Filing a first claim for disability compensation can be a stressful experience. The stress can originate from one or more of the following factors:
–Physical or mental discomfort
–That transitional feeling when you are no longer in the military but not really a civilian
–Concern about the outcome
–Lack of knowledge of the process
–Things you have heard from other Veterans and the media and, just
–Dealing with a bureaucracy
During this discussion I’d like to use my experience as both a Veteran and a senior VA official to demystify the process and empower you with information you need and what you can expect.
Dealing with large organizations can be frustrating. Some things that appear clear and certain to you may not be to others. Additionally, legal requirements can sometimes be confusing and time consuming. To have the best experience possible I recommend the following:
1. If you are still on active duty and thinking about getting out and filing a claim, go through the Benefit Delivery At Discharge or BDD program at your installation. To qualify you must have between 60 and 180 days left on active duty. We will take your claim and get you examined before you go home. Normally, decisions are available about two months after you separate or retire.
2. If you are still on active duty but have less than 60 days to go, you can still file a “Quick Start” claim. Quick Start claims are processed at dedicated facilities so decisions are quicker for most Veterans.
3. If you are out of service for less than a year, think you might have a claim, but are unsure if you want to “go through the hassle” apply. The evidence is fresher and cleaner, there are unlikely to be what we refer to as “inter-current injuries” (i.e. you back hurts a little but when you get out you get a job as a long hall truck driver or a construction working and don’t file a claim for years. In such cases even if there is some documentation of “something in service” without evidence of treatment for the condition within the first year, service connection is less certain).
4. If you’re concerned that it might not be appropriate to take money for a condition because “I’m fine, was just doing my duty and I have a job”–there are a lot of people who feel that way–consider this. I think you should file your claim. If granted you can always decline to receive the money. If, at a later date, your condition worsens or you age and it interferes with our work, or you decide you want compensation after all you can always contact us. That way we will examine you and determine your current level of disability. We won’t be trying to determine whether you warrant service connection in the first place.
5. If you have been out of the service longer but still think you have a condition related to your service apply! There is no filing time limit. It just might be a little more complex and take a little longer because of the need to develop more records.
6. Our goal is to complete all claims within 125 days or four months by 2015 with 95 percent accuracy. Right now more than 30 percent of our claims have been pending longer than that. Some claims, such as those involving participation in nuclear tests, covert operations, military sexual trauma or other similar circumstances where records may be difficult to locate can and frequently do take longer, sometimes much longer.
7. To meet the challenge of a rapidly growing claims volume, VA has been provided with significant numbers of new staff in the last couple of years. Their jobs are complex and it takes a while to become fully qualified so if you think we made a mistake, ask you may be right. As I said earlier, one of our goals is to get our quality level to 95 percent by 2015. Currently our quality level is 84 percent. While a significant portion our quality problems reflect process errors rather than errors in the final decision with respect to the granting or denying of benefits, rates paid and effective dates of payment, we do make mistakes.
How You Can Help Yourself and VA
The claims process doesn’t need to be a hassle. Here is what you can do to help yourself and VA:
1. Communicate, communicate, communicate
2. Appoint a representative. While there are attorneys who will represent you for a fee, it is rarely necessary to pay to have your claim processed efficiently and successfully. National Service Organizations such as the Disabled American Veterans, Veterans of Foreign Wars, American Legion, Vietnam Veterans of America, Paralyzed Veterans of America, as well as State Departments of Veterans Affairs or Veterans Commissions and County Veteran Service Officers can give excellent assistance and its free. Call your local regional office to see what organizations are available at that office.
3. Consider what you want to claim. Many Servicemembers and veterans have been told they should go through their service medical records and claim everything they have ever had or been treated for. While you can do that, it is likely to significantly increase your frustration level, result in unnecessary examinations, and slow the process without getting added benefits. You should not claim acute disabilities or illnesses you had in service unless they left a residual. For example, if you got the flu in service and got over it, the claim will be denied. On the other hand if you broke your leg and recovered from it you should claim that because the fracture, if found on x-ray, can be service connected. While it might only warrant a zero percent evaluation now, if you develop arthritis at the site later, you are covered. Don’t claim things like personality disorders, baldness, the fact that you wear glasses, or similar kinds of things because they are considered “constitutional or developmental abnormalities” that you would have gotten whether or not you were in service. The law doesn’t permit payment for these. Don’t claim lab results like hematuria (blood in the urine) or high cholesterol. We don’t pay for those either. On the other hand, you should claim pseudofolliculitis barbae (a skin condition that affects some black people).
4. If private providers have treated you, get the records and send them to us. While the application you fill out does offer the opportunity to sign a release and we will request the records for you, we cannot compel providers to send us records nor can we pay for them. It is my experience that many times–maybe even most–when VA sends a release a private provider, the provider ignores the request. If the provider does respond, many times they will ask that we pay them in advance for the records. In either case, we will have to write to you and tell you that if you want the records considered you will have to get them and send them. In the worse case this can add two to three months to the process.
5. Show up for your examinations.
6. The first thing you will get from VA once you file your claim is a lengthy letter commonly referred to as a “VCAA letter.” This is a letter required by the law that tells you what we will do, what you will be expected to do, and in very general terms tell you how we will decide. The letter may also include specific requests from your local regional office for information. Read it carefully for specific requests for information from us. Finally, the letter offers the option of completing an attachment telling us you have no more information. If that is the case, complete the form and return it immediately. If you don’t and you have no more information, we will wait for 30 days before proceeding for no good reason. Even if, during the course of working the claim you do get additional information you can always submit it when you get it.
7. When you get your decision, read it carefully. It will have attached to it the text of the actual rating decision explaining why we decided what we did. If you think our decision didn’t consider something, didn’t cover a topic, or is wrong, call your representative right away. If we have made a mistake, we would rather just fix it now than get involved in a lengthy appeal that isn’t terribly satisfying for you or VA.
Final Note: VA exists to serve those who served and their survivors. I have worked for VA for over 36 years and the overwhelming majority of people who work for VA are committed to the mission. If we are not clear or you think we have made a mistake, let us know so we can both fix it, and provide a learning opportunity for our staff to serve other Veterans better.
After serving in Vietnam as an Infantry Platoon Leader with the 101st Airborne Division, Thomas Pamperin began his career with VA in 1974. Having risen through the ranks, he is currently VA’s Deputy Under Secretary for Disability Assistance and is responsible for oversight of Compensation Service, Pension Service, Benefits Assistance Service, Fiduciary Service, and Insurance Service in the Veterans Benefits Administration.