Eligibility for VA Disability Benefits

Have you served in the U.S. military? Are you suffering from an illness or injury related to your service? Then you may qualify for disability benefits from the U.S. Department of Veterans Affairs (VA).

Vets National Advocates want to help you determine if you’re eligible for these tax-free monthly payments. That’s why we’ve created this guide.

Simply follow the instructions here to learn how to gather the evidence that you need for your benefits claim.

Evidence of Eligibility

In order to be eligible for VA disability benefits, you have to establish three main criteria. Specifically, you have to show that (1) you have a current disability, (2) you experienced an injury or illness during your military service, and (3) the current disability is related to the in-service injury or illness. Let’s break this down further.

1. A Current Disability

In order to receive VA disability benefits you must have some medical condition during the period on appeal. This does not always mean you have to have a diagnosis, but a diagnosis can be helpful in establishing a current condition. This also does not mean that you have to have a consistent condition throughout the entire period on appeal, as the VA can award staged ratings.

If your current disability started before or after service, you may still be eligible for VA disability benefits if your military service aggravated your current condition, or caused your condition to arise after service.

In order to establish this prong, you will either need to submit your medical evidence to the VA to establish a condition or attend a Compensation and Pension examination, during which a VA doctor will examine you and provide an opinion on the existence, origin, and severity of your condition.

If you choose to submit a medical opinion from a private doctor, you may want the doctor to complete a Disability Benefits Questionnaire for your condition. The doctor should also review, and note the review of, your records, and provide an opinion on the severity of your condition and its connection to your military service.

2. An In-Service Injury or Illness

This prong requires that you meet certain military service standards and that an in-service injury, illness, or exposure occurred during the eligible service period.

First, you must have served on active duty, active duty for training, or inactive duty training. Additionally, if you received an other than honorable, bad conduct, or dishonorable discharge, you may not be eligible for VA disability benefits. Information on how to apply for a discharge upgrade.

For the in-service injury, one of these three must be true:

• You got sick or injured while serving in the military—and can link this condition to your illness or injury (called an in-service disability claim), or
• You had an illness or injury before you joined the military—and serving made it worse (called an aggravation or pre-service disability claim), or
• You have a disability related to your active-duty service that didn’t appear until after you ended your service (called a post-service disability claim)

To establish this prong, the VA will review your military records. Although the VA will collect these records, it is sometimes helpful for claimants to review their own records and submit the most important records to the VA, as this expedites and focuses the review process. You can obtain a copy of your military records from the National Archives website, or by using Standard Form 180.

Claimants can also submit statements from friends, family, and fellow-service members to establish in-service symptoms and certain military service conditions.

The important thing to focus on with this evidence is showing that your service and discharge type fit the eligibility criteria and that an in-service event or injury occurred.

3. A Connection Between the Current Condition and the In-Service Injury or Illness

The final prong needed to establish eligibility for VA disability benefits is a connection between the current condition and in-service injury. In most cases, this connection will come from a medical professional, either private or through the VA. It may help to obtain a medical opinion and/or provide the VA with articles or other evidence establishing a connection.

However, in some cases this connection will be automatic, based on the type of condition and the nature of service. Those cases are called “presumptive conditions.” If you have a presumptive condition, you don’t need to prove that your service caused the condition. You only need to meet the service requirements for the presumption.

Submitting Your VA Disability Benefits Claim

You do not need to wait to compile all of your evidence before filing a claim. In fact, you shouldn’t. The date you file your claim becomes the “effective date” of any future awards, so you’ll want this date to be as early as possible.

For example, if you file a claim on May 10th, then submit your evidence on July 10th, then the claim is granted on September 10th, the effective date is May 10th and your benefits will begin on June 1st (the first day of the month following the month in which you applied). Therefore, you should not wait to file your claim, but rather file it, then submit the evidence as soon as possible afterward.

That said, if you already have the evidence needed to file a claim, you can use the Fully Developed Claims program, which may yield a faster result. To file a Fully Developed Claim, you will submit VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits (and check the “FDC” box), submit all the necessary evidence, and certify that there’s no more evidence that the VA needs to decide your claim.

Either way, when you are ready to file your claim, you can do so in five ways:

• You can file a claim online.
• You can file by mail.
  • a. Download and complete VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits.
  • b. Submit the form to this address:
• Department of Veterans Affairs
• Claims Intake Center
• PO Box 4444
• Janesville, WI 53547-4444 3. You can file in person at your local VA Regional Office.
• You can file by fax.
  • a. If you’re in the U.S., the claim can be faxed to 844-531-7818.
  • b. If you’re outside the U.S., the claim can be faxed to 248-524-4260.
• You can file with the help of a professional, such as an accredited attorney, claims agent, or Veterans Service Organization (VSO) representative.

Appeals for Denied VA Benefits

Contact Vets National Advocates if the VA denies your disability benefits claim. We can help you file an appeal and navigate the challenging appeals process.

Call 877-777-4021 to talk to one of our disability advocates. Or, fill out our Denied Claims Rapid Response Form.