What Can I Do If My Claim Is Denied
There are three different ways to appeal a denied claim. These include:
For most veterans, we recommend a supplemental claim request using VA Form 20-0995. Youll need to provide new evidence to support your claim for this type of appeal to work. This type of review is generally processed the fastest, but you must appeal within one year of the date of your denial.
If youre a veteran with a service-connected disability, you may be entitled to VA benefits. Dont wait to file a claimthe sooner you file, the better.
Our Law Firm Is Here To Support Disabled Veterans
To summarize how to apply for VA disability benefits, you need to ensure that you are eligible, submit supporting documentation, complete an application and file your claim. While this is only four steps, each one can be time-consuming and expectations are difficult to understand at times.
The best thing we can advise is to request a VSO if you feel uncertain. Paying attention to details and providing enough supporting documentation is key to a successful outcome with initial VA disability claims.
To easily file online, visit VA TurboClaim to skip the paperwork and submit your claim 100% online. And to learn more about the claims process, be sure to check out our e-book The Road to VA Compensation Benefits.
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What Is The Timeline To File A Decision Review
A veteran has up to a year after the VA receives an initial claim to provide additional information to support the claim. If additional information is provided for a claim in the FDC process, it becomes a standard claim.
The VA must assess and evaluate all evidence in a claim, so anytime additional information is added to a claim file, the evaluation process is lengthened, and a decision delayed.
The VA may also require the vet to undergo a medical examination by a VA doctor or seek a medical opinion based on the evidence in the claim, if necessary to decide the claim. The vet may have their medical provider or a VA doctor complete a VA Disability Benefits Questionnaire for their specific conditions. DBQs provide medical information directly relevant to determining disability ratings and ensure that VAs ratings specialists have precise information.
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Can You Get 100% Va Disability And Work
Many Veterans dont like the idea of sitting at home all day, even if they do have a 100% disability rating. Can you work with 100% VA disability? is one of the most common questions we see from Vets.
In most instances, Veterans can still work even with a 100% VA disability rating. However, if the 100% VA disability rating was categorized under Total Disability/Individual Unemployability, then the Veteran is not allowed to obtain substantial gainful employment.
As long as your rating is not listed as a total disability with unemployability, there are no restrictions on your being able to work a job other than your own abilities or limitations. If you are listed as totally disabled and unemployable, you can still go out and do non-gainful work, like volunteering for local charities.
Eligibility & Covered Conditions
To be eligible for VA disability, both of the following must be true:
- You currently have an injury or illness, a.k.a. a condition, which affects your mind or body.
- You served as an active-duty military member, you were on active duty for training, or you were on inactive duty for training.
In addition to both of these requirements, at least one of the following must also be true:
- Your condition occurred during your service, and you can verifiably link the two.
- You had a pre-existing condition that was made worse as a result of your service.
- You developed a disability directly related to your service that did not appear until after your service had ended.
If your dependents have been adversely impacted as a result of your service, they may also be eligible for VA disability. Knowing how to apply for VA disability for dependents is a different process, however.
Conditions and disabilities that are usually covered include but are not limited to:
- Your childs birth defects that can be linked to your service
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I’ve Submitted A Claim Now What
You or your VSO has submitted your claim. After it is received at your local VA Regional Office, a claim is established in the VA computer system. The paperwork you sent in is scanned to see which types of benefits you are seeking, and end products are established. The DEERS database is checked to verify your dates of military service. An end product is VA-speak for type of claim, and allows your individual claims to be tracked. One end product may contain multiple parts: a claim for disability compensation may include claims for three different disabilities.
General Stages of the Process for Disability Compensation Claims
Following are the general stages of the process for disability compensation claims. Other types of claims such as education and loan guaranty have different steps and are usually simpler and easier to process. The VA made many automated improvements to the education process and as a result, was able to shift employees from processing education claims to disability claims to reduce the backlog.
Once your claim is established, it will be sent to triage where it will be reviewed and assigned to a lane for completion. The VA sends claims with one or two issues to the express lane. There are also different lanes for specialized issues and standard claims.
What Is A Total Disability For Va Rating Purposes
A Total disability exists when there is any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation.
Total disability may or may not be Permanent.
Total ratings will not be assigned, generally, for temporary exacerbations or acute infectious diseases except where specifically prescribed by the rating schedule.
Total ratings are authorized for any disability or combination of disabilities for which the Schedule for Rating Disabilities prescribes a 100% evaluation or, with less disability with the requirements of the rating schedule.
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Prepare For Filing A Disability Claim
Filing a “Fully Developed Claim” is the fastest way to get a decision from the VA, this simply means that you should submit all of your supporting documentation with your claim for benefits. This documentation includes:
- Medical evidence , this includes both military and civilian documentation
- You should also attach any copies of your DD214 or separation documents you may have –
- Dependency records
If you don’t have your records you can get them from the government, see our Military Records Overview page for details.
Remember, if you have any doubt as to whether or not you should submit a document ALWAYS SUBMIT IT! And most importantly, never send the VA original documents, copies will suffice.
In certain circumstances you can apply for benefits before being discharged from the military, please visit our Pre-Discharge Program for Disability Compensation page for details.
Only claim lingering conditions that are the result of acute disabilities or illnesses acquired during your service, claiming other conditions will slow down your decision.
Can Working Veterans Receive Disability Benefits
Yes. Most veterans receiving Disability Compensation continue to work, as they have no prohibitions on obtaining and/or maintaining employment. Only those few who receive a higher rating because they are considered Unemployable would run into problems by working. Some veterans receiving Disability Compensation can even continue their military service, although they can not receive military pay and disability payments at the same time .
Veterans receiving Non-Service Connected Pension can also work part-time so long as their income does not exceed the income cap for the program. If they are capable of working full-time, they would not meet the 100% disabled requirement for this benefits.
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What Documents Will I Need To Support My Claim
We require certain documents to support all claims for disability benefits.
Youll need to submit or give us permission to gather these:
- Your DD214 or other separation documents
- Your service treatment records
- Any medical evidence related to your illness or injury
Note: In 1973, a fire at the National Personnel Records Center in St. Louis destroyed records held for Veterans who were discharged from the Army and Air Force during certain periods of time. If your records were destroyed in this fire, you can get help reconstructing them.Find out how to reconstruct your records
The Longer You Wait The Harder It Can Be To Prove Service Connection
The other reason to file as soon as possible is that it can be harder to get benefits the longer you wait.
This is because, over time, it becomes more difficult to find evidence to support your claim. For example, if you were injured in combat and didnt seek treatment until years later, there might not be any records of your injury.
Or, lets say you have PTSD and are trying to prove that its related to your time in service. The longer you wait, the harder it is to find witnesses who can attest to your symptoms and how theyre connected to your time in service.
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What Qualifies A Veteran To File A Va Disability Claim
Before you take the time to gather paperwork and complete the VA application, it is important that you ensure you meet the eligibility requirements. There are four criteria you need to meet in order to file a successful disability claim:
The severity of your condition will determine the percentage of your disability rating. You can also find out what to expect beforehand with our VA Disability Calculator.
What Should The Evidence Show To Support My Disability Claim
This depends on the type of claim youre filing. Find out what evidence youll need for the different claim types listed below.
Notice to Veterans and service members of evidence needed: Were required by law to tell you what evidence youll need to provide to support your disability claim.
For your convenience, the information below is a summary of evidence requirements . You can review the official evidence requirements in VA Form 21-526EZ .
Original claimthe first claim you file for disability benefits
Youll need to submit evidence of:
- A current physical or mental disability from a medical professional or layperson , and
- An event, injury, or disease that happened during your active-duty service, and
- A link between your current disability and the event, injury, or disease that happened during your service. Usually we need medical records or medical opinions from health care providers to support this link.
Under certain situations, we may conclude that theres a link between your military service and your disability even if theres no evidence. This usually applies to:
Increased claima claim for more compensation for a disability that weve already determined to be service connected and thats gotten worse
Youll need to submit current evidence from a medical professional or layperson that shows your disability has gotten worse.
Youll need to submit evidence of:
Youll need to submit evidence of:
PTSD
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Va Claims Lawyer: Applying For Veterans Disability Benefits
Like so much else, the application process for veterans disability benefits has moved online. VA says using the online process is the best way to apply, though the claim form VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits is also available for printing and mailing in.
VA Form 21-526EZ is 10 pages long, six of which are instructions that refer the applicant to additional forms, which may be necessary to fully substantiate a benefits claim.
According to VA disability laws, to apply for benefits, a veteran must have access to:
- Discharge or separation papers
- Medical evidence
- Dependency records
When applying, the vet may submit a Fully Developed Claim or file through the Standard Claim Process.
An FDC is faster, according to VA, and may be pursued if the vet has or can obtain or identify all relevant evidence necessary to substantiate the claim. This includes the records above, and:
- All, if any, relevant, private medical treatment records.
- An identification of any relevant treatment records available at a federal facility, such as a VA medical center. VA will retrieve relevant records the veteran adequately identifies and authorizes VA to obtain.
- Any forms required for special circumstances benefits, e.g., Post-Traumatic Stress Disorder , Individual Unemployability , Aid and Aid Attendance benefits, etc.
Can I File A Va Claim By Myself
Yes, you can file a VA claim by yourself. However, we recommend working with a specialist to help you file.
Veteran Service Officers can help you gather the evidence you need and ensure that your claim is filed correctly, for free. There are many different VSOs with different levels of training and knowledge, so be careful who you choose. You can learn more by reading our post on selecting the right VSO to help you file.
VA Claims Insider can also help. We make VA disability benefits EASY by providing Veterans with a suite of expert-level educational resources across our websites and in our Membership programs. Our veteran coaches also make sure YOU are NEVER alone in this fight!
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Collect Your Medical Evidence
Medical documentation, including records from the initial diagnosis, follow-up appointments, referrals to specialists and surgical records, is necessary to prove your VA disability claim.
To receive compensation, the evidence must connect your injury, illness or initial contact with a hazardous substance that caused a disease to your military term of service and your activities there.
For example, if you are on active duty but break your arm at a theme park while on leave, you probably wont be able to claim disability. However, if you break your arm while in active combat or in a training course while serving, your disability claim is more likely to be approved.
If youre filing a claim for a mental illness you developed during service, such as PTSD, chronic adjustment disorder, anxiety or depression, youll need to submit a psychiatrists diagnosis of your condition.
You may be asked to obtain statements from your therapist or psychiatrist about the onset of your disorder and how it impacts your ability to work, go to school or perform other daily activities.
The more detailed information you can present, the stronger your claim will be. However, the VA may ask for a second opinion for some diagnoses. You may be required to complete a physical or psychological exam at a VA hospital or medical center as well.
How To Apply For Va Disability
Military veterans and service members who are injured or become ill during active duty or while completing active or inactive training may be eligible to receive disability pension and other disability benefits from the U.S. Department of Veterans Affairs .
There are several classifications of illness or injury that may be eligible for disability benefits. These include physical problems, mental concerns and exposure to toxic materials or chemicals.
Filing a claim for benefits is usually straightforward. You can complete a claim online or visit your local veterans affairs office for assistance. If your VA disability claim is denied, you may appeal or hire a lawyer with experience in contesting VA disability claims to help you.
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How Long Does It Take For My Claim To Be Processed
The first thing that will happen after you send your claim, will be that the VA will notify you that it has been received. If you filed online, this happens within hours. If you mailed your application or dropped it off in person, it could take up to two weeks.
The VA will also let you know if they need additional information.
During the phase where evidence is gathered, you may be required to complete a Compensation and Pension Exam, which will be helpful in determining your rating. The VA will send you a notification when the C& P exam has been scheduled.
The VA claims process is notoriously slow. It can take anywhere from months to even years to get a decision on your claim. If your claim gets denied, an appeals process will add even more time. As of May 2022, the VA is averaging 141.9 days to process claims.
Working With An Accredited Representative
VA encourages individuals who are applying for disability compensation to work with an accredited representative or agent to assist them in completing Fully Developed Claim for submission through eBenefits. Being accredited means organizations and individuals must have VA permission to represent Veterans before the Department in their claims for VA benefits. The purpose of this requirement is to ensure that Veterans have qualified and competent representation. These individuals receive specialized training in VA benefits law and procedure. You may search for an accredited representative in eBenefits on the Manage Your Representative for VA Claims page.
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Reasons Your Claim May Get Denied
When starting the process of applying for VA disability benefits, you need to be aware there is a real possibility you will get denied. As most lawyers who handle these types of cases will tell you, getting denied the first time around is fairly common. Some of the most common reasons a soldier may be denied their veterans disability benefits are:
- The condition they have was caused by their own negligence
- The veteran was dishonorably discharged
- Injuries sustained happened when soldier was AWOL
- The accident happened while the soldier was in military prison
When applying for VA disability benefits, you have to make sure you acquire all documentation to corroborate your claims. Having medical records and statements from your doctor is important. The more evidence you are able to produce, the easier you will find it to get the benefits you are entitled to.