To become service connected (SC) for a disability: 1. Event/Issue in service 2. Current diagnosis 3. Doctor connecting 1 and 2 There are other avenues which include presumptive conditions, like if you were deployed under certain circumstances (like Vietnam, OEF/IEF, etc…), or if a chronic condition appeared within a year after you got out.
There are also secondary claims, where a SC disability, or medication used to treat a SC disability, caused another disability. For Guard/Reserve, there are special line of duty (LOD) requirements which may apply.
To become service connected (SC) for a disability:
- Event/Issue in service
- Current diagnosis
- Doctor connecting 1 and 2
Evidence is very important, so try to get all that you can. When you have it, compare it to what you may already have.
- Make sure you have an account setup with MyhealtheVet. After additional authentication, you can pull your personnel file and VA medical records.
- Do the same for Ebenefits
- Request a copy of your personnel record via Military Service Records Online from the National Archives.
- Request a copy of your claims file (c-file) from the VA. This could take weeks to months (most likely) to arrive
- Request a copy of your service medical records from the VA. These are often available by contacting the Release of Information Office at your VAMC. They claim it will take 4 business weeks or so, but in reality it likely will take longer.
- If you had medical treatment at a civilian facility, try to get those records too. Please bear in mind that they may have destroyed copies and/or might charge you money for copies, which can add up. Only get what you deem potentially relevant to current or future claims.
- Please bear in mind that some facilities (VA, military, and civilian) may keep dental and/or imaging (X-ray, CAT scan, MRI, etc…) records apart from regular records and they may need to be obtained separately. Some VAMC’s keep these at their Radiology department, but they will make you fill out a release of information form first.
- Try to obtain copies of Monday Morning Reports (MMR’s) and unit records from units with which you served.
- If you are or can get in contact with people who knew you before/during/after service, and who could attest to observing your condition, then they may be able to write a “buddy letter” on your behalf. These are not guaranteed, but may help when other evidence is unavailable. If you or them kept any journals, diaries, etc.., they may become helpful.
- If you send anything via the mail to the VA, keep copies of everything. Don’t send originals. Use certified mail so you can prove they received it.
- Keep a log of activity between you and the VA, more or less like a diary. It can help if you need to see what was done and when.
The exams should be to what you’re asking for, what kind of compensation. If it’s the first claim to say that something is related to service, like a back claim saying, “I believe that my back was injured in service and that’s why I currently have this disability,” the question isn’t really so much the extent of this disability now; the question is whether it’s related or not.
But most of the C&P exams we see are for the rating to say, “Is this the proper rating?” The veteran goes and, as Carol said, hopefully they’ve called to see what kind it is, but we feel like there is more than just calling that should take place. Source: Hill and Ponton
The effective date for disability compensation benefits is usually the date the Department of Veterans Affairs (VA) received your application. Disability benefits will be due to you from the first day of the month following the month of the effective date.
Have you recently received an award letter from the Dept. of Veterans Affairs? These days with the backlog in VA claims processing, you may have been awaiting a long time for this day to come. He
Greetings: I am grateful that one afternoon a few years ago, I Googled “I’ve had it with the VA”. That simple “search” born out of utter frustration led me to “Hadit”. And there it all started! As of two weeks ago, I’m rated 100% (long overdue). And, I am still NOT done with the VA.
For those looking to do there own research I offer this process:
- Obtain your Military Service and Medical Records by mailing (certified, return receipt requested) an SF-180, found here: Download SF-180
- Obtain your full VA treatment records from the “release of information” window at the center you receive treatment at.
- Review the CD-rom (PDF file) for all CHRONIC medical conditions, treatments, and diagnosis – chronocity is critical!
- Identify the incident, event, or situation in service that “caused” this condition. If it’s in your active duty medical records that’s extremely valuable. If it manifest after service you’ll need to find a way to “connect” it to service – the “nexus”.
- Next search USC 38 part 4 for your CHRONIC DIAGNOSIS, found here: 38 CFR 4 Schedule for Rating Disabilities
- Match up the conditions and rating percetnage to the CHRONIC diagosis in your medical records.
- Review the DBQ the C&P examiner “must” use to rate your current condition, found here: List By DBQ Form Name
- Search for VA court cases on your condition(s) to understand how the VA Regional Offices is likey to “rule and rate” on your claim. HINT, the cases tell you what evidence actually supports a claim.
- For example, here’s a search for Sleep Apnea secondary to chronic Sinusitis: Google sleep apnea secondary to chronic sinusitis
- Look for evidence in these cases that would support your claim, and THEN match and find your evidence – NEVER, EVER lie!
- Gather all your evidence, write up a Statement in Support of Claim, found here: Veterans Affairs Statement in Support of Claim and mail it certified return receipt requested.
- NUMBER every single page, make copies, and wait.
- Make someone sign for your mailed packaged – VA has NEVER lost my packages!
- Before you go to a C&P review your evidence and especially the questions the Dr. is going to ask from the DBQ. I usually hand write a list of the 6-7 items that supports my claim. I make sure the examiner see this. I’m so done with the VA, I walked into to my last C&P with my 4″ binder and the Dr. undersood I knew what is going on. A C&P exam is a LEGAL MEEETING, not medical treatment.
I submitted my last three claims in July and they were fully decided correctly in six months. Help the VA help YOU! And, most importantly, never, never, never, ever give up. Be relentless! Most grateful, PJ
I got a request to see how I wrote Claims, so here they are:
Hearing loss, Peripheral Vestibular Discorder, and Tinnunitis.
VA’s 2015 Decision on these three Claims.
- STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS – PG-1- redacted.pdf
- STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS – PG-2 – redacted.pdf
- STMT IN SUPPORT OF CLAIM – PERIPHERAL VEST DIS FOLLOWED BY TINNITUS – PG-3 – redacted.pdf
- DBQ WITH TINNITUS – HEARING LOSS & PERIPHERAL VEST DIS – AMENDMENTS_Redacted.pdf
- C&P EXAMINER’S DBQ FOR EAR CONDITIONS.pdf
- STMT SUPPORT CLAIM – RHIODS 2014 – redacted.pdf
- DBQ FOR RHOIDS – FOR C&P.pdf
- STMT SUPP CLAIM – ECZEMA 60% – PG 1-2.pdf
- STMT SUPP CLAIM – ECZEMA 60% – PG 3.pdf
- STMT SUPP CLAIM – ECZEMA 60% – PG 4.pdf
- 2015 DX REDACTED FOR HADIT_Redacted.pdf
I encouraged you to keep the exam in perspective. What is that Perspective?
Honestly, it comes down to recognizing that the purpose of the C&P Exam is NOT to convince the doctor that your injury is service connected, but to let him or her conduct their exam and draw their conclusion. In the end, your current disability either is or is not related to military service. Regardless what the doctor says, what the VA Rater says, the limitations or symptoms either are, or are not, related to your time in service.
A doctor’s opinion can’t change what is or is not. It’s just another piece in the puzzle of proof. And the C&P Exam is just another piece in that puzzle. It is not the only piece – but if we view it as such, we often make our claims harder than they have to be. And we certainly make them more stressful.
#1 Every C&P Exam has 2 Goals.
The first goal is to have the doctor confirm that your injury, disability, or limitations are related to your military service – to prove the Nexus Pillar – and/or to establish the degree you are disabled – the Impairment Pillar. The second goal is to draw out the “evidentiary gap” in your claim through a C&P exam. The evidentiary gap is the difference between what is IN the record, and how the VA SEES what is in the record. If you are denied service connection, it is almost always because of an evidentiary gap – and rather than throwing a haystack at the RO and then yelling at the VA for not finding the needle – let the Examiner tell you what is missing by reading his/her opinion.
They tell you what is missing by what they focus hardest on. The key is NOT to provide excessive amounts of information in your C&P exam – keep your answers short, and “make” the doctor get into your file to review the evidence. It is THEIR report which shows the evidentiary gap – not your statements in the C&P. Which brings us to the next tip….
#2: Answer only the questions the doctor asks.
If the doc asks “How are you doing”, and you throw the entire history of your claim at her over the next 15 minutes, what happens? She zones out. She doesn’t hear what you are saying, and may find it hard to care about what you are saying. I get emails every day – some are 8-9 pages of micro-detailed histories of a VA Claim. It’s hard to read them. It’s hard to understand them. It’s hard to pick up the phone and call that person because I know I’m going to get more facts that I don’t need. Listen, I’m really good at doing this work, and while there are some real shit-bird doctors out there, there are some really good ones. They know how to call out the information they need, to get the facts to understand the situation. So just answer the question you are asked – not the question that you want to answer. But when you do answer the question, follow Tip #3
#3: Keep it Simple and Basic.
Limit what you say to symptoms and limitations or nexus to brief statement. If you can’t answer the question “Why is your injury related to military service” in under 20 seconds, you are talking too much. Here’s a great example of how you might respond to a VA C&P Examiner’s question about nexus: “You should defer to my Claims File as that has my complete position on why my injury is related to my service….but, very generally….. Because of the in service injury to my right knee, I began to overcompensate and now my left knee needs replacement.” or “I was raped in basic training, and during the rape, my attacker broke my jaw. I now cannot eat or swallow properly.” or “I was diagnosed with prostate cancer while in service.” The more you talk, the more ways an examiner has to deny your claim without ever looking at the file. The less you talk – the more direct and to the point you are – the more they have to read the file.
Types of VA Disability Claims
There are numerous types of claims that apply to disability compensation. They can be based on disabilities that existed when entering military service, but were made worse, disabilities that occurred during service, or disabilities that arose after you left military service. Additionally, there are claims that are filed for special circumstances.
Service members that are within 180 days of separation or retirement from active duty or full time National Guard duty may file claims for disability compensation. Learn more about pre-discharge claims
It is to your advantage to submit your disability compensation claim prior to separation, retirement, or release from active duty or demobilization. Processing times tend to be much shorter for claims submitted pre-discharge than after discharge. Pre-discharge programs provide Servicemembers with the opportunity to file claims for disability compensation up to 180 days prior to separation or retirement from active duty or full-time National Guard or Reserve duty (Titles 10 and 32).
You can apply for disability compensation through one of the following:
Claims Based on Pre-Service Disabilities
Individuals may enter military service with a known disability. Should this disability become worse due to military service, VA may be able to pay compensation. This is known as aggravation; however, compensation can only be paid for the level of aggravation. For example, at entry into military service, an individual has a disabling condition that could be considered 10% disabling. In order for this condition to be considered aggravated, it would have to have worsened due to military service to at least 20%.
Claims Based on In-Service Disabilities
These claims are based on disabilities that are a result of an injury or disease that occurred in active service, and in the line of duty. Injuries or diseases as a result of the Veteran’s own willful misconduct or abuse of alcohol or drugs are excluded.
Claims Based on Post-Service Disabilities
Claims for post-service disabilities would include claims for disabilities that are a result of disabilities considered to be service-related, even though the disability arose after service. There are various classifications of presumptive disabilities which can be based on location or circumstances of service or just by military service itself. Learn more about post service claims
Claims Based on Special Circumstances
Claims regarding compensation are not always based on an in-service event. In other words, after a disability has been determined to be service connected, there may be other types of claims a Veteran or surviving spouse may wish to file. This might include a claim for a temporary 100% rating due to surgery for a service-connected disability, or additional compensation based on being in need of regular aid and attendance. Learn more about special claims
How VA Identifies Claims
An original claim is the first claim you file for compensation from VA. This can be filed by a Servicemember, Veteran or survivors of deceased Veterans.
A reopened claim is a claim filed for a benefit that could not be granted and the decision has become final, meaning that it is over one year old and has not been appealed. VA cannot reopen these claims unless new and material evidence is received. New evidence is evidence that the VA has never before considered in connection with the specific benefit claimed. Material evidence is evidence that is relevant to and has a direct bearing on the issue at hand.
A Veteran was treated several times during service for pain in the right elbow. He filed a claim for service connection in 1989, but his claim could not be granted because no orthopedic abnormalities were found on VA examination. Two years later, his private physician x-rayed the elbow and noted arthritic changes in the joint. The Veteran submitted the new evidence to VA. Because it suggested a residual of his in-service elbow problems did exist, VA reopened his claim.
A Veteran was discharged from service in 1977. He filed an original claim for service connection for pes planus (flat foot) 20 years later. VA was unable to grant his claim because pes planus was never noted in the Veteran’s service treatment records. In 2001, he attempted to reopen his claim by submitting a statement from his private physician confirming the diagnosis of pes planus. VA was unable to reopen the claim because, while the evidence was “new,” it was not “material,” in that it failed to demonstrate the Veteran was diagnosed with pes planus during service.
A new claim is a claim for a benefit that may or may not have been filed before. Generally, the decision made on the claim is based entirely on new evidence. These may include claims for:
- An increased disability evaluation
- Special monthly compensation
- Individual unemployability
A new claim differs from a reopened claim in that a decision on the claim is totally independent of any evidence submitted in connection with an earlier claim.
These are claims for disabilities that developed as a result of or were worsened by another service-connected condition. In other words, it is recognized that a service-connected disability may cause a second disability. This second disability may not otherwise be considered service-connected.
A Veteran has a service-connected knee injury that causes him to walk with a limp. He subsequently develops arthritis in his hip. Although the arthritic condition was not incurred during or aggravated by service, service-connection may still be established if the arthritis is a result of his knee condition.
A Veteran was in the Army for twenty years. During her military service, she was diagnosed with hypertension. After her discharge, service-connection was established for hypertension. She was subsequently diagnosed with a heart condition. Service-connection for her heart condition may be established as secondary to the hypertension.
How To Apply
For more information on how to apply and for tips on making sure your claim is ready to be processed by VA, visit our How to Apply page.
VA Disability Compensation
The Compensation program provides tax-free monthly benefits to Veterans in recognition of the effects of disabilities caused by diseases, events, or injuries incurred or aggravated during active military service. The program also provides monthly payments to surviving spouses, dependent children, and dependent parents in recognition of the economic loss caused by the death of individuals during their military service or as a result of service-connected disability after their discharge.
Appeals process: The multi-stage appellate process is available to you after you have already received one or more decisions on your claim, but disagree with some aspect of VA’s decision. During the appellate process, an appeal undergoes additional independent reviews, often multiple times and by different adjudicators, as you or your representative submit new evidence and/or a new argument. Nearly 74 percent of appeals are from Veterans who are already receiving VA disability compensation, but are seeking either a higher level of compensation or payment from an earlier effective date.
1 Appeals and Claims are different
You submit a claim when seeking VA disability benefits (or increased benefits) for one or more medical conditions you believe are related to military service. These claims can be filed online through eBenefits, submitted by mail or in person at the nearest VA regional office. The claim submission, the military service and health care records and any other evidence associated with the claim are reviewed in order to provide you a rating determination.
The Appeals Process
The multi-stage appellate process is available to you after you have already received one or more decisions on your claim, but disagree with some aspect of VA’s decision. During the appellate process, an appeal undergoes additional independent reviews, often multiple times and by different adjudicators, as you or your representative submit new evidence and/or a new argument. Nearly 74 percent of appeals are from Veterans who are already receiving VA disability compensation, but are seeking either a higher level of compensation or payment from an earlier effective date. Continue Reading
When I represented Veterans at the Board of Veterans’ Appeals, my clients usually had a lot of questions about the appeals process and the differences between a claim and an appeal.
2 Appeals at the Regional Office
Once a VA office issues its decision on your claim, you have one year from that date to file an appeal. Read the decision letter closely: it will tell you why VA made the decision it did. If you are unsure why or how VA made its decision, ask a Veterans service officer for help. You can also call VA or go to your regional office.
If you disagree with VA’s decision for any reason – the effective date of your award, the rating percentage you were given or the reason you were denied – you should file a Notice of Disagreement (NOD). Continue Reading
Use the VA Historical Disability Compensation Rates to calculate your retroactive pay.
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Have you recently received an award letter from the Dept. of Veterans Affairs? These days with the backlog in VA claims processing, you may have been waiting a long time for the letter to arrive. Here’s how you can figure out the amount of your retroactive payment. I.