When it’s time to retire or separate from military service, getting your medical records and having your medical issues rated by the Department of Veterans Affairs is an important part of the process.

When you get rated by the VA for possible compensation for service-connected or service-aggravated medical conditions, it’s easy to assume that this is a one-time only process. But if you feel your conditions are improving or getting worse, you may be able to petition the VA for a review of your condition for a revised rating.

There are no guarantees when it comes to pursuing a revised VA disability rating, and there is also potential that the Department of Veterans Affairs may lower the rating based on the evidence. But there are plenty of cases where the review-and an increase in disability rating-is justified and necessary.

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Should Veterans Apply For Increased Ratings From The Department Of Veterans Affairs?

This is a question best answered on a case-by-case basis. There are no guarantees that the VA will raise your disability rating, and your entire file may be subject to review not just the condition you want to have reviewed.

So the answer is not simple, but there are ways you can get closer to a decision. One of those is to examine the VA Schedule For Rating Disabilities, also known as 38 CFR Book C.

Reviewing this document can go a long way toward helping you understand what the VA is looking for, how the agency rates your specific condition, and what the compensation percentages are.

As mentioned above, the VA is willing to re-examine your medical claim, but if you don’t understand how the VA does this, under what conditions additional compensation may be justified, and what the maximum compensation might be for your condition, you take a big risk in getting re-evaluated.

VA Maximum Compensation Rules

 There are some medical conditions that are assigned a specific percentage of disability. In many cases that percentage cannot be increased. If you are rated at a certain percentage for a given condition, you may not be eligible for more compensation even if the problem gets worse.

If you are already at the maximum amount of VA compensation for that medical issue, a review of the condition will not give you the opportunity for additional payment.

The Tinnitus Example

An excellent example of this can be found in 38 CFR Book C under the heading Impairment of Auditory Acuity. One of the most common types of VA medical claims involves hearing damage. Military people are commonly exposed to loud noises, continuously running engine noise, power tools, etc.

As a veteran you may experience hearing damage with resulting loss of hearing, degraded hearing, or persistent hearing problems such as tinnitus.

Tinnitus is a continuous or prolonged ringing in the ears. The ringing (or other auditory disturbance related to the condition) may be intermittent or it may be continuous. The ringing can get louder over time depending on the extent of the damage or future exposure to loud noises.

The VA medical claims process includes a disability rating percentage for tinnitus. But the maximum compensation amount for this condition is 10% and will never increase beyond that unless the VA revises its’ schedule of compensation and disability ratings for the condition.

That means that if you submit a request to have your tinnitus reviewed and are already collecting the maximum amount, you won’t be awarded more even if it’s demonstrable that your tinnitus has gotten worse since leaving the military. The maximum percentage rate is your “ceiling” for compensation for that condition.

Not All VA Disability Ratings Are Awarded At The Maximum

All that said above, you may not be awarded the maximum amount of compensation for a specific medical issue, or you may have been awarded the maximum amount for an issue “as-is” without added complications.

In those cases, when the condition gets worse or begins showing signs of complications, you may be fully justified in getting your case reviewed by the VA to see if more compensation and treatment are needed.

If you don’t know the maximum VA disability rating for your condition in its current state or whether certain complications may increase your eligibility for more care and disability pay, you should definitely review the VA Schedule For Rating Disabilities at the VA official site to see what your options are.

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How To Prepare For A Request For The VA To Review Your Medical Conditions

If you feel confident that, after reviewing the VA literature on compensation and maximum limits for your conditions, that you have a case for increased compensation, you’ll need to be careful and methodical about moving forward.

This includes several steps that can help you make the strongest case possible for a review and increase in VA disability percentages.

Know And Understand Your Current VA Rating

As mentioned above you will need to fully understand the VA disability rating for your existing condition and the VA justification for assigning that rating.

For example, tinnitus ratings are a maximum 10%. Do you know why this is? Or understand what VA policies dictate the cap on such ratings?

These are important things to understand going forward as these details can help you decide if you have a case the VA will take seriously or if you should leave well enough alone based on the risk of actually having the rating lowered based on current VA policies.

Gathering Evidence

It’s not enough to proceed with your original medical records from the first time you submitted the claim. VA doctors want to know that the condition has changed and under what circumstances that change has occurred.

The going advice is that you should never assume the Department of Veterans Affairs will do this work for you. It’s your claim, and you will need to be proactive about gathering the documentation to support your claim.

If you do not have any medical records to support the claim that your condition is worse than originally diagnosed, or that your condition has gotten worse since the original claim, you will need to generate those records by getting evaluated and diagnosed all over again.

Getting Evaluated By An Expert

You may need to get re-evaluated by an independent medical authority not associated with the Department of Veterans Affairs before you submit your request for a claim review. What you need is an expert in disability medicine who can help make more sense out of medical issues that are unclear or that may be misinterpreted or misdiagnosed during the VA’s review process.

For example, what is the difference between the symptoms of PTSD and Traumatic Brain Injury or TBI? Are there any differences in these symptoms? Are medical or emotional problems related to either of these considered “co-morbid” with other medical conditions? Does TBI occur simultaneously with PTSD?

You may not know the answer to these questions, but an independent medical expert with expertise in disability medicine can help you understand what is diagnosable, what is treatable, and when your condition may be complicated by other factors. And if there has been a general worsening of the condition overall, you may be able to get help tracking and identifying such complications.

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How To File A Request For An Increased VA Disability Rating

 You will be required to fill out ​VA Form 21-526EZ. This form may be a bit confusing at first as it is used for a variety of things including applying for:

• Disability Service Connection
• Benefits Based on a Veteran’s Seriously Disabled Child
• Increased Disability Compensation
• Individual Unemployability
• Special Monthly Compensation
• Specially Adapted Housing/Special Home Adaptation
• Automobile Allowance
• Adaptive Equipment Compensation under 38 U.S.C. 1151
• Secondary Service Compensation
• Temporary Total Disability Rating

Who VA Form 21-526EZ Is For

VA instructions on this form advise those submitting a claim for increased disability compensation or for those who “disagree with an evaluation decided more than one year ago” to complete and submit VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits. But not all can use this form.

Those who disagree with a VA evaluation “decided within the past year and have new and relevant evidence” OR  for those who need to file a supplemental claim, (described by the VA as a claim after an initial claim for the same or similar benefit on the same or similar basis was previously decided) will need to file VA Form 20-0995, Decision Review Request: Supplemental Claim.

You Can Apply Online

It is strongly encouraged for veterans to apply for VA disability compensation via the eBenefits portal.

This online application process allows you to upload all supporting documentation and file a claim without having to do the initial paperwork in person. The VA also allows you to get help from an accredited Veterans Service Officer (VSO). You can start looking for a VSO at your state’s Office of Veterans Affairs. A state-by-state guide to these offices is at the VA official site.

It is a very good idea to get the help of a VSO when submitting such claims; these officers have experience working with the VA system and may be able to help you save valuable time, better utilize your resources for gathering medical evidence, and may even be able to advise you on the practicality of your revised claim based on past experience in similar cases.

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Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News

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Military members who are about to retire or separate from the military are urged to begin the VA medical claims process as soon as they know they are going to separate. That doesn’t mean you can start submitting your VA claim whenever you want but you should begin to research the medical conditions you need to make claims for and how the VA rates them.

Hearing damage, hearing loss, tinnitus, and related conditions are among the most common types of medical issues for military people and getting the VA to take such claims seriously requires a qualifying medical diagnosis of the condition.

If you need to make a VA claim for hearing damage and similar problems, you may be able to get audio testing from a VA facility, but barring that you will need to submit medical evidence gathered by a licensed audiologist. In either case the VA will require two types of audio testing – one is called the Maryland CNC test, the other is a pure tone audiology test.

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The Two Types Of Hearing Tests Required To Rate Hearing Loss

The Maryland CNC test measures hearing loss using a 50-word exam that is designed to score how well you recognize the spoken word. The results of the Maryland CNC test helps the VA determine your hearing damage, whether the severity of the damage qualifies for VA disability payments, etc.

The other hearing test is known as the Puretone Audiometric test, sometimes referred to as Pure Tone Audiometry or a Pure Tone Audiometry Test. This test measures overall hearing loss by determining the quietest tones you can hear while the test is administered.

These tests are done without the use of assistive devices such as hearing aids; the intent is to learn how diminished your hearing is without the use of these devices.

How The Pure Tone Audiometric Test Works

The patient is placed in a sound-isolated environment which could utilize a soundproof room, a sound booth, the use of headphones, etc. Both ears must be tested even if there is only hearing loss, tinnitus, etc. in only one ear.

The test, administered to measure the quietest sounds you can hear, is run at a variety of sound frequencies which may include the following frequencies for “bone conduction”:

• 1000 Hz
• 2000 Hz
• 3000 Hz
• 4000 Hz

The following frequencies are tested for “air conduction”:

• 250 Hz
• 500 Hz
• 1000 Hz
• 2000 Hz
• 3000 Hz
• 4000 Hz
• 6000 Hz
• 8000 Hz

A VA procedural manual from 2007 describes the Pure Tone test steps as including (but not limited to) the following:

• Exposing the patient to pure tones “well below the expected threshold” with a starting point recommended at 0 dB.
• Pure tones are played for the patient in “ascending 10-dB steps” until there is a patient response.
• The level is decreased by 10 dB and increased in 5-dB steps until there is a response from the patient.
• The lowest level at which responses occur (for at least 50% of ascending trials with a minimum of three responses at any single level) is considered to be the threshold.

Part of the VA mission for evaluating hearing loss in veterans using these tests is to differentiate between organic hearing loss and non-organic hearing loss. The official site of the National Library of Medicine contains studies that describe non-organic hearing loss as follows:

“Non-organic hearing loss (NOHL) may be either psychogenic, feigned or artefactual when there is either inattention or misunderstanding of the audiometric task.” There are many tests available to distinguish between organic and non-organic hearing loss including quantitative tests such as “evoked potentials” and “otoacoustic emissions.”

These may or may not be administered for veterans seeking VA compensation for hearing damage; such tests may be considered on a case-by-case basis to rule out false positives (depending on circumstances).

The 2007 VA procedural document mentioned above takes non-organic hearing loss issues quite seriously, stating that it “not sufficient” to simply observe “the existence of non-organicity”; the manual states that multiple tests may be required to determine “true organic thresholds.”

Furthermore, “The results of special procedures, inter-test inconsistencies, and uncooperative behavior, evasiveness, misrepresentation of facts, or unwillingness to respond or cooperate with testing, should be thoroughly documented.”

Since hearing can degrade over certain frequency ranges, the VA wants to test your ability to hear some of the most commonly lost (due to hearing damage) audio frequencies. These tones may be administered in certain ranges of loudness (measured in decibels). The results of this test, as well as the frequencies tested, will factor in for the second test, described below.

How The Maryland CNC Test Works

The Maryland Consonant-Vowel-Nucleus-Consonant test measures the patient’s ability to recognize speech. Part of this process is determining what is professionally known as the “speech reception threshold (SRT).”

SRT is described in VA medical documentation as the level, measured in decibels, “at which the patient correctly identifies 50% of a set of two-syllable (spondaic) words.”

This portion of VA hearing test requirements “should be in agreement” with the average of pure tone test thresholds from 500 to 2000 Hz. As you can guess, the pure tone test results are important for this portion of the required hearing examination.

The starting level for the CNC test is 0 decibels and in 10-dB steps “until the patient responds correctly.” The audio levels are then lowered by 10 dB with words presented in 2-dB or 5-dB ascending steps.

VA medical documents at this stage state that in cases of no response at the 100-decibel level, “100+ will be recorded.” The speech reception threshold for this test is defined as “the level at which 50% of the stimuli is correctly identified.”

The purpose of speech recognition testing in this context is described by the VA as being necessary “to obtain the patient’s best performance under optimum, controlled, and reproducible conditions.”

That means that “live voice presentation” of the test, in other words, having someone read the words into a microphone live and in person, is not permitted. Instead, the words must be pre-recorded.

Things To Remember About The Maryland CNC Test

• The VA says speech recognition scoring is not designed to “simulate real-world performance.”
• Normal speech recognition performance is defined by the VA as 94% or better for a 50-word list.
• If speech recognition is worse than 94% after presentation of 50 words, “a modified performance-intensity function must be obtained to determine best performance.”
• In addition to all the testing described above, VA rules require all patients to receive “an otoscopic examination by an audiologist or physician to determine the presence of middle-ear disease” and to make sure the ear canal is free of debris, cerumen, or conditions that “preclude audiometric testing.”
• A complete exam includes “external examination of the pinnae as well as otoscopic visualization of ear canals and tympanic membranes” according to the Department of Veterans Affairs.

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What Else Should Veterans Do When Considering A Hearing Damage or Hearing Loss Claim

• Make detailed notes for submission to the VA and/or your healthcare provider describing any incidents where military service exposed you to loud sounds, gunshots, explosions, or airplane engines.
• Describe and date when you remember hearing damage, tinnitus, or other problems occurring for the first time, if possible.
• Explain why you didn’t seek medical treatment for any ear-related problems, when applicable.
• Note in detail how chronic or sporadic your hearing issues are or have become.
• Identify the severity of the hearing issues you have related to military service.
• Note how your hearing loss affects your ability to work, socialize, and live your life in general.

Making a medical claim with the VA for compensation involves submitting supporting evidence, medical documentation, and other paperwork.

If you suspect you are experiencing service-connected hearing damage, hearing loss, tinnitus, or physical damage to the ears above and beyond noise exposure, it is extremely important to seek medical attention as soon as possible for the purposes of adding this to your medical records.

Ideally this should be done while you are still serving in the military, but in cases where that is not possible, get an evaluation as soon as possible for best results in filing your VA claim.

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Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News

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There are two distinct and separate types of disability compensation for military members, and that means two separate disability ratings. It’s easy to confuse the two at first, but as we will explore below these two programs are quite different in their structure and guidelines.

The two basic types are Department of Defense (DoD) Disability and VA Disability and those leaving the military soon with potential medical claims should know the details of both.

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The Difference Between Military Retirement And Medical Retirement

Before exploring the differences between DoD Disability Pay and the VA equivalent, it’s important to know the difference between ordinary military retirement pay and being medically retired/being given Military Disability Retirement Pay.

When a service member reaches military retirement time-in-service (20 years or more), they can file retirement paperwork, leave the military, and begin drawing retirement pay. Service members do not normally have to retire the second they hit the 20-year mark; some choose to continue serving as long as military regulations will permit.

But the main thing to remember here is that retiring is the servicemember’s initiative and filing the papers means starting the process with an eventual retirement paycheck coming.

Military Disability Retirement is something else; it is not selected by the service member but comes as the result of a medical review process; a military doctor or team of doctors may determine that a veteran’s medical condition warrants disability retirement and this can happen at any stage in the servicemember’s career.

Disability retirement is not automatic even when it is determined that the patient can no longer perform military duties as expected and must be medically separated or retired. Why?

Because if the decision to medically retire or separate someone comes before they have put in the full 20 years of service required to draw retirement pay, the service member could simply be medically separated with severance pay rather than being awarded disability retirement pay.

Remember, this is happening at the DoD level, NOT the Department of Veterans Affairs level. The VA claim process is completely separate from this type of retirement or separation determination.

DoD Disability

When military members are hurt or get sick on duty, the first step in the list of priorities for the Department of Defense is to get the patient treatment and rehab services with the intent of returning the military member to duty as soon as feasible.

During this time, the service member’s physician or care giver team is tasked with determining if the patient is able to return to active duty or if there needs to be further medical assessment under the DoD’s military Disability Evaluation System (DES).

The ultimate goal of DES is to evaluate the patient’s ability to return to duty/fitness for duty. DES is a way to provide a consistent and uniform approach to such evaluations.

DoD Disability Ratings: The Basics

The Defense Finance and Accounting Service (DFAS) official site provides guidelines for service members who need to know how the DoD Disability Rating pay system works. Starting from the time the patient is awarded a disability percentage (determined by the military’s Physical Evaluation Board) a decision will be made as to whether the disability requires retirement or separation from military service.

• Those with less than 20 years of active service who are assigned a permanent disability rating of 30% or more qualify for disability retirement.
• Those assigned a disability rating below 30% are separated, not retired.
• Those with active service totaling 20 years or more will be recommended for retirement “regardless of disability rating”.

There is a very important caveat; for those who had the disability prior to entering military service separation may be recommended without benefits.

According to DFAS, a qualifying patient may be placed on the Temporary Disability Retired List (TDRL) or the Permanent Disability Retired List (PDRL) depending on circumstances. “A member of the TDRL or the PDRL is a retired member of the armed forces. You are entitled to all rights and privileges of a military retiree.”

What You Need To Know About DoD Disability Ratings

As indicated above, there are two general types of disability ratings-permanent and temporary. Each has a set of percentages that may apply to the level of disability. Once you get a DoD disability rating, that percentage will not change over time unlike a VA disability rating which does have the potential for change.

If you get a 30% DoD disability rating and are placed on the DoD Permanent Disability Ratings List, that rating remains for the lifetime of the veteran.

DoD Disability Ratings are determined based on time-in-service, rank, and the disability percentage. This is in contrast to VA disability ratings which are based only on the severity of the medical issue.

DoD ratings apply only to the specific medical issues being evaluated where the VA takes a more holistic approach, considering the entire medical condition of the patient overall. That means that multiple injuries or conditions aren’t necessarily evaluated by the DoD: only the issues directly being evaluated.

What You Need To Know About DoD Temporary Disability

A service member is not automatically placed on the permanent disability list; those who are found to be “unable” or “unfit” to perform military duty thanks to a medical issue that is temporary could find themselves assigned on the DoD Temporary Disability List (TDRL).

In such cases, the DFAS official site states, “While on the TDRL, a physical examination is required at least once every 18 months. If you fail to report for your physical examination, your Branch of Service will remove you from the TDRL list and your retired pay will be suspended until your examination has been completed.”

This kind of retirement pay is calculated as follows:

• The servicemember’s DoD disability percentage (requiring a minimum of 50% for payment purposes while on the TDRL), OR
• Total years of active military service.

In cases where a rated disability “stabilizes” and as a result is awarded a 30% or higher rating, the patient is transferred to the Permanent Disability Retired List (PDRL).

For those with disabilities that stabilize but have ratings lower than 30% and less than 20 years of military service, separation from the military with severance pay will be recommended.

Eligibility For Healthcare, Severance Pay, Other Benefits With A Permanent DoD Disability Rating

Those awarded a permanent disability rating between 30% and 50% by the Department of Defense are eligible for healthcare “with military disability retirement benefits, but may have a lower priority for VA healthcare benefits.” In general a 50% or better rating is required to get the highest priority in the VA healthcare system.

Any disability-related severance pay awarded by the DoD “will be deducted from any later-awarded VA benefits for the same disability” with certain exceptions which include the following:

• The disability occurred in the line of duty in a combat zone
• The disability was the result of a “combat-related event”

Those with less time in service and of lower rank may receive less from the DoD than would be awarded by the VA because of the DoD’s rank-based system. You may also receive a different disability rating from the VA than you would from the Department of Defense.

VA Disability Pensions

The DoD Disability rating system is used before the service member has left active service, and is used in part to determine whether or not the patient should be retired or separated. The VA Disability Rating system and all other associated disability benefits are for after the service member has left the military. The evaluation period may begin prior to retirement or separation, but any compensation would be awarded after leaving the service.

The VA offers benefits based upon service-connected or service-aggravated disability. You may be offered, depending on the nature and severity of the condition(s), VA Disability Compensation or a VA Disability Pension.

Disability compensation is the better-known benefit; if you get a VA-rated disability percentage for a certain medical condition “incurred or aggravated during active military service” you will be awarded compensation based on how the percentage of disability is rated by the VA.

But for low-income veterans who are permanently and totally disabled, OR are at least 65 years old, a Disability Pension may be possible. This type of pension is a need-based benefit and there are income and asset limits. Any such VA Disability pension payments awarded would be reduced based on the income of the veteran, spouse or dependent children residing with the veteran.

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Important Differences Between VA Disability and DoD Disability

• DoD disability ratings are for life; VA ratings are subject to change depending on whether the conditions get better or worse within certain VA time frames.
• VA ratings include a review of the patient’s entire medical condition used to inform the rating. DoD disability ratings are only awarded for specific conditions under review.
• VA disability payment may be altered if DoD Disability severance pay was awarded. If you are paid $5 thousand dollars in DoD severance for a disability and the VA awards you disability benefits, those payments will be withheld until the amount of the severance pay has been recouped by the government.
• VA disability benefits are not calculated using time-in-service, time-in-grade, or any such similar factor including rank. By contrast, DoD disability pay is calculated with those factors as an important part of the math.

Receiving DoD Disability Retirement and VA Disability Benefits Concurrently

Under previous legislation and/or government program guidelines, veterans were not permitted to “double dip” by receiving full VA disability benefits and full military retirement pay. However, changes in the law and program guidelines have made the following applicable at the time of this writing:

• Military retirees who have 20 years of active military service and a 100% service-connected rating are entitled to full VA disability benefits and full military retirement.
• Retirees with at least 20 years of service and totally disabled with “individual unemployability” are allowed full VA disability benefits and full military retirement pay.
• Retirees with 20 years of service and a service-connected disability rating between 50-90% are eligible for full VA disability benefits and full military retirement pay.
• Veterans with 20 years of service OR a disability incurred in the line of duty AND a VA disability rating of at least 10% may be eligible to collect both.

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Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News.

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What is VA disability back pay and why should veterans be well-read on the subject? The simplest answer is that not knowing could wind up depriving you of funds you are entitled to by law.

Many veterans don’t have a problem collecting VA disability pay and/or any back disability pay they may be entitled to. But if there is a problem and a veteran isn’t awarded the back pay they deserve in the appropriate circumstances, knowing what you are supposed to get is the first step toward correcting the problem.

How VA Disability Back Pay Works

When military members and veterans file compensation claims for service-connected medical issues, there can be a delay between the VA investigation and decision making on the claim and the eligibility date of compensation.

This delay is made up with VA Disability Back Pay. This pay essentially makes up the amounts that would have come to the veteran if payments had started immediately. The longer the VA takes to decide, the more back pay you could have coming.

That said, much depends on when you file your claim-that is an extremely important factor to consider, which we’ll address below.

Who Is Eligible For VA Disability Back Pay?

A veteran’s eligibility to get VA Disability Back Pay is determined according to two basic scenarios.

In cases where the veteran submits a VA disability claim up to one year after retiring or separating from military service, the date of separation or the date of retirement would be the date used to start VA Disability Back Pay eligibility.

In cases where the VA claim is submitted later than one year after military retirement or separation, the back pay date is the date when the VA received the claim. This means there is high potential for lost pay that would otherwise be offered to the service member if the claim is not submitted within a year of separation or retirement.

That is a very important detail to note.

An Exception To The Rule

There is one exception. In cases where Congress approves measures that change the laws governing VA Disability Pay. When those laws change, the amount of VA Disability Payments will change also. If the amount of pay increases, VA Disability Back Pay may be applicable and the veterans affected would see that back pay based on how the legislation is worded.

For example, if the increase in pay is listed in the law as being effective on a certain date, the back pay would be the difference between the previous rate of pay and the new rate of pay, prorated from the effective date of the legislation to the present day.

No Action By The Veteran Required

In such cases there is nothing the veteran needs to do in order to receive the back pay, it will be generated automatically and no signups would be required.

Two Types Of VA Disability Ratings

When the Department of Veterans Affairs investigates your claim, it may determine that there is a “direct service connection” and proceed as appropriate. VA guidelines in this area include the following information for the veteran:

“The effective date for a disability that was caused—or made worse—by military service is whichever of these comes later:

• The date we get your claim, or
• The date you first got your illness or injury (also known as the date your entitlement arose)

In cases where the VA gets a veteran’s claim within a year of leaving the military, “the effective date can be as early as the day following separation”.

The other type of VA disability claim may fall under a presumptive service connection. VA rules in this area state that in many cases, if the VA assumes your condition is related to military service and the agency gets a medical claim for conditions that fall into the presumptive category “within one year of your separation from active service—then the effective date is the date you first got your illness or injury.”

In situations where the VA gets the claim more than a year after leaving the service, ”the effective date is the date we got your claim or when you first got your illness or injury—whichever is later”.

What A Presumptive Condition Is In The Eyes Of The VA

The VA official site describes a presumptive condition as one that has been “diagnosed by a doctor and that we consider to be related to your military service because of a specific aspect of that service.” This can include:

• A chronic (long-lasting) illness appearing within one year after discharge OR
• Medical problems caused by “contact with contaminants (toxic chemicals) or other hazardous materials” OR
• Illnesses caused by time spent as a prisoner of war.

The VA Presumptive Service Connection Rule

The Department of Veterans Affairs is on record stating that in most cases, when the VA is convinced your medical issue or condition is related to military service, “known as a presumptive service connection” and the agency receives the veteran’s claim within a year of separation from military service, the effective date of the claim is the date “you first got your illness or injury.”

In cases where the claim arrives to the VA more than a year after leaving active service, “the effective date is the date we got your claim or when you first got your illness or injury—whichever is later.”

This policy applies specifically to medical issues with presumptive service connections. Examples of that may include exposure to Agent Orange, traumatic brain injuries, PTSD, or other conditions depending on circumstances. All conditions are evaluated individually.

Important VA Terminology You Need To Understand About VA Disability Back Pay

The potential for missing out on pay a veteran would otherwise have coming via VA Disability Back Pay (assuming the veteran qualifies) is high and it is very important to fully understand the details. There are some terms and definitions to keep in mind:

Claim date: This usually refers to the date the VA received the veteran’s medical claim

Diagnosis date: The date you received the actual diagnosis of your condition (not the date of evaluation for that condition).

Retirement Date: The date you are legally out of the military as a retiree, and officially a civilian. Note that this date is after any terminal leave, permissive TDY for house hunting, etc.

Separation Date: The date you are no longer legally obligated to perform active military service. This is the date you are effectively considered a civilian and is after any terminal leave, permissive TDY, etc.

Effective date: The start date the VA uses to determine when VA compensation payments should begin, “based on the veteran’s claim or the date when the veteran is diagnosed with the condition to be compensated.”

VA Rating Reduction: A VA disability rating can be reduced if the veteran’s service-connected medical issues improve after leaving military service. This is generally done via a medical review process and is not arbitrarily determined without reviewing the veteran’s condition.

VA Staged Claim: In some cases, a veteran’s condition may get worse during the review process. In these circumstances the veteran will have her condition reviewed for a staged rating which may result in a staggered amount of compensation based on the severity of the condition or how severe it becomes over time. It is possible to get retroactive or VA back pay increased in these cases related to the severity year to year when justified.

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Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News

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Remember, if you win a VA claim and have no intent on pursuing further action with the Department of Veterans Affairs, there are different issues to be concerned with than someone who has more business to conduct with the VA.

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VA Healthcare Claims: What You Need To Know Going In

The first thing you need to understand about the VA claims process is that there is the initial claim the military member will file – a claim for VA compensation for service-connected medical issues. This claim should ideally be completed during the military member’s final out-processing time but this is not always possible, depending on circumstances.

After the initial claim is filed, the VA will make a determination and notify the veteran. This can take more than three months to manage and veterans may find their waiting times will vary depending on several variables.

If the veteran accepts the decision of the Department of Veterans Affairs, that’s basically the end of the process and the advice in this article pertaining to direct deposit, monitoring your benefits payments, and other payment-related information will apply.

For those who do not accept the VA decision and wish to file an appeal, there is a separate process for doing so and the results are not guaranteed.

But there are many veterans who have filed appeals and have won them, and some of the advice you read below pertains strictly to them. In any case those who win VA claims have some important steps to take next.

Double Check The Vital Details Of Your VA Claim Once It Has Been Awarded

This is an extremely important area – upon your first news of the status of your VA medical claim award, you will need to double check the disability rating percentage you have been awarded AND double check the date of the award.

The actual date of your claim decision will play an important part in calculating any back pay you may be entitled to for VA compensation (if there is pay to be claimed) and if the dates or the percentages have errors, you will need to apply to have them corrected as soon as possible. The correct effective date of your award is extremely important.

Sign Up For Direct Deposit After Winning A VA Claim

You may get instructions on how to sign up for Direct Deposit of your VA compensation in VA mailers, but you can also sign up at the VA official site or by calling 1-800-827-1000 which is a general VA hotline that has prompts that can direct you to Direct Deposit information.

Direct Deposit of your VA compensation payments is an important part of keeping your VA funds safe but also for tracking those payments in case of a dispute, late or delayed arrival of compensation, etc.

Receiving paper checks from the Department of Veterans Affairs is discouraged – the potential of such payments arriving late, getting lost in the mail, or lost before getting mailed out is much higher than the equivalent complications of electronic transfer. It is far easier to document the non-arrival of a VA payment that is scheduled electronically than it is to track an envelope that may have gotten lost in transit.

Consider Filing A New VA Claim For An Increase In Benefits

Because many VA processes can be time consuming, it’s possible for some claimants to experience a worsening of their medical conditions in the meantime. Your VA claim payments are hypothetically based on the most up-to-date information at the time, but you should file a claim for an increase in benefits if your medical issues are getting worse. You can file these claims at the VA official site.

Sign Up For VA Health Care

You may have no intention of using VA health care options today, but as veterans get older the VA health care system offers more benefits that can be useful if the vet has a medical condition that requires in-home care, trained services provided on an outpatient basis, respite care, palliative care, etc.

The earliest days of your retirement or separation from military service may not find you needing as much care as you may down the road. Those who do choose to enter the VA health care system immediately should apply as soon as their claim has been awarded, if not sooner.

Explore Your Other Veteran Medical And Non-Medical Benefits

There are a variety of options for veterans in the VA health care system, but for those who have VA disability ratings, there are extended options including insurance, career assistance, transition assistance, and specific help with certain conditions the VA offers programs for (such as hearing aids, support animals, and other benefits).

Non-medical VA benefits to explore include Vocational Rehabilitation and Employment (VR&E). This benefit is intended for those with service-connected medical issues that interfere with their ability to find or keep jobs. VR&E, also referred to as Chapter 31 benefits can help eligible veterans explore their employment options and any required training needs. In some cases, your family members may also be eligible for certain benefits.

Explore State Veteran Benefits

If you have a VA decision on your claim and have been awarded a disability rating, depending on your state’s veterans benefits you may be eligible for property tax breaks, state veteran home loan programs, reduced or discounted license plate fees and more.

There may be state-level versions of federal programs such as the VA’s Vocational Rehabilitation and Employment (see above) and other job-related resources. Disabled veterans may also qualify for state benefits for college tuition at state-supported schools.

Certain disabled veterans may be eligible for education benefits that apply for spouses or children of those with qualifying disabilities. Each state will set its own unique requirements in this area, so it’s best to ask questions of your state agencies about applying for or qualifying for such benefits.

At the state level, these resources will be made available via the state Department of Veterans’ Affairs office, which is sometimes referred to in some states as a State Bureau of Veterans’ Affairs or a similar variation.

Remember, the state-level Department of Veterans Affairs (or whatever name it goes by in your state) is not associated with the Federal Department of Veterans Affairs, though it may administer similar programs or help veterans sign up for federal VA programs.

Know Your Benefits

It’s not enough to get a VA disability rating and a payment amount; you need to know what your VA benefits offer you as a VA-rated disabled veteran including the availability of life insurance, healthcare options from the VA, when you may be entitled to be given a temporary 100% disability rating (this is possible in certain cases) and the circumstances under which you may apply for that rating.

Another area to know is how the Department of Veterans Affairs handles Cost of Living adjustments to your benefits payments each year. This adjustment won’t seem like much at first, but you could, over time, watch your VA payments increase, by as much as $25 to $50 per month over a long enough period of time.

Again, these increases will be gradual each year and will likely represent single-digit percentage adjustments.

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Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News

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