Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

  • homepage-banner-2024-2.png

  • 2024-001-donate.png

  • Search VA Disability Claims Information via HadIt.com Veterans

  • 14 Questions: VA Disability Benefits Claims

       (0 reviews)

    Tbird

    14-va-disability-claims-questions-yellow.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, they tend to ask many questions. Over the last ten years, the following are the 14 most common basic questions I am asked about when it comes to filing Veterans Affairs Disability Claims. [Reprinted here with permission from Veterans Law Blog] 

    1. What benefits do you get from a VA Disability claim?

    There are several major categories of VA benefits you can get when you file and win VA Disability claims. You should look at the VA’s “derivative benefits matrix” to see what other VA benefits you may be eligible for from the VA.

    CATEGORY 1: Non-Service Connected Pension. These benefits are available to “wartime” veterans with no or low income due to non-servive connected disabilities. The calculation of the amount of the pension can be very difficult, so reach out to any attorney if you have been denied or feel like the VA didn’t calculate the pension correctly.

    CATEGORY 2: Education Benefits. There is a wide array of VA educational benefits available to veterans seeking additional education, from the GI Bill to Dependents Educational Assistance and additional monthly compensation for dependents in college. Not only should you look at the VR&E benefit in Category 5, but you should also evaluate your eligibility fo

    CATEGORY 3: Survivor benefits. The VA provides many programs to assist veterans' spouses, dependents, survivors, and caregivers. You can find a rather thorough list on the VA’s website.

    CATEGORY 4: Health Care benefits. VA Healthcare is available to all veterans, with more disabled veterans (and veterans in special groups) getting higher priority access to care. You can learn more about what VA healthcare is and what it covers by clicking here. In some cases, your dependent, spouse, or survivor may be eligible for CHAMP-VA coverage.

    CATEGORY 5: Employment Benefits. This category involves benefits such as access to the VA’s Vocational Rehabilitation program (now called VR&E, for Vocational Readiness & Employment) services to help with job training, employment accommodations, resume development and job-seeking skills coaching. You might also be eligible for help starting your own businesses or getting help with independent living services if you are severely disabled and unable to work in traditional employment. Veterans with a service-connected disability have access to a 10-point federal employment hiring preference.

    CATEGORY 6: VA Disability claims for “Service Connected” compensation benefits. It is this sixth category of benefits that is the focus of this post – and the focus of the Veterans Law Blog since 2007. In this category of benefits, veterans receive monthly compensation for the impairment of earning capacity that results from diseases, conditions, and disabilities that had their origin in military service.

    (Note that you do not need to show that military service CAUSED the disability Congress long ago recognized that Veterans should get benefits even if a disease or disability that wasn’t caused BY service has its origins IN service.

    When it comes to VA Disability claims for service-connected disabilities, the primary benefit is financial.

    Once you prove to the VA that your current medical condition, disease, or disability is related to your military service, they will assign a percentage of disability to that condition – using a complicated table and formulas.   That percentage of disability translates to a monthly dollar amount.  10% equals one amount….20% another amount… and so on and so forth. You can see the 2021 VA disability ratings by clicking here.

    You can take a look at the current VA Disability claim compensation amounts by clicking here.

    In addition to the basic rates of compensation mentioned above, you can get additional compensation for different scenarios that you raise in your VA Disability claim. The VA, in fact, has a legal duty to maximize a veteran’s benefits in VA disability claims by broadly construing disability compensation claims and awarding as much compensation as the facts and evidence support.

    The best place to begin a search for these benefits is to look at the VA Benefits Eligibility Matrix to see if you are eligible for what the VA calls “derivative benefits” — benefits that derive from VA disability compensation or even a non-compensable service-connected disability rating.

    Here are just a few (you can read about even more by clicking here)

    • A Veteran who has a certain percentage of disability ratings for multiple disabilities can be eligible for additional Special Monthly Compensation.  This Special Monthly Compensation is also available to Veterans with certain disabilities that limit the use of, or that resulted in the loss of, their extremities, their reproductive organs, and organs of special sense (vision, etc). Some of these benefits can be substantial – like SMC(t) for veterans with a TBI who have difficulty caring for themselves (or whose family has difficulty caring for them).
    • Veterans who are unable to work because of their service-connected disabilities are entitled to a 100% total rating under a benefits program called Total Disability for Individual Unemployability, or TDIU.
    • Veterans who need special aid and assistance with certain activities of daily living are entitled to an additional amount of compensation.
    • And Veterans with a spouse or certain dependents are entitled to higher rates of compensation as well.
    • There are certain vocational rehabilitation benefits available to Veterans with service-connected disabilities.
    • The total percent rating of your  service connected disabilities can play a role in the ease you get VA Healthcare or the Priority Group you are assigned to.
    • There are grants available for special adaptations to housing or automobiles that can grow out of your service-connected disabilities.
    • Survivors of Veterans are entitled to non-service connected survivors’ pensions – also limited to the lowest-income survivors. These survivors are typically spouses or children, but in some cases, include parents and adult children who were permanently incapable of support before they turned 18.

    2. How do I file a VA Disability claim?

     The VA’s answer to this question is found by clicking here. It used to be that you could file a VA Disability claim for a service connected condition, disease or disability just by writing your claim on a piece of paper – a famous anecdote that floats around the Veterans’ community is the veteran who  wrote his claim on a square of toilet paper while in prison.

    This is no longer the case: filing a VA Disability claim has, like many other things in this world, become increasingly complicated.

    Generally, filing a VA Disability claim requires a series of actions:

    Step 1: Filing Phase

    You can first file an informal claim for benefits using the required “intent to file” VA Form.  If you formalize your claim within one year of that informal claim, the VA treats your informal claim as a formal claim.

    There are currently two claims & appeals processes. The legacy system covers cases where the veteran received a VA Ratings Decision before February 19, 2019 (and did not opt into AMA). The AMA Modernized Appeal system covers cases where the veteran received a VA rating decision dated after February 19, 2019. The system you are in primarily controls the process the VA uses, and, for the most part, the laws pertaining to service connecting a disability are largely the same.

    Step 2: Development Phase

    You can let the VA develop the evidence to support your claim – officially, they have a Duty to Assist the Veteran in this development of certain claims in limited situations.

    Or, you can be more proactive and develop your OWN claim, using the three types of evidence common to VA disability claims and appeals.  Theoretically, these claims are supposed to be decided more quickly, and for the most part, they are.  But by developing your own claim and using the knowledge, information, and tools I share on the Veterans Law Blog, you can set your claim up for more thorough decisions, more proper decisions, quicker decisions, and….worst case scenario, if you have to appeal, a better chance at winning your claim on appeal.

    Step 3: The Decision Phase

    In this phase, the VA will decide that there is possible merit to your VA Disability claim for service connection of one or more conditions.

    In most scenarios, they will send you to a C&P (Compensation & Pension) Examiner, who is, in theory, a medical doctor who will decide if your diagnosed condition is related to your military service and how bad your condition is, percentage-wise.

    The VA might, before or after that review, issue a denial or a grant of benefits that is supposed to address a few questions, what I call the ‘4 Pillars’ of a VA Claim:

    Pillar 1: Are you eligible to file a VA Disability claim for compensation benefits

    Pillar 2: is the medical condition – or conditions – in your VA Disability claim related to your military service? (This pillar is often called the “service connection” or “nexus” element of your VA Disability claim)

    Pillar 3: To what degree does your disability impair your ability to seek and hold work, or engage in average daily living activiites? I call this pillar the “Impairment Rating”.

    Pillar 4: What effective date are you entitled to (it is the effective date that governs how far back in the past your benefits will be retroactive).  Some Veterans call this “back-pay” or “past-due benefits”, and depending on how long you have been battling the VA, they can often go back decades.  My colleague at another law firm won a case for a Veteran with a service connection granted all the way back to the 1950s, for example.

    by-the-way-it-is-in-this-4th-pillar.png

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         

    Step 4: The Administrative Appeal Phase.

    If you are not satisfied with the VA’s decision in step 3, you can appeal.

    How you appeal has recently become very complicated. As of February 2019, the VA introduced a new appeal process called the Modernized Appeal system (or AMA), replacing the old “Legacy Appeal system.

    You can read about the Legacy Appeals process by clicking here – there is a TON of information on the Veterans Law Blog® for those veterans who remain in the Legacy Appeals system.

    You can read about the AMA appeals process by clicking here. As we learn more about this relatively new process, the Veterans Law Blog® will share what we learn.

    Under the Legacy Appeals process, the goal was to get your denied VA disability claims reviewed by either or both a DRO (Decision  Review Officer), or to a Veterans Law Judge (VLJ) at the  BVA (Board of Veterans Appeals). To do the latter, you had to  “perfect your appeal” by filing several forms in a particular sequence and on a specific timeline. Under the Legacy system, you could then get a BVA hearing: an in-person hearing in DC, during a video conference hearing from a VA facility near you, or waive the hearing and submit a “brief” with “exhibits” and have the VLJ review your claim “on the record” before it. The BVA Judge could do one or more of the following – reverse, remand, grant, or any combination of those 3. By far, a combination of the 3 is most common. After that, these are the different things the BVA VLJ can do, in order of most to least common:

    1. Remand the claim for the development of more evidence;
    2. Deny your appeal (also known as affirming the VA denial of your VA Disability claim);
    3. Grant your appeal (also known as reversing the VA Denial of your VA Disability claim).

    The VA AMA modernized appeal process is much different. You can seek a Higher Level Review, file a supplemental claim, or appeal to the BVA. If you appeal to the BVA, you have to pick one of three “hearing” lanes. The BVA judge cannot remand except in incredibly limited scenarios.

    Step 5: The Court Appeal Phase

    If you are not satisfied with your BVA Decision, so long as it is not a remand, you can appeal to the Court of Appeals for Veterans Claims (aka, the “CAVC” or the “Veterans Court”).  That court only decides whether a BVA decision is proper under the law or properly applied law to fact….it cannot make factual findings.

    On average, between 70-80% of BVA Decisions contain a reversible or remandable legal error, so if you have a BVA Decision, please talk to an attorney with experience at the Veterans Court to discuss appealing it.

    Veterans do not pay out-of-pocket for lawyers at the CAVC…if the Veteran wins at the CAVC, the VA has to pay the lawyer out of IT’S own pocket and NOT out of the Veteran’s past-due benefits.

    The CAVC can do any of the following: affirm (uphold) a BVA Decision, reverse (reject) a BVA decision, vacate (erase) a BVA decision, and remand (send a decision back to the BVA for repair of legal errors.  It can also combine 2 or more of those types of relief, depending on the case.

    Step 6: Judicial Review phase

    If you are not satisfied with your CAVC Decision, you have a limited opportunity for judicial review at the Federal Circuit Court of Appeals (Fed Circuit) and then the  Supreme Court of the United States.

    The Federal Circuit only has the ability to decide PURE questions of law…I’d be willing to bet that 80-90% of Fed Circuit decisions in Board cases are “Rule 36’s”… decisions without a written opinion, typically because the Court does not have jurisdiction over the appeal.

    Getting review at the Supreme Court is much harder, and appeals to both courts can be very expensive….filing fees alone at the Federal Circuit cost $500 and the cost of copying and filing the brief and the record of proceedings below costs between $2,000 and $5,000….so attorneys and Veterans tend to be more conservative about appeals to these courts.

    3. When do I file a veterans benefits claim?

    Ideally, you want to file your VA disability claim within a year after discharge from military service. (Learn about the one VA Program I like – the Benefits at Discharge Delivery, or BDD, Program)

    However, most conditions do not get diagnosed for years or decades after service.  In those cases, if you are filing an original VA Disability claim (i.e., for the first time), you should file at least the intent to file a claim form mentioned above as soon as you have a suspicion that your condition is related to military service.

    This protects the earliest possible effective date for your VA Disability benefits claims.

    If you are filing claims for increased compensation, then you want to file the claim for increased rating as soon as you believe your condition is getting worse.

    3. Where do I file my VA benefits claims?

    Technically, your VA Disability claim is filed with the VA Regional Office for your geographic area.

    However, you can file your VA Disability claim online through the eBenefits portal for Veterans, or, if you want to be sure that you create a paper trail for your claim to make sure it is not lost by the VA, you can file it by sending it to the Evidence Intake Center (also known as the VA’s EIC in Janesville, Wisconsin).

    5. Who can help me file and appeal claims for service-connected VA disability compensation?

    Anyone that you trust can help you with VA Disability claims.

    However, nobody can charge you a fee for filing your VA Disability claim – attorneys and accredited agents are only allowed to charge a fee for filing or helping you in your VA Disability claim after the VA has denied the claim.

    There are some fly-by-nighters who pretend to be VA claims insiders, telling you that they have the secrets that nobody else has. Those same self-proclaimed “VA disability claims insiders” will charge you fees that are illegal and, even when they are legal, are far higher than you should pay an unlicensed and unaccredited clown.  If someone tries to tell you that they are an insider with secrets that can help you with your VA disability claims, check to see if they are either or both an accredited agent, an attorney, or work for a VSO.  If not, the chances of getting cheated out of your benefits get pretty high.

    Some national organizations, like the Disabled American Veterans (DAV), Veterans of Foreign Wars (VFW) and the American Legion (Legion or AL) have what are called “Veteran’s service representatives” or VSOs that volunteer to help with filing initial VA disability claims. The quality of work or help you get varies widely, and I’ve seen both extremes: I’ve seen VSOs that do amazing work for free, and I’ve seen VSOs that pull the rug out from under their “client” or “member.

    Organizations like the Paralyzed Veterans Association (PVA) and the Vietnam Veterans of America (VVA) get consistently high marks for the work they do for their members.

    6. How long does it take to receive compensation after filing VA Disability Claims?

    The amount of time that it takes for the VA to decide a VA Disability claim can very greatly, and depends on a lot of variables: how difficult your claim is, how many conditions you include in the VA Disability claim, how well your claim is prepared, whether your claim is a Fully Developed Claim or not, how big your VA Regional Office is, etc.

    Here are some general rules:

    * If you click here, the VA provides its current time for processing claims (154 days as of the date of this writing). Keep in mind, appeals can take much, much longer, but for the most part, we are seeing most veterans get VA rating decisions on their original claims in under 6 months.

    * If you are really bored, or like looking at really small numbers on mind-numbingly complicated spreadsheets, click here to see how long claims are currently taking in your geographic region.  Pour a scotch or glass of wine…these spreadsheets are consistent with everything the VA does….hard to understand, loaded with jargon, and obvious number juggling to hide problems in the system.

    * Claims for VA disability benefits that are filed with smaller urban and rural VA Regional Offices are faster than VA Disability claims filed with larger metropolitan VA Regional Offices.

    * Once you file an appeal, it can take 3-10 years to get a decision, again, depending on variables that are too numerous to list here

    * Veterans can speed up the timeframe by filing well-developed and well-documented claims, like we teach here on the Veterans Law Blog®.

    7. How do I check the status of my VA Disability claims?

    That, right there, is the million dollar question.

    The VA will tell you to call their VA toll-free number 1-800-827-1000 to get the status. Veterans that use this approach find that they are able to enjoy their favorite hobby while waiting to talk to someone at the VA: some Veterans relax and enjoy 2-3 hours of hold “muzack”, others read the week’s newspapers or a few magazines, and others have actually written a book while waiting on hold.  If you are among the patient and lucky few that get through to a human being on the 1-800 line, here are some tips and pointers how to get more value and information out of the call.

    The VA also suggests that you check your status on eBenefits. eBenefits is a federal government site online which you log into and perform several claims-related actions, including file a claim.

    Be forewarned, though – eBenefits is a glitchy and inaccurate tool.  For example, if you log into my eBenefits account, it shows that the VA held a hearing on my VA Disability Claim 2 years before I filed it.  That’s a true story, folks.  Now that is efficiency – maybe the VA will start a new pilot program: the pre-claim denial process.

    Be careful what you see on eBenefits..it’s not always your claim status, and its not always accurate, and its rarely up to date.

    8.How are VA service-connected compensation benefits calculated?

    I wish that I could tell you that the VA simply added up your disability ratings from individual conditions to reach your total disability rating, and paid you according to that rating.

    But the VA doesn’t do it that way. They use a unique system called “VA Math” to “combine” your individual disability ratings into a total, and then they award a monthly amount of compensation that corresponds to the resulting total impairment rating.

    You can read more about impairment ratings here – Veterans have a lot more control over these ratings than they have been led to believe, however.  I teach Veterans how to improve or maximize their ratings for a TON of conditions – knee/arthritis, sleep apnea, PTSD, Tinnitus, Hearing Loss, Fibromyalgia and Chronic Fatigue, Gulf War, Migraines, Diabetes, Parkinson’s Disease and many more!

    In my 5+ hour video training course, “How to Prove the 4 Pillars of a VA Claim“, I teach Veterans how to prove the 4 Pillars of a VA Claim, including a lot of specific ways to prove the degree of disability you experience and get the highest rating possible.

    The only way to get access to this course is to become a subscriber of the Veterans Law Blog®….look at the other perks of subscribing, here.

    9. Does the VA have to pay Veterans retroactive pay (back-pay)?

    Yes, they are required by law to pay all past-due benefits.

    The question is “how far do they go back”?

    There is a whole set of rules that helps the VA decide how far back in time to go to pay retroactive benefits. These rules are called the effective date rules, and there are hundreds of them.

    There are a few general guidelines….it’s not all the rules for every effective date for every type of VA Disability Claim, but it should give you an idea how much you have NOT been told about VA disability benefits over the years.

    * In most VA disability claims, the effective date will be the LATER of the date you filed your claim and the date the entitlement arose. Click here to learn more about what that means.

    * If you file your VA disability claim within 1 year of leaving service, your effective date will typically be your date of separation from military service.

    * Claims for Increased compensation rates follow the general effective date rule, except that if you can show that the worsening of your condition started to occur BEFORE you filed your claim, you can get up to 1 year earlier.

    * In some cases, if the law changes while you are trying to prove a claim, or after you’ve been denied a claim, and your claim is granted pursuant to that change in law that made it easier for you to win (in other words, the change in law is a “claim liberalizing rule”) you may be able to get up to 1 year prior to the date of your claim as your effective date

    * If you reopen a previously denied claim by submitting New and Material Evidence, and you  win the reopened VA Disability claim based on military records, military service records, or military medical records that were previously unavailable to the VA or that the VA neglected to get in the prior claim, you can use the effective date rule in 38 CFR 3.156(c) to get an effective date of your original VA Disability claim date. (NOTE: REOPENED CLAIMS ARE ONLY AVAILABLE IN THE VA LEGACY APPEALS SYSTEM. In the AMA modernized appeals system you will need to file a supplemental claim with new and relevant evidence to revive a previously final claim.

    * If you submit New and Material (under the Legacy System) or New and Relevant evidence (under the AMA Modernized Appeals system) within 1 year of the date your ratings decision denied your VA Disability claim, your claim is “open and pending” (Legacy) or “continuously pursued (AMA Modernized Appeal system) until the VA issues a new ratings decision, and if your benefits are granted based on that new and material evidence, your effective date could be the original date of your claim. This is a risky path to take, though, because if the VA denies your claim because the evidence wasn’t New and Material, then you may have lost your original effective date if you did not file an appeal within that same year after the VA Ratings Decision.

    * If you are a “Nehmer Class Member”, meaning a veteran exposed to dioxin (aka, Agent Orange in Thailand, Vietnam, Korea, or other places), a whole set of effective date rules apply due to the VA’s settlement of a class action lawsuit in the 1980s. These are called the “Nehmer Rules”, and they can get pretty complicated pretty quick.

    * A survivor who files a claim for survivor benefits (DIC, service connection of the cause of death and substitution, for example) will get survivor benefits retroactive to the date of the Veteran’s death if they filed their VA Form 21-534 within one (1) year of the Veteran’s death. If they file the claim for accrued benefits within that year, they may be able to get retroactive benefits paid to the date of any VA Disability claim or appeal pending on the date of the veteran’s death.

    10.Are VA Disability benefits for life?

     I’ll answer this question along with #11.

    11.Are VA Disability benefits permanent?

    Generally speaking, they can be.

    If a medical condition substantially improves, the VA can propose to reduce your disability compensation benefits to different levels.  The rules that they have to follow to do this can differ depending on certain factors, but here are a few considerations…you can click here to learn more about how the VA tries to pick Veterans’ pockets by reducing benefits, and get an idea how to stop it.

    * The VA can only reduce “continuous ratings” (those that have been in effect for 20 years or more) after showing that they were awarded based on actual fraud by the veteran.

    * There are 3 types of ratings in VA Disability claims that are considered “protected” ratings, which the VA cannot reduce without showing first a “substantial improvement” in your medical condition.

    * If a VA Disability rating is considered “unprotected”, the VA can reduce it, but they have to send you notice of their intent to respond, give you an opportunity to respond and submit evidence and if you request it, provide a hearing.  The timelines on this type of reduction are pretty friendly to the VA, and pretty hard for the person filing the VA Disability claim to understand, no less follow, so be ready to move quick and do plenty of legwork to understand what is happening and how to stop it.

    * If you are incarcerated for more than 60 days, on the 61st day, the VA can reduce your VA Disability compensation to no less than 10%, and must reinstate it after your release from jail. Click here to learn more about each time of rating and how long they stay in effect.

    12.Are VA Disability benefits subject to child support?

    Yes.

    In every state that I am aware of, VA Disability benefits are considered income for the purposes of calculating child support.

    Child support laws differ in each state, so there may be nuances from state to state how much is subject to child support, particularly when a portion of your VA Disability benefits is offset by military retirement payments.  The best thing to do is get out ahead of this situation by talking to a local family law attorney and making sure you do right by your kids, state  law, and federal law.

    If you need a referral to a family law attorney in Texas or Arkansas, fill out a support ticket.  I know a lot of family law attorneys in both states and may be able to give you a couple referrals.

    13.Are my VA disability compensation benefits taxable?

    Nope.

    At least not under Federal law.  Amounts paid to Veterans or their families for education, training, subsistence allowances, clothing allowances, disability compensation and/or pension payments are not taxable by the Feds.

    As to whether these benefits are taxable at the State level, consult your state’s income tax agency, as the answer will vary state-by-state.

    14. What are the most common medical conditions that Veterans seek to service connect?

    The VA actually publishes a report of the conditions it service connects, the average ratings for each, and more. Click here to check out the report.

    If you don’t have the stomach to read MORE VA propaganda – and honestly, who can blame you – here are the Top 10 conditions that the VA reports as being part of most original VA Disability Claims (click on the links to see information published on the Veterans Law Blog about these conditions common to VA Disability claims)

    Tinnitus

    Hearing loss

    Lumbosacral or cervical strain

    Limitation of flexion, knee

    Scars, general

    Post-traumatic stress disorder (PTSD)

    Limitation of motion of the ankle

    Migraine

    Impairment of the knee, general

    Bursitis

    Here are some other conditions that I see very frequently in many a VA Disability Claim (click on the links to see information published on the Veterans Law Blog about these conditions common to VA Disability claims)

    Sleep Apnea

    Fibromyalgia

    Peripheral Neuropathy

    Diabetes

    Parkinson’s Disease

    Particulate Matter in the lungs

    Gulf War Illness (aka, Chronic Multi Symptom Illnesses)

    Traumatic Brain Injury

    What other questions do you have?

    If you have other questions about VA disability claims, the claims and appeals process, or other issues related to VA service-connected disability compensation, please type a comment below.

    I do not publish all the comments, but I do read each one and use your questions to expand this post to have the most information possible about VA disability claims.


    User Feedback

    Recommended Comments

    There are no comments to display.



    Create an account or sign in to comment

    You need to be a member in order to leave a comment

    Create an account

    Sign up for a new account in our community. It's easy!

    Register a new account

    Sign in

    Already have an account? Sign in here.

    Sign In Now

×
×
  • Create New...

Important Information

Guidelines and Terms of Use