The Veterans Benefits and Claims Process
The VA provides veterans, their spouses, and dependents a variety of veterans benefits. Commonly, veterans and their families apply for the following benefits:
- Service-connected disability compensation
- Pension for non-service-connected disabilities
- Dependency and Indemnity Compensation (“DIC”)
- Compensation for injury or death caused by VA (“1151 claim”)
- Dependent’s Educational Assistance
- VA health care and health care reimbursement
- Burial benefits
The most common type of claim is for service-connected disability compensation. In order to establish entitlement to these benefits, three things must be established through evidence: (1) the veteran has a demonstrable disability (2) the veteran first showed symptoms of a disease or suffered an injury, or an aggravation of a pre-existing disease or injury, while in service or within a short period afterward (3) there is a causal relationship between the current disability and service. If the VA is satisfied that all three of these elements are shown by the evidence, then a veteran is “service connected” for the disability, i.e. eligible for compensation. The amount of compensation is based on how severely the veteran is impaired by the disability. To determine this amount, the VA will use the Schedule for Rating Disabilities in the regulations (38 C.F.R. Part 4). This schedule is based on the average impairment in earning capacity resulting from the disability, and the condition is rated between 0% (non-compensable) and 100% (totally disabling), in 10% increments. The effective date – that is, the date from which payments begin – will generally be either the date of VA’s receipt of the claim or the date on which the evidence shows entitlement to the benefits, whichever is later. Though the proof requirements vary, claims for other VA benefits follow this same process.
When you submit a claim, the VA is required to provide you with notice that explains the types of information required to qualify for benefits, and to provide certain sorts of assistance in developing the evidence. The ultimate responsibility for developing your claim, however, is yours.
The VA must issue a written decision granting or denying benefits. You then have one year from the date stamped on the cover letter transmitting the decision to file a “Notice of Disagreement,” which is simply a statement that you disagree with the decision or any part of it (e.g., the rating percentage) and want to appeal to the Board of Veterans’ Appeals. If a Notice of Disagreement is not filed within that one year, the decision becomes final and, except in a very few unusual cases, cannot be revived and altered.
Once a Notice of Disagreement is filed, the VA will either attempt to resolve the dispute or will issue a Statement of the Case. You have the remainder of the year from the date on the letter with the Rating Decision or 60 days after the date the Statement of the Case is sent, whichever is longer, to submit a Substantive Appeal (Form 9) to the regional office, which sends your case to the Board of Veterans’ Appeals. The Board will render a decision upon review of the entire file, including any new evidence submitted. The Board may grant or deny benefits, or send the claim back for further development by the agency.
If the Board denies all or part of the claim, you may file a further appeal to the U.S. Court of Appeals for Veterans Claims no later than 120 days after the date the decision is mailed to you. Note that the appeal to the Court must be based on legal or procedural errors, not on the ultimate question of whether you should get benefits. When the Court sees such errors, it sends the case back to the VA to be redone.
We can represent you if you have a recent Board decision or have already filed your appeal to the Court, and we can represent you at the agency after such an appeal or if you have filed a timely Notice of Disagreement after June 20, 2007.