Do you know how to win a VA disability claim? There are plenty of areas you will need to pay attention to, and the information that follows does not guarantee a VA decision in your favor, but following these steps can bring any claimant a lot closer to a VA decision to award compensation for service-connected medical conditions.
It’s not just a matter of being prepared, doing your homework, and gathering your supporting evidence-you need to understand what the VA is looking for in a claim and why they approve or deny those claims.
What The VA Looks For When Making A Decision About A Claim
The VA disability claim process is complex, but what the VA is looking for in that process is not – at least not generally speaking. The VA wants to know that a medical issue, condition, or illness has a bona fide link to military service:
- There must be a current injury, disability, etc. that has been diagnosed and has documentation to back up that diagnosis.
- The condition must have occurred during military service or aggravated by military service.
- There must be a medical connection between the servicemember’s claimed condition and military service.
- The medical issue does NOT have to be the result of combat, training, etc. The condition may be the result of off-duty activities, or as the result of something that happened outside the typical scope of military service. “When” is not as important in this context as “What”.
Does The VA Have A Responsibility To Help The Veteran Filing A VA Claim?
The Department of Veterans Affairs has traditionally had a responsibility to help veterans making claims but the Appeals Modernization Act instituted some changes in how that happens. The Appeals Modernization Act requires the VA to make “reasonable” attempts to help the veteran get medical records and other documentation.
But the VA obligation to help may be limited; according to some reports, assistance from the VA is only required when the veteran makes an initial claim for benefits, or in cases where a supplemental claim is needed and there is new evidence for the VA to consider.
How To Win Your VA Disability Claim
What follows is advice on how to present the strongest possible VA claim to the government for review. It is NOT a guarantee that you WILL win; only the Department of Veterans Affairs can make that determination.
But by taking the steps described below, you will find yourself much closer to an award in your favor. Remember that current legislation, military regulations, and VA programs are all subject to change at any time for any number of reasons, and you will need to make sure you understand the nature of the claims process and how the most current guidelines apply to you.
Document Any Medical Problem You Have Or Have Had In Uniform As Early As Possible
Where VA medical claims are concerned, it pays to be extremely aggressive about documentation as soon as you know you have an issue. Yes, this extends to those who are not done with military service yet and have no plans to retire or separate soon. The fact is, the burden of proof is on you when making your VA claim and you will need to be as proactive as possible in the earliest stages possible.
Those who do so long before they retire or separate have a much better chance of giving the VA what it needs to approve a claim. That said, don’t give up just because you haven’t done this and are now already retired or separated; you still have your military and civilian medical records to fall back on, but you may need to dig deeper to find certain documentation to back up your claims.
It’s not impossible to do this, just more time consuming. In this respect it is important to know that the earlier you file your claim the better chance you have at claim approval, but do NOT rush into the process if you feel you lack enough evidence to be taken seriously.
You can initiate a claim and submit more evidence later, but it is extremely important to ask what the current procedures for doing this are and what time restrictions you face depending on how and when you file the VA medical claim.
Keep Personal Copies Of Your Medical Records If At All Possible
Ask your primary care provider to furnish copies of your medical records, make copies if you are given your medical records to hand carry to a new military assignment, or make copies of the records when you get them at discharge time.
You never want to be without the means to supply copies of your medical records to a lawyer, Veteran Service Organization helping you with a claim, or even in case there is some kind of issue with your records at the organizational level at the Department of Veterans Affairs.
Get Statements From Family, Friends, And Co-workers
Get written statements from anyone who can attest to how your medical issues have affected your ability to live and work. Statements from non-medical sources should concentrate on personal observations of the symptoms rather than attempts to lay-diagnose a condition. Have your friends, family and co-workers concentrate on what they personally observe.
Do Not Artificially Limit Your VA Claim
Naming a single diagnosis in your VA medical claim isn’t just restrictive on you in terms of what you may be awarded, it’s also bad science. There may be many causes for physical, emotional, or mental symptoms, and some symptoms may be common across a variety of medical problems.
Your lower back pain could be the result of a back injury, but may also be a physical symptom of high anxiety, stress, or other issues. Let the doctors decide whether your symptoms are due or not due to a single cause.
Get Your Own Medical Information In Addition To Relying On VA Evaluators
If you are making a claim and are required to provide supporting evidence, having your own civilian medical expert weigh in on your condition in writing can give your VA claim evaluators something to think more about before arbitrarily deciding to deny a claim.
When you do this, remember that the most effective thing your non-VA medical expert can do is to directly link your medical issues with military service in the most direct manner possible. It won’t be as effective if your medical provider merely infers a connection – ask the doctor to clearly identify anything that could be construed as service-connected and why.
Do Not Give Up If The VA Initially Denies Your Claim
It is said that a large number of first-time claims are rejected by the Department of Veterans Affairs. Do not be discouraged by this. Instead, re-submit your claim and remember that some vets go as far as to hire a disability lawyer with experience working with vets and the VA in order to get those claims approved.
Don’t rule out hiring legal help as an option if you need to. Remember that you have the right to appeal the VA decision.
How To File A Claim For VA Compensation For Service-Connected Medical Issues
You will file a VA medical claim with VA Form 21-526, VA Form 21-526c, or VA Form 21-526EZ. Form 21-526EZ may sound like a short-form type of application (especially since federal tax forms labeled EZ have in the past been shorter and simpler to complete). But the EZ form is, when submitted, viewed as a fully developed VA medical claim and the Department of Veterans Affairs will not insist on additional evidence.
Thanks to the Appeals Modernization Act, additional documentation may be required such as VA Form 20-0995 for supplemental claims, VA Form 20-0996 which is a request for higher-level Va claim review, and VA Form 10182, which is the Notice of Disagreement.
You must submit your supporting evidence with the initial claim if at all possible – submission of this documentation at a later date means a more prolonged decision-making process.
When you seek to establish a service connection to a claimed medical condition, your goal should be to get an official, in-writing medical opinion stating that it’s the professional view of that medical official that your disability, illness, or condition is “at least as likely as not” related to military service.
In cases where you seek disability benefits “based on individual unemployability” according to the VA, any diagnosis or medical statement about your condition must include information directly stating that due to your condition(s) you are “unable to maintain, follow, or secure gainful employment.”
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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