Navigating the Veteran's Administration Disability Claims Process

Filing a disability claim with the Department of Veterans Affairs (VA) can seem like a daunting task for the newly-discharged service member. Indeed, a veteran may become easily lost in the VA’s vast labyrinth of red tape and mindless bureaucracy.

A formula for navigating the claims process quickly and efficiently does exist, however. This formula may change slightly according to the veteran’s individual circumstances, but the general guidelines apply to nearly everyone. A veteran who developed a medical condition (or medical conditions) while serving in the military should file a disability claim as soon as possible. Filing this claim may lead to a monthly, tax-free compensation check, free healthcare, benefits for family members, and educational benefits. 

Preparation

The first, and perhaps most painstaking, step in the process is gathering documentation and evidence. The veteran will need a copy of his DD-214, military treatment record, and current treatment record (or at least the relevant pages from the treatment records). In some cases, the veteran will already have copies of everything he needs. Otherwise, the veteran may request a copy of the DD-214 and other records at this website: https://milconnect.dmdc.osd.mil/milconnect/

Obtaining a copy of the military treatment record may be a little trickier, depending on when the veteran was discharged. The VA should have received the medical records of veterans who separated between 1992 and 2014. Veterans who left the service after 2014 should be able to find the location of their medical records by consulting this site: https://www.archives.gov/veterans/military-service-records/medical-recor...

Filing the Claim

Filing the claim is the next step. The standard VA form for disability claims is the 21-526EZ. A pdf is located here:
https://www.vba.va.gov/pubs/forms/VBA-21-526EZ-ARE.pdf

The veteran may complete and submit the form on the ebenefits website after registering:
https://www.ebenefits.va.gov/ebenefits/homepage


The veteran may alternatively complete the form by hand and mail to 
Department of Veterans Affairs
Evidence Intake Center
PO Box 4444
Janesville, WI 53547-4444

Helpful Tips

Before submitting the claim, though, the veteran should complete a few extra items to ensure success. 

  •  If possible, find evidence of the medical condition in the military treatment record. Make copies of the pages where the condition is mentioned. Use a highlighter to mark these entries so that the case manager will not overlook them.
     
  •  Now, highlight evidence of the condition in the current treatment record.

    Remember: the VA will analyze the claim to make sure that a) the condition developed during the member’s military service and b) the condition continued or worsened after the veteran left military service.

    The veteran should also take the time to include a brief form letter.
     

  • In a couple of paragraphs, state the medical condition, the date when it first developed, and how it has continued to worsen. Explain in detail how this condition has affected employment, family life, and/or overall quality of life (this is not the time to be a tough guy!). 

This letter allows the veteran to craft a clear narrative for the VA case manager to follow. Bring as much detail to the case manager’s attention as possible.

In some cases, the veteran’s military treatment record may not include evidence of a medical condition. For example, the member may not have sought treatment for PTSD after serving in Iraq or Afghanistan. This lack of evidence does not mean that the veteran will automatically be denied VA compensation. In the instance of PTSD or other combat-related conditions, the DD-214 and personnel record will show combat-related activity. However, the veteran should seek treatment for the condition as soon as possible, and should consider an extended period of treatment (six months to a year) before submitting a claim. Here is where the aforementioned letter becomes important. The veteran should also consider supplementing the claim with a letter from a spouse or parent. The family member has witnessed firsthand how the medical condition has affected the veteran and his family.

What’s Next?

After submitting the claim, the veteran should receive an acknowledgment letter from the VA within a month or so. This letter will be followed by a phone call (about two weeks later) so that the VA can schedule an evaluation appointment, also called a compensation and pension exam. This exam will take place either at a VA facility or at a civilian medical practice (the VA is currently contracting this work out to independent providers). 

The veteran should not be nervous about this exam, especially if he has made a strong case on the initial claim. At the exam, the veteran should clearly communicate his condition, symptoms, effect on quality of life, etc. 

  • This is not the time to act tough. 
     
  • The doctor will directly ask if this condition developed during military service. State with assurance that the condition did begin during military service. Be prepared to answer when it started, why it started, and how it started. Do not hesitate here.

The Decision

The VA’s decision letter should arrive about a month to six weeks after the exam. The VA will either grant compensation and benefits or deny them. If compensation is granted, the VA will determine the payment according to the rating (or percentage) of the disability. Disability compensation rates may be found at this site:
https://www.va.gov/disability/compensation-rates/veteran-rates/

  • The monthly payment is higher if the veteran is married, has children, etc. Carefully check to make sure that the VA is paying the correct amount.

    If the VA denies the claim, all is not lost. The veteran may appeal the decision.

    Consult this page for appeals:https://www.va.gov/decision-reviews/
     

  • Hiring a lawyer is recommended at this point in the process.
     
  • For those who cannot afford a lawyer, strengthen the claim before making an appeal. If possible, visit a private medical practice to obtain more evidence. The words of a doctor carry a lot of weight during this process. 
     
  • The aforementioned letter becomes even more important when making an appeal. Remember to craft a narrative for the appeals board. Be as specific as possible. Present a timeline if necessary.