How To Win
Your Claim For
VA Disability Benefits
How the system really works.
How do I win my claim?
Winning your claim isn't a spectator sport. Every day we see veterans and others who knee-jerk to the standard advice, "Call your VSO! He'll take care of it for you."
We believe that our veteran status entitles us to be able to hand over our VA disability claim problems to an experienced expert who will "take care of it" for us.
Nothing could be further from the truth. If you don't get involved, if you don't have the time, if you don't like to read all those rules and regulations...you lose.
For example, this is a very long page. There's a reason for that. We're presenting to you the best we have regarding how to win a VA disability claim.
If you have a well grounded claim and you invest a few hours of your time to learn how to play the game...strictly by the rules and regulations...you'll win.
It's that easy.
Filing...and winning...a claim at your VA isn't rocket science.
No matter what others would have you believe, if you take a little time to understand the rules and if you have a well grounded claim, you'll prevail.
To prevail will take some time. How long that will be will vary with a lot of different circumstances and there's not much you can do to control some things that happen.
But if you are willing to learn how VA insists the game be played. you'll win. It really is that easy. The rules aren't difficult. You must be eligible. You must have evidence of an event in service that caused you illness or injury. You must have evidence that the in service event is the source of the condition(s) you claim today.
How hard is that?
VAWatchdog believes that most veterans are intelligent. We know that nobody cares about your claim the way you do. We strongly recommend that veterans file their own claims without the assistance of and sort of representative...except for an appeal. We urge veterans to retain a veterans law attorney for every appeal.
To DIY means that there is no middleman, no lost papers and no misunderstandings. If you DIY you won't be pressured into buying a life membership in some organization that you have little use for.
The VA rules and regulations must be followed. That's not a big deal once you grasp just how simple your claim can be.
If you have a condition, any injury or illness,
and you reasonably believe that the condition was caused by or
aggravated by your military service, you are eligible to file a claim
for VA disability compensation.
On this page you'll learn what it takes to win as you file your claim.
The process is really pretty simple. Don't believe all the chatterboxes
that plague the Internet with horror stories. Most of the nameless,
faceless, whining voices you'll hear in chat rooms either didn't have a
well grounded claim to begin with or they turned it over to a stranger
so that person could "represent" them.
When they lose their claim, they're always pissed off at the VA. There's
plenty of reason to be pissed off at the VA...that's a fact. But, if
you follow each and every one of the tips you'll read here, you will win
The VA process of adjudication (making a
decision) on your claim is straightforward. If you stick to the rules
from the start, your claim is more likely to have a smooth trip through
that VA Regional Office of yours. If you try to manipulate the process
or if you don't think the rules should apply to you, you will lose.
All the things you'll read on this page are compiled from years of
experiences helping vets with claims. The items below are presented to
you in no particular order. Each one is as important as the next.
There is work involved. You have to do the work. This page contains a
lot of facts and references. We've answered a few of your most common
If you aren't willing to read all of this page thoroughly, stop here. You're wasting your time and our bandwidth.
If you like winning, please proceed. We're doing our part to help. We've
laid out this page, the entire web site, to make the world of the VA
benefit claim as simple as we can for you.
The rest is up to you.
File That Claim! It isn't going to file itself. The claim that isn't filed can't be won.
This is a simple concept, yet many veterans spend months and years
debating with themselves whether or not it's worth the trouble.
We hear it all the time..."I don't have the time to mess with the VA."
Then, at some point after you submit your claim, you'll be scheduled to attend a C & P examination. That may take a day or two, depending on how far away you are from the facility where the exam will take place.
Along the way, you'll probably get a handful of letters from the VA that
make no sense at all to you and reading those will consume a few hours.
Eventually you'll get your award letter. That's probably going to take 2
years. If you've done it right the first time and you get the award you
believe is correct, you're finished. You'll probably be notified of a
few thousand dollars of retro pay being deposited in your bank account.
You don't have time for all that? I don't believe it and neither does anyone else.
If you believe that you have a disabling condition that is somehow
linked to your military service, go ahead and file. You may have to give
up a few episodes of your favorite TV show to get it done but the
reward will be cash money. If you don't want to do it for yourself, do
it for your family.
File the claim. Right now.
Do you really have a claim?
Veterans are allowed to file for anything
(injury, illness) they believe is connected to their military service.
Not that long ago VA required that your claim be "well grounded" or they
didn't have to adjudicate it.
Today you can file for anything that
comes to your mind. However, if your claim doesn't have evidence, if you
don't have a current condition, if you haven't been treated for what
you want to claim, do your homework before you file.
Yes, it's important to get the claim in so that the effective date is
recorded as early as possible. However, if you don't have a claim, why
This is difficult to discern in a lot of cases. We get email from vets all the time who are clearly trying to milk the system.
Be reasonable. If you really believe you have an injury of illness that
your military service caused or contributed to, file. If you just want
some extra money and you think this is a good way to get it, don't
Understand the VA Disability Claims Process.
The more you know about how VA really works, the better.
Businesses large and small are similar in many ways. Each business has a
product. Whether manufacturing widgets, caring for patients in a
hospital or selling flowers, what a business does at the end of the day
is its product.
One of the important products of VA is
the fair and timely adjudication of a veterans claim for disability
benefits. This occurs within the Compensation and Pension (C&P) division of the Veterans Benefits Administration (VBA). The VBA is one part of the Department of Veterans Affairs.
To build the VA product means that raw
material (The VA Form 21-526 application and supporting evidence) enters
via the mail room and through a defined process, the accumulated
material is formed into an adjudicated decision. Subsequently a letter
of award or denial is delivered to the veteran.
Businesses are often divided into
categories that define how they operate. Some businesses are customer
driven. In a customer driven business the customers largely define the
end products that the business produces. This might be true of Ben and
Jerry's ice cream, for example.
Other businesses are driven by a
pre-defined, complex and rigid process. Companies or entities that are
regulated by strict laws are often process driven; The IRS, medical
device manufacturers and pharmaceutical manufacturers are oriented to
numerous processes, laws, rules and regulations that control how they
The VA is a process driven business. To
the VA the process of adjudication of the claim is a goal unto itself.
VA "customers" are paid scant attention. Crossing T’s and dotting I’s
are seen as integral to accomplishing daily goals.
There is little room for “customer” error
in the VA process. Mistakes in completing the process are not often
overlooked or forgiven.
The process of getting the VA Form 21-526
from input to decision and notification is the driver for everything
done at the VA Compensation and Pension service.
The veteran and/or advocate who may try
to skirt around the process will do so at their own peril. If a notice
received by mail tells the veteran that an adverse action is being
proposed, it also tells the vet that in order to disagree with the
proposal the veteran must take
certain actions. Usually the required actions involve a timely written
communication to the VA from the veteran.
Many veterans ignore this step in the
process and start a series of phone calls in hopes of finding a
sympathetic ear who can fix the problem without all the fuss of letter
writings. This is always a mistake. The process must be followed or the
veteran will lose.
The veteran or advocate who takes time at
the start of the process to learn basic VA expectations and
requirements will fare better than anyone who chooses to wing it.
When you first file a claim with VA, it sets the tone for the rest
of the process for that claim. Your claim may be sent to appeals hell if
you don't cross the T's and dot those I's in the first round. Sure...if
you're confident of your claim, go ahead and file today so you can set
the effective date. And then get to work.
Submitting clean copies of your evidence is one of the keys to winning
your earned benefits. Don't think someone will do this stuff for
you...that isn't going to happen.
Read below and then read it again. You'll be glad you did.
The game is changing. Stay alert to the new rules.
I am a service officer in NewYork
& I'm a Disabled Veteran. I agree with you that DBQ's are, at best, a
mixed bag. However, I have had some success with them in the past 18
months. They tend to work better if you can get a VA Doctor to
complete one at a VA Clinic or VA Hospital and if the claim is simple.
For example, A Vietnam Veteran who served "In Country" and now has Type
II Diabetes caused by Agent Orange. This is a presumptive claim and a
DBQ for DMII is likely to speed up the process
a great deal.
However, a more complicated claim like a Service Connection claim
For ALS (Amyotrophic Lateral Sclerosis ) is not likely to be helped much
by a DBQ. I do know that the VA is contacting doctors to verify the
I have also had a VSR call my office and ask me
to get a DBQ completed for a Veteran and fax it to him. We did and the
Veteran got a very favorable result in a timely manner.
What has been your experience with DBQ's? What have you heard from other Vets and/or Service Officers?
Thank you for your time. Have a great day.
The above message inspired me to ask an expert.
I wrote to a friend who is an RVSR...a senior "rater" who is one of the
many good people at your VARO who is working hard to get your claim
This "rater" is one of the many resources we use at your VAWatchdog to
ensure that we get our intel right. Rumors or misinformation won't help
VAWatchdog delivers the facts that can make a difference to your claim...and your life.
I'm getting a fair amount of feedback on the Fully Developed Claim (FDC)
process. The comments run about 50/50, negative or positive.
However, the FDC process seems to be gaining traction with some advocates.
If you have any thoughts to share, I'd enjoy hearing them.
As we consider the FDC process, does adding a DBQ bring value?
If a veteran is in my recommended mode of DIY his/her own claim, how
does the veteran submitted FDC get attention at the RO? Our impression
of the receiving process of claims at each RO veries a bit but mostly it
seems chaotic and scattered. Does an FDC really get any particular
the current focus on working old claims, the Fully Developed Claim
(FDC) is the best way to go as it is considered a high priority claim to
be worked with the older claims and not after the old claims are
worked. There were problems with the FDC program early on because there
was some confusion as to what “fully developed” meant. We are still in a
learning curve here but the process is much clearer since the most
recent fast letter and the change of the forms to “ez”.
FDC claims are
“flashed” when they entered into the system and tracked closely. RO's
are reminded regularly that FDC claims are priority and some of my
Veteran co-workers have used them (with DBQ's) and gotten their claims
adjudicated within weeks, not months.
An FDC claim is one where
the Veteran acknowledges he or she has received VCAA notification (now
called 5103 notices), has submitted all of the evidence he or she has
and waives the 30 day period VA usually has to wait before rating the
claim. Unless the Veteran submits some medical evidence with the claim,
he or she may have to undergo a VA examination which will delay the
claim somewhat. There is also some other development that is allowed
under FDC but keep in mind that even with a priority claim, the more
work VBA has to do, the longer that claim is going to take to get done.
This is where the DBQ comes in.
The DBQ's that are available to
the private sector are much simpler documents than those used within
the VHA system. They are designed to align with the rating schedule so
that RVSR’s can more easily assign an evaluation. There was a time when
raters were requesting examinations even when DBQ’s were submitted but
it was mandated some months ago that unless the DBQ appeared to be
altered in some way it is to be accepted and used for rating purposes
unless there a credible reason such as the need for a medical opinion.
the DBQ frequently does not do is establish the nexus which is why a VA
medical opinion (C & P exam) might be required. For example, the Veteran is
diagnosed with a knee strain in 1980, gets treated twice that same year,
is released from active duty in 1986 and the separation examination
shows no residual knee problems. He sends in a DBQ in 2013 that shows a
diagnosis of arthritis in 2012 of that same knee. Unless the provider
writes somewhere on the DBQ that the arthritis of the knee is
progression of the strain, you can bet that a VA examination will be
ordered to get a nexus opinion.
Nexus opinions are a large percentage
of the reason why examinations are ordered because there is frequently a
gap of many years between the time of the injury and the time of the
claim. If the arthritis was diagnosed in service, there would be no need
for the nexus opinion no matter how many years have passed.
are times when private treatment records are as effective as a DBQ but
most of the time the private records do not include the information
needed to rate a claim according to the rating schedule. Examples of
this include notes on joints with no ranges of motion or mental health
records without the multiaxial assessment, including GAF score, cardiac
treatment records with no ejection fraction or METS. In these cases, an
examination would be needed which is why the DBQ works best. Using DBQ’s
takes the pressure off of the Veteran to figure out what to send in. I
have seen Veterans send in lab results, bills, etc. None of this is
I will give you some idea of when treatment
records are just as good as a DBQ. If the Veteran is service connected
for arthritis of the knee and undergoes a knee replacement. The hospital
or surgical summary is good. This holds true for just about any
condition already service connected and surgery is performed. Newly
diagnosed cancer claims that are still in the active stage. ALS claims.
most of the claims we see these days are so very complicated, RVSR’s
(at least those in my office) love to see FDC’s or claims that can be
rated quickly as they are a refreshing break.
I'll get back to you soon with more details about what excludes a claim from FDC.
Veterans Health Administration (VHA) Directive defines policy for the
useof Disability Benefit Questionnaires (DBQs) to provide medical
information for disability evaluations or examinations for eligible
Veterans in support of the disability compensation process.
Read the Fine Print
To begin a disability claim requires that
the veteran complete the VA Form 21-526. This is an intimidating tome
of some 26 pages of seeming gobbledygook and jargon.
When one reads it, you discover that only
3 of the pages are required to be completed. The rest is boilerplate
and covers a great deal about options for claims other than disability
Most of the verbiage is included so as to
meet the VA’s burden of the “duty to assist”. VA provides many pages of
detailed information in an attempt to avoid criticism by veterans that
may begin with, “I didn’t know...”.
This same hint holds true throughout the
rest of the process. Any mailing from VA may be critically important to
the outcome of the case. There are numerous requirements regarding
timeliness of replies and filings and to miss a deadline is to ensure
that your case will be derailed. Carefully reading, understanding and
following through with every communication from VA will save a lot of
time going forward.
This is going to take 2 years. From start to finish, you're looking at a 2 year time period for your claim to be adjudicated.
There is no way to expedite your claim. There is no way to track your claim. You must prepare to wait 2 years for your claim to be completed.
VA will not help you financially while you wait. You're on your own.
I have compared working with VA to a
tennis match. There are two players, one on either side of the net and
there is one ball. The first player begins by hitting the ball to the
other side. While the ball is traveling and while it's on the other side
of the net, the first player is patient and prepares for the second
player to send it back.
If player #2 is slow to react and
seemingly isn’t paying any attention to the ball, player #1 may become
impatient and lob another ball across the net. When this out-of-
sequence play begins, the game is soon out of order and confusion
reigns. Too many balls in play will bring about chaos.
Don't allow yourself to become impatient.
Don’t begin writing letters or making phone calls to try to move the
claim along. Don’t start calling the local newspaper or your Senator or
Currently VA is way behind in processing claims...possibly as many as one
million claims are languishing for weeks or months with no action. That
figure is debatable but even if we agree to cut that in half, the backlog is daunting.
If you follow the hints here you’ll know
that your claim is in process (the certified mail RRR). When you
submitted the claim you were sure it was well grounded and you made it
easy for the Rater at VA to read and understand.
While the claim processes, take up a time-consuming hobby, read War and Peace, go for long walks and otherwise wait quietly.
The decision on your claim will be made when it is made, not a moment sooner.
In the final analysis, filing a claim for
disability benefits at VA is simple. If done precisely and correctly
from the beginning, the claim is likely to move through the process with
no problems. Paying close attention to details and playing strictly by
the VA rulebook will result in more favorable claims with fewer
Spell It Correctly
I don't believe that veterans should
have to become professors of literature to file a claim.
However, if you
don't bother to spell anything correctly, your message will be that
much harder to decipher. Take the extra time to get this done right. Use the correct terminology to describe your condition.
Most browsers and all word processing
programs these days have spell check programs. Take the time to use one.
You'll make the task of processing your claim easier.
Denied? Retain A Lawyer
Once you receive a denial in the mail,
you are eligible to retain a lawyer to help you with your appeal. Don't
hesitate. Don't waste time wondering what you should do. Go to the How To Hire A Lawyer page right now and once you've studied that, get busy with your appeal.
Know Who Is Giving You Advice About Your Claim
You're searching on the Internet seeking
help in dealing with the VA. Hey, you're here right now. There are
dozens of sites that are available today by a simple Google search. Many
are interactive, old-style bulletin boards. You can look around for a
thread that covers your topic and find a place to post your question.
Before you are allowed to post a question, you'll probably have to
register. That's no big deal depending on how much information about
yourself you want to give up to strangers.
Before you do that, think it over. Look around at the postings. Is the
site full of dancing images, silly icons flashing at you and moderators
with handles like "BitterAngryVet"? Do you detect an aura of a few
senior people who appear to enjoy their authority over others and puff
out their chests at how expert they are?
Are the postings you see filled with angry diatribes about how the author was screwed by the VA?
Most importantly...are you able to contact the owner of the web site by
email and get a reply? Does that person tell you his name? Do you feel
like you know who he is based on his openness to share information with
If you run into excuses like "I can't tell you because VA will punish me
for going public" or "You don't need to know who I am, you just need to
listen to me", you should probably shy away.
The VAWatchdog, since the beginning, has published names and email
addresses of contributors. We don't require registration. We have no
plans to capture your personal information so we can send you spam. If
you don't contact us, we don't contact you. There is no record kept by
us about your visit. We treat ever email confidentially and respect your
The data you find here is derived from reliable sources. Skilled
veterans attorneys, other accredited advocates and VA executives all
guide us with the guidance and articles posted here.
Before you listen to someone on the Internet, give it a lot of thought.
You may end up buying the Brooklyn Bridge and wondering what happened to
Enhance Your VA Medical Records
Your communications to your VA
primary care provider (PCP) are often rushed. The PCP is focused on the
signs and symptoms that he or she believes are most important to keep
you healthy. The PCP isn't likely to talk with you about your service
connected joint problem but will probably be focused on things like your
blood pressure, diabetes, tobacco use and the sorts of things that may
With proper preparation, you can control some of the conversation and
influence what is written into your medical records. Over the long run,
these little notes are important to you when you want to review your
claim and consider asking for an increase due to your condition becoming
worse. If there are no records of your increasing pain or immobility,
the person who is tasked to rate your claim won't have much evidence to
Be prepared when you go to see your PCP or any other health specialist. I
urge every patient to make brief notes...talking points...about the
things that are most important to them. The key to success here is to
keep these notes very brief. The notes are only reminders so that you
don't forget to ask for what you want. Make your notes neat enough that
you can hand them to your PCP and tell him/her "I'd really like to tell
you a little about this. You may keep my notes if that helps."
You may ask that your PCP enter your discussion points into the record.
Always be courteous and as brief as you can. You may explain that you
will be seeking an increase of your rating % and that the notes made by
the PCP will be of value.
You may also ask the PCP to write a statement that will support your
request for an increase. You can also use the new "Secure
Communications" to write a message directly to your PCP that will become
a part of your records. Both of these techniques are described in
detail further down on this page.
Every few months, get a copy of your recent medical records and review
them for accuracy. These are your records and your benefits. It's up to
you to ensure that they're correct.
State Your Claim Clearly and Precisely
Although VA is often forgiving when the
veteran isn't clear about what benefit they seek, the advantage always
goes to the veteran who clearly communicates why they are making a claim
and what they believe the outcome should be.
"I want to claim my agent orange benefits
because I am sick from that stuff. Also I need the money before I lose
my house in the divorce."
"I am a Vietnam veteran. I claim that
exposure to Agent Orange has caused my diabetes. I have read The
Schedule For Rating Disabilities and according to the criteria set by
VA, I am eligible to have a disability compensation rating of 40%. I
have included my medical records."
If you were the "Rater" who opened those
files on your desk at about the same time, which statement do you
believe would get through the process of adjudication the quickest?
Note that the claim and expectation is in
plain English. The veteran or advocate doesn't have to copy and paste
in large segments of the law...that VA Rater already knows all that.
Writing to the person at VA just as if you were speaking to them works
A brief but thorough written
communication to the VA Regional Office is a prime ingredient to
encourage VA to swiftly generate a fair award to the deserving veteran.
Use certified mail with return receipt requested.
This is one of the most important things you can do when filing your claim!
Telephone calls, emails and so on are
lost and have little meaning. The certified letter gives you solid
evidence of your communication date and what it was you said to VA.
DO NOT fax, email, rely on
eBenefits, IRIS or the toll free number.. If you don't want to bother
with this extra little bit of trouble, you lose.
The Well Written Letter is Your Best Friend
Veterans want to talk to someone.
Most of us believe that, "If I can just get to that one individual who will listen to me, this can be resolved in minutes."
When vets call VA they may notice that a
single toll free number is available to contact VA from anywhere in the
U.S. The number does not connect to a Regional Office where files are
located, it connects to a "call center". The call center staff do not
have access to any files, they are not decision makers and can not take
any actions on any aspect of the case.
(If you are an accredited attorney or
agent, you may have access to internal phone numbers and systems not
available to others. This hint may not apply to you.)
Once the veteran hangs up, the call is
lost to history. There is no record of what was said or of any
commitments made by the call center representative.
Any and all communication to VA should be made via certified letter, return receipt requested.
Letters should be brief and strictly
factual. There should be no venting or any release of any frustrations.
Letters to VA should be as respectful as any documents VA will send to
the veteran. Always double check to ensure the accuracy of addresses,
that the document is signed and that any reference numbers have been
included on each page.
The veteran or advocate who communicates
via certified mail, RRR and who carefully builds an organized paper
trail is usually at the head of the race for benefits.
Writing a letter isn't a big deal. Even if you aren't the most accomplished writer on earth, we've made it easy.
Request your complete C-File
Do this as soon as you begin to perfect
your claim. It may take months to get it so don't delay. Many attorneys
won't do this for you. Make a copy to work with and keep a clean copy
in a safe place. Get your medical records, both civilian and VA. VA
often can't get civilian records due to the costs imposed by civilian
facilities for copying. Read more about your C-File here.
Veteran Scott Millard has a tip for you
I may be stating the obvious, but I want
to give every Veteran a heads up. If you are an active user of the
MyHeathEvet website, listen up. When you use the new Secure Messaging
system to communicate with your Primary Care doctor, each message is
instantly entered into the VISTA system and becomes a permanent part of
your medical record. I use it to document symptoms, medication
reactions, and consult requests.
I really think this is a great tool for
the veteran. I used to have to write everything down and then hand it to
the doctor for them to translate and evaluate. This gives me the
opportunity to document symptoms in the "moment", as they are happening.
I totally believe that this can be a win-win tool for both Veterans and
their physicians, as long as it is used properly.
Ranting and raving obviously, whether in
person or though Secure Messaging is counter-productive no matter what.
One simple rule...if you can't control your tongue or keyboard, have a
spouse or friend as a "mediator".
Thanks for sharing this discovery. This
has the potential to revolutionize how we get important data into our
records. That last sentence may be the most important of all. Don't risk
losing your credibility by ranting.
Important Points to Remember
As you work with VA to secure all the benefits you earned by your
honorable military service, there are a great many steps you must take
to ensure that your claim will be given fair and accurate treatment. You
must always remember that VA is an agency that is operating in a crisis
and chaos mode every day. If you make any errors in submitting your
claim, the VA staff will compound those errors.
Do it right the first time. That isn't difficult. It does require that
you do it yourself and that you pay attention to details and the simple
rules of submitting a claim.
* Nomenclature is very important. You must take the time to understand
the language of the VA. It's not so different from the language you used
on active duty. If you aren't sure of a word, a term or your spelling,
look it up. VAWatchdog has compiled a page of common terms for you here.
"how long after va compensation approval letter before payment"
This question is asked every day. There is no way to accurately predict
how long it will take to process any particular claim or payment. There
is also no way to track a claim as it travels through the VA process of
adjudication. Your claim may have a decision in as little as 6 months or
it may take 24 months...or longer. The claim may be "brokered" to
another VA Regional Office to be serviced where it will get lost in the
shuffle. The majority of claims, once adjudicated, will contain so many
errors that you will have to appeal. There is no way to speed up the
process. There are no effective programs in place that will expedite a
claim. To learn more, click Track Your Claim and The Backlog.
"va presumptive benefit wait time after filing"
The wait time to process a benefit varies from one claim to the next. There is no preference given to a presumptive claim. VAWatchdog estimates that a claim filed in the 2010 through present time will take from 12 to 24 months.
This will bring the veteran the first award/denial letter. VAWatchdog
estimates that 70% of these first-round letters will have significant
errors and the decision will warrant an appeal. The first step appeal should normally be at the DRO Process
level and will add another 12 to 24 months to the process. If that
appeal is not successful (most are) then the next appeal is to the BVA via a Form 9. The BVA appeals process may add another 2 years or more. After the BVA appeal is the CAVC and an appeal there can add many years to the wait time. There is no expedited process.
"how long will my comp and pen claim be in preparation for notification phase"
VA commonly uses phrases like "notification phase" when communicating
with veterans. You may also hear things like "decision phase" and many
other ambiguous terms that have no real meaning. This always happens
when the veteran uses the toll free number, IRIS or the eBenefits site
to try and track a claim. The phrases are meaningless. Every claim is in
"the decision phase" from the moment it comes in the mail room to that
moment when you get your decision letter. The use of these terms is a
sort of ruse that VA uses to make you think that there is progress on
your claim. The truth is that nobody knows where your claim is at any