VA DISABILITY APPLICATION PROCESS: AN OVERVIEW

VA DISABILITY APPLICATION PROCESS: AN OVERVIEW

VA DISABILITY APPLICATION PROCESS

Looking to learn more about the VA claims process? The following provides an overview of the disability compensation claims from initial filing to appeals.

Filing a Claim for Disability Benefits

Intent To File:

An intent to file (VA Form 21-0966) is not a claim for disability; rather, an intent to file is submitted to indicate a veteran’s intention to file a completed disability claim at a future date. It is important to file this form because the date of submission of the intent to file will set the effective date for the veteran’s disability claim. This could potentially award months of additional disability payments.

The veteran’s disability claim must be submitted within one year of filing the intent to file in order for the effective date to reflect the date of the intent to file.

An intent to file may be filed through one of three ways:

  • Send a claim through the mail:
    Department of Veterans Affairs
    Claims Intake Center
    PO Box 4444
    Janesville, WI 53547-4444
  • Verbally notify intention to file by calling 800-827-1000
  • File with assistance from an accredited representative: Find Accredited Representatives Here

Download the intent to file form here: VA Form 21-0966

Initial Disability Claim:

A disability claim for compensation can be submitted through the Department of Veterans Affairs (VA) for an illness, injury, or condition that was caused by or worsened during the veteran’s active-duty service.

To successfully submit a new disability claim, the veteran must include an Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ) with all probative evidence for the claim. Common documents submitted as evidence with VA Form 21-526EZ include VA medical records, private medical records, and supporting statements. The VA suggests the veteran submit their evidence as soon as possible, but the veteran has one year from the date of filing the disability claim to submit all evidence. It is also possible for the VA to require additional medical exams at a VA Medical Center upon review of the claim.

The VA may assist in obtaining evidence that is not within the veteran’s possession if the veteran fills out VA Form 21-4142 and VA Form 21-4142a with identifying information regarding the needed records. But, in the case that the VA is unsuccessful in obtaining the evidence, it is the veteran’s responsibility to ensure the VA obtains all necessary evidence.

The following forms must be submitted with a disability claim if:

  • The veteran was treated at a VA Medical Center: submit VA Form 21-4142
  • The veteran is claiming dependents: submit VA Form 21-686c
    • The veteran is claiming a child in college: submit VA Form 21-674
  • The veteran is claiming individual unemployability: submit VA Form 21-8940
  • The veteran is claiming PTSD: submit VA Form 21-0781
    • The veteran is claiming PTSD from an assault: submit VA Form 21-0781a
  • The veteran is claiming Specially Adapted Housing or Special Home Adaptation: submit VA Form 26-4555
  • The veteran is claiming Auto Allowance: submit VA Form 21-4502
  • The veteran is claiming additional benefits for Aid and Attendance: submit VA Form 21-2680
    • The veteran is claiming Aid and Attendance for a nursing home: submit VA Form 21-0779

Find VA Forms Here

To download VA Form 21-526EZ with instructions: Click Here

A disability claim may be filed through one of four ways:
1. File a claim online: File a Claim Here
2. Send a claim through the mail:
Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444
3. File in person at a VA regional office: Find a Regional Office Here
4. File with assistance from an accredited representative: Find Accredited Representatives Here

After Filing a Claim for Disability Benefits

Normally, the VA will provide the veteran a decision regarding their disability claim within about 100 days of filing. The veteran may submit their evidence as quickly as possible in order to receive an expeditious decision. The veteran must also attend any exams the VA requests while awaiting the decision on their claim.

Note: Veterans who submit a claim through the mail should receive a letter affirming that the VA has received their claim. This letter should arrive about 2 weeks after mailing the disability claim.

When the VA makes a decision regarding the veteran’s disability claim, the veteran will receive a packet that includes details about the decision on the claim. The VA will either grant, deny, or defer the decision.

See What is a Deferred VA Claim? for more information.

Aside from appealing a decision that denies benefits, there can be several reasons to appeal a granted decision:
1. Did the VA fail to consider evidence which would indicate service connection for any claimed disabilities that were not awarded?
2. Did the VA fail to consider evidence which would increase the evaluation of any claimed disabilities?
3. Did the VA fail to consider evidence which would indicate an earlier effective date?
4. Did the VA fail to award any additional circumstances filed with the disability claim, like individual unemployability?

If the answer to any of the above questions are unsatisfactory, the veteran’s next step might be appealing the VA’s decision. If the claim was granted and the veteran is satisfied with the decision: Congratulations!

Appeal Process

The VA observes two types of appeal systems. Determining which appeal system applies to the veteran’s claim is simple:
1. If the veteran’s appeal was filed before February 19, 2019: the appeal follows the Legacy system
2. If the veteran’s appeal was filed on or after February 19, 2019: the appeal follows the Appeals Modernization Act (AMA) system

The Legacy System:

An appeal must be made within one year of the decision, so all appeals under the Legacy system must already be filed. If the veteran has a decision on a claim they wish to appeal which was decided before February 19, 2019, the veteran must submit a new disability claim regarding the conditions from the prior claim.

Under the Legacy system, the veteran must file a Notice of Disagreement with the VA, indicating the veteran’s intention to appeal the decision. The VA will return a Statement of the Case in response, which explains the reasoning for the decision. If the veteran still disagrees with the VA’s decision, they should submit a VA Form 9 within 60 days of receipt of the Statement of the Case. VA Form 9 indicates the veteran’s choice to appeal to the Board of Veterans’ Appeals (BVA).

If the veteran does not submit any additional evidence with their appeal, then the appeal will be sent directly to the BVA. If the veteran submits additional evidence or the VA requests additional evidence, the VA will return a Supplemental Statement of the Case.

Upon the BVA review, the veteran has the option to request a hearing with a Veterans Law Judge.

The BVA will return a decision after the hearing (if one occurs) and review of the case. Their decision may conclude a grant, denial, or remand. If the veteran disagrees with the BVA decision, they may appeal the decision in the U.S. Court of Appeal for Veterans Claims (CAVC) within 120 days of the opinion.

The AMA System:
There are three ways to file an appeal in response to the VA’s decision on the veteran’s disability claim:

  • Supplemental Claim
  • Higher-Level Review
  • Board Appeal

Supplemental Claims should be filed if the veteran would like the VA to reconsider its decision regarding their disability claim based on new evidence that the veteran wishes to submit or a recent change in the law. Common forms of new evidence are a new medical report and a Statement in Support of Claim (account of a fellow service member who witnessed the cause of the disability).

If the veteran wishes to submit additional evidence after the VA’s decision on their claim, the evidence must be new and relevant. This means that the evidence must be information which was not submitted with VA Form 21-526EZ and must support the veteran’s claim. The VA may assist in obtaining new and relevant evidence that is not within the veteran’s possession if the veteran fills out VA Form 21-4142 with identifying information regarding the needed records.

A supplemental claim may be filed through one of four ways:
1. Fill out a supplemental claim online: File a Supplemental Claim Here
2. Send a supplemental claim through the mail:
Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444
3. File in person at a VA regional office: Find a Regional Office Here
4. File with assistance from an accredited representative: Find Accredited Representatives Here

If the veteran is not satisfied with the decision from the supplemental claim, the veteran may file another supplemental claim, file a request for Higher-Level Review, or file a Notice of Disagreement to the Board of Veterans’ Appeals.

Higher-Level Review should be requested if the veteran would like the VA to reconsider its decision regarding their disability claim without the submission of new and relevant evidence. A request for a Higher-Level Review must be filed within one year of the decision on the disability claim.

An informal conference may be requested for Higher-Level Review. An informal conference is a phone call in which the veteran or their representative may speak with the higher-level reviewer about the case. This provides the opportunity for the veteran or their representative to explain the errors made in the decision and what should be changed. This conversation is based solely on the evidence submitted prior to the decision.

A higher-level review request may be filed through one of three ways:
1. Make a request online: Request a Higher-Level Review Here
2. Send a request through the mail
Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444
3. Make a request in person at a VA regional office: Find a Regional Office Here

If the veteran is not satisfied with the decision from the Higher-Level Review, the veteran may file a supplemental claim or file a Notice of Disagreement to the Board of Veterans’ Appeals.

Board Appeals send the decision on the veteran’s disability claim to the Board of Veterans’ Appeals (BVA) for review by a Veterans Law Judge. A request for a Board Appeal must be filed within one year of the decision on the disability claim. A request is made in the form of a Notice of Disagreement.

There are three Board Appeal options:

  • Direct Docket: The veteran may not submit new evidence for a direct review; rather, the Veterans Law Judge will review the claim with all evidence that was previously submitted.
  • Evidence Docket: The Veterans Law Judge will accept new evidence for 90 days after the VA receives the request for the Board Appeal to consider when reviewing the veteran’s claim.
  • Hearing Docket: The veteran may request a hearing and the Veterans Law Judge will accept new evidence during the period prior to the hearing and up to 90 days after the hearing. The hearing may be held virtually at home, virtually in a VA location, or in-person in Washington D.C.

A Board Appeal request may be filed through one of three ways:
1. Send a request through the mail
Board of Veterans’ Appeals
PO Box 27063
Washington, D.C. 20038
2. Make a request in person at a VA regional office: Find a Regional Office Here
3. Fax a request to 844-678-8979

If the veteran is not satisfied with the decision from the Board Appeal, the veteran may file a supplemental claim within one year of the decision or file an appeal in the U.S. Court of Appeals for Veterans Claims (CAVC).

Sources:
1. https://www.va.gov/resources/your-intent-to-file-a-va-claim/
2. https://www.va.gov/disability/how-to-file-claim/evidence-needed/fully-developed-claims/
3. https://www.vba.va.gov/pubs/forms/VBA-21-526EZ-ARE.pdf
4. https://www.va.gov/disability/after-you-file-claim/
5. https://www.va.gov/decision-reviews/supplemental-claim/
6. https://www.va.gov/decision-reviews/higher-level-review/
7. https://www.va.gov/decision-reviews/board-appeal/