VA Disability Appeals

A claimant (usually the veteran, although not always) must be determined eligible to receive disability compensation. To be eligible, the veteran must have served on “active duty,” “active duty for training,” or “inactive duty for training.” The veteran must also have a service-connected condition. Each service-connected condition must fall into one of three categories: (1) a condition directly caused by military service (direct service connection); (2) a condition that arose before service, but worsened due to service (aggravated service connection); or (3) a condition caused by another condition that is already service-connected (secondary service connection).

A claimant must gather all evidence that is pertinent to the claims process. A claim will first need all the evidence documenting the veteran’s service. This will usually include the veteran’s DD214 form that they acquired at discharge or some other equivalent. Next, the claim will need all medical documentation regarding the conditions being proposed for compensation. The veteran’s in-service medical record will be key here. Also important is any medical professional’s statements/treatments since leaving service and any hospitalization or surgery paperwork. If applicable, the veteran’s dependent records should be submitted, showing the relationship to spouse and children.

The submission of the claim. The claimant will primarily use VA form 21-526EZ when submitting his or her claim, but a different form may be used based on the type of compensation the claimant is requesting. The 21-526EZ is for regular disability compensation. After the claimant has gathered all the evidence and completed his or her claim form, the claim can be submitted. The claimant can either do so electronically or through the mail. To do so electronically, the claimant needs to go to www.ebenefits.va.gov and create a new account or login to an existing account. Upload all their evidence documentation and submit the completed electronic form with their evidence. To submit by mail, the claimant needs to fill out their VA form 21-526EZ and mail it to their closest VA claims office. These locations and other helpful information can be accessed through www.va.gov . A claim can also be submitted through an accredited Veterans Service Officer (VSO).

Usually, the claimant will not be required to do anything else while their claim is being decided. However, the claimant may be required to submit extra evidence to support their claim. The average processing time for a decision on a disability claim is 79 days (as of March 2020). A claimant can receive updates on his or her individual claim by calling the VA toll free number (1-800-827-1000) or going to https://www.va.gov/claim-or-appeal-status/.

When the VA makes a decision, a decision packet will be assembled and mailed to the claimant’s address. This decision will include reasons for the decision and information about how the benefits, if any, will be paid. If the claimant disagrees with the decision or any part of it, it can be appealed. For information regarding the appeals process, click here.