The VA disability process can be confusing. In talking with many veterans, we realize that so many don’t understand where their claim stands in the VA disability process. Whether you are going to handle your claim yourself or get the help of a veterans disability attorney, you need to have a basic idea of how the VA disability process works and how a claim makes its way through the system.
The Start of the VA Disability Process: Filing the Claim
You begin the VA disability process by filing an application for benefits with the Department of Veterans Affairs. In most cases, your claim will be assigned to the local regional office. You can find a listing of VA regional offices (also known as ROs or VAROs) here.
Until recently, you could file a claim informally. This meant that a phone call to the VA or anything in writing asking for benefits for a disability was sufficient. Recently, those rules changed, so you cannot file a claim informally anymore. You must now file your veterans disability claim on the appropriate VA form.
The Next Stage of the VA Disability Process: Development of the Claim
Once your claim is in the system, the local RO will gather evidence to support your claim. If you have such evidence, you will want to submit it to the VA so they can consider it as part of your claim.
This evidence can be divided into two categories: medical evidence and lay evidence. Medical evidence is usually treatment records or opinions from doctors about the severity of your disability or its connection to your military service. Lay evidence is everything else. This can be military service records. It can be statements from you or from other people such as your spouse or family members. It can be anything else to substantiate an element of your claim.
During this stage of the process, the VA may send you for a Compensation & Pension examination (also known as a “C&P exam”) with a doctor of their choice. This exam is used to evaluate the disability, its severity, and/or its connection to your military service.
The Ratings Decision: Not Necessarily the End of the VA Disability Process
Once the Regional Office has gathered and considered the evidence in your claim, it will issue a Ratings Decision. This document will detail whether the VA thinks your disability is service connected if it is not already.
If service connection is established, the Ratings Decision will also assign a disability rating. The disability rating is a percentage rating that corresponds with a specific monetary amount of disability compensation. If you are a surviving spouse, your decision will only decide service connection since the level of benefits is predetermined. When you receive a Ratings Decision, you must decide if you want to accept the decision or try to have it changed in whole or part.
Appeals in the VA Disability Process Begin with the Notice of Disagreement
You may not agree with the Ratings Decision because it denies service connection. You may think it gives too low a rating. You have the opportunity and right to appeal.
You have one year from the date of the Ratings Decision to file a Notice of Disagreement. Again, you used to be able to file any type of correspondence as long as it indicated you disagreed with the decision and wished to appeal. Now, the VA requires veterans to use the VA Form 21-0958 Notice of Disagreement.
You can opt to have your appeal decided by a Decision Review Officer who is a higher level employee in the same Regional Office that issued your Ratings Decision review the initial decision, or you can opt for the “traditional review process,” which does not utilize the DRO process.
The Regional Office’s Last Step in the VA Disability Process: A New Ratings Decision or Statement of the Case
If you elect the DRO process, the Decision Review Officer will reconsider your claim and any additional evidence you submit. If you want, you can have a hearing before the DRO.
If the DRO agrees with you that the first Ratings Decision was wrong, he or she will issue a new Ratings Decision. If they do not change any portion of it, they will issue a Statement of the Case.
The Statement of the Case is mostly an explanation of the law that is relevant to your claim. Toward the end of the Statement of the Case will be the reasons and bases for the decision. This is where you can learn why the RO decided the claim the way it did.
If you opted not to go the DRO route, the Regional Office will eventually issue a Statement of the Case as described above. That triggers the next step in the VA disability process that sends your claim to the Board of Veterans’ Appeals. We will get into those steps in our next article about the VA disability process.