Nuts and Bolts of a VA Disability Claim
Recent, protracted, and violent wars in Afghanistan and Iraq have pushed the official number of
veterans with a VA disability claim of at least 70% disability to over two million. That unofficial count, including veterans with less than a 70% disability, may be much higher.
This unofficial number also includes veterans who abandon their claims after initial denials and veterans who try to “tough out” their disabilities, often for decades, before they relent and file claims.
A VA disability attorney often unlocks advanced options, like TDIU (Total Disability due to
Individual Unemployability) and DIC (Dependency Indemnity Compensation) to help disabled
veterans, and their families, obtain the benefits they need and deserve. However, before an
attorney can do any such thing, an attorney must build a basic disability claim, usually from the
ground up. Also, VA disability claims have two basic parts: a current disability and a service-related
connection.
Current Disability
This component can be further broken down into two parts: a current diagnosis and a disabling
condition. A veteran needs both for the current disability requirement to be met. For example,
if a veteran has an old knee injury but it doesn’t impact his or her daily life at all, the current disability requirement might not be met.
Getting a “current” diagnosis is not always as straightforward as it sounds. While most
disabilities are progressive, a few get better. For example, if the veteran with the knee injury
gains weight, his or her bad knee may worsen. If he or she loses weight, it may improve.
Typically, when a veteran files a disability claim, the Veterans Administration automatically
schedules a “compensation and pension” (C&P) examination to determine whether the veteran has a current disability. The examiner is expected to review the veteran’s file with the VA, including
any records from the veteran’s service period. Depending on the nature of the claimed condition,
the examiner may need to conduct specific tests, such as hearing or range of motion tests.
C&P Doctors And VA Disability Claims
Problems with understaffing have often resulted in rushed appointments with examiners who are
unfamiliar with the veteran’s claimed condition. Since most C&P doctors are VA contractors, the
agency has little or no control over what doctor sees what veteran.
In other words, a C&P examination is like a visit to a hospital emergency room. Veterans see the available doctor who may or may not be fully qualified to assess their medical condition.
Claims examiners may rely on the results of a C&P examination to grant or deny a claim. The
good news is the VA considers independent medical evidence as well. To supplement the C&P
diagnosis, VA disability attorneys often request such evidence through private treatment
providers. The examining physician usually focuses on certain kinds of disability cases.
Additionally, it has become easier for the veteran to grant the private physician access to the
claims file to review, which lends more credibility to their eventual findings.
Disabling Condition
A condition must impact the veteran’s ability to live a normal life for it to be considered
disabling. This may depend on the veteran’s professional requirements. For example, a veteran
who is exposed to burn pit smoke may develop exercise-induced asthma. If that veteran’s
profession only requires them to sit at a desk all day, the condition does not really impact their
ability to work.
If the condition does impact the veteran’s ability to work, the VA will assign a “rating” to the
condition, between 0% and 100%. Ratings are usually in increments of 10.
Also, it is worth noting that having more than one disabling condition can increase a veteran’s rating, but not by simple addition. Say a veteran has a 50% back disability and a 50% PTSD disability.
She or he is only 80% disabled. 50% of 100% is 50%. Then, the VA adds 50% of 50% or 25%. And then the VA rounds 75% up to 80%.
Service-Related Connection
This element is a bit more straightforward. There must have been some event or injury while the
veteran was on active duty (or active duty for training purposes) that led to the current disability.
The event itself doesn’t have to be service-related — it could be a car crash, for example — or it
could be simply that a long-term illness first appeared during that time period.
Generally, service records such as exit examinations or treatment notes are helpful here.
Sometimes, a VA disability attorney uses buddy statements from people who were stationed with
the applicant to better establish this element.
Providing Your Own Evidence
The VA is required to assist veterans in developing their claims. However, the veteran has to
help to the extent they can. Also, the VA is required to inform the veteran of what type of evidence
they need to submit depending on what type of claim they’ve filed. Additionally, the VA is required to help you obtain private treatment records as long as you give them the authorization to do so.
Work With Dedicated Attorneys
An attorney is a valuable partner in all phases of a VA disability claim. For a free consultation with
an experienced veterans disability lawyer, contact Cameron Firm, P.C. at 800-861-7262. Or
fill out the contact box to your right. We are here to represent veterans nationwide. And, there is no fee until you win.
This article is for educational and marketing purposes only. Therefore it does not create an attorney-client relationship.