record and the medical nexus you provided and determine if the two are connected.
During the initial review process, the VA will decide if they need any more evidence from you to support your claim. This may include documentation from your doctor or additional information about your military service. If they don’t need more evidence, they’ll move to the full evidence-gathering stage.
Once the VA has all the evidence they need from you, they will begin to gather their own evidence. They may talk to your healthcare providers to gather more information about your condition and treatment plan. Many condition ratings depend on whether your condition can be managed with medication.
The VA may talk to various governmental branches, particularly those associated with the branch of the military you served in. They may want to confirm your account about the incident that caused your condition. They may also need to check on your service record if you’re applying for compensation for a presumptive condition.
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The C&P Exam
As part of the evidence-gathering process, the VA may require you to attend a Compensation and Pension Exam. This exam can serve to reinforce your diagnosis and give the VA a more extensive view of your symptoms. It may also replace an opinion by a doctor the VA considers unqualified to provide an expert medical opinion.
If the VA asks you to attend a C&P exam, do everything you can to attend the first one they schedule. This will help move your claims process along quicker and make sure the VA has everything it needs on schedule. If you absolutely cannot attend your scheduled C&P exam, you can reschedule it for a different time.
Review and Decision
Once the VA has all the evidence it needs, it will begin an earnest review of your case. Your VA reviewer will look at all the documentation the VA has gathered, as well as the documents you provided. They will consider whether your medical nexus seems credible, how strong the evidence is for your service connection, and how severely your condition impacts your life.
After a full review is complete, your VA reviewer will make a decision about your case. First, they will decide whether to approve your claim or not. If they do approve your claim, they will determine what sort of rating your condition warrants (more on ratings later).
Preparing the Claim Decision Packet
It should take about three months for the VA to reach a decision regarding your case. According to the VA website, as of April 2020, it takes the VA 105.9 days to complete disability-related claims. After the VA makes their decision, they will prepare a claim decision packet to send to you.
The VA will mail you a packet that includes details about your claim decision, including your award letter if your claim was approved. It’s crucial that you hang onto this packet for later business you may have to conduct with the VA. You should expect to receive your packet between seven and ten days after the VA makes a decision.
If You Agree with the Decision
If your claim is approved, your claim decision packet will include information about your VA disability rating. It will also let you know how much you can expect to receive in compensation each month. This money is tax-free and is based on your disability rating and how many dependents you have.
If your decision seems fair, you will begin to receive compensation checks from the VA each month. You will also receive a lump sum payment to cover the time between when your condition began (known as your effective date) and the present. So if your VA claim seems to be taking a while, don’t worry; you’ll be covered for this time, too.
Appealing a Low Rating
In many cases, even if your claim gets approved, the rating the VA assigns you may be too low. For instance, many veterans with PTSD have symptoms that fit into one of a few different rating tiers. The VA may try to average the tiers for which you have symptoms, rather than giving you a rating of the highest tier for which you have symptoms.
If your rating seems too low, you can file an appeal with a VA to have them review your case. In this appeal, you may need to include additional information about your symptoms. You can also include information about previous VA decisions that set a precedent for your case.
Appealing a Denial
If your claim is denied outright, don’t panic; you can always appeal denials, too. In fact, you can appeal your case all the way up to the BVA in Washington, D.C., if needed. We’ll discuss in a moment how to request a higher-level review of your case and file additional appeals.
If you plan to file an appeal, either for a higher disability rating or for a denial, it’s a good idea to hire a lawyer who specializes in VA disability claims. For one thing, they can help you to navigate the confusing world of paperwork and deadlines that comes with VA appeals. But they can also give you tips on how to make your claim as successful as possible.
VA Rating Schedule
Before we talk more about how to manage the appeals process, let’s talk about what VA disability ratings are and how they impact your compensation amount. The VA uses percentage ratings to express how much a condition impacts your ability to live a normal, healthy life. The higher the rating, the more your condition impacts your life.
VA ratings range between 10 and 100 percent, and ratings are rounded to the nearest 10 percent for the purposes of determining compensation. If you have more than one condition, the VA rates each of them separately. These ratings will be combined to give you one overall disability rating.
Disability Compensation Rates
The VA will use your disability rating as the primary factor in determining how much compensation you will get each month. If you get a rating of 10 percent, you will receive $152.64 per month. For a rating of 20 percent, you will get $301.74.
All ratings above 30 percent will get the VA to also consider whether you have people who depend on you financially. If you have a rating of 60 percent and no spouse or children, you will receive $1,214.03 per month.
Requesting a Higher-Level Review
If your appeal is denied or your claim is too low, you can always request a higher-level review. You’ll want to start this process by requesting a phone call from this higher-level reviewer. This will be an informal call to discuss the details of your case and the reason you feel the original decision isn’t fair.
During this call with the reviewer, you will not be able to submit any new evidence. This will simply be a call to discuss your case and identify any errors in the original decision. After this call, the senior reviewer will continue their review of your case and will make a final decision.
Filling Out the Form
If you’d like to request a higher-level review, you’ll need to fill out VA Form 20-0996. In Part I of the form, you’ll need to select a benefit type that you wish to have reviewed. Most of the time, the benefit type will be compensation, but you’ll need to fill out separate forms if you have multiple benefit types you need to be reviewed.
In Part III of the form, you’ll need to list the issues you want reviewed from your original decision. You can include as many or as few of these issues as you like, but you’ll need to include the date the VA made a decision for each separate issue. This process still does not allow you to submit new evidence, so if you need to do that, you’ll need to choose one of the other appeal options.
If you need to submit new evidence for your claim, you’ll need to file a Supplemental Claim. In order to do this, you’ll need to submit Form 20-0995 along with the new and relevant evidence you have. The VA may send you a letter asking for more information after you submit your appeal, and you may need to submit Form 21-4142 to ask the VA to gather new evidence from a private healthcare provider.
If you receive a decision from your higher-level review or your supplemental claim that you still don’t agree with, you can request a Board Appeal. If you go this route, you’ll have three options for how to manage this process. You can request a direct review of existing evidence by a Veterans Law Judge, you can submit more evidence for the judge to review, or you can request a hearing with a Veterans Law Judge.
We handle all of these decisions with you at Woods and Woods, The Veteran’s Firm. We’ll discuss your options and find out from your file and from your specific disability case which forms you’ll need. We work together with you and your loved ones every step of the way.
Tips for a Successful Claim
The appeals process currently takes around four or five months, so if possible, you want to avoid it. One of the best ways to make sure your claim is successful the first time is to be completely honest about your symptoms. The VA can’t rate symptoms it doesn’t know about, and they need to see the full impact your condition has on your life.
It’s also important that you make sure all evidence has made its way to the appropriate parties. Sometimes, a piece of evidence you submitted may not get to the right reviewer and missing evidence could lead to a denied claim. We will double-check with the VA that all of your documents have been received and given to the appropriate parties.
Learn More About the VA Review Process
The VA review process for disability claims can be complex and confusing. Just remember, if your decision doesn’t seem fair, don’t give up. You have a number of appeal options available to you, so stay organized, keep an eye on your deadlines, and don’t give up until you get a fair rating.
If you’d like help navigating the VA review process, get in touch with us at Woods and Woods, The Veteran’s Firm. We fight for veterans every day, and you don’t pay unless we win. Contact us today and start getting the compensation you deserve.