VA Disability Claims and Appeals Process

Disability Claims & Appeals Process 

This Disability Compensation claim process map outlines the steps involved in the disability compensation claim process including how much time is required for each step. Applications for disability compensation are processed using the Claims Processing Improvement (CPI) model. The CPI model was developed in 2001 by the Claims Processing Task Force to increase efficiency in processing disability compensation benefit claims and to reduce the number of errors. The model requires triage of incoming mail and analysis of incoming claims. It promotes specialization that improves quality and expeditious handling of claims. VA employees who process claims for disability compensation are organized into specialized teams that perform the triage, pre-determination, rating and post-determination functions. The following describes the sequence of the disability compensation claims and appeals processes.

Claims Chart

VA Disability Claims and Appeals Process

1. Application: The veteran begins the process by completing and submitting an application for disability compensation benefits with the VBA.

2. Triage: The triage team has the responsibility for reviewing, controlling, and processing all incoming mail. Team members are responsible for deciding whether a claim can be processed immediately or it will need additional development.

3. Pre-Determination: (Development Initiation): The pre‑determination team’s primary function is to develop evidence for disability compensation claims. At this time, a VA examination may be scheduled if medical evidence obtained by such an examination is necessary for a fair determination of the claim

4. Pre-Determination: (Evidence Gathering): During this phase, team members obtain all pertinent military medical records.

5. Rating: VA rating specialists make decisions on claims that require consideration of medical evidence.

6. Post-Determination: After a rating specialist has decided a claim for disability compensation, members of the post-determination team process awards for disability compensation benefits and they notify claimants of decisions.

7. Appeals: The primary function of the appeals team is the expeditious processing of appeals and remands. The team is responsible for establishing and monitoring appealed claims, developing issues on appeal and preparing revised ratings when a review indicates that the appeal can be favorably decided based upon the evidence of record.

8-9. Appeals: If the veteran is not satisfied with adjudication of their claim by the VBA, the veteran can file an appeal with the Board of Veterans’ Appeals

10- 11. Appeals: If the veteran is not satisfied with a decision rendered by the Board of Veterans’ Appeals, the veteran can file an appeal with the US Court of Appeals for Veterans Claims.

Not shown on the chart is the public contact team. VA conducts personal interviews with, and answers telephone calls from, veterans and beneficiaries seeking information regarding benefits and claims. VA directs claims and evidence to triage via personal interviews, telephone calls, e‑mails, and other outreach activities.

NOTE: The above information came from The US Department of Veteran’s Affairs, Task Force on Returning Global War on Terror Heroes, Report to the President, Appendix C

This article is only one of more than 60 homeless veteran posts.  In addition there are more than  30 posts on homeless youth .   If you are interested in more, click one of these links.  Thank you for coming by.  Please consider adding me to your feed (see link below my picture.)  Thanks,Oldtimer

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27 responses to “VA Disability Claims and Appeals Process

  1. i am a fellow dissabled vet. i have been waiting for over 3 years for my claims to be completed. thank ya so much for the info. i love ya.

  2. Hello:
    I am a Viet Nam vet. I served on 1968-69 and after my return my life is missirable. My impressions of the war, the close that I was with the death, the granade that hit me and so many situations still living inside me. It is impossible to forget or erase the jungle, the ambush in the rice party, to be scare of bubby traps and motors attacks. When I came back I remember that only my brother and mom received me but in hometown and in anyplace nobody called me a hero or a good soldier who served proudly.
    No matter the Bronze Star, Purple Heart, Ar Com. Air Medal CIB, and about 12 more awards,
    nobody cares. Only they though that we were criminals, drugs user or crazy people. Please send me your comments about mine. I don’t have all the space that I need to explain all my horribles experiences that still moving around my mind.
    Thank you, very much for reading my comments.

    Luis A. Camacho
    PS My wife says that Viet Nam is here at our home because I still fighting this war in my mind.

  3. Luis, it is my pleasure to read your comment and say and confirm that you are a hero to this country, not just to me or our readers. To the very country that birthed us and we all love – A hero.

    I am so sorry that you have had so many bad experiences as a returning veteran, apparently continuing for too many years, and it sounds like you feel it even today. I know it is an all too common one for far too many Viet Nam veterans.

    It is something that many of us have taken up the flag to try to make sure that never happens again to our returning heroes such as you are.

    You served your country well and unselfishly, was wounded in many ways that do not show. Then you were not honored as you should have been, not treated as you should have been, not rewarded or even compensated as you should have been. We all should feel ashamed for all that. I hope someday you will forgive us.

    We can never repay our debts to the men and women who defended our country, fought our battles, and saved our skins. We owe each of you so much.

    All I can do is say thank you for being the hero that you are and for what you did for us all.

    Oldtimer

  4. In the middle of a deep clinical depression many years ago, when I would go for nights on end without good sleep, I dreamed of a deep azure blue stream bending around a log cabin in green woods with tall snow capped peaks in the background. The water was so blue, and clear, the air so pure, and there was a delicious humming in my heart as I slept. I felt it. I felt the gold glowing in my body, like an intense opiate high. I knew I was asleep, and dreaming, but I was there, in that scene, and I was achingly happy. It occurred to me as I slept that I had died, and here was heaven. It was the warmest feeling that I have ever experienced, and the dream has stayed with me for decades. Many years later I dreamed of Vietnam again, after years of nothing. I remarked, that next morning, to my wife as we sipped coffee on the deck watching the sun rise, that my nightmare had been a field of charred bodies, burning in the jet fuel fire of a Chinook helicopter crash that I had witnessed so long ago. She was silent for a full minute before she asked if we should invite the neighbors over for dinner that night. I said that would be fine. I don’t remember what we did the rest of that day.

    I like to read fiction that is prose of the finest art. And I like to fly fish in clear green rivers. I like to share both of these things with my closest friends. Little else interests me these days, other than the safety of my family. I find this prose occassionally, but seldom have the opportunity, or inclination anymore to share it. It is my friend. I have not fished since leaving Colorado and moving to Tennessee ten years ago. The water is not the same here, and it is not about the fish.

    Oldtimer’s comment: Thanks Bob for coming by. Thank you for serving our country so well. At first I thought you might be related to a famous Judge in our fair city, Judge Robert E. Flournoy, but I see that you likely are not. You are, however, a good writer and I admire you for that.

  5. Thanks…here is something else I wrote a few years ago.

    The Wall

    The second time I went to the Vietnam Memorial was more meaningful than the first. That initial time in 1982 was a circus. Absolute carnival atmosphere that agitated, angered me. Balloons, snacks, crowded, an absolute lack of the sober subdued holy atmosphere that I expected, and that in my mind the shrine demanded. The place was still relatively new, and it was a summer Saturday with the sun shining which encouraged the throngs to turn out, which included, unfortunately, a couple hundred guys who thought that they needed to dress up like bikers in old fatigues which were plastered with ribbons and patches, boonie hats and the obligatory granny shades. And head bands. And drooping mustaches. All carrying on with one another, hugging, power hand shaking, crocodile tears, milling around on the path directly in front of the black depths of that wall, here I am check me out. Dude. Total bull shit. I have found that for every ten guys who tell you they were in ‘Nam, as many as half are lying, and when it comes to who did what, most of them were airborne ranger CIB gun slinging bad asses who stalked the jungle with cold steel resolve and by God I’ve earned my booze but don’t talk to me too much about it because once established that I am the real deal then we just don’t go there. Man. Total bull shit.
    Second trip was also a Saturday, many years later, in the fall, nippy with some bluster in the wind, fading color in the hardwoods. Only a couple of dozen older people paused reflectively in front of the mirrored finish of names, some hesitantly rubbing the inscriptions off onto various finishes and fabrics, almost apologetically, standing silently looking down at their work to see if some magic would appear, some who looked at the name they had sought out with a sense of bewilderment, trying to comprehend, after 30 years or more. A few guys my age, jeans, sweatshirts, light jackets, graying, thinning hair, standing off a little with arms crossed, unmoving, looking for something that they were not having any luck finding, quiet, pensive, detached.
    I stood awhile, also detached, eyes glazing off into the distant depths of the marble, wandered off, found a to go coffee and drifted back onto the grass to resume watch for awhile longer. I didn’t seek out the names this time. I knew where they were. And I left.

    Bob Flournoy
    September 2001

  6. hELLO , MY NAME IS JAMES FRINK SERVED IN VIETNAM 04-1970 TO 04- 1971 I AM BACK ALIVE
    THANK GOD . BUT SOME TIME
    I AM STILL IN VIET-NAM WITH THE FLASH BACK IT IS DARD TO

    LIVE A PEAFUL DAY I HAVE PTSD
    AND ALL MY DOCTORS STATEMENT, STRESSOR AND PTSD
    HOSPITAL RECORD OR ONE FILR.

    MY CLAIM HAVE BEEN SUBMITTING TO APPEALS TEAM
    I AM HOPEING MY ENTITLEMENT
    TO SERVICE CONNECTION FOR PTSD WILL BE GRANTED.

  7. Thanks for all you do Old Timer. All the best on this Memorial Day, and all days ahead. Here is something I wrote.

    Showing Up

    There were plenty of reasons not to go,
    The government,
    Fear,
    Selfishness,
    Social Conscience,
    God, or
    Religion (hardly connected).
    Plenty of reasons not to go,
    For some.

    But for those that did go,
    There was never a choice.
    No decision to be made.
    It never occurred to do anything,
    but,
    Show up.
    To have done anything else,
    Would not have felt right.
    It would not feel right forever.

    Bob Flournoy
    Memorial Day, 2008

  8. Hello and happy holidays.My appeal was at the Rating Board for 50 days,Today I call the 800# and they tell me that is back at the Appeals team.can this be good news.Is my appeal finally finish.
    thanks

    • I have an appeal remanded back from the washington dc. vba to my regional office. what does this mean.

      I have a claim for PTSD in the rating office at the regional office what does this mean. two separate items. thankyou

      • Patrick, a remand from washington means that the court looked at your appeal and found that the regional office missed something so they sent it back to them for further consideration. Baiscally it is a stall tactic hoping that you will drop the appeal or die. Either way they won’t have to pay. Also, PTSD claim in the rating office at the regional office indicates that the regional office decision review officer is looking at your appeal and will make a decision sometime soon. Good luck with your appeals.
        I am a freelance Veterans advocate who writes a Veterans column for examiner.com. I have written several articles about the Va claims and appeals. Log onto http://www.examiner.com select Florida as the state and Gainesville as the city. Then click on the politics tab. There would can view all my stories. If you have any other questions just send me an email. Happy holiday’s.

  9. I was Married five months & drafted in 1970. I was sent to Fort ORD. I was injected with a series of shots & Sugar Cubes to avert Meninjetis. I went into the Hospitol @ Fort Ord. Wy father died while I was in Basic training. While ZI was home for my fathers services I went to see my home town doctor. I was told that I had Pneumionia. I lost my vision and went to see my Fresno Doctor. I was sent to use the new medical equipment MRI. I was told that I have Multiple Sclorosis. I have sent my appeal in for the third time. I have ten stints in my heart & walk with acane of a walker. My appeal is in DC.

  10. The appeals process in Baltimore is broken and there is no evidence that it has been fixed. I have been at it for a couple of years and have become upset with the process. The American Legion person is also at a loss to explain the backlog except that it is huge. What does on do after contacting Congress, Senators, the press, the American Legion, and several vet websites?

    • Don, you are 100% correct although I am not sure we don’t have a regional office that isn’t broken. I am a freelance Veterans advocate since 2003 as well as a featured Veterans policy writer for examiner.com . I just published an article that hits on that very topic. If interested log onto http://www.examiner.com and select Florida as the state and then gainesville as the city. You then click on the politics tabs and you can see all my articles but especially the last one. If you have any questions or comments please feel free to shoot me an email. Good luck and Happy holidays

  11. Anybody who has an appeal that is only 3 years old consider yourself lucky. I am retired army and have an appeal in washington that is going on 9 years old. There is a conspiracy against military retirees by the VBA in Waco Texas. They do not want to get us up to 50% because they will have to pay us disability compensation due to the concurrent receipt law.

    • John, I must say you know what you are talking about. I am a freelance Veterans advocate and a Veterans policy writer for examiner.com. If you are interested log onto http://www.examiner.com select Florida then gainesville. Once there hit the politics tab and you will see all my articles especially today article. I am sure you will be interested in keeping track of my writing. If you have any questions and comments feel free to send me and email at letfreedomsing@yahoo.com, good luck and have a nice holiday.

  12. Colonel Zalme

    I am a recently retired Air Force dentist. I have serious double vision, neuralgia, and tremor of my dominant hand. All of these are a result of on the job injuries or infections. I have had these disabilites for more than 17 of my last years of active duty (1985 and 1992). It is all thoroughly documented in my medical record. The physician doing the medical examination never mentioned these in his report. I submited several verbal and written complaints on official veterans forms before the board met. I cannot in anyway practice dentistry again. I cannot even write my name. The board ignored my complaints and gave me zero disability for any of these. What do you think of that!

    • Col. Zalme, I am so sorry for your troubles, you donot deserve to be treated like this. I hope by now that your problems have been resolved. I am a freelance Veterans advocate and a Veterans policy writer for examiner.com. You should take time and log into www. examiner.com select Florida as the state and gainesville as the city. Once there click the politics tab which you will be able to see my writing especially todays article dated 12/17/. Hope you enjoy my work and you find the writing useful. If you have any questions feel free to shoot me an email. Good luck with your claims and happy holidays.

  13. Hi,

    Thanks to all for serving. My Dad served in Viet Nam and he died from melanoma last year. He had it once back in 1980, Stage 4, but beat it. It came back and killed him. It always comes back in your gastrointestinal system – ALWAYS. He just didn’t know it and neither did I until I did a ton of research on the internet. I firmly believe that the melanoma was caused by Agent Orange and will be fighting to get him his disability he should have gotten and maybe that will help my Mom.

    I served in Desert Storm in a 155mm unit as a Battery Commander supporting 2nd ACR. I also served in Afghanistan, as I was a reservist that got called up and spent 9 months there. Lots of problems from that deployment. I was a 40% disabled veteran when they sent me over and they wondered why I went? I was in the Reserves. Why wouldn’t I go? I didn’t know there wasn’t a choice, but it was my duty to go and I was not going to shirk it. They only told me after I got back that I probably shouldn’t have been deployed. Great.

    Anyway, I went before an MEB and those stupid, stupid, stupid people gave me 10% for what the VA had given me back in 1993. Not only that, but the when I submitted my medical records to the VA they lowered their rating to 10%. This was already a permanent condition and they just arbitrarily changed it. I just went recently to get an evaluation for my back which I had three surgeries on including a neurostimulator implant to deal with nerve pain in my left leg. The contract doctor I saw was an OB/GYN doctor and it really should have been an Orthopedic Surgeon, but I figure if she doesn’t give me my 40% back, I will go to an orthopedic surgeon and get another finding that will give me that back and add hopefully another 20%. I have 60% now, even after they lowered my 40% to 10%, but it is not right what they did and if they do it to me, they will do it to others and that really, really, really, pisses me off as there are Soldiers that are getting screwed and don’t even know it or know what to do.

    Needless to say, I am writing the VA Director and the President, as well as Congressmen and Senators for sure. There are a bunch of letters I will be sending out because this is just so messed up.

    There is a board now convening to look over the medical records from Soldiers that got less than 30% to see if they should have been rated higher. I am waiting on my records so I can send them to this board. The Army at a minimum, should have medically retired me off of active duty at 60%. If the VA is going to use the Army rating, the Army should use the VA rating and I am going to be fighting that issue as well.

    Just a word to the wise. Fight back. Go to the DAV or other org to represent you as you will get a higher claim if you do. I am a lifetime member of the DAV and I am going to push them to get my proper ratings. There are still problems like IBS, and other conditions that weren’t even rated. Go by either the Army or the VA and they are serious. Got to fight that battle as well.

    Hope that everyone gets the proper ratings and don’t get screwed like so many do. I hope to help change the system and it may be painful for them when I go on TV, but the system will change!

    Good luck to everyone and God Bless You and the United States of America!

    Very Respectfully,

    David

  14. David, I understand completely what you are talking about. I went through just about the same thing. I didn’t give up and finally was awarded IU perm and total. I am a vietnman Veteran and freelance Veterans advocate. I am also a Veterans policy writer for examiner.co. You can log onto http://www.examiner.com select Florida for the state and gainesville for the city. Once there click on politics tab where you can see my work. I just published an article today part 1 which I am certain you will find interesting. I too am a life member but I can not honestly recommed any service organization 100%. At times they play ball with the Va plus their NSOs have a rapid turn over rate. Remember their services are free, often times free is not always the best. I hope everything works out for you, if you have any questions feel free to shoot me and email. Good luck and happy holidays.

  15. for all my brother and sister that our having problems related to PTSD, as above, to help you understand your problem, you need to take the time and use your coumpter or get a book on ptsd, and study the symtoms., you can’t beat around the bush, when it come to claims., I fired my rep, about seven year ago when he said I have bend here for 26 years and you will never get to 100%, well VA has the rating book, I had my $200.00 coumpter, and the will to kick their ass, I started with a bk-40%, 10%-hearing, now over 300% or as va don’t add, 100%, and still going. they write thier own rule, and step on the CFR, but with God help and good family support I did it and the same with SS, not attorney need it all on the coumpter. I was In Veitnam 65-66, I gave my foot to a land mine, and a lie, just like Irag and Aft, a Lie and we die for it, thie our thing worse than death, I know I live with it ever day, you might put up the bible up, it the time of Revlation is here. God help us all, danny horn logan,ohio

  16. I spent 9 month’s overseas mine sweeping in the Tonkin Gulf , and participated in the obtaining of body bags, and listening to many Vietnam vets in sick bay screeming from shrapnell and many other injuries. At the age of 17 years old 1973-74 was a nerve racking time for me in Vietnam. There is a lot more I could say, but instead I will tell you that after 10 Appeals and 36 years later the BVA finally service connected me at 70%; but my attorney is going after the remaining 30 % that is due me. It was worth every bit of time when they backed payed me which is confidential. My case was closed twice and I managed to keep my claim alive through out this whole period. “Get an Attorney right away” And most of all get the Doctors to place you at the scene where it all started. The Board will find anything to deny you of any benefits. Don’t give up the ship. Most veterans will quit after 5-15 years; stick with it. It will payoff in the end. Leo

  17. donnie lee mdaniel

    we/ve been waiting six year to hear from some one to help us with our disabilty. if you know how we can get some help let know if you have anything please let us know.

  18. I AM A DISABLED mARINE WHO HAS TRYING TO GET TOTAL COMPENSATION FROM THE VA! I HAVE BEEN TRYING SINCE 2005, TRUSTING EVERYONE WHO SAID THEY COULD HELP ME BUT IT ALL HAS BEEN LIES! I WAS A BERIUT AND GILF WAR VETERAN AND THEY TELL ME I LOOK OK! THEY ALSO HAVE MISDIOGNOSED ME OFTEN WITH MEDICATION WHICH HAS MADE ME WORST! FINALLY I TRUSTED A SERVICE REPRESENATIVE WITH AMVETS AND DUE TO HIM NOT FILING A PAGE NINE LETTER IN A TIMELY MANNER MY CASE HAS BEEN CLOSED! I HAVE CALLED THIS GUY WHO I GAVE POWER OF ATTORNEY TO DO WHATS RIGHT ON MY CASE,CALL MANY TIMES NO CALL BACK! THEY SAY NOW ITS MY FAULT AND I HAVE TO START ALL OVER AGAIN BUT NO PAPERS SAYING MY CASE IS CLOSED! I FEEL THEY KNOW OF MISTAKES AND WON’T OWN UP TO IT NOW! I WOULD NOT WANT THIS TO STOP THAT IS THE EASY WAY OUT FOR THEM!PISSED OFF!!!

  19. Walter was sent your post and feel your pain, I am alwasy willing to help my fellow Veteran and work with them trying to get what they deserve. I am an experienced private advocate who is willing to work with Vets just like you. I can’t tell you how many Vets found that a service organization service officer has dropped the ball and lost their claim. The problem is they are held unaccountable for their incompetence and they don’t even have to explain their actions. The first thing you should do is send a letter to the Va telling them that you are taking over your own claim and no longer want that service organization to have POW. Of course notify the organization with a letter as well. After you do that if you want to contact me I am willing to look at what you have. It appears that you have the foundation for a claim of TDIU which would give you 100% compensation based on in ability to work due to service connected injuries. The key is service connection. At present time I am out of town, I should return next week. After I return I am planning to return to the radio and will be talking about disability claims and appeals. Feel free to contact me through my email at roadman1948@gmail.com or call me at 352-208-9566. Good luck don’t give up. Willing to give a hand up.

  20. I served in the USMC from 1966 to 1968. I served with the 3rd Marines in Nam from 11/67 to 8/68 I did not change clothes are take a bath from jan30 till may 5th from Phu Bai to Hue (ambushed) to Quang Tri. I first filed in 2003 was denied and given a year to appeal (it was to painful) since then I have been raising two children by myself and have appealed for their sakes in Jan 2010 and I am at the final phase which they say is 16 to 27 days…but for me my PTSD symptoms have been magnified since the process has begun again in Jan 2010…how many have we lost along this ardous task of filing and appeals? I am hanging on but the sound of nails on a blackboard is 24/7 pounding in my head…giving up a piece of my prostrate day after tomorrow…

  21. Is there any way to check the status of a VA Disability claim online?
    I am wondering because it’s been 2 years

  22. Veterans in Utah get discounted representation in the salt lake county area. A law firm called “lawyers for veterans, first responders and educators” provides the representation. http://www.representveterans.com They were started by a young Army combat veteran

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