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Some Tips for Filing a VA Disability Claim
January 4, 2011 by Tom Pamperin
Filing a first claim for disability compensation can be a stressful experience. The stress can originate from one or more of the following factors:
–Physical or mental discomfort
–Financial need
–That transitional feeling when you are no longer in the military but not really a civilian
–Concern about the outcome
–Lack of knowledge of the process
–Unrealistic expectations
–Erroneous assumptions
–Things you have heard from other Veterans and the media and, just
–Dealing with a bureaucracy
During this discussion I’d like to use my experience as both a Veteran and a senior VA official to demystify the process and empower you with information you need and what you can expect.
Recommendations
Dealing with large organizations can be frustrating. Some things that appear clear and certain to you may not be to others. Additionally, legal requirements can sometimes be confusing and time consuming. To have the best experience possible I recommend the following:
1. If you are still on active duty and thinking about getting out and filing a claim, go through the Benefit Delivery At Discharge or BDD program at your installation. To qualify you must have between 60 and 180 days left on active duty. We will take your claim and get you examined before you go home. Normally, decisions are available about two months after you separate or retire.
2. If you are still on active duty but have less than 60 days to go, you can still file a “Quick Start” claim. Quick Start claims are processed at dedicated facilities so decisions are quicker for most Veterans.
3. If you are out of service for less than a year, think you might have a claim, but are unsure if you want to “go through the hassle” apply. The evidence is fresher and cleaner, there are unlikely to be what we refer to as “inter-current injuries” (i.e. you back hurts a little but when you get out you get a job as a long hall truck driver or a construction working and don’t file a claim for years. In such cases even if there is some documentation of “something in service” without evidence of treatment for the condition within the first year, service connection is less certain).
4. If you’re concerned that it might not be appropriate to take money for a condition because “I’m fine, was just doing my duty and I have a job”–there are a lot of people who feel that way–consider this. I think you should file your claim. If granted you can always decline to receive the money. If, at a later date, your condition worsens or you age and it interferes with our work, or you decide you want compensation after all you can always contact us. That way we will examine you and determine your current level of disability. We won’t be trying to determine whether you warrant service connection in the first place.
5. If you have been out of the service longer but still think you have a condition related to your service apply! There is no filing time limit. It just might be a little more complex and take a little longer because of the need to develop more records.
6. Our goal is to complete all claims within 125 days or four months by 2015 with 95 percent accuracy. Right now more than 30 percent of our claims have been pending longer than that. Some claims, such as those involving participation in nuclear tests, covert operations, military sexual trauma or other similar circumstances where records may be difficult to locate can and frequently do take longer, sometimes much longer.
7. To meet the challenge of a rapidly growing claims volume, VA has been provided with significant numbers of new staff in the last couple of years. Their jobs are complex and it takes a while to become fully qualified so if you think we made a mistake, ask you may be right. As I said earlier, one of our goals is to get our quality level to 95 percent by 2015. Currently our quality level is 84 percent. While a significant portion our quality problems reflect process errors rather than errors in the final decision with respect to the granting or denying of benefits, rates paid and effective dates of payment, we do make mistakes.
How You Can Help Yourself and VA
The claims process doesn’t need to be a hassle. Here is what you can do to help yourself and VA:
1. Communicate, communicate, communicate
2. Appoint a representative. While there are attorneys who will represent you for a fee, it is rarely necessary to pay to have your claim processed efficiently and successfully. National Service Organizations such as the Disabled American Veterans, Veterans of Foreign Wars, American Legion, Vietnam Veterans of America, Paralyzed Veterans of America, as well as State Departments of Veterans Affairs or Veterans Commissions and County Veteran Service Officers can give excellent assistance and its free. Call your local regional office to see what organizations are available at that office.
3. Consider what you want to claim. Many Servicemembers and veterans have been told they should go through their service medical records and claim everything they have ever had or been treated for. While you can do that, it is likely to significantly increase your frustration level, result in unnecessary examinations, and slow the process without getting added benefits. You should not claim acute disabilities or illnesses you had in service unless they left a residual. For example, if you got the flu in service and got over it, the claim will be denied. On the other hand if you broke your leg and recovered from it you should claim that because the fracture, if found on x-ray, can be service connected. While it might only warrant a zero percent evaluation now, if you develop arthritis at the site later, you are covered. Don’t claim things like personality disorders, baldness, the fact that you wear glasses, or similar kinds of things because they are considered “constitutional or developmental abnormalities” that you would have gotten whether or not you were in service. The law doesn’t permit payment for these. Don’t claim lab results like hematuria (blood in the urine) or high cholesterol. We don’t pay for those either. On the other hand, you should claim pseudofolliculitis barbae (a skin condition that affects some black people).
4. If private providers have treated you, get the records and send them to us. While the application you fill out does offer the opportunity to sign a release and we will request the records for you, we cannot compel providers to send us records nor can we pay for them. It is my experience that many times–maybe even most–when VA sends a release a private provider, the provider ignores the request. If the provider does respond, many times they will ask that we pay them in advance for the records. In either case, we will have to write to you and tell you that if you want the records considered you will have to get them and send them. In the worse case this can add two to three months to the process.
5. Show up for your examinations.
6. The first thing you will get from VA once you file your claim is a lengthy letter commonly referred to as a “VCAA letter.” This is a letter required by the law that tells you what we will do, what you will be expected to do, and in very general terms tell you how we will decide. The letter may also include specific requests from your local regional office for information. Read it carefully for specific requests for information from us. Finally, the letter offers the option of completing an attachment telling us you have no more information. If that is the case, complete the form and return it immediately. If you don’t and you have no more information, we will wait for 30 days before proceeding for no good reason. Even if, during the course of working the claim you do get additional information you can always submit it when you get it.
7. When you get your decision, read it carefully. It will have attached to it the text of the actual rating decision explaining why we decided what we did. If you think our decision didn’t consider something, didn’t cover a topic, or is wrong, call your representative right away. If we have made a mistake, we would rather just fix it now than get involved in a lengthy appeal that isn’t terribly satisfying for you or VA.
Final Note: VA exists to serve those who served and their survivors. I have worked for VA for over 36 years and the overwhelming majority of people who work for VA are committed to the mission. If we are not clear or you think we have made a mistake, let us know so we can both fix it, and provide a learning opportunity for our staff to serve other Veterans better.
You will find a ton of info in the over 600 responses to Tom’s Blog. Here are just a few. You will want to follow his blog for much more: PTSD Tips
684 Comments to “Some Tips for Filing a VA Disability Claim”
Wayne Bufford says:
January 4, 2011 at 9:51 pm
Also check you DD214, the person who filled mine out did not take the time to turn the page of my records to say I served over seas in Vietman!! Had to fight to get that cleared up. finally got my Metals after filing and asking for them, they were approved but never issued to me during my service. I got them 2 yrs after requesting them. If you are hurt or have PTSD, if they say no the first time, Keep your records and doctors records and Keep filing appeals.
Check with your state to see if they have a state funded commission who has vets to help vets free of charge to get the appeals filed correctly and on time. If it goes to a hearing they will go with you and they will fight for you. we did not have any luck with the group at the VA Hospital who was suppose to help me get my compensation for serving or for my disability now.
God Bless Brother and Sister, Welcome Home!!!Keep fighting!!
Berta Simmons says:
January 5, 2011 at 9:52 am
Excellent article! Thank you very much Mr Pamperin!
Keeping the claim simple (as you indicated)is a big help too.Focus on the primary potential SC disabilities and then add what are possible secondaries to each primary.
But be reasonable.Claims that involve 15 or 20 issues make my eyes glaze over, as a veteran’s advocate, so I imagine a rater would feel the same way too.
I totally agree with Jim too,in every thing he said here.
I always tell vets that the best service rep they will ever have is the person they see in their bathroom mirror every morning.They must be proactive with their claim whether they have a vet rep or not.
Vet reps handle hundreds of claims(and maybe even thousands that are still in appellate processes) but veterans or survivors usually have only one main claim that could have some additional issues.
This article is a MUST read for all of us!!!!I am printing this out as well as passing it on.
Thank you again!!!!!
Dylan Finsand says:
March 6, 2011 at 4:36 am
Being your own best rep isnt always true. I have a TBI with dementia. Some have serious cognitive problems and are not thier best rep. Ive had VSO and good people at VA tell Dylan dont ever do anything on your own with your claims again! Just something to keep in mind. Thanks for reading
Thomas J Dittmar says:
January 7, 2011 at 10:35 pm
Sir, I filed a gulf war illness claim with the Seattle RO in the 90′s but the gulf war illness claim was deferred in the 90′s with no further contact by VA. I refiled the claim march of 2010. Approximately 2 months ago I received a notice that I would be contacted by VA medical for an exam but never heard another word. Can someone explain to me what is happening with my refile? I don’t want this claim to be lost like the one in the 90′s
SCOTT PRATER says:
January 8, 2011 at 11:28 pm
It would be best to contact the local regional office and make sure they actually received the claim and supporting documents. Call 1-800-827-1000 and it will send your call from the switch to you local office. I select 1 when finally given the option and 0 for general assistance. It can take different lenths of time but they can make a decision on you claim, or usually they sent a request to a company called QTC who will send you to an unbias doctor to see you and possible run tests to support your claim. If it has been sent to QTC you will be told so and can get the headquarters number and ask for info from them if they have scheduled you and appt. or what the status is. The VA reps also may need to ask you questions and input them in the system or transfer your call to someone able to record needed info related to your claim so it can move forward. Hope this helps.
Scott
Dylan Finsand says:
March 10, 2011 at 11:44 pm
Or VA is looking at it and are gonna tell you that its not service connected because they have a habit of not having all your records. But most likely it waiting in line with every one elses cause it does take time.
Bekki says:
September 22, 2011 at 6:38 pm
My husband has filed a claim twice and once the person that in the claim review office told him that since he is a Vietnam Vet he is on the back burner and the service men and women that are coming home now have priority….. Lets think about this a minute if is wasn’t for those who have served in Vietnam we wouldn’t have the service men and women fighting now…. That is how back words our Government really is. We are still waiting, and the last time we put in a claim was years ago.
Miguel Cucue says:
December 6, 2011 at 6:17 pm
Bekki,
I am one of those soldiers that just returned from our current war. I honestly agree with you and that is WRONG! Veterans from older wars should have priority. The government’s system is all messed up!! My best goes out to you, your husband and your family. Keep fighting because I am still battling to get my claim going.
Carmen Tellez says:
March 3, 2012 at 4:18 am
Mr Michael Cucue:
You’re absolutely correct every veterans needs to be recognized/compensated for their service to our country. My late husband served in Korea (front lines) for 3 years, Frank came home 12/54, we met 12/71 & married 6/71 after our son was born, he was born with Cerebral Palsy & Autism, not easy but thru love & lots of patience he’s very functional but still needs supervision. Frank was diagnosed with PTSD 3/93 but it took VA till 11/2004 to admit it was due to war. He passed away on 4/16/2010 because of PTSD.We were sure that our son & myself would be compensated nicely instead we have been denied all benefits except commisary, what’s wrong with this goverment.
My apologies for wordy letter, I’m angry & hurt, we were married 38 years, please advise if possible.
My heartfelt thanks,
Carmen Tellez
An angry & hurt veterans widow.
Romy A. says:
January 12, 2012 at 2:23 pm
It is very frustrating for a Viet Nam veteran like me as well because we did not get separation briefing at all to explain our benefits. Now, it seems like all help are concentrated to other war era veterans. Presumed illnesses are hardly applied to the Viet Nam vets unless one served close or in mainland for the Agent Orange issue. I think VA should be more open minded and really look at the illnesses claimed if the job can be related to that. Outside doctors(PPOs) only keep their patient’s record for the most 5 years. So, a vet like me is out luck for securing those records as proof for the claim.
Halrow says:
March 1, 2012 at 3:11 pm
Hello, Im also a vietnam combat veteran……You say your husband
is a Viet Vet and his claim is taking a long time.The truth is ,that his
VA medical Record and DD214 needs to be intact and in the hands
of the VA or the organization representing your Veteran Husband.
Having said that ,i can tell you that claims ,that have real and lawful
entitlements to a veteran by way of his service connected health
issues ,should be readily provided to the entitled veteran as
earned compensation.The matter of taking a long time ,may be
a hard ship issue to some older and more serious ill vets ,however
it should be noted by you Bekki ,that a legal veterans compensation
award is paid retroactive to the date the VA acknowledges the
innitial reciept of your husbands claim…In other words for every
month that passes on a pending claim the veteran gets paid when
the claim is finaly awarded.Having said that ,it should be noted that
any retro active award payment,ofcorse depends on the amount,
determined by the service connected disability anywhere from
10% to 100% . I wish you and your husband all the best wishes
and hope this takes some pressure off you and any entitled vets
that suffer from poor sleep and probable PTSD and stress
related health issues. Im getting stressed my self right now,and
must keep watching my blood pressure….After 6 long life threatening
surgerie..and a low lvf of 40 i need to take life a bit more casualy
these days. I like helping others though, so i hope this message
helps.
John says:
September 14, 2011 at 6:18 am
The best thing you could ever possibly do is get your DD214, your doctors/hospitals names, addresses, phone nrs. and contact your closest Disabled American Veteran organization for a service officer and have them represent you. Doing it alone by yourself, no matter how much documentation you have, can be totally fruitless.
Laura says:
September 19, 2011 at 1:11 am
My uncle was in vietnam. He was blown up, exposed to agent orange and still has metal in his body. He never filed and cannot take off work because the money he does bring in doesn’t cover his bills as it is. What can I do to help him
Melissa says:
October 13, 2011 at 10:31 am
He can contact a service organization by phone and they can send him out the paperwork and help him get started. If I assist a veteran in this situation, I try to give them as much info as I can over the phone, mail them the forms, have them fill them out and send back to me for review. If there are areas that need to be addressed, my assistant or I call the veteran and get those areas clarified. The vet will eventually have to have to take off to attend any exams the VA schedules, but those would be the only time he would have to miss work. My service organization is Military Order of the Purple Heart. We have National Service Officers in most states. You can check out our website at http://www.PurpleHeart.org and find the nearest representative to you, if you are interested in our assistance.
joseph roe says:
September 20, 2011 at 5:21 am
i was told several years ago that i suffered from ptsd. soon after i was seeing another dr and they would not diagnose. they say i have depression. ive been suffering for 15 years and 1 out of many drs said i had a service related illness. after that they refuse to diagnose me.
Aledia Jones White says:
March 29, 2012 at 5:58 pm
Get to your local va clinic. Explain it all to your primary care physician. They will then set up an appointment with the va mental health clinic. They are very good and well experienced at recognizing ptsd. I wish you well.
I would have loved to add them all but there isn’t enough room. The responses bring up so many interesting questions and in many cases great answers that I recommend following this blog
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