This is an introductory podcast on VA disability benefits. I will be doing a complete series son these and will be inviting expert guests to come on in the future who will discuss the ins and out of filing a successful VA disability claim!
Veterans who have become injured or suffered a military exposure type of sickness while serving in the military are eligible for what is called VA Disability Compensation. Veterans whose existing conditions have been aggravated, accelerated or worsened because of their service can also avail themselves of the VA Disability Compensation.
If you are a veteran who suffered injury or military service related illness, you can apply for and receive your compensation pay by making a disability claim. In this PODDCAST, I will give a brief summary of what to do to file a VA disability claim. Filing a VA disability claim is not as difficult as it sounds. There are four key things you need to do:
(1) Determine if you are eligible for VA Disability Compensation
(2) Gather sufficient proof to support your disability claim
(3) Fill out all the necessary VA disability claim forms to complete your claim
(4) File your claim through one of the three approaches: mail, in person, online
Ok let’s review the following disability qualification criteria to determine your VA case:
You must meet both of these:
Have a current condition — illness or injury — that affects your body or your mind and
Have served on active duty, training active duty, or training inactive duty.
Plus, you must tick at least one of these:
You can make an inservice disability claim: You became injured or sick because of/while serving or
You can make a preservice disability claim: You had an injury or illness prior to the military but serving aggravated it or
You can make a post-service disability claim: You have gotten a disability related to your active-duty service that became apparent after you have parted from the military.
Conditions that are covered by VA disability benefits include:
Chronic back pain as a result of a current diagnosed back disability
Breathing problems as a result of current lung disease or condition
Serious hearing loss
Scar tissue
Loss of motion range
Ulcers
Cancers as a result of contact with toxic chemicals or other hazards
Other possible conditions are:
Anxiety
Depression
TBI: Traumatic Brain Injury
PTSD: Posttraumatic Stress Disorder
Here are illnesses that can be concluded and covered if symptoms appear within one year after your service:
Arthritis
Diabetes
Hypertension (High blood pressure)
Peptic ulcers
However, do note that the illnesses must be at least 10% disabling.
Visit Title 38, Code of Federal Regulation, 3.309(a) to find the detailed list of valid illnesses.
If your discharge was something other than honorable (aka. dishonorable or bad conduct), you might not be qualified for the VA disability application. Luckily, there is one potential solution: getting a discharge upgrade.
If your discharge was linked to any of the following, you have a good chance of being approved for an upgrade:
Mental health conditions like posttraumatic stress disorder
Traumatic brain injury
MST – Military Sexual Trauma: Sexual assault or harassment during service
You could apply for another discharge upgrade if you failed the first time. But you must disclose that you are reapplying by selecting YES when asked if you have applied before.
After getting a discharge upgrade, you will be issued a DD215 that shows the corrections to your DD214 and attach the old DD214 along with it. If you want a new DD214 that shows no record of your earlier discharge status, click here and select:
Evidence You Need:
Once you are certain that you are in the position to file a VA claim, prepare sufficient evidence. It will depend on the disability you claim, but in general, these supporting docs are needed:
VA medical records, private medical records, hospital records, and service treatment records relating to your injuries or illnesses or show your rated disability has aggravated
Supporting statements from your family, friends, clergy members, the law enforcement, or those who were in service with you
DD214 or other separation papers
The evidence you submit need to demonstrate
That you have a physical or mental disability, and thus, are less able or totally unable to do normal daily tasks and meaningful work and…here is the most important part!
An event, injury, or illness that caused the disability, occurring during service
Finally, a link between the first and second bullet points above.
If you do not submit any supporting documents, you will need to arrange a claim exam with the VA to disclose information about your condition(s).
This process of gathering evidence can be done on your own, with the help of a professional, or through the VA’s programs: standard disability claim and fully developed claim.
VA Disability Claims Require a Medical Nexus Report
What is a Nexus Report?
A nexus report is a medical causation report where your physician provides the medical explanation of how your injuries or conditions are service connected. Unfortunately for our Vets, we have observed that many VA physicians, Physician Assistants and Nurse Assistants are not knowledgeable that the VA Disability law is supposed to be fair to vets.
The VA will help you request your records from VA medical centers, any federal agency, and the Social Security Administration. Plus, the VA will help you schedule a health exam or get a health care provider’s opinion. VA values evidence from your private treatment providers because they are familiar with your medical history, often over a long period of time. VA appreciates the trusted and special relationship between private treatment providers and their Veteran/patients.
How To Submit Private Medical Evidence for Your VA Claim
Talk to your healthcare provider (family physician, urgent care visits, any Tricare-covered treatment after discharge) and explain that you are filing a claim for VA benefits; discuss the conditions for which you are filing a claim. Or schedule an appointment with career Govt doctors such as the one’s at our clinic who have been filling out these forms for decades. Experience makes difference!
If required, complete your healthcare provider’s release of information form, obtain your records, and submit with your claim, OR
Complete VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA) and VA For 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA); submit completed forms with your claim and VA will attempt to obtain your records through our Private Medical Records contract. VA Forms 21-4142 and 21-4142a are used in conjunction with each other and both forms must be completed in order to obtain treatment records.
I will provide the link in the podcast https://www.vba.va.gov/pubs/forms/VBA-21-4142-ARE.pdf
Public Disability Benefits Questionnaires (DBQs) https://benefits.va.gov/compensation/dbq_publicdbqs.asp
How To Incorporate Federal Records With Your VA Claim
Tell us about your Federal records (from any federal agency*) and we will gather these on your behalf. If you received treatment at a military hospital or clinic after your discharge, please include facility information and the date ranges of your medical treatment records for your claimed conditions when completing VA Forms 21-4142 and 21-4142a.
*It is not necessary for you to submit your Service Treatment Records (STRs) or treatment records from a VA medical facility as we have access to these records.
You can work with an accredited VSO: Veterans Service Office if you want.
Claims Assistance
I encourage all Veterans to work with an accredited organization for assistance in completing claims for VA benefits. A list of accredited organizations can be found on the Office of General Counsel site at this link: Search the VA Office of the General Counsel’s list. I will put a link on the podcast for the
Searchable list of accredited organizations including attorneys that you can search for to help you with your claim. If you want our doctors to recommend some of the people that we know do a good job just give us a call at 813-877-6900.https://www.va.gov/ogc/apps/accreditation/index.asp
You can start your application first and take up to a year from the date VA receives your claim to collect the proof. It will be recognized as long as you complete the process in 365 days.
There are three ways you can submit your claim:
(1) By mail
Fill out the VA Form 21-526EZ: Application for Disability Compensation & Related Compensation Benefits and mail it to the following address:
Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444
(2) In Person
Alternatively, after filling out the form, you can bring it to a VA regional office and submit it in person. Use this tool to locate the nearest office!
For either of these approaches, you should turn in an intent to file form first. This will give you time to compile the evidence and supporting documents you need and not have to wait for a later start date (dubbed an effective date). Plus, you may be able to receive retroactive payments, which is compensation that begins at a point in the past.
You can submit this form through mail or in person. But you must call and notify 800-827-1000 first. You have one year to complete and submit your official claim form after your intent to file form is received by the VA.
Note: This is not necessary if you are filing your claim online because your effective date is set when you start filling the form online and before you submit it.
(3) Online
After you have filed your disability claim, you may be sent a letter requesting more information or be scheduled for claim exams. So, keep this in mind.
The average time it takes for the VA to process disability claims is 160.9 days.
Up until now, we have been talking about your original disability claim. But there are also other types of claims that you may want to know and consider making.
Increased Claim: Claim for more compensation on a disability already recognized.
New Claim: Claim for added benefits or other specific benefit requests.
Second Service-Related Claim: Claim for a new disability linked to your existing one.
Special Claim: Claim for special needs linked to your service-related disability.
Supplemental Claim: Provide new proof for a claim previously rejected.
If you have not been discharged but know that you want to file a disability claim, then consider the pre-discharge claim. This is applicable if you have 180 to 90 days left in service (active duty).
This type of claim can help you obtain a claim decision sooner. You are eligible if:
You are serving full-time active duty and
Have a separation date in the next 180 to 90 days and
You can go to VA exams for 45 days from your claim submission date and
You can submit a copy of your treatment records for your present service period
https://benefits.va.gov/compensation/dbq_disabilityexams.asp
Lastly, Once your claim for disability benefits has been approved, you can request an increase in your VA rating whenever you need one. The VA is well aware that a veteran’s condition can grow worse over time, and that as you age this is more likely to happen. All you need to do to seek an increase in your VA disability rating is to request the VA review your rating and provide evidence that your condition is worsening.
So, that is a lot of information…. This is definitely not a simple one step process. This podcast is an introduction into the basic understandings of what to do. You can reach out to me anytime with questions and or feel free to make an appointment for a nexus report.
Well that does it for this episode of Federal Workers Comp Coffeebreak Podcast.
