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What Are the Steps in the VA Claim Process?

A Veterans Affairs disability claim proceeds through specific steps to determine your eligibility for benefits.

The ability to receive Veteran’s benefits depends on having a history or military service or being a military dependent. Military service in any branch, at any time, qualifies you to receive VA benefits as long as you have any discharge status that is not “dishonorable.” A Veterans Affairs claim proceeds through specific phases, or steps—knowledge of these helps understand the VA claim process.

8 Steps in the VA Disability Claim Process

  1. Receive veteran’s claim at VA disability office
  2. Review initial file by VA representative or other VA officials
  3. Gather and organize medical and other evidence
  4. Review of evidence by representative and physician(s)
  5. Claim decision is made – allow or deny
  6. VA disability rating is established
  7. File returned to local disability office
  8. Written notification is prepared and sent to applicant

Claim processors, known as VA representatives, do the best they can to ensure a quick turnaround. However, the average fully developed claim takes 3 months (93 days at last county), while a standard claim takes 101 days. The good news is that the VA is getting more efficient and significantly faster at making decisions: In 2018, the average VA claim took 141 days.

A fully developed claim (FDC) refers to one in which you, the claimant, have collected all the relevant medical records and other material. The standard claim is one in which the VA does the document gathering. Let’s examine the VA disability process in more detail.

1. File VA claim and receive notification from VA disability office

If you file online, you will immediately receive confirmation that your VA disability claim has been received. If you mail in an application, the VA will respond with a letter in 1-2 weeks. This part of the disability process is quite straightforward: Fill out the online VA form then wait for electronic communication. It is easier to apply online unless you are unable to photograph and scan documents for a fully developed claim. 

During this first step, some veterans decide to choose an attorney representative to help. This is a common decision because the paperwork can be intimidating and it is easier to talk through the questions with an experienced guide.

2. Review initial file by VA representative

Claims processors at the VA have several jobs: intake, claim review, and review oversight. A Veterans Service Representative (VSR) at a regional office will take the first look at your claim. It is now in “under review” status and if it is an FDC, your claim will automatically move to Step 3 (review of evidence). 

We highly recommend collecting your own medical records and submitting an FDC rather than a standard claim, but if you are working solo and find it difficult to gather your medical records, that may be your only choice. If so, the next step—for standard claims—is the VA gathering evidence.

3. Gather and organize medical and other evidence

The VSR will now begin the relatively long process of evidence gathering, which can take anywhere from one to two months. During this period, your claim may move to an RVSR (Review VSR) for periodic review. It may stay with that VA worker, or go back and forth between VSR and RVSR. Much of this depends on how complete the evidence is to make a decision.

4. Review of evidence by representative and physician(s)

Review of evidence depends somewhat on how quickly the evidence comes in, but in all cases, the RVSR and physician assigned to your case will review (1) medical records (2) reports from family and friends, and (3) service records. In some cases, there may not be enough medical evidence, in which case it is during this phase when a claim exam may be scheduled. It’s critical to attend such an exam, even if you believe it isn’t necessary.

5. Claim decision is made – allow or deny

The next step of the VA disability claims process is the decision, which is made partially according to the complex VA rules and partially by the physician who reviews the medical evidence. The RVSR helps organize all the information and consults with the physician (or physicians) to determine if you are disabled, a simple “yes” or “no.” The most important part of the decision is a rating about how much the claimant can still do—especially in terms of paid employment.

This step is crucial to the process, and a second tier authority (beyond the physician and RVSR) will usually review the file to ensure quality.

6. VA disability rating is established (Rating)

This next step is quite different from the other disability program managed by the Social Security Administration. In the SSA system, it’s “all or nothing” and the disability benefit is a simple yes or no. But VA disability benefits happen on a scale, so a claim is a percentage disabled. For example, the claimant may have a back injury, a foot injury, and PTSD and may be rated 10% for back, 10% for foot, and 30% for PTSD for a total rating of “50% disabled.” The monthly cash benefit will be in accordance with the percentage. 

A claim decision will always produce some kind of disability rating, in some cases 100%.

7. File returned to local disability office and prepared

Once the regional office has reviewed evidence and made a decision, the claim is returned to the local VA office and a decision packet is prepared. This step takes 1-2 weeks but is important because during this period, your file is in transit and all the details are reviewed by yet another government employee.

8. Written notification is sent to applicant

All decision packets and decision notifications are sent via U.S. Mail, no matter how the original claim was received. The decision packet is comprehensive, but you can call the VA during any step of the process at 1-800-827-1000. 

What Benefits Will I Receive?

Veteran’s disability compensation refers to back pay, a monthly check, and a list of other benefits such as housing, education, and other compensation. While all veterans are eligible to get health care through any VA hospital, disabled veterans can get an automobile allowance and vocational rehabilitation, for example.

This link summarizes and explains all Vet benefits (whether a disabled vet or not), while you can go here to see the list of benefits available to disabled veterans which explains VA compensation. 

Does everyone who files a VA claim need an exam?

Most veterans do not need a VA claim exam, because most veterans have medical records. In some cases, however, an exam is necessary to establish current health. This may include medical tests such as X-rays. The “C&P” exam (compensation and pension exam) can last anywhere from 30 minutes to two hours.

The C&P is not necessary for every vet, but if you have not received medical care in the last six months or have a new condition, including a psychological one, you may need to go to an exam. 

If you have new medical evidence while you are waiting for your claim to be processed, you may file a supplemental claim. This will allow you to add evidence to your claim, which could help you get approved.

How Long Does a VA Disability Claim Take?

While it's natural to desire a quick resolution, it's important to understand that the timeline can vary based on several factors. Let's dive into the details so you can better understand what to expect.

The length of time it takes for a VA disability claim to be processed can depend on various factors, including the complexity of your case, the availability of supporting evidence, and the current workload of the VA. On average, the entire process can take anywhere from several months to several years.

The initial phase of the process involves filing your claim with the VA. After submitting your application, you can anticipate an initial decision within a few months. However, it's crucial to note that this timeline can vary, and sometimes it may take longer due to factors like the volume of claims being processed.

If your claim is approved at this stage, you'll receive a rating decision outlining the disability rating you've been assigned. If you're dissatisfied with the rating or your claim is denied, you can file an appeal.

The appeals process can significantly extend the time it takes for your claim to be fully resolved. The VA has implemented a new appeals system called the Appeals Modernization Act (AMA), which aims to streamline the process. However, it's still important to prepare for potential delays, especially if your case proceeds to the Board of Veterans' Appeals (BVA) or higher levels of review.

The length of the appeals process can vary widely. It can take several months to a few years for a decision to be made, depending on factors such as the complexity of your case, the availability of evidence, and the workload of the specific VA office handling your claim.

It's worth noting that the VA has taken steps to reduce the overall backlog and streamline the claims process. Veterans with serious illnesses or injuries will likely have expedited work. However, managing your expectations and preparing for potential delays is important.

While waiting for your claim to be resolved, staying proactive is crucial. Keep track of all communication with the VA, respond promptly to requests for additional information or examinations, and provide all necessary supporting documentation to strengthen your case.

If you have concerns about how long it's taking to process your claim, you can contact your local VA office for updates. You can also get help from a veterans' service officer (VSO)an attorney specializing in VA claims, or an application advisor. They can help you navigate the process, address any delays, and guide you on the best course of action for your situation.

Remember, each VA disability claim is unique, and the timeline can vary. Patience and perseverance are essential during this process.

What if my claim is denied?  

If you receive a denial notice, you should always appeal the decision. This doesn’t mean the appeal will be quick, as most appeals result in a wait of 12-18 months before any disability payments are received. This is one reason to hire a disability attorney, or use a Veteran’s advocacy group, when you appeal.

You begin by filing a Notice of Disagreement (NOD) to tell the VA you don’t agree with their decision, and you can also request a DRO (Decision Review Officer) be assigned to review your file. Only the most senior claim’s examiners can act as DROs, but the bad news is their review can take up to 2 years.

You can take another road, however, by going straight to the review board in Washington DC. This isn’t much faster, however. The timeline to get in front of a Board of Veterans Affairs (or BVA) is also measured in years – 3 to 4. The BVA is analogous to an Administrative Law Judge, however, and they are more likely to approve a claim and the BVA decision is more likely to be in your favor. 

If the DRO denies a claim, it will end up in front of a BVA anyway, so some claimants opt to take the more direct path and cut the DRO step out altogether. In the appeal process, always make sure to keep records. It is very helpful at this stage to hire a disability attorney, or other veteran service organization if you have not already done so.

Why do VA claims get denied? 

If you receive a VA claim denial, there are usually two main reasons. First, you might be considered medically disabled but your impairment is not the result of a service-connected illness or injury. Second, you may have a service-connected impairment but it is not severe enough to be considered disabling. It can be helpful to check with your veteran’s service organization or attorney about the typical reasons for denials before you apply.

Does the VA back pay disability?

If you apply for disability benefits within 1 year of separation from the military, you are eligible for VA back pay. The veteran’s claim may take 14 months to be processed, but the applicant will receive back pay during the processing period. For example, if Keisha leaves the Navy and applies for disability three months later, then her decision takes one year, she will receive 15 months in back pay (the normal monthly check x 15). 

If Keisha doesn’t fill until a year and half (18 months) after she is discharged, and her claim takes a full year to process – she will only receive one year of back pay (the total time it takes for the VA to process her claim).

The VA Claim Process

The VA claim process is a tough nut to crack, no matter how many “easy” steps we break it into. 

VA officials do their best with few resources to process claims accurately and quickly, but you’ll need a lot of patience after you submit a claim. If you are applying, we recommend doing it online, submitting a fully developed claim, and working with a veterans disability attorney or experienced vet advocate. With an attorney, you’ll have a lawyer’s full attention. But with an advocate – who may be very experienced – you may only get a small percentage of his or her attention. For example, vet advocates are often overwhelmed by housing and education applications.

The VA is getting faster, but the more information you can collect up front to speed up the process, the better. Gather your evidence, apply as soon as you can, and get assistance. In the event of new medical evidence, file a supplemental claim. If you have the misfortune to get denied, begin the appeals process as soon as you can.

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