How To
File A Claim
Do It Yourself
"DIY"
Nobody Cares About
Your Claim As Much As You Do
How To File A Claim
Do It Yourself...DIY..."Gosh, that was easy!"
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 An Attorney.)
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.
I 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.
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.
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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.