There has recently been a lot of buzz about the upcoming changes to the VA compensation rating schedules. You’ve probably seen the news or read about it online. So, I started thinking about what I wanted to cover in this blog regarding these changes. The reality is, whatever changes the VA decides to implement, they will be what they are. You either meet the criteria for the new rating, or you don’t.
So, how can I, as the VA guy, help you file a successful VA compensation claim, even with these changes? Where do you start? Think about this process as building a house. You always want to start with a solid foundation. If your foundation is strong, you can build a robust structure. We’re going to get back to basics because having a firm foundation is crucial for a successful claim.
Basic Requirements for VA Compensation and Other Benefits
Each VA benefit has its own unique eligibility requirements — compensation, pension, education, and other programs. Today, we’re focusing on VA compensation. However, there are basic principles of eligibility that apply to all VA benefit programs. These fundamental principles help the VA determine your eligibility.
First, are you even a veteran according to the VA’s definition? The VA bases this on whether you had military service, if it was active, and the circumstances of your discharge. Did you serve in the Army, Navy, Air Force, Marines, Coast Guard, or Space Force? Was your service active? Generally, active service does not include time in the Reserves or National Guard, but there are exceptions.
Next, was your discharge honorable? If it was less than honorable, you’re probably not eligible. But there are processes to change your discharge status. Other principles affecting your eligibility include whether your military service was during a time of war, like Korea or Vietnam, and the length of your service. For instance, to qualify for a VA pension, you need at least one day of active service during a wartime period and 90 days of consecutive service thereafter.
The VA claims process can be broken down into two steps. First, establish your basic eligibility. This means meeting the definition of a veteran, having active service, and a qualifying discharge. Second, establish your entitlement to a particular benefit. Entitlement relates to your qualifications for that benefit, whether you’re a veteran, a dependent, or a survivor.
VA Compensation Claim Guidelines
Now, let’s dive into VA compensation claims. For service-connected disability compensation, you must submit evidence of a current disability. This usually includes medical records from the VA or private doctors and might involve a C&P exam. Without competent medical evidence, proving a current disability is tough, and your claim will likely be denied. Remember, VA compensation is only available for current disabilities. Simply contracting a disease or suffering an injury during service isn’t enough. If you sprained your ankle in service but it’s fine now, you won’t qualify for VA compensation.
Another crucial aspect is proving a Nexus, or a connection, between your current disability and your service. For instance, you were in Vietnam, exposed to Agent Orange, and now have prostate cancer. There’s a Nexus linking your current disability to your service. Without this connection, your claim is at risk of denial. The Nexus is often the most overlooked requirement in successful claims.
There are various ways to prove a Nexus besides medical records. Buddy statements from those who served with you can help, but these can be hard to get if you’ve lost touch. Medical evidence is typically the best way. If your doctor can say it’s more likely than not that your condition is related to your service, it strengthens your claim.
Let’s review the five basic ways to prove a Nexus:
- Direct service connection: A direct link between your disability and something that occurred during service.
- Aggravation: Your condition pre-existed service but worsened during service.
- Presumptive service connection: Certain conditions are presumed to be service-connected due to specific exposures, like Agent Orange or burn pits.
- Secondary service connection: Your current disability is caused or aggravated by another service-connected condition.
- VA medical malpractice: Your condition resulted from negligent VA medical care.
If you’re struggling to get the maximum benefit, it’s probably not the rating schedule. You likely have a Nexus problem or insufficient medical evidence. Presenting additional medical evidence or getting a second opinion from a private physician can make a big difference. Never rely solely on the VA for medical opinions unless you agree with them and are satisfied with your rating.
Contact Us So We Can Help!
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