VAWatchdog knows that filing a claim is simple. There is no mystery to filing a claim.

Over the years "veterans advocates" have tried to convince veterans that the filing of a disability benefits claim is dangerous and if some self proclaimed expert doesn't help you, you'll lose.

Nothing could be further from the truth.

Filing a claim is simple. All you have to do is follow a few easy to understand rules.

You must be eligible. You must have a diagnosed medical condition that is a part of your records. You must complete one form at the beginning of the claims process...the VA Form 21-526.

That's it. If you can do that, you can open a claim for yourself.

Sure, there are some claims that can become complex as they process. If your evidence is shaky or if there is any confusion about the diagnosis of your claimed medical condition, VA will question that during the process of adjudicating the claim. But that may happen no matter who files your claim.

Go ahead...keep reading. You'll discover just how easy it is to take charge of your own claims and win.

How To File A Claim...and Win

(1) First time to file a claim? Complete the VA Form 21-526. If you have filed before, write a brief letter.

(2) Enclose the required evidence. Mail this to your VA Regional Office (VARO) in Certified Mail.

(3) Wait.

(4) Wait some more. Filing today means an 18 to 24 month wait. You'll get a C & P exam scheduled. Click; C & P  

(5) Wait a little longer.  Click; The Backlog

(6) Open the brown envelope that tells you your claim is denied. There is a 70% chance your claim will be denied.

(7) Appeal just as you knew you would have to. Start at the DRO Process.

(8) Wait.

(9) Wait some more. Appeals today mean an 18 to 24 month wait. You'll have another C & P exam scheduled.

(10) Open the brown envelope to read that the DRO has awarded your benefit. Be happy.

Yes, it really is that easy. You do not need a representative. There isn't much paperwork required. Filing a claim is simple. If you have a well grounded claim, if you are eligible, if you have basic evidence, if you follow the steps above, you will prevail.

You earned these benefits. The law is there that guarantees your benefits will be delivered to you. Just because the VA tries to discourage you is no reason that you should shy away from the process that will get you the benefits you deserve.

Don't forget to explore secondary condition claims! If you have a service connected condition that has caused another disabling condition, you may be eligible to have the 2nd condition rated as service connected. You earned these benefits. Don't be discouraged by a little paperwork.

How To File A Claim

This is how the VAWatchdog does it.  Do It Yourself...DIY...  "Gosh, that was easy!"


** Is this your first claim for VA compensation? Please stop here. Click here and print the VA Form 21-526 now.


Filing a VA disability compensation claim is not difficult. I urge veterans to Do It Yourself. I recommend the DIY method because nobody cares about your claim as much as you do.

(This does not apply to appeals. I almost always recommend that any appeal be handled by a competent attorney. Many veterans attorneys are listed on these pages. Read more about this option by clicking  How To Hire A Lawyer.) 

Filing a claim for VA disability compensation is not a spectator sport. If you aren't deeply involved, you'll lose. Because nobody cares about your claim as much as you do, you have to be the driver.

At any point after a veteran has completed military service and he or she believes that military service has caused an injury or illness (called a "condition" by the VA) or that a preexisting condition was aggravated by military service, the veteran may file an application for disability compensation.

There are no time limits or restrictions except in a few very limited circumstances. As a rule, the veteran may seek disability compensation for any condition they reasonably believe was caused or aggravated by their service at any time.

The initial filing of a claim for disability benefits is simple. The veteran may file the appropriate forms himself or he may seek representation and assistance from an accredited Veterans Service Officer who will likely work for a Veterans Service Organization. At this stage of the process, the veteran is not allowed to pay anyone to represent them. In practice, this means that a veteran who wants to have someone representative him or her will likely use the services of a VSO, as very few attorneys work on preparing initial claims.

More about representation follows later. For the purposes of this chapter, we will assume that veterans who read on are interested in filing the claim for themselves.

Eligibility

Prior to filing your claim you should consider some of the basic elements that are required to obtain an award of benefits.

(1) You must be eligible. In other words, you must have served and possess a discharge that is other than dishonorable. If your discharge is other than honorable but not dishonorable, there may be restrictions on the type of benefits you may receive.

(2) You must have an current injury or illness (condition) that can be attributed to your service. This means that you should have a clear diagnosis in a medical record prepared by a qualified health care provider, preferably a physician. The more precisely defined the condition is in the record, the better it is for your application for benefits.

(3) You must have evidence to support your claim. The strongest evidence is that of an event that is recorded in a Service Medical Record (SMR) and a detailed description of the cause of the injury or illness leading to the condition, as well as how it was treated and any residual effects of the event. If the condition is related to a non-combat related event, documentation of the accident or incident that caused a condition (such as a broken bone), documentation of an admission to a military or other hospital, a record of treatment and follow-up care.  Not everything is required for every claim, but the more supporting evidence, the better chance of an award.

(4) Your medical evidence must be clear enough to prove to VA that your current condition is connected to the in-service event - this is called "service connection" or "nexus."  Without a service connection, all the evidence in the world of a current medical condition and an event in service will not result in an award of benefits.

We suggest that you consider another set of requirements before you file a claim for yourself. You should be well organized and prepared to deal with the requirements of a lot of paperwork, copying of files and searching for evidence. It helps if you are familiar with the way to conduct a search for records on the Internet, use a word processor, own or have access to a scanner and copier and you're confident that you have the patience to deal with details.  The VA process, even at its best, is slow, prone to error, and requires constant attention. A veteran who can organize his or her information and keep good records of interactions with VA during the claims process is much better positioned to be successful.

If you believe that you meet these requirements, you should proceed to apply for your deserved benefits.

You should file your claim as  soon as possible after you decide that you are eligible to apply for benefits. This is because  the date of filing (when the claim form is received by VA) establishes the start date of your award. You do not need to wait to file your claim until you have gathered all the supporting evidence.  You'll have plenty of time to submit your evidence after you file.  Waiting until you gather every last piece of evidence only costs you money because VA will only pay you from the date of the claim, no matter when the condition began.

You may file an informal or a formal claim. An informal claim may be as simple as a brief letter to the VA stating you wish to file a claim. The VA will accept that and then ask you to complete the VA Form 21-526 to formalize your claim.

Jim's Mailbag 


Hello Jim,

Thought I would pass these points along that might help others with getting a successful award.

I accumulated 12 years of medical records from one VA medical center. I made it to every appointment and cooperated with the people providing my health care. As you have pointed out many times, a record of steady treatments and appointments with VA health care providers tells the VA that your condition is real and that it is persistent.

When I filed my most recent and final claim, I had finally reached a level of physical therapy and could not achieve the next higher level of performance.

I requested and received a "Functional Capacity Test". I believed that such a test in my VA medical records could be the missing link for getting my claim awarded, as it clearly defined my limitations.

I had been represented by the a veterans service organization and then by an attorney during the previous 12 years. This time I was filing this claim on my own. I had been following your advice on VAWatchdog over time and learned a lot. I specifically stated that I was representing myself as the last line of my personal letter to the VA regional office when I filed my claim.

It took time but following your methods, I was awarded 100% TDIU with significant retroactive pay. That is the award that I deserved. I just had to show VA that they could only make one decision...to award me the benefit I earned by my honorable military service.

I don't know if these thoughts are helpful to you as you help other vets but wanted to pass them along while they are still fresh in my mind.

(Signed)

A Grateful Veteran


Reply,

VAWatchdog has always promoted a Do-It-Yourself (DIY) methodology for working with VA when filing a claim. We believe that at the most basic level of filing a claim for any benefit, veterans will achieve better outcomes if they don't turn the relatively simple paperwork over to a stranger.

The veteran who sent us the email message above is a long time reader of VAWatchdog. We've communicated over the years as he has progressed from being extremely frustrated by his VA to his current level of satisfaction with VA and his life in general.

He decided that rather than getting angry he would get smart. He took control of his claim and straightened out the details necessary for him to prevail. His approach to VA was exactly what we recommend; steady, constant, respectful, consistent and playing strictly by the VA rule book.

The claims process at the regional office should be administrative and non-adversarial. Veterans who have a working computer, access to the Internet and who are willing to spend the time required to learn the details and finer points of what VA needs to see will always win their well grounded claims.

We don't say that it's easy. The veteran must be willing to do the required homework. The claim must be "well grounded".

As we look to 2013, we'll continue to do our best to show you what works and what doesn't work. Tips and tricks and advice like that above is always appreciated. When a veteran reaches out to help another veteran that act accomplishes more than most people can imagine.

We're renewing our focus on "how-to". You'll begin to see more templates to use when you communicate with VA as well as more advice from other veterans who have been awarded the exact benefit that they earned.

The VA system is broken. Badly broken. That doesn't mean that it's unusable. It only means that you must work a little harder to receive the benefits you earned. It may take 2 or 3 years to see the fruits of your labors. So what? What else do you have to do today? If you miss a few reruns of your favorite TV show that isn't likely to cause you any harm and may be good for you.

Exercise your rights and your brain today. File that claim that you've been thinking about. The experience will be a pain in the ass to begin and VA will annoy you as you go along. Again, I ask you...so what?

If you get started today, maybe you'll be writing to me in December of 2014 to tell me that you prevailed and you've finally achieved the goal of forcing VA to do the right thing.

We'll be waiting to hear your success story.

Informal v. Formal Claims

There is a popular Internet rumor suggesting that you should file an informal claim so that you can set the effective date and buy some extra time. That makes no sense as you will have all the time you need.

If you are reading this, there is really no reason to file an informal claim because eventually you have to complete the formal claim form anyways.  Also, there are often disputes over informal claims and you risk VA later not recognizing your claim.

The much preferred method to file a claim is to complete a VA Form 21-526. The form is a 23 page document on the VA web site. This is a PDF document and that requires that you have a free PDF reader installed on your computer.

As of this writing, the Form 21-526 on the VA site is "fillable". This means that you may complete the form by using your computer to type information into the required places. After you've done that and finished the form, you may print it out for mailing to the VA Regional Office that will serve you. If you aren't comfortable doing that, you may print out copies to complete in ink and mail to VA.

If your computer refuses to cooperate with you, you may go to any VA facility such as a regional office, VA medical center or clinic and they will provide you with one. You may also call 1-800-827-1000 to ask that a form be mailed to you.

Before you begin, carefully read through the instructions. While the form isn't difficult to complete, understanding what will be required before you begin will save you time and frustration.

Once you've completed and signed the form, it's time to mail it in. The VA doesn't want all those instructions so you may keep those for your records. Be sure you keep a good copy of the completed form for yourself.

It should be mailed to the VA Regional Office (VARO) in the state where you live (or the closest VARO if you live in a state with more than one) using Certified Mail with Return Receipt requested. I strongly recommend that this is the only way that you should ever send documents such as forms and evidence to the VARO. I do not recommend using a fax machine, any sort of email or even hand delivery. Certified mail will provide you with signed evidence of delivery just in case a document goes missing.

Once you've mailed off your 21-526 application and you have the receipt proving delivery in hand, you should begin in earnest to gather the evidence you'll need to support your claim. VA will eventually notify you that they have received your application and over the next few weeks and months you will receive letters that will remind you to submit any and all evidence possible.

It's worth noting that the letters you'll receive will often be repetitive and they'll make you wonder if VA has received anything you've sent in already. Not to worry, the letters are computer generated and are part of the requirement that VA has to assist you in developing your claim. You should keep everything you receive from VA in case you run into a problem about whether or when something was or was not sent to you. If you get into the habit of putting everything you send to and receive from VA in a file in by date, you will have no trouble finding whatever information you may need in the future. If you've used certified mail and return receipts, you should save each one of the certified receipts and return receipts with the documents that they go with.  Also, if you have the receipts, VA received your documents and they'll get around to them in turn.

If you do not receive any letter from VA in about two months, you may want to send another copy of your claim and a copy of the certified mail and return receipts, along with a cover letter explaining to VA that you sent in the form before, but have not received any acknowledgement.  This will usually prompt a response.

You are probably going to receive a notice or a call about a compensation and pension exam. Even if it's short notice and it may be inconvenient for you, you should make every effort to get to the exam as soon as possible. If you just can't make it on the date scheduled, notify VA at your earliest convenience. If you don't show up for an exam or if you're extremely late for a scheduled exam, the VA may default to a denial of your benefits and you then have a real issue to confront.

Now you wait. You may wait six months to a year before any progress is made. During this time it's important that all you do is wait. Don't call the VA to ask why it's taking so long, don't write angry letters to your Senator or Congressman. Any action you take now, other than submitting supporting evidence, is likely to slow your claim down. The VA is estimated by various sources to be a year or more behind in the processing of some 400,000 to 800,000 claims. Yours is in line with those and if you have done your job well with your application and evidence, your claim will eventually have its turn to be rated.

The only time I recommend that you ask VA to speed up your claim is if you are truly critically ill or your doctors do not believe you will outlive a long wait. In that case, VA may prioritize your claim for processing after you've notified them. The notification of your desire to have your claim prioritized should be sent as a brief letter via certified mail and should include a statement from a physician as to the seriousness of your condition.

If it sounds simple to file a claim for disability compensation benefits, it's because it is. Winning your claim after you've filed is another matter entirely. If you do this part of the process well, you've just markedly increased your chances of a good result.

But your task isn't complete. If you aren't confident you can do all that, you should seek a representative. Even if you do ask a representative such as a VSO to help you, the VSO will want you to be involved in your own claim. You may be told that, "This isn't a spectator sport!" Your VSO will do a much better job for you if you're actively helping to gather evidence an getting good copies of evidence to the VSO for review.

Points To Remember...

* You do not need a representative to file a VA disability compensation claim. VAWatchdog recommends that you Do It Yourself.

* You only need to complete the VA Form 21-526 once, the first time you file a claim. After that most additional claims may be filed by writing a simple letter to your VARO.

* You must know the process. It's much simpler than you think. You file a claim. VA acknowledges that you filed a claim and asks for evidence. You provide evidence. VA schedules you for a C & P exam. You attend the C & P exam. Now you wait. VA will eventually adjudicate your claim and notify you by letter. This process will probably take 2 years.

* You should proceed expecting to be denied. The denial is routine. The appeal is routine. Most claims are denied. It won't matter the quality of your evidence, claims are denied by mistake...usually 7 of every 10 cases will be denied and then won on appeal.