What You Need to Know About Eligibility for VA Disability Benefits
If you have served in the United States military, you may be eligible for VA compensation for service-connected medical issues, injuries, illness, or related conditions. The Department of Veterans Affairs has a screening and application process for VA benefits you can use to start the claim process. This process is open to those retiring and/or separating, as well as qualifying dependents.
How Do I Know If I Qualify For VA Disability Benefits?
In general, the following must be true; you must have a medical condition that affects your body or mind and you must have served on active duty, active duty for training, or inactive duty training. Furthermore, one of the following must apply:
- Your condition began while serving and can be associated with military service OR;
- Your condition existed before you served and military service made the condition worse OR;
- You have a condition related to military service that didn’t appear after you retired or separated.
The VA has a list of “presumed disabilities” that may affect your claims, such as a long illness that appears within a year of leaving the military, medical issues associated with toxic chemicals or hazardous materials, and conditions associated with being a prisoner of war.
The Nature Of Your Military Discharge Counts
VA disability benefits may not be offered to those with military discharges characterized as Dishonorable, Bad Conduct, or Other Than Honorable. The VA recommends approaching a discharge review board to upgrade such discharges.
How To Apply For VA Compensation
Applying for VA disability compensation should be a standard part of your final out-processing, but not all troops are able to get an appointment to do so.
If you are retiring or separating, contact the Department of Veterans Affairs as soon as you know you are doing so, and also be sure to ask your command support staff about scheduling an appointment for this process. Many bases offer group sessions to introduce soon-to-be-veterans to the VA claims process.
You will need to have access to as much of your military medical history as you can remember or review as the VA claims questionnaire can be lengthy and require specific information. Do not be in a hurry when you fill these documents out as this application process is a crucial first step toward getting compensation.
If you are in a forward-deployed, remote, or hardship assignment location these options may be limited so be sure to check with your unit to learn how and where to get started.
When completing the paperwork for VA compensation, the process can seem lengthy and overwhelming. It can be hard to resist the temptation simply to enter information in the fields provided and get the application over with, but it’s a very smart idea to provide as much supporting evidence as you can with your application or supplemental to that application.
This should include statements and medical records from any private, out-of-network, or otherwise non-military care that may be relevant to your claim.
Talk to your care providers and explain what you need and why you need it–you may find the best results with this kind of transparency. You’ll also want to complete VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA) and VA Form 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA).
The VA official site advises you to send these completed forms with your claim so that the Department of Veterans Affairs may “…attempt to obtain your records through our Private Medical Records contract. VA Forms 21-4142 and 21-4142a are used in conjunction with each other and both forms must be completed in order to obtain treatment records” according to the VA.
It’s entirely likely that the VA will require medical exams and other in-person medical reviews in addition to the paperwork, medical records, and supporting documentation you submit. Expect to be examined for any condition you list including PTSD and other mental health issues that may be relevant. A VA medical examination may be required as a condition of getting your VA disability rating; it’s important to make these appointments in order to move your claims forward.
What Conditions May Be Covered
There isn’t enough space here to list all possible medical conditions that could qualify for VA compensation but in general, you may find the following list helpful. VA claims are typically approved for conditions that include one or more of the following:
- Chronic back pain
- Breathing problems
- Severe hearing loss
- Scar tissue
- Range of motion issues
- Certain cancers
- Traumatic brain injury
- Posttraumatic stress disorder (PTSD)
This is not an exhaustive list.
VA Disability Ratings
The VA assigns disability ratings based on a review of your medical records, any supporting evidence you submit, and other data. The rating is given based on the severity of your condition using specific criteria to make those determinations. The rating informs how much you are compensated for the medical issues in question if the VA decides the medical issues are indeed service-connected.
The VA bases your rating on a whole person concept, so if you have multiple conditions you will be compensated up to a 100% disability rating. Some medical issues are capped at a certain percentage, while others may be rated all the way to 100%.
For example, a veteran who is paralyzed may receive a rating up to 80% due to the nature of the paralysis. If there are other conditions that contribute to the disability they may make up the remaining 20% of the 100% disability rating, but the total overall rating cannot exceed 100%.
VA Disability Pay
The VA pays disability compensation based on the percentage of disability. Depending on the percentage of your disability you may be eligible for a with-dependents rate. This begins at 30% disability or higher at press time, with VA compensation for 10% and 20% offering no with-dependents rate.
The percentages are paid at a rate fixed at the start of each year. For example, VA compensation for a person with an overall 20% disability rating would receive just above $300 in 2022. The amount paid may be subject to a Cost Of Living Adjustment (COLA) depending on the year. To receive VA compensation, it may be necessary to set up a direct deposit account or make arrangements to do so for the best results.
Not all medical claims are approved during the VA claims process. If you disagree with a decision made by the Department of Veterans Affairs, you do have an appeal process to use to have your case heard.
Re-examination of your case is not guaranteed and you should start the appeals process as early as you can for best results. VA appeals include the ability to check the status of your appeal online at the VA official site; to do so you will need to create an account using your credentials from Login.gov, ID.me, DS Logon, or a My HealtheVet account.
VA appeals should contain any supporting evidence that was not included in the original claim, this can be helpful to demonstrate a condition that is getting worse or one that isn’t deteriorating but isn’t improving, either. You don’t have an unlimited window of opportunity to appeal a VA decision; it’s best to act as quickly as possible to get your claim reviewed.
At any stage of this process, you can get third-party help from a veterans service organization such as the USO, DAV, AMVETS or others who work with veterans to help them obtain their VA benefits. A Veteran Service Officer can work with the VA on your behalf once you give them written permission to do so. You can also get direct assistance from your nearest VA field office or VA medical facility.