Claims Overview
Federal law grants the US Department of Veterans Affairs (USDVA or simply "the VA") authority to compensate veterans for injuries, disabilities, and conditions that were incurred or aggravated during active military service, provided that you were released under honorable conditions (honorable or general discharge). See Disability Compensation for more information about this benefit.
Filing a claim for disability benefits through the federal VA is actually a legal process. In order to receive benefits and compensation, you must file a claim with the United States proving eligibility through legal, military and medical evidence.
Though it is possible to file a claim yourself (just as it is possible to represent yourself in a court of law), it is highly recommended that you seek the free assistance of an accredited veteran service officer (VSO).
VSO assistance is available in every county and several federally recognized tribes. VSOs represent veterans, their dependents and survivors through each stage of the claims process, including appeals.
How to File a Claim
You can find your local county or tribal Veteran Service Office at this link: Locate Services
Your Veteran Service Officer will be able to explain what benefits you may be eligible for, based on your unique military service and circumstances. They will work with you to establish a plan to gather needed evidence and file a disability claim.
If possible, you should bring a copy of your DD214 or other discharge document with you to your first appointment. If you do not have a copy of your discharge records, your VSO will be able to assist you in requesting a copy. Depending on your situation, you may also want to bring private medical records, your marriage certificate and other dependency records or information, and direct deposit information.
You must submit evidence to support your disability claim. The type of evidence required will depend on the case, but generally, you will need to prove that you served in the U.S. armed forces, that you have a disability and that your disability resulted from or was aggravated by your service.
This evidence may include service records, medical records and lay testimony (also
known as “buddy letters” or “buddy statements”).
Your disability evaluation will be based on the evidence you provide and the results of your Compensation & Pension exam (see Step 3 below) so it is essential that the information you provide is accurate and complete. Your VSO will assist you in this process.
If eligible, claims submitted with all the relevant evidence may qualify for expedited review from
the VA through the optional Fully Developed Claim initiative.
The disability claim process begins the moment you file a claim. To file your claim through a VSO, you must sign a United States Department of Veterans Affairs (USDVA) Appointment of Representation form, which authorizes the VSO to act on your behalf in preparing, presenting, and pursuing your claim for any and all benefits from the federal VA.
A successful claim must demonstrate that your disability is currently affecting your physical or mental/behavioral health. This is typically done in a Compensation and Pension Exam (commonly referred to as a C&P exam) at a VA medical facility or through a VA contractor or through an Acceptable Clinical Evidence Exam (ACE exam). The VA will schedule the exam and let you know when, where, and what exams are scheduled.
The C&P exam will generally involve a physical examination of the affected area. Depending
on the type of disability you are claiming, it may also include lab work, X-rays and other diagnostic tests. The examiner’s goal is to establish a "snapshot" of your disability, documenting the physical effects that are observable and measurable at the time of the exam.
Afterward, a medical report from the exam will be prepared and sent to the VA for review.
A federal VA rater will be assigned to your case and will decide your claim based on the evidence submitted.
If your claim is approved, a rating will be decided based on how severe your conditions
are. The ratings are on a 10-point scale from 0 to 100 percent (e.g., 10 percent, 20 percent, 30 percent, etc.), and are defined and set based on federal law.
The VA will notify you of their decision on your claim by US mail. You can also check the status of your claim through the VA's website, VA.gov.
Once you receive your decision letter from the federal VA, you will want to schedule an appointment with your local VSO to review the decision. Even if you are happy with the results of your claim, it is important to meet with your VSO to discuss next steps and additional state and local benefits for which you may now qualify.
If your claim is denied, or you believe the decision regarding your claim is inaccurate, see below for steps available to you.
For more information: Federal VA: Disability Compensation.
What if My Claim Is Denied?
If your claim for disability compensation is denied by the VA, you may appeal or request a review of the decision. You may also appeal or request review if your claim is approved but you disagree with the rating or any other part of the VA's decision.
VA appeals involve a long, complicated, and multi-step adjudication process between you, your VSO, and the Veteran Benefits Administration. There are a number of different options for appealing your case, and your VSO will work with you to determine the best course for your situation. An important timeline to keep in mind is that these appeal/review options must be filed within one year of the VA decision letter.
Since February 2019, when the Appeals Modernization Act (AMA) took effect, there are three "lanes" available for appeal of a federal VA decision: a Supplemental Claim, a Higher Level Review, and a Notice of Disagreement to the Board of Veterans Appeals. You and your VSO may select any of these lanes for each issue you wish to appeal.
To file a Supplemental Claim, "new and relevant" evidence must be provided to the federal VA for their consideration. "New" evidence is evidence that the federal VA did not have in their possession when the claim was last decided; "relevant" evidence is evidence that could prove or disprove something in your claim. You can submit new and relevant evidence through your VSO, or ask the VA to get evidence from a VA Medical Center, other federal facility, or your private health care provider. A Supplemental Claim will not be accepted without new and relevant evidence.
The VA's goal fo completing Supplemental Claims is an average of 125 days.
Filing a Higher Level Review asks the federal VA to take a new look at the evidence already in their possession. A more experienced VA Review Specialist takes a second look at the same evidence. There is an option for a one-time telephonic informal conference with the Review Specialist to discuss the error in their prior decision. It is important to note that this is not an opportunity to add new evidence to the record; in a Higher Level Review, it is a closed record review (no new evidence permitted).
The VA's goal for completing Higher Level Reviews is an average of 125 days.
Filing a Notice of Disagreement (NOD) with the Board of Veterans Appeals brings the contended issue(s) to a Board of Veterans Appeals (BVA) judge. There are three docket options available for an appeal to the BVA: the evidence-only docket, the direct docket, and the hearing docket.
The direct docket is a closed record review; no new evidence may be submitted with this docket choice and a hearing is not permitted. The goal processing time for this docket is 365 days.
The evidence-only docket allows additional evidence to be submitted to the Board with 90 days following the submission of the NOD. This docket option will take more than one year for the Board to complete.
The hearing docket allows a hearing for the veteran and their representation before a BVA judge. If you want a hearing before a judge, this is the docket choice for you. After your hearing, you will have 90 days to submit any new evidence you wish to have reviewed by the judge as they consider your case. There are two different options for hearings before a Veterans Law Judge: a Virtual Hearing from any internet connected device or a Video Hearing at a VA location near you. The in-person hearing docket option wait time is currently 3-4 years before a hearing is scheduled.
Regardless of which docket you choose, the Veterans Law Judge who reviews your case will grant or deny each issue in your appeal, or choose to remand one or more issues back to the VA regional office for further investigation.
Click below to learn more about what you can expect at a Virtual Hearing:
What If I Don't Agree With The Decision?
If you disagree with the decision made on your appeal, you should meet with your VSO to determine what next steps are available to you.
If you disagree with the decision made on a Supplemental Claim, you may either file another Supplemental Claim (which would require additional new and relevant evidence), file a Higher Level Review (see information above), or file a Notice of Disagreement with the Board of Veterans' Appeals (see information above).
If an issue is denied by the Board of Veterans' Appeals and you want to pursue further action, you may file a Supplemental Claim, which requires new and relevant evidence, or you may appeal your case to the U.S. Court of Appeals for Veterans Claims (CAVC). You will have 120 days from the decision of the Board of Veterans' Appeals to file a written Notice of Appeal with the Court. You may not request a Higher Level Review of a Board decision.
For more information: Federal VA: "How Do I Appeal?" | Federal VA: Board of Veterans' Appeals