COVID-19 Presumptive VA Claims: Who Qualifies?

CCK Law: Our Vital Role in Veterans Law

Veterans who contracted COVID-19 during or shortly after qualifying military service may be eligible for VA disability compensation for any lasting health problems the virus caused.

Under 38 USC § 1164, VA established presumptive service connection for COVID-19, which means that in certain circumstances, VA will assume a veteran’s COVID infection was connected to their service without the veteran needing to prove it directly. In this article, you will learn how to qualify for these presumptions to earn VA benefits for COVID.

Key points in this article include:

• VA does not provide disability ratings for COVID-19 itself, only the chronic conditions it leaves behind, known as “residuals.”
• The presumption under 38 USC § 1164 covers active duty, active duty for training, and qualifying National Guard service between March 1, 2020, and January 5, 2024.
• Even with these presumptions, veterans may still need medical evidence showing their current symptoms were caused by their COVID-19 infection.

Can I Earn VA Benefits for COVID-19?

Yes, but not for the virus itself, only its residuals.

“The first thing to understand is that COVID-19 itself does not have a VA disability rating,” says Bradley Hennings, partner at CCK Law. “It is an acute illness, meaning it typically runs its course and resolves. VA cannot compensate you for a disease that is no longer present.”

Instead, VA compensates veterans for COVID-19 residuals, the chronic and ongoing health problems that the virus leaves behind. The condition of having one or more residual COVID symptoms is often called “long COVID” or “long-haul COVID.”

Common COVID-19 residuals that may qualify for VA disability benefits include:

• Persistent respiratory problems, such as shortness of breath or reduced lung capacity
• Cardiovascular issues, including inflammation of the heart muscle (myocarditis)
• Neurological effects, often called “brain fog,” such as difficulty concentrating or memory problems
• Loss of taste or smell (anosmia/ageusia) that does not fully recover
• Mental health conditions, such as depression or anxiety linked to the infection or its aftermath
• Fatigue, headaches, joint pain, kidney damage, or other organ complications

According to a 2023 study of nearly 470,000 VA patients, approximately 3.93 percent of the veterans who contracted COVID-19 were subsequently coded for long COVID. This comes out to about 16,000 veterans for this study alone, each of whom might be suffering lasting effects from the virus.

Watch CCK Law Partner Bradley Hennings explain the basics of COVID-19 presumptive VA claims:

Am I Eligible for Presumptive Service Connection for COVID-19?

Under 38 USC § 1164, veterans with qualifying service may be eligible for presumptive service connection for residuals related to COVID-19.

Essentially, this means that as long as the veteran served during the following periods of time, VA will automatically presume that any COVID-19 infection they suffered was contracted in the line of duty. This makes establishing service connection easier, as the veteran does not have to prove a link between their service and the infection.

To qualify for VA presumptive service connection for COVID-19 infection, veterans must have:

• Served on active duty between March 1, 2020, and January 5, 2024, for more than 48 consecutive hours
• Served on active duty for training or full-time National Guard duty performed under Title 10 orders between March 13, 2020, and January 5, 2024, for more than 48 consecutive hours
• Been diagnosed with COVID-19 during that service or within 14 days after it ended

“But, and this is important, this presumption only gets you to the door,” says Bradley Hennings. “While it establishes that your COVID-19 was connected to service, VA still requires you to show that your current chronic symptoms are actually caused by that COVID-19 infection.”

To prove that their current chronic symptoms are the result of their COVID-19 infection, veterans will likely need to provide VA with the following evidence:

• Medical records from their treating provider documenting their ongoing symptoms.
• A nexus opinion, which is a medical opinion written by a doctor or other health care professional that draws an explicit connection between the veteran’s current conditions and their COVID-19 diagnosis.

Veterans should note that if they do not qualify for the above presumptions, they may still be eligible for VA benefits for COVID-19 through other forms of service connection like direct service connection or secondary service connection. However, these pathways typically require more proof from the veteran to establish.

How Does VA Rate COVID-19 Residuals?

“If your COVID-19 was diagnosed and resolved during service, but you are now experiencing long-term complications, VA is required to rate those residuals under the appropriate body system in its schedule for rating disabilities found at 38 CFR Part 4,” says Bradley Hennings.

In other words, instead of having a single diagnostic code for COVID-19, VA rates COVID residuals using the diagnostic codes for the particular body system that the virus damaged.

For example:

• A veteran whose COVID infection left them with persistent lung damage might be rated under the respiratory system criteria, using diagnostic codes like DC 6600 (chronic bronchitis), DC 6825 (diffuse interstitial fibrosis), DC 6844 (chronic pleural effusion or fibrosis), or others.
• A veteran whose COVID infection left them with cardiac complications might be rated using VA’s general rating formula for diseases of the heart, or under specific diagnostic codes like DC 7005 (coronary artery disease), DC 7020 (cardiomyopathy), and more.
• A veteran whose COVID infection left them with mental health issues (e.g., depression or anxiety) would likely have them rated under VA’s mental health rating formula.

The rating VA assigns will depend on the severity of the veteran’s symptoms, as well as how much they affect the veteran’s ability to function at work and in daily life. These ratings could likely range anywhere from 0 to 100 percent disabling.

In some cases, veterans with significant COVID-19 residuals that prevent them from working may also be eligible for Total Disability based on Individual Unemployability (TDIU), which compensates at the 100 percent rate even if the combined rating is lower.

Watch CCK Law Partner Emma Peterson and colleagues break down presumptive VA disability claims and how they work:

How Can I Prepare a COVID-19 Disability Claim?

For veterans who believe they are suffering from residuals related to a service-connected COVID-19 infection, there are several steps they should consider taking if they wish to file a disability claim with VA:

• Gather service records — Veterans should gather their service records to confirm the dates and nature of their service during the qualifying period (March 1, 2020—January 5, 2024, for active duty; March 13, 2020—January 5, 2024, for training duty).
• Collect medical records — Veterans should also gather any medical evidence confirming a COVID-19 diagnosis or any residual symptoms connected to a COVID infection (e.g., an HRCT scan showing post-COVID lung scarring).
• Request buddy statements/lay evidence — Getting a statement from someone who observed your illness can help corroborate a COVID diagnosis, particularly for veterans who may not have had formal COVID tests during the early pandemic.
• Get a nexus opinion if needed — If a veteran’s treating physician believes there is a connection between the veteran’s current symptoms and their COVID-19 infection, the veteran should ask them to write a medical nexus opinion to further support the claim.
• File an Intent to File as soon as possible — Filing an Intent to File preserves a veteran’s effective date (i.e., the date from which VA will calculate any back pay) while the veteran gathers the evidence they need to complete the claim.

Need Additional Assistance?

Frequently Asked Questions

Does VA have a disability rating for COVID-19 itself?

No, VA does not assign a disability rating to COVID-19 as a standalone condition because it is an acute illness that typically resolves within a few days or weeks.

VA will only compensate veterans for chronic residuals, which are the lasting health problems COVID-19 leaves behind. These are often referred to as “long COVID” or “long-haul COVID.”

What is the qualifying service period for presumptive COVID-19 service connection?

Under 38 USC § 1164, the qualifying periods for COVID-19 presumptive service connection are:

• March 1, 2020, through January 5, 2024 for active duty
• March 13, 2020, through January 5, 2024, for active duty for training and Title 10 National Guard duty
• In both cases, a COVID-19 diagnosis must have occurred during qualifying service or within 14 days of separation.

What if I did not serve during the qualifying period? Can I still file a COVID-19 claim?

Possibly. Veterans who do not meet the presumptive criteria may still pursue a claim if they can demonstrate a direct connection between their COVID-19 infection and their service, or if their COVID-19 worsened a pre-existing service-connected disability (i.e., secondary service connection).

These cases are evaluated individually and generally require more medical evidence.

What is a nexus opinion and do I need one?

A nexus opinion is a medical statement written by a medical professional that links a veteran’s current condition to their military service (or in this case, to their service-connected COVID-19 infection).

Because the presumption under 38 USC § 1164 only establishes that COVID infection is service-connected, veterans will likely need a nexus to show that the infection actually caused their ongoing residuals.

Can COVID-19 residuals affect my existing VA disability rating?

Yes, if COVID-19 worsened a condition that is already service-connected, a veteran may be eligible for an increase in their disability rating for that condition. They may also file new claims for any residuals that were not previously rated.

In cases where the total impact of COVID-19 residuals prevents the veteran from maintaining substantially gainful employment, TDIU may be worth exploring.

Are mental health conditions caused by COVID-19 eligible for VA benefits?

Yes, mental health conditions such as depression and anxiety that are linked to a COVID-19 infection can qualify as service-connected residuals. Typically, VA rates these conditions under its mental health rating formula.