How To File A Claim For VA Disability Benefits
How To File A Claim The VAWatchdog Way...and Win!
How To File A Claim
At any point after a veteran
has completed military service and he or she believes that military
service has caused an injury or illness (called a "condition" by the VA)
or that a preexisting condition was aggravated by military service, the
veteran may file an application for disability compensation.
There are no time limits or restrictions except in a few very limited
circumstances. As a rule, the veteran may seek disability compensation
for any condition they reasonably believe was caused or aggravated by
their service at any time.
The initial filing of a claim for disability benefits is simple. The
veteran may file the appropriate forms himself or he may seek
representation and assistance from an accredited Veterans Service
Officer who will likely work for a Veterans Service Organization. At
this stage of the process, the veteran is not allowed to pay anyone to
represent them. In practice, this means that a veteran who wants to have
someone representative him or her will likely use the services of a
VSO, as very few attorneys work on preparing initial claims.
More about representation follows later. For the purposes of this
chapter, we will assume that veterans who read on are interested in
filing the claim for themselves.
Is this your first or original claim? Keep reading.
Have you ever completed the VA Form 21-526? If you are already in the system (having once completed the VA Form 21-526), you do not have to complete the VA Form 21-526 again.
You may proceed to file a new claim for a new disability by notifying your VA regional office in writing. A simple letter will do the trick.
If you have existing ratings but you feel they should be higher, click here.
Prior to filing your claim you should consider some of the basic elements that are required to obtain an award of benefits.
(1) You must be eligible. In other words, you must have served and
possess a discharge that is other than dishonorable. If your discharge
is other than honorable but not dishonorable, there may be restrictions
on the type of benefits you may receive.
(2) You must have an current injury or illness (condition) that can be
attributed to your service. This means that you should have a fairly
clear diagnosis in a medical record prepared by a qualified health care
provider, preferrably a physician. The more precisely defined the
condition is in the record, the better it is for your application for
(3) You must have evidence to support your claim. The strongest evidence
is that of an event that is recorded in a Service Medical Record (SMR)
and a detailed description of the cause of the injury or illness leading
to the condition, as well as how it was treated and any residual
effects of the event. If the condition is related to a non-combat
related event, documentation of the accident or incident that caused a
condition (such as a broken bone), documentation of an admission to a
military or other hospital, a record of treatment and follow-up care.
Not everthing is required for every claim, but the more supporting
evidence, the better chance of an award.
(4) Your medical evidence must be clear enought to prove to VA that your
current condition is connected to the in-service event - this is called
"service connection" or "nexus." Without a service connection, all the
evdence in the world of a current medical condition and an event in
service will not result in an award of benefits.
I suggest that you consider another set of requirements before you file a
claim for yourself. You should be well organized and prepared to deal
with the requirements of a lot of paperwork, copying of files and
searching for evidence. It helps if you are familiar with the way to
conduct a search for records on the Internet, use a word processor, own
or have access to a scanner and copier and you're confident that you
have the patience to deal with details. The VA process, even at its
best, is slow, prone to error, and requires constant attention. A
veteran who can organize his or her information and keep good records of
interactions with VA during the claims process is much better
positioned to be successful.
If you believe that you meet these requirements, you should proceed to apply for your deserved benefits.
You should file your claim as soon as possible after you decide that
you are eligible to apply for benefits. This is because the date of
filing (when the claim form is received by VA) establishes the start
date of your award. You do not need to wait to file your claim until you
have gathered all the supporting evidence. You'll have plenty of time
to submit your evidence after you file. Waiting until you gather every
last piece of evidence only costs you money because VA will only pay you
from the date of the claim, no matter when the condition began.
You may file an informal or a formal claim. An informal claim may be as
simple as a brief letter to the VA stating you wish to file a claim. The
VA will accept that and then ask you to complete the VA Form 21-526
to formalize your claim. If you are reading this, there is really no
reason to file an informal claim because eventually you have to complete
the formal claim form anyways. Also, there are often disputes over
informal claims and you risk VA later not recognizing your claim.
The much preferred method to file a claim is to complete a VA Form
21-526. The link will take you to the 23 page form on the VA web site.
This is a PDF document and that requires that you have the free PDF
reader installed on your computer. That PDF reader is available by
As of this writing, the Form 21-526 on the VA site is "fillable". This
means that you may complete the form by using your computer to type
information into the required places. After you've done that and
finished the form, you may print it out for mailing to the VA Regional
Office that will serve you. If you aren't comfortable doing that, you
may print out copies to complete in ink and mail to VA.
If your computer refuses to cooperate with you, you may go to any VA
facility such as a regional office, VA medical center or clinic and they
will provide you with one. You may also call 1-800-827-1000 to ask that
a form be mailed to you.
Before you begin, carefully read through the instructions. While the
form isn't difficult to complete, understanding what will be required
before you begin will save you time and frustration.
Once you've completed and signed the form, it's time to mail it in. The
VA doesn't want all those instructions so you may keep those for your
records. Be sure you keep a good copy of the completed form for
It should be mailed to the VA Regional Office (VARO) in the state where
you live (or the closest VARO if you live in a state with more than one)
using Certified Mail with Return Receipt requested.
I strongly recommend that this is the only way that you should ever
send documents such as forms and evidence to the VARO. I do not
recommend using a fax machine, any sort of email or even hand delivery.
Certified mail will provide you with signed evidence of delivery just in
case a document goes missing.
Once you've mailed off your 21-526 application and you have the receipt
proving delivery in hand, you should begin in earnest to gather the
evidence you'll need to support your claim. VA will eventually notify
you that they have received your application and over the next few weeks
and months you will receive letters that will remind you to submit any
and all evidence possible.
It's worth noting that the letters you'll receive will often be
repetitive and they'll make you wonder if VA has received anything
you've sent in already. Not to worry, the letters are computer generated
and are part of the requirement that VA has to assist you in developing
your claim. You should keep everything you receive from VA in case you
run into a problem about whether or when something was or was not sent
to you. If you get into the habit of putting everything you send to and
recieve from VA in a file in by date, you will have no trouble finding
whatever information you may need in the future. If you've used
certified mail and return receipts, you should save each one of the
certified receipts and return receipts with the documents that they go
with. Also, if you have the receipts, VA received your documents and
they'll get around to them in turn.
If you do not receive any letter from VA in about two months, you may
want to send another copy of your claim and a copy of the certified mail
and return receipts, along with a cover letter explaining to VA that
you sent in the form before, but have not received any acknowledgement.
This will usually prompt a response.
You are probably going to receive a notice or a call about a
compensation and pension exam. Even if it's short notice and it may be
inconvenient for you, you should make every effort to get to the exam as
soon as possible. If you just can't make it on the date scheduled,
notify VA at your earliest convenience. If you don't show up for an exam
or if you're extremely late for a scheduled exam, the VA may default to
a denial of your benefits and you then have a real issue to confront.
Now you wait. You may wait six months to a year before any progress is
made. During this time it's important that all you do is wait. Don't
call the VA to ask why it's taking so long, don't write angry letters to
your Senator or Congressman. Any action you take now, other than
submitting supporting evidence, is likely to slow your claim down. The
VA is estimated by various sources to be a year or more behind in the
processing of some 400,000 to 800,000 claims. Yours is in line with
those and if you have done your job well with your application and
evidence, your claim will eventually have its turn to be rated.
The only time I recommend that you ask VA to speed up your claim is if
you are truly critically ill or your doctors do not believe you will
outlive a long wait. In that case, VA may prioritize your claim for
processing after you've notified them. The notification of your desire
to have your claim prioritized should be sent as a brief letter via
certified mail and should include a statement from a physician as to the
seriousness of your condition.
If it sounds simple to file a claim for disability compensation
benefits, it's because it is. Winning your claim after you've filed is
another matter entirely. If you do this part of the process well, you've
just markedly increased your chances of a good result.
But your task isn't complete. If you aren't confident you can do all
that, you should seek a representative. Even if you do ask a
representative such as a VSO to help you, the VSO will want you to be
involved in your own claim. You may be told that, "This isn't a
spectator sport!" Your VSO will do a much better job for you if you're
actively helping to gather evidence an getting good copies of evidence
to the VSO for review.
A Checklist For Filing A Claim The VAWatchdog Way
* First time filing a claim? Complete a VA Form 21-526.
* Filed a claim before? Don't use the 21-526, just write a letter.
* Tell VA (in a brief letter) what you want for your rating. Be BRIEF and specific.
* Enclose evidence with your letter. Be sure your name and numbers are on every page.
* Mail the letter and evidence using certified mail, RRR. (Yes. we're old school.)
* You do not need a representative. (DIY is the WTG.)
* You should not use the eBenefits site.
* Wait for the green certified mail receipt. When you receive it, you know VA has your letter.
* Unless you have earth shattering evidence, don't send anything else to VA.
* Be on the alert for a notice about a C & P exam. Do not miss or reschedule.
* Wait patiently for the award/denial letter.
* While you wait, consider your appeal. Some 70% of you will be denied for the wrong reasons.
* If you have existing ratings, you may file for any new conditions and/or you may file for increases in existing ratings.
* Don't compare your disabilities and ratings with others.
* Don't listen to advice from strangers at VA facilities. If you ask 10 people about your claim, 8 of them will give you wrong answers.
* Be patient. VA is a badly broken machine and your anger won't fix it.
* Plan your future as if you will never receive a VA benefit. Don't rely on VA to help you, always have a Plan A and a Plan B. Plan B is the VA.
If you have a well grounded claim and you stick to the hints above, you'll prevail. Eventually. This will probably take a while. Think; One year minimum. Prepare for; Three years for the first adjudication. If you must appeal, prepare for 5 or more years.