What to Expect When it’s Time to File Your VA Disability Claim
I separated from active duty in the summer of 2021 and moved across country for a one-year, term graduate fellowship position in Washington, DC. That winter, I finally got all my medical paperwork together and reached out to the Disabled American Veterans (DAV) office in downtown Washington, DC.
Next to joining the service, filing my VA Disability Claim was the single most life changing decision of my life.
I had heard years of horror stories of transitioning service members trying to file their VA Disability Claim. So, when it was time to file myself, I was surprised to discover that wasn’t my experience. Perhaps my case was the exception, but just in case, here was my journey to provide at least one positive case study.
1. Collect ALL Medical Records
Prior to Separation
Prior to separating, upon advice from many others and my Transition Assistance Program (TAP) counselors, I requested and collected all of my records from medical and dental on base. It should be noted, medical and dental records are usually maintained independently at your Military Treatment Facility. This may have changed since MHS Genesis’s recent assumption of the Military Medical Record contract. As always, don’t be afraid to ask a lot of the same questions to multiple people! You frequently get different answers.
I had even done a good job of keeping my records from off-base providers. It took many days sitting on the floor of my room, scanning the tall stack of papers one bunch at a time with my personal printer/scanner but eventually, I digitized all those records.
Digital Records
I also downloaded what I could find in my Tricare Patient Portal including collections of doctor visit history, doctor’s notes, and lab results. Between my digitized and printed records, I had gathered everything that mattered and sent them to my DAV representative.
Don’t worry about trying to pre-screen your medical records. Pre-screening your records and only giving them the records you think matter may inadvertently exclude conditions that may have qualified for a rating. Your VSO should be skilled at culling through hundreds of pages of medical records to find what they need. If they are overwhelmed by the volume of your medical records, perhaps you should consider going through another VSO representative or VSO entirely.
2. Choose a Veteran Service Organization (VSO)
Veteran Service Organizations (VSO)
Veteran Service Organizations (VSO) VA-accredited organizations, primarily non-profit, available to assist Veterans in applying and accessing their VA benefits. Most commonly VSO assistance is associated with disability claims, but they can also support access to VA education, healthcare, burial benefits and more. If you authorize in writing, your VSO representative becomes your designated representative, and advocate, when working with the VA.
The most recognizable are, of course, Disabled American Veterans (DAV; chartered 1932), Veterans of Foreign Wars (VFW; chartered 1936), and The American Legion (chartered 1919), just to name a few. The complete list of Congressionally-chartered VSOs can be found at the House Committee on Veterans’ Affairs Veteran Service Organization page.
While there are VA-accredited attorneys and agents to assist you in these claims, VSOs by law, cannot charge you a fee for their service. Keep in mind, you have no loyalty to a particular VSO. If you don’t think they’re providing the service, or possess the professional industry knowledge, you need, approach another VSO. Their whole existence is to support you, the Veteran. Don’t settle.
Upon a recommendation from a colleague, I chose the DAV office in downtown Washington, DC. I signed, authorizing my DAV Representative to represent me with the VA and I sent him all my digital and digitized medical records.
Don’t Expect Your Medical Records Returned
Keep in mind, any records you give to a VSO, will not be returned to you upon adjudication of your claim. Do not send your VSO your original records, only send copies that can be easily replaced.
3. File a Claim (Preferably within 1 Year of Separation)
There is a no statute for filing a VA Disability Claim, but there are certainly advantages to filing within one year after separation. You can even file while you’re still on active duty and within 180 days of separation.
If you file within one year of separation and you are awarded a VA Disability Rating, you are entitled to disability back pay since the date of your separation.
Filing Within One Year
The general rule of thumb for post service claim is to file within one year after separation. According to the VA website, “If you have certain chronic (long-lasting) conditions that started within 1 year after your discharge from active military service, you may be eligible for VA disability compensation.” (“Disabilities that appear within 1 year after discharge” VA.org)
In other words, if you file within one year of separation, the VA will likely presume your condition was service connected. By that logic, the longer you wait, the less likely the VA will presume your condition was service connected. Moreover, if you file within one year of separation and are awarded a VA Disability Rating, you are entitled to disability back pay since date of your separation.
I had approached DAV about six months after separation. After I signed authorization for my DAV representative to represent me with the VA and sent him my multiple files of medical records, he scheduled me to come down to the office to review and sign off on my proposed claim.
Preparing a List of Claimed Conditions
I assumed I would have to advocate to my VSO representative what and why I thought I could claim, but it when very differently. He presented me with a long list of conditions he thought I could claim. I had several health conditions in mind, including several injuries, but his list was far more thorough. Clearly, I was not his first claimant.
All the proposed claims were conditions I had been treated for while active duty, all verifiable by my accompanying medical records. Whether the VA awarded a service-connection and disability rating was up to them. I signed and my DAV representative send the list and medical records to the VA on my behalf.
After a few more weeks, the VA’s contracted claims service reviewer contacted me to schedule three appointments: dental, mental health, and general medical. I was able to stack them on back-to-back days. I had to take two days off work, but it was definitely worth it to be able to focus on my claim appointments.
4. Prepare for Your Claims Appointments
The night before my appointments, I reviewed my medical records, taking notes of the months and years when each claimed condition began, the general treatment plan, and any subsequent flare ups. This was exactly how my appointments went.
Tell the Story of Your Condition
An injury flare-up once or twice a year can still be a chronic condition if those flare ups have been persistent or reoccurring.
It was story time. One by one, the contracted claims service reviewer would go down the list of claimed health conditions, and I would tell my story of that condition, when it started, the treatment approach, and subsequent flare ups. Then, they asked me how that condition was currently impacting my life now six months post-military. Did I have flare ups weekly, monthly, once a year? How has this condition impacted my daily life? How has it impacted my ability to perform my civilian job duties? Do I miss any work throughout the year as a result of that condition?
Clearly, I had not been totally incapacitated by my injuries—I was working a full-time office job with regular travel. A VA Disability Rating isn’t exclusively a measure of your ability or inability to work though. Rather it seems an acknowledgement that your baseline health has fundamentally changed because of your service and, while those health conditions may not prevent you from working, they will require proper management in one way or another for a long time to come, perhaps the rest of your life. Proper management here meaning access to health care services.
A Note on “Chronic” Pain
A note on “chronic” pain. I am not a doctor, but I did a definition search of the word “chronic.” Chronic does not necessarily mean constant; it means persistent or reoccurring. An injury flare-up once or twice a year can still be a chronic condition if those flare ups have been persistent or reoccurring.
As you’re telling the story of your conditions to the reviewer, be deliberate about how you use the word “chronic” or respond to questions related to a condition’s “chronic” nature. Chronic does not necessarily mean constant.
Be Honest
I did not hold back. Unlike my countless military doctors throughout the years who tried to downplay, deflect, or even deny my “alleged” injuries—”are you sure your hip pain isn’t just stress-related?”—the VA’s entire existence is to simply provide treatment.
My hip pain was not stress, by the way, it was a labral tear that had gone undiagnosed for a year and a half because my military doctor didn’t want to refer me to imaging.
The VA on the other hand, carries no national security imperative burden to keep patients in a “fit for duty” status and keep readiness numbers up.
Tell the Whole Truth
I did not know exactly what was coming next, but I couldn’t see any potential benefit to downplaying or glossing over my conditions and symptoms. I didn’t lie, I didn’t exaggerate, but I did tell the whole truth. I’m not sure exactly why, but it was terrifying, sitting there in front of this stranger on the upper level of this office park with wall-wide windows to trees and stoplights, battling with my internal self if I was going to tell her that whole truth—that last 10% I had only told the Chaplain—while she waited in patient silence.
At one point, she asked, “How much alcohol do you drink on a given week?” I think I actually said, “This sounds like a trick question.” She didn’t react except a slight crease of her brow as if to say, “Excuse me?” Despite my brain’s programming to provide the stock, military answer, I told the truth. I figured whatever the outcome, if I’m honest, then I’ll never have to wonder if my VA claim could have gone differently.
5. Wait for a Rating and Prepare to File an Appeal
About two months later, $16,000 showed up in my bank account, presumably for VA Disability backpay. I had expected some backpay because I had filed within a year of separation, but not the equivalent of the 5% down payment on my condo. I called my VSO and they said I had been awarded a 100% total and permanent disability rating. A few weeks later, over $3,000 was deposited for the next month’s pension.
From submitting my medical records to DAV to receiving an adjudication took about four to five months. According to the VA, “the average number of days to complete disability-related claims” is 103.3 days (as of September 2023).
To keep this process on track, prioritize it. Don’t delay responding to your VSO representative and reviewing their proposed claims. Don’t delay scheduling your on-site appointments with the contracted claims reviewer. No one will take your claim more seriously than you will. Set the standard.
A Note on “Total & Permanent” Rating
It should be noted that not all 100% VA Disability Ratings are considered “total and permanent.” The “total and permanent” distinction is a separate and must be written in your award letter to be in effect. If you have a 100% rating, take a closer look to see if you were also rated “total and permanent.”
A Note on 0% Ratings
It’s possible the VA may rate some of your conditions as 0%. This means they acknowledge it was service-connected, but did not determine it to have much, if any, impact on your life. This is still better than not.
As long as you have a 0% rating today, if the condition becomes worse at any point in the future, you can file an appeal to be re-evaluated and potentially have that rating increased. However, if you never filed and never got the 0% to begin with, then later down the road, you’ll have to prove the condition was service-connected at all–which becomes more and more challenging the longer it’s been from your service.
Receiving My Rating
After many phone calls, I finally got the letter with my disability breakdown. 70% was for mental health, 30% migraines, and then a long list of 20%, 10%, and 0% conditions. VA disability math is still a bit of a mystery to me, but however they did it, I had indeed been awarded a 100% total and permanent VA Disability Rating.
I thought surly there was a mix up. How could the VA believe my mental health was in the state it was when my military mental health provider wrote in my file that I “needed to work on my maturity.”
The VA would downgrade my rating once they had a moment to take a closer look. The retain the right to review their decision at any time. They haven’t yet. I’ll let you know if they ever do.
Filing an Appeal
However, if you do not receive a totally satisfactory rating, be prepared to file an appeal. Hopefully your VSO will be able to advise you. Perhaps you’ll need to seek additionally treatment separately and submit supplemental medical records. Whatever the additional steps may be, try it.
If You’re Awarded at Least 50% VA Disability Rating
A VA Disability Rating can be life-changing, especially if it’s at least 50%. Veterans who receive a 50% VA Disability Rating or higher can use the VA for all their healthcare needs, regardless of whether the particular condition is service connected. They may provide coverage for qualifying Veterans who visit an ER not at a VA hospital. The VA also has a special Foreign Medical Program (FMP) to provide care for qualifying disabled Veterans living or traveling abroad. They’ve recently expanded the criteria to make it easier for disabled Veterans to be referred to Community Care Providers including shorter distance thresholds to VA facilities and shorter appointment wait thresholds.
Although I agree, the VA Healthcare system may leave lots to be desired, they do have a substantial care program. In my humble opinion, I believe they are trying to make it more accessible. Regardless of your healthcare choice, it’s wonderful to have options.
This is all separate from the VA Disability pension, a monthly tax-free disbursement for eligible disabled Veterans scaled on their disability rating. It’s also eligible for, and historically has, annual cost of living adjustments by Congress. While these adjustments may not keep up with actual inflation, it sure does help.
Conclusion
It is impossible to undersell how life changing a 100% total and permanent VA Disability Rating has been. For a while, I will still carry that invisible anxiety that one day I will receive the letter announcing they’ve reviewed my case and downgraded my benefits.
If it ever comes, I plan to appeal. For now, I’m getting accustomed to using the VA for primary care and investing my disability pension to prepare for a career change and/or an early, partial retirement. I whole-heartedly recommend you apply for VA disability with these steps:
- Collect ALL Medical Records
- Choose a Veteran Service Organization (VSO)
- File a Claim (Preferably within 1 Year of Separation)
- Prepare for Your Claims Appointments
- Wait for a Rating and Prepare to File an Appeal
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