VA Disability Claim Timeline and Process: A Step-By-Step Guide
Tue Jul 18 2023|
Veteran Legal Editors
The Department of Veterans Affairs (VA) provides disability benefits to veterans with injuries or illnesses that were incurred in or aggravated during active military service. However, navigating the VA disability claims process can be complex and frustrating. Having a clear understanding of the timeline and key steps can help streamline your journey.
This article provides an overview of VA disability claims and explains the importance of comprehending the VA disability claim timeline. It outlines the eight-step VA disability claim process from initial filing to final decision. Further sections offer guidance on the role of evidence, required documents, different claim types, and fully developed vs standard claims. Finally, it covers critical components like claim status, first payments, addressing disagreements with decisions, and appeals.
Understanding the VA Disability Claim Timeline
The duration of a VA disability claim depends on the type of claim filed and how fully developed it is. However, on average, veterans can expect the process to take anywhere between 3 to 8 months for an initial decision. Claims involving appeals will extend this timeline further, though gathering evidence and skilled legal advice can help make the process as efficient as possible. Comprehending this timeline sets proper expectations and helps veterans plan accordingly through the process.
When a veteran files a disability claim, they are initiating a legal proceeding to obtain benefits from the VA. This requires formal submission of application forms, evidence, and documents that conclusively prove the validity of injuries, illnesses, or disabilities incurred during active duty. Navigating each step thoroughly leads to faster and more successful outcomes.
The eight key steps in the VA disability claims process include:
Step 1: The Claim is Received
This step signifies formal commencement of the disability claim. Completed forms are submitted by the veteran, appointing Veterans Service Officers, or accredited attorneys. Documents arrive at one of the VA Regional Office Pension Management Centers for processing.
Step 2: Initial Review
VA officials review documents for completeness and determine if enough evidence has been provided to decide on the outcome. The claim may be rejected if substantial data is missing at this stage. If satisfactory, it moves to evidence gathering.
Step 3: Gathering of Evidence
The VA retrieves the veteran’s military treatment records, service records, medical exams, hospital records, etc. The veteran may be required to undergo a medical examination by an independent VA doctor.
Step 4: Review of Evidence
VA officials evaluate all evidence applicable to the disability claim to determine if it meets eligibility requirements. This concludes the evidence gathering phase.
Step 5: Preparation for Decision
A rating official reviews all evidence and prepares to make a decision by determining the percentage of disability that will be approved.
Step 6: Pending Decision Approval
A rating authority approves the proposed rating decision. Additional information may be requested from medical examiners if needed before approval.
Step 7: Preparation for Notification
The VA prepares and sends notification to the veteran via mail regarding the decision.
Step 8: Claim Completed
The veteran receives their rating decision in the mail, concluding the claims process. Favorable decisions mention awarded benefits and assigned disability percentage.
The Importance of Evidence in VA Disability Claims
Since disability claims aim to prove legitimate injuries or illnesses connected to military service, evidence forms the basis of all successful VA claims. You should gather as much relevant evidence as possible before submitting your forms and documents.
There are three main categories of evidence required:
- Medical evidence proving the diagnosis and history of disabilities claimed. These can include doctor’s reports, hospital records, clinical findings, and medical opinions certified by health professionals.
- Lay evidence consisting of eyewitness accounts and third party reports supporting occurrences of injuries and symptoms witnessed. These are usually buddy statements from comrades.
- Expert opinion evidence contains medical judgments confirming disabilities and symptoms through physical evaluation and opinion. These require a doctor’s assessment of the veteran’s conditions.
Such evidence validates the circumstances, diagnoses, causes, and effects of disability factors claimed by veterans.
The Role of Documents in VA Disability Claims
Specific essential documents required to support all VA disability claims include:
- Discharge papers like DD214 showing character of exit from service.
- Military medical records proving in-service incidents, diagnoses, and treatments.
- VA medical records revealing outpatient treatments and hospitalization history.
- Private medical records further validating continuity of symptoms, disabilities.
- Statements from credible witnesses confirming incidents.
Documents should demonstrate a clear connection between current disabilities and incidents that occurred within period and type of active duty. They must reveal chronicity of symptoms from service until current day. Nexus opinions from doctors help establish this link.
Understanding Different Types of Claims
There are several types of VA disability claims, including:
Initial disability claims filed for new conditions that have not been previously decided on by the VA.
Filed for worsening symptoms of a service-connected condition that was earlier awarded benefits at a lower rating. A reevaluation is requested via increased claim.
Supplemental Claims/Appeal or Reopening Denied Claims
Allows appeal of a denied claim adding new evidence within one year of denial, or can reopen a previously denied claims with new and relevant evidence proving validity of disabilities.
Higher Level Review (HLR)
Requests reconsideration of a prior decision without submitting new evidence.
Notice of Disagreement / Appeal to the Board of Veterans Appeals
A formal appeal to the Board of Veterans Appeals can be filed with or without new evidence, and asks for review by an administrative judge. This level of appeal can be lengthy but effective.
The Difference between Fully Developed Disability Claims and Standard Disability Claims
To expedite process times, you can opt for the Fully Developed Claims program where they gather all relevant records and documents before submitting them to the VA. Candidates of this optional program must:
- Submit VA form 21-526 EZ for disability benefits
- Include all supporting documents – medical records, DD214, etc.
- Attend medical exams arranged by the VA if required
Such “ready-to-rate” claims enable faster decisions as no further evidence needs to be collected by the VA.
Standard claims do not include some/all such records, thereby requiring longer processing times for the VA to retrieve information before deciding.
The VA disability claims process comprises eight steps starting from initial filing of documents to final rating decision. The timeline averages 3-8 months through these stages. Compiling credible evidence to prove validity of disabilities expedites approvals. Understanding protocols for appeals or refiling claims also helps veterans dispute unfavorable outcomes. Equipped with knowledge of this process, veterans can navigate each phase smoothly towards obtaining benefits they rightfully deserve.