Common Mistakes Veterans Make When Filing for VA Benefits

CCK Law: Our Vital Role in Veterans Law

When it comes to filing for VA disability benefits and compensation, there are many steps involved.  It is not uncommon for veterans to make mistakes throughout this process.  In this blog, we discuss some of the most common mistakes veterans make and how to prevent them.

Mistake #1: Waiting to File Your VA Disability Claim

On many occasions, veterans will wait to file their VA disability claims until they have obtained all the evidence they want to submit or until their condition has reached a certain level of severity.  While these factors are important, it is also important to recognize that waiting to file can delay your effective date.

An effective date is the date that a benefit became effective and it used by VA as a start date for the payment of disability benefits for a claim.  Importantly, the effective date of a claim determines the amount of retroactive benefits a veteran will receive.  Generally speaking, the earlier the effective date, the more back pay a veteran will receive.

VA allows veterans to file a claim and then supplement that claim later on with additional evidence.  Veterans may also submit legal arguments after the claim has been filed.  Therefore, filing a claim as early as possible will result in an earlier effective date than if the veteran waits until they have collected all the evidence they wish to submit.

Additionally, filing a claim can sometimes trigger VA’s “duty to assist.”  Duty to assist essentially means that VA has a duty to go out and obtain evidence on the veteran’s behalf.  Examples of such evidence might be medical records or service records.  This means that waiting to file a claim in order to obtain evidence may end up being detrimental to a veteran’s case in some instances, as it can cost them an earlier effective date.  Retroactive benefits are awarded based on a veteran’s effective date, which is why it is so important to have as early an effective date as possible, as this will result in more compensation.

Even if VA initially denies your claim, your effective date will be preserved as long as you appeal in a timely fashion.  If the veteran was granted service connection but was unable to submit the evidence necessary to demonstrate the need for a higher rating, the effective date will be preserved as the date the claim was originally filed and then the veteran can submit the additional evidence as part of an appeal to obtain an increased rating.  Therefore, waiting to file a claim for VA benefits can potentially cause you to miss out on more compensation.

Mistake #2: Filling Out Forms Incorrectly

In order to receive disability benefits, veterans must first file a claim with the Department of Veterans Affairs.  VA allows veterans to file initial claims for disability benefits in a number of ways, including:

• Online, using VA.gov;
• By completing VA Form 21-526EZ: Application for Disability Compensation and Related Compensation Benefits and mailing it to the Evidence Intake Center or sending it by fax;
• With a legal representative, such as a Veterans Service Organization (VSO) or accredited attorney or agent; or
• At a VA Regional Office with help of an employee.

Regardless of how veterans choose to file their VA disability claim, it is important that they do so correctly.  If not, their claim may be denied or the process may be delayed.

VA Form 21-526EZ is comprised of eleven sections in total, several of which are very important for veterans to complete in full.  The sections address several categories, including information regarding the veteran, the veteran’s service, and the veteran’s condition(s).  For more information regarding VA forms, visit our blog on the most important VA forms and how to use them. 

Additionally, there are several forms that VA has introduced under the Appeals Modernization Act, including: (1) VA Form 20-0995, Veteran’s Supplemental Claim Application; (2) VA Form 20-0996, Application for Higher-Level Review; and (3) VA Form 10182, Notice of Disagreement.  Each form corresponds to a review option, or lane, within the new appeals system.  For help filling out these forms, check out: “VA’s New Forms Explained: How to File Appeals”.

If VA does not accept a form because it was not filled out correctly, or because it was the wrong form, the veteran could be at risk of losing their effective date, and, in turn, their retroactive benefits.  VA may contact the veteran for clarification regarding a form or ask the veteran to fill out a new form.  In this case, it is important to fill out the new form or reply to the VA as soon as possible, because there is often a deadline.  Not meeting the deadline in time could put the veteran’s claim or appeal in jeopardy.

Mistake #3: Not Filing for Secondary Conditions

A secondary service-connected disability is a disability that resulted from a condition that is already service connected.  There are several ways that a primary disability can cause a secondary disability.  Some diseases lead to other health complications that could become serious enough to be considered a secondary disability.  Common examples of secondary service-connected conditions include peripheral neuropathy due to diabetes mellitus and depression due to orthopedic conditions.

It is important for veterans to file for secondary conditions at the same time that they file for primary conditions for several reasons.  First, it is likely that the evidence in support of the primary condition will also pertain to the secondary conditions.  This allows VA to clearly see that the two conditions are related to one another and should therefore be granted benefits together.  Second, the effective date for the secondary service-connected conditions may match that of the already service-connected condition, again resulting in a larger retroactive award.

Detailing all the veteran’s secondary conditions, or residuals of their primary condition, can be vital in receiving benefits for secondary conditions later.  If a veteran does not outline their secondary conditions, VA may only grant service connection for the primary condition and overlook the evidence linking the secondary conditions to the primary condition because they were not detailed, or not detailed thoroughly, in the original claim.

Explaining to VA, clearly, what conditions were caused by an already service-connected condition, or a primary condition that the veteran is seeking service connection for, can help outline the veteran’s eligibility for secondary service connection disability benefits.

Play

Mistake #4: Failing to Obtain a Medical Opinion

VA will often deny veterans’ claims based on a lack of medical evidence linking their conditions to their time in service.  As such, a medical opinion from an expert or a nexus letter from a private healthcare provider can make a big difference.  A nexus letter is a document prepared for a veteran by a medical professional that explicitly connects an in-service event to the current condition for which a veteran is seeking service-connected compensation.

Veterans often make the mistake of relying on Compensation & Pension (C&P) examinations alone, which may not adequately represent the true nature or extent of their disabilities.  Expert opinions and nexus letters may be helpful in this case, as they may provide a clearer picture of the veteran’s symptoms or counter the VA examiner’s findings.  The veteran’s physician, or a medical provider, can provide a nexus letter.  Accredited representatives, or attorneys, may also be able to obtain an expert medical opinion to serve as the nexus letter.

A strong nexus letter should:

• Be written by a licensed professional in the appropriate medical or clinical field;
• Be based on the veteran’s service medical and personnel records;
• Be based on the veteran’s medical history before, and following, service;
• Address whether it is “at least as likely as not” that the veteran’s disability was incurred in or caused by service; and
• Provide supporting rationale for the conclusion, or in other words, the medical professional “shows their work” by elaborating on how they reached their determination

Veterans may also fill out, or have their treating physician fill out, a Disability Benefits Questionnaire (DBQ).  These are forms created for the veterans’ use in the evaluation process for VA disability benefits.  The forms allow the veteran, or their healthcare provider, to answer questions about aspects of their disability, including symptoms, severity, possible cause, and relation to other disabilities.

Mistake #5: Submitting Evidence That is Not Relevant to the Claimed Condition

When filing for VA benefits, veterans may be tempted to send all their service and medical records to VA.  In doing so, veterans might send too much paperwork, making it difficult for VA to locate the pertinent evidence that is most relevant to the claimed condition.

In submitting records to VA, the veteran should be certain that the records are pertinent to the conditions for which they are seeking service connection.  Submitting extraneous medical information regarding non-service-connected claims could weaken the veteran’s case or prolong a decision from VA.

It is important to include evidence with VA disability claims, but veterans must make sure the evidence is necessary to get benefits.  Otherwise, it will likely cause undue delays and VA rating authorities might overlook what is actually important.

Mistake #6: Not Understanding How VA Grants Disability Benefits

Many veterans are unaware of how the VA disability claims process actually works.  While it does involve filling out forms and waiting for benefits, it can be much more complicated than that.

VA only awards service-connected compensation when (1) you have a current, diagnosed condition; (2) you experienced an in-service event, injury, or illness; and (3) you provide a medical nexus linking your current, diagnosed condition to the in-service event.  It can be difficult to establish all three elements of service connection.  Nonetheless, it is important for veterans to know what VA is looking for when adjudicating their claims for disability benefits.

Veterans may be frustrated that their service records indicate an in-service event, yet they are not receiving benefits.  However, the condition must be current for a veteran to receive benefits, which means that a diagnosis is generally necessary.

For example, a veteran’s service records might show repeated head injuries or head injury residuals.  Without a current diagnosis indicating that the veteran, after their service, experiences head injury residuals, the veteran will not receive disability benefits.  Additionally, the veteran would need a nexus letter linking those head injury residuals to the repeated head injuries that occurred during service.

For increased rating claims, Veterans should make sure that they understand how their disability is rated under diagnostic codes.  In order to receive an increased VA rating, the veteran will have to indicate that their disability meets the criteria outlined for an increased rating.

For example, a veteran who is currently service-connected at the 30 percent level for headaches may be seeking an increased rating to the 50 percent level.  The 30 percent rating indicates that the VA acknowledges the veteran’s headaches are typically “prostrating” and “occur on average of once a month” over the course of several months.  In order to be awarded this increased rating, the veteran will have to demonstrate that their headaches occur with “very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.”  If the veteran does not meet these criteria, or cannot demonstrate meeting these criteria, VA will not award the increased rating.

While it may be clear to a veteran or their family, veterans must establish their condition as service-connected to receive compensation. Establishing the three elements of service connection is necessary for VA to recognize that the condition was caused or exacerbated by service, whereas demonstrating entitlement to an increased rating requires meeting the next level contained in the diagnostic criteria.

Mistake #7: Not Continuing to Appeal After Receiving a Denial from VA

After receiving a denial from VA, many veterans may feel as though there is nothing left to do.  Veterans may feel exhausted from the VA claims and appeals process and want to give up on their claim.  However, if the veteran does not appeal the denial, they could lose their effective date, and essentially any retroactive benefits from that date if they are able to secure a positive decision in the future.

Veterans have the right to appeal unfavorable decisions from VA.  In other words, if you receive either a denial or a disability rating that is lower than you deserve, you can disagree with VA’s decision and continue to seek service connection or an increased rating.

Veterans are highly encouraged to appeal unfavorable decisions in a timely manner in order to preserve their effective dates.  Once again, effective dates are important as they correspond to the amount of retroactive benefits you will receive.  Under the new VA appeals system, veterans can chose from three different review options, or lanes, when filing an appeal: (1) the higher-level review lane; (2) the supplemental claim lane; or (3) the Notice of Disagreement lane (i.e., appeal to the Board of Veterans’ Appeals).

Continuing to pursue a claim through the appeals process allows a veteran to preserve their effective date, and could entitle them to a larger sum of retroactive benefits down the road.  Often, pursuing a claim can lead to securing other VA benefits as well, such as health care or education benefits.

“Abandoning” a claim, or not appealing it within VA’s timeframes, could have consequences.  If the veteran decides later to file for that condition again, their original effective date will no longer be preserved, meaning the date that they refile for the condition will be the new effective date.

The retroactive benefits that could have been awarded if the first claim had not been abandoned will be lost and benefits will only be awarded from the time the claim was filed the second time.  In some cases, the veteran may be able to secure an earlier effective date, however the best way to keep the original effective date would be to keep the claim up to date by filing an appeal within the allotted time after a denial (i.e., generally one year).

While the VA claims and appeals process can be lengthy and sometimes discouraging, it is important to keep up with one’s claim and file any appeals in order to receive the full benefits to which you are entitled.

Mistake #8: Not Seeking Representation to Assist with the Claims Process

The VA disability claims process can be very complex as the regulations are constantly changing and the procedures are continuously evolving.  Recently, VA underwent a complete overhaul of its appeals process, transitioning from the Legacy appeals system to the new Appeals Modernization system.  As this shift brought many changes to how veterans file claims and appeals, it may be helpful to have a knowledgeable representative helping you navigate the updated processes.  Representatives can help gather evidence to support your case and ensure that your claims and appeals are filed correctly and in a timely manner, adhering to all deadlines.

Was Your VA Disability Claim Denied?

The experienced attorneys and advocates have spent decades successfully representing Veterans before the Department of Veterans Affairs and the Court of Appeals for Veterans Claims. If your VA claim has been denied, our office may be able to help. Contact us for a free consultation today at 800-544-9144.