2024 Disability Claims Process | How A VA Lawyer Can Help (2024)

The VA offers a tax-free monthly compensation (payment) to veterans with physical conditions (such as chronic illness or injury) and mental health conditions (such as PTSD) that occur before, during, or after service.

Who is eligible for VA benefits?

To be eligible for VA disability compensation, you must have a current diagnosed physical or mental condition that meets the following requirements:

• You served on active duty, active duty for training, or inactive duty training—AND
• You have a disability rating for your service-connected condition.

Also, at leastoneof the following must be true:

• You got sick or injured while serving in the military and can link that event, injury, or disease to your current condition. (This is called anInservice Disability Claim.)
• You had an illness or injury before you joined the military and serving made it worse. (This is called aPreservice Disability Claim.)
• You have a disability related to your active-duty service that didn’t appear until after you ended your service. (This is called aPost-Service Disability Claim.)

It is important to note that if you received an other-than-honorable, bad conduct, or dishonorable discharge, you may not be eligible for VA disability benefits.

If this is the case for you, you can apply for adischarge upgrade.You may have a good case for a discharge upgrade if you can prove your discharge was related to any of the following:

• Mental health conditions
• Sexual assault or harrassment during military service
• Sexual orientation (Don’t Ask, Don’t Tell Policy)

You may be able to access VA disability compensation even though you are unable to obtain a discharge upgrade through aCharacter of Dischargereview. During this review process the VA can determine that your service was “honorable for VA purposes.”

If you fit into any of the categories listed below, it is time to consider applying for VA disability compensation.

If you have never applied for VA compensation in the past, you start this process by filling out anApplication for Disability Compensation and Related Compensation Benefits(VA Form 21-526EZ). This form can be downloaded on your computer. The VA refers to this initial claim as your “original” claim.

Gather all documents that support your claim of disability.

Be sure to fill out your application completely, then submit it together with your evidence of disability (supporting documents).

What evidence do I need to support my claim?

You can help your VA disability compensation claim move along by submitting the following evidence of your condition:

• VA or private medical records and hospital reports that relate to your disability and show that your condition has gotten worse.
• Supporting statements from family members, friends, clergy, law enforcement personnel, or those who served with you that can attest to an in-service event or your illness and how it has gotten worse. This is referred to as a “buddy letter.”

Should you need time to gather all your evidence, you can go ahead and start your claim by filing anIntent to File, also called an ITF (VA Form 21-0966). This form is a simple one-page document that preserves an effective date so long as the formal claim (VA Form 21-526EZ mentioned above) is filed within one year of the ITF.

How do I file my VA disability compensation claim?

What happens after I file my VA disability claim?

The VA will access and review yourCertificate of Release or Discharge from Active Duty(Department of Defense form DD214) as part of their evaluation process.

The next stage of this process for you will be a waiting period. You may receive a letter from the VA asking for more information. Obviously, the sooner you reply the faster your claim will proceed.

Also, the VA may schedule medical exams (referred to as C&P exams) for you—be sure not to miss them.

How fast will I get approved?

To speed your VA disability claim along, you will need to be organized and respond to any VA requests or medical appointments in a timely manner.

According to recentVA data, it takes between 92.9 and 100.8 days to review and make a decision on a disability claim.

If I am approved for VA disability compensation, when will I get my payments?

VA disability compensation may include financial payments and/or other benefits, such as health care and job training.

Once you receive a decision notice with a disability rating (more about this later), you will be able to receive your compensation and/or other benefits.

If your disability rating is at least 10%, you will receive your first payment within 15 days—and then monthly thereafter.

What is a disability rating?

After you have applied for VA disability compensation and the VA has determined that your injury or illness is service connected, the next step is for the VA to determine a rating for your disability.

A rating reflects the severity of your condition and how much it affects your ability to work. The rating is expressed as a percentage (0% to 100%).

This rating is used to determine the amount of compensation you will receive each month. It is also used to determine if you are eligible for other benefits, such as VA health care.

If you have multiple disabilities, each one will be rated individually, then a calculatedcombined ratingwill be assigned (more about this later).

The combined rating involves more than just the total percentages of each individual condition. Therefore, your combined rating will be different from the sum of your individual ratings.

How is my disability rating determined?

To assign your disability rating, the VA uses a tool called theSchedule of Rating Disabilities.

This schedule breaks down disabilities into different categories based on which body part is impacted. Each diagnosis is given a diagnostic code.

It works like this: To rate your disability, the VA starts with the body system category (the body part that is affected), then locates your diagnosis on the schedule, and finally assigns the diagnostic code that best matches your symptoms.

The severity of your symptoms is taken into consideration when assigning a disability rating. For example: Should you have an ulcer, you must have symptoms including periodic vomiting and only partial relief from therapy to get a severe rating of 60%.

When determining your disability rating, the VA will base your rating on the following:

• Doctor’s reports and medical test results (you supply this evidence).
• The results of your VA claim exam (C&P). The VA may or may not request this exam, and sometimes will accept aDisability Benefits Questionnaire(DBQ) from your doctor instead.
• Information the VA may receive from other sources, such as federal agencies.

Your particular disability may not be listed on the Schedule of Rating Disability. If this is the case, the VA will find a disability on the schedule that is closest to the one you have. You will then be evaluated based on the diagnostic code for the related disability.

It is important to note that with a disability rating of 30% or higher, you are eligible to apply for increased monetary compensation for your qualified dependents. Also, a disability rating of 0% does not pay any monthly compensation but it still may qualify you for health care or other VA benefits.

How does the VA disability rating system work if I had a preservice condition that got worse because of my service?

Monthly compensation for a preservice disability is based on thelevel of aggravation.This means how much worse your preservice condition got because of your military service.

For example: If you had an illness or injury that was rated at 10% when you entered the military and it became 20% disabling as a consequence of your service, the level of aggravation would be 10%.

What does each rating pay?

The VA disability ratings are assigned in 10% increments. The more severe your condition, the higher your rating will be. Veterans with higher disability ratings receive a larger monthly compensation.

Compensation amounts also depend on whether you have any dependents.

Special Monthly Compensation (SMC)

The VA has made extra provisions for veterans with more serious disabilities or injuries.

Injuries such as those listed below are entitled to a compensation increase of $96.00 a month.

• The loss of a single hand or foot
• Blindness or severe eye injury
• Loss of ability to speak
• Deafness

The loss of both hands or both feet, blindness in both eyes, or a permanent bedridden state entitles a veteran to $3,327.00 a month.

In addition, the VA is empowered to make provisions for other very severe disabilities that merit higher payments. These special compensation payments can go up to $4,667.00 per month.

Below, you will find aVA Disability Rating Calculatorto help you determine your disability rating.

Has your VA disability claim been denied?

You have the right to appeal.

The VA appeals system has changed as of February 2019. The appeals process is now a review process that allows you to choose from three decision review options:

• Supplemental Claim
• Higher-Level ReviewHigher-Level Review
• Board Appeal

What is a Supplemental Claim?

If you have new and relevant evidence that is pertinent to your case, you can choose to file a Supplemental Claim. You can supply the new evidence yourself or request the VA to obtain the evidence from places like a VA medical center, other federal facilities, or even from your private medical providers.

According to the VA: “New Evidenceis information that the VA didn’t have before the last decision.Relevant Evidenceis information that could prove or disprove something in your claim.”

You can file a Supplemental Claim at any time, however, it is best if you can file within one year from the date of your decision letter in order to preserve the earliest possible effective date.

Once your Supplemental Claim is submitted, your new evidence will be reviewed and a new decision will be rendered.

How do I file a Supplemental Claim?

Here are the steps to take:

• Complete theDecision Review Request: Supplemental Claim(VA Form 20-1995).
• Gather your new and relevant evidence.
• Apply by submitting your application by mail (same address as above), in person, or by fax (844-531-7818).

You can expect this process to take between four and five months.

If you get a Supplemental Claim decision that you do not agree with, you can request aHigher-Level Reviewor file for aBoard of Appeal.

What is a Higher-Level Review?

If you disagree with the decision made on your Supplemental Claim, the next step is to request to have a senior reviewer take a look at your case. This request must be filed within one year of the date on your Supplemental Claim decision.

Here are three things to note:

• This option is available to you only one time. You can not file again after you have received a Higher-Level Review decision unless you first file a new Supplemental Claim.
• You will not be able to submit any evidence. If you have new evidence, you will have to go through the Supplemental Claim process again.
• You can speak to the reviewer by phone to articulate the reason(s) you do not agree with the decision made on your Supplement Claim.

How do I file for a Higher-Level Review?

• Complete theDecision Review Request: Higher-Level Review(VA Form 20-0996).
• Apply by submitting your application by mail (same address as above), in person, or by fax (844-531-7818).

If you disagree with the decision on your Higher-Level Review, the next step is to make a request for aBoard of Veterans’ Appeals (BVA) Review.

What is a Board of Veterans’ Appeals (BVA) Hearing?

A BVA hearing is a request to present your disability claims case before a Veterans Law Judge.

With this process, you can request a video conference hearing where you can present testimony about your disability claim to a judge. This hearing will be translated and becomes a part of your appeal file.

Please note that a hearing is not required for this appeal process.

How do I file for a BVA Hearing?

If you decide that a BVA hearing is the best option for you, here are the steps to follow:

• Complete theDecision Review Request: Board Appeal(VA Form 10182).

In Part II of this VA form, you need to check one of three boxes. These are:

Box 11A:“Direct Review by a Veterans Law Judge.” Checking this box means you are requesting a judge to review your disability claim file, but you do not want a hearing and you do not want to submit any evidence.

Box 11B:“Evidence Submission Reviewed by a Veteran Law Judge.” Checking this box is a request for a judge to review new evidence that supports your disability claim. This is not a request for a hearing, it is only a review. All evidence must be submitted to the judge within 90 days of filing the Notice of Disagreement (NOD).

Box 11C:“Hearing with a Veterans Law Judge.” This is a request for a hearing with a judge. With this process, you can also submit new evidence that supports your disability claim. However, all new evidence must be submitted to the judge within 90 days of the hearing.

• Apply by submitting your application by mail (same address as above), in person, or by fax (844-531-7818).

What happens if I decide to file for a BVA hearing?

Here is a snapshot of how this process works:

• Once you have filed your request for a BVA hearing, it is put on the Board’s docket. All requests are registered in the order in which they were received and the BVA is required to decide cases in docket order.
• After your BVA hearing is scheduled, you will receive a notification by mail at least 30 days before your hearing date.
• A hearing in front of a judge can be formidable. For many veterans, hiring a professional to help prepare for a BVA hearing is the best option. Please note that your representative must be a VA-accredited lawyer, claims agent, or someone from a Veterans Service Organization (VSO). Your representative will be allowed to attend the video hearing with you.

What happens if I disagree with the decision of the Veterans Law Judge?

If your appeal with the Board of Veterans’ Appeals is denied, you can pursue further action. You may:

• File a Supplemental Claim with your local VA office;
• File a motion asking the Board of Veterans’ Appeals to reconsider the decision.
• File a motion requesting the Board of Appeals to revise its decision based on “clear and unmistakable “clear and unmistakable” error (commonly referred to as CUE).
• File aNotice of Appealwith the United States Court of Appeals for Veterans Claims.

What happens at a BVA hearing?

Here is what to expect at a BVA hearing:

What happens if I disagree with the decision of the Veterans Law Judge?

If your appeal with the Board of Veterans’ Appeals is denied, you can pursue further action. You may:

• File a Supplemental Claim with your local VA office;
• File a motion asking the Board of Veterans’ Appeals to reconsider the decision.
• File a motion requesting the Board of Appeals to revise its decision based on “clear and unmistakable “clear and unmistakable” error (commonly referred to as CUE).
• File aNotice of Appealwith the United States Court of Appeals for Veterans Claims.

What is the process for an appeal at the Court of Appeals for Veterans Claims (CAVC)?

With all the earlier appeal stages discussed above, it is a good idea to have some sort of VA-certified representation.

However, once you are at the level of a CAVC appeal, you can try to tackle this alone—but realistically, a VA-certified lawyer is a necessity.

Here is an overview of the CAVC appeals process:

• ANotice of Appeal(NOA) with the CAVC must be filed within 120 days of your BVA decision.
• The case will be put on the Court docket and you will be issued aNotice of Docket from the court clerk. At this point, your appeal claim officially becomes a court case.
• The VA will supply you with a complete copy of your file (which is called theRecord Before the Agency—or RBA) and the Court will issue you a 60-dayNotice to File a Brief.
• You will need to develop a strategy and a plan of action to deal with the Court. Here is where a VA attorney is invaluable.
• If you have an attorney, through a conference with the Court’s Central Legal Staff (CLS), you will present your case and try to get your original decision overturned. Self-represented or pro se appellants at CAVC do not have the opportunity to participate in a CLS conference.
• If all issues aren’t resolved, you will be able to proceed to briefing. (Briefs are written arguments to the Court.)

Once the Court has received all records and briefs, your case will be assigned to a Veterans Claims Judge who will render a decision.

How can I increase my disability rating?

In general, there are two classifications of a veteran’s disability: High-value VA claims, and low-value VA claims.

High-valueclaims receive disability compensation at a rate of 30% to 100%. The most common types of injuries or illnesses that fit this category are:

• Post Traumatic Stress Disorder (PTSD)
• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder
• Somatic Symptom Disorder
• Sleep Apnea
• Migraines
• Respiratory Conditions (e.g. heart and lung conditions)
• Cancer or other serious disease processes.

Low-value claims receive a 0% to 20% rating. The most common type of conditions that fit this category are:

• Tinnitus
• Hearing Loss
• Scars
• Musculoskeletal conditions

Obviously, to get a higher rating you need to focus on your high-value condition(s).

What happens if I have multiple conditions?

Here is where you have to deal with the VA’s mystifying math.

Multiple disabilities are NOT cumulative. They are factored into each other in numerical order from highest VA rating to the lowest, then multiplied against each other to determine your overall combined VA disability rate.

Here is an example:

You have a 60% heart condition and a 30% foot condition, which would seem like you have a 90% disability rating.

Not so.

Here is how it works:

60% of your body is disabled, so you are 40% healthy
100% – 60%= 40% healthy

Now the 30% disability is factored into your 40% healthy rate.

.30 x .40= .12 (or 12%)

Next you take your 60% disability and add it to your factored disability of 12%.

60% + 12%= 72%

The VA only works with 10% increments so your rate of 72% is rounded down to 70% which is now your combined rating.

Rather than trying to do the math yourself, you can refer to the rate calculator referenced above.

How can I expedite my disability rate increase?

If your injury or illness has worsened, you may decide to apply for an increase of your disability compensation rate.

Here are a few tips:

• Know exactly what your current rating is: You can download letters that certify your current disability level and/or print out information on what disabilities are service connected on the VA’seBenefitssite.
• Get the ball rolling with the VA: You can establish an effective date by filing anIntent to File a Claim for Compensation(VA Form 21-0966).
• Find out what your options are: Educate yourself as to what disability rate your condition is eligible for by checking out theSchedule for Rating Disabilities.
• Gather evidence and records: Make sure you have any civilian medical records, buddy letters, or any other documents that support your claim for an increase.
• Consider obtaining anIndependent Medical Opinion(IMO): An IMO needs to be completed by a physician who specializes in the area of your disability. An IMO is not a medical examination—but rather a medical opinion based on a review of all evidence currently of record.
• Now you are ready to file for a claim increase: File a claim on the VA’s standard application form (VA Form 21-526EZ)

Caution:When you ask the VA to open your file to consider a disability compensation rate increase—you open the door for a complete review. Many veterans have reported that they received an unwelcome surprise when instead of getting the rate increase they wanted, they got a proposal to decrease one or more ratings. So, make sure you have all your ducks in a row before you tackle this process.

Frequently Asked Questions

What do I do if my VA claim is denied?

HOW CAN A VA LAWYER HELP ME?