At any point after you have completed military service, you may file an application for disability compensation. Here are the basic tests:
You believe that military service has caused an injury or illness (called a "condition" by the VA) or you believe that a preexisting condition was aggravated by military service.
There are no time limits or restrictions except in a few very limited circumstances. As a general rule, you may seek disability compensation at any time for any condition that you reasonably believe was caused or aggravated by your service.
Can I file a claim myself? Do I need a lawyer?
The initial filing of a claim is simple. You may file the appropriate forms yourself or get help from an accredited Veterans Service Officer who will likely work for a Veterans Service Organization or a State Veterans Service Office. You are not allowed to pay anyone to represent you at this stage of the process.
How do I know whether it's worth filing a claim?
Let’s assume you are going to represent yourself in this claim. Before you file, you'll need to understand the basic requirements.
Eligible military service: You must have done military service, and you must have a discharge that is other than dishonorable. If your discharge is other than honorable but not dishonorable, you may be qualified for only some types of benefits.
Current condition: You must have a current injury or illness (condition) that can be connected to your military service. This means that you should have a fairly clear diagnosis. It should be stated in a medical record prepared by a qualified health care provider (preferably a doctor). The more precisely defined the condition is in the record, the better.
Evidence: You must have evidence to support your claim. The best evidence is an event that is recorded in a Service Medical Record (SMR). This is a detailed description of the cause of the injury or illness leading to your condition, how it was treated, and any residual effects of the event. If the condition is related to a non-combat event, you will need documentation of:
A clear service connection: Your medical evidence must be clear enough to prove that your current condition is connected to the in-service event. This is called "service connection" or "nexus." If you can’t prove the service connection, you will not receive benefits.
What else do I need to know?
I suggest that you consider another set of requirements before you file a claim. You should be well organized and prepared to deal with a lot of paperwork, including copying of files and searching for evidence. It helps if you are familiar with searching for records on the Internet, know how to use a word processor, own or have access to a scanner and copier are confident that you have the patience to deal with details.
The VA process, even at its best, is slow, prone to error, and requires constant attention. You are much more likely to be successful if you can organize your information and keep good records of interactions with VA. If you believe that you meet these requirements, I encourage you to apply for your deserved benefits. If you have trouble with these kinds of tasks, you may want to seek help from a VSO or your state veterans affairs office.
NOTE: If it's not too late for you, plan ahead. The process can be much easier for military members who are still serving,. Once you file a VA claim, your Service Medical Record is sent to the VA by your branch of service. Thus, if a soldier visits medical for claimable injuries and builds a sound medical history of the injury while still in service, the process could simply involve filing a claim, going through a VA medical examination (if necessary), and waiting to hear back about your disability rating. Your military records become your VA evidence. Therefore, through good prior planning, veterans can avoid much of the headache involved in the claim process.
The C & P Examiner does not make the decision about your claim!
The Ratings Veterans Services Representative (RVSR) is a primary decision maker of the outcome of your claim for VA disability compensation benefits. Once the veteran has filed for the compensation benefit a folder or file is created and data (called evidence) is added to the file for consideration by the RVSR.
The condition you claimed will likely have some past evidence in the form of a Service Medical Record (SMR) or records of diagnosis and treatment from civilian providers.
No matter the amount of evidence you have, it's likely that the Veterans Service Representative (VSR) or the RVSR will request that a VA contractor perform a C & P exam on you.
The C & P examiner will not treat you or order any medications. Lab work, x-rays and other such studies may be ordered by the C & P examiner.
The depth of the examination is determined by order of the VSR or the RVSR and is included in the request for examination. When you have filed a claim or VA has decided to review the status of your condition, the VSR completes an order to have you attend a C & P exam. The order is very specific as to exactly what the VSR believes should be examined. If you have claimed a condition of your left leg, the C & P examiner will only address issues about your left leg.
The examiner has no authority to go beyond what is ordered by the VSR. Frequently the examiner will not have your medical records or any other history available. That is often the case when the VSR only wishes to determine the degree of function of a joint, as in a knee injury.
In that instance, the examiner won't consider that the history or treatments over time is of any particular importance. She or he will only be looking for the physical effects that are observable and measurable at that moment. The knee may be flexed and rotated so that the examiner can record those motions for comparison to the norm.
If there is scarring, crepitus (joint noise), swelling or redness, all of that will be noted in a report.
In other cases, the VSR or RVSR may request that the examiner give the medical record a very thorough review to determine whether or not a condition originated in the time of military service. A claimed back injury may have a reference of a similar injury in the SMR of 30 years prior to the date of the claim.
The examiner will be asked for an opinion that will state that the condition of today is or is not likely to have resulted from the injury in the SMR or if it is a condition that is of different origin and likely happened long after the ETS.
This is sometimes referred to as a nexus letter and may connect the condition you allege today with an event that happened many years ago.
The Must Do & Must Not Do of the C & P Exam
* The examiner does not make the decision about your claim.
* You may take records with you but the examiner may refuse them.
* The examiner won't treat you or prescribe medicines.
* NEVER try to fake any symptom. If you aren't prescribed a neck brace, don't wear one.
* The examiner will only perform the task assigned by an order of the regional office.
* You do not have to allow the examiner to cause you pain or discomfort
during the exam by manipulating joints, etc.
* The examiner does not have any insight about how your claim will be decided. Don't ask.
* You may request that a family member or friend join you during the exam.
The examiner may agree or refuse your request.
* DO NOT attempt to secretly record any part of the exam.
* DO make notes for yourself before you go. This is the only way you'll
be sure to tell the examiner all the details you want to share.
* DO NOT over-exert yourself trying to please the examiner. This exam is
about your worst symptoms, not the best.
* DO be courteous at all times. Don't complain to the examiner about all the
indignities you've suffered. Focus on the reason you're there.
* DO use your common sense. This exam probably won't make or break
the decision about your claim but it can help.
If VA finds that a Veteran has multiple disabilities, VA uses the Combined Ratings Table to calculate a combined disability rating. Disability ratings are not additive, meaning that if a Veteran has one disability rated 60% and a second disability 20%, the combined rating is not 80%.
This is because subsequent disability ratings are applied to an already disabled Veteran, so the 20% disability is applied to a Veteran who is already 60% disabled. Below you will find the steps VA takes to combine ratings for more than one disability and examples using the Combined Ratings
Table to illustrate how combined ratings are calculated.
The disabilities are first arranged in the exact order of their severity, beginning with the greatest disability and then combined with use of Combined Ratings Table.
The degree of one disability will be read in the left column and the degree of the other in the top row, whichever is appropriate.
The figures appearing in the space where the column and row intersect will represent the combined value of the two.
This combined value is rounded to the nearest 10%.
If there are more than two disabilities, the combined value for the first two will be found as previously described for two disabilities.
The exact combined value (without rounding yet), is combined with the degree
of the third disability.
This process continues for subsequent disabilities and the final number isrounded to the nearest 10%.
Examples of Combining Two Disabilities
If a Veteran has a 50 percent disability and a 30 percent disability, the combined value will be found to be 65 percent, but the 65 percent must be converted to 70 percent to represent the final degree of disability.
Similarly, with a disability of 40 percent, and another disability of 20 percent, the
combined value is found to be 52 percent, but the 52 percent must be converted
to the nearest degree divisible by 10, which is 50 percent.
Example of Combining Three Disabilities
If there are three disabilities ratable at 60 percent, 40 percent, and 20 percent,
respectively, the combined value for the first two will be found opposite 60 and
under 40 and is 76 percent. This 76 will be found in the left column, then the 20 rating in the top row. The intersection of these two ratings is 81. Thus, the final rating will be rounded to 80%.