Claims and VSOs

How do I apply for disability compensation for the veteran for whom I care?
A veteran must apply for disability compensation, it is not automatic. If a veteran is still on active duty, he or she can go through the Integrated Disability Evaluation System process, which puts together the military medical retirement board process and the VA disability application and rating process. If the veteran for whom you care is no longer in the military, you will have to file an application at the VA regional office nearest the veteran (there is at least one office in each state).

When filing a VA claim, consider getting the help of a veteran service officer (VSO), who, at no cost to you, will fill out the paperwork and often have the ability to follow up and check on the status of your claim. Also consider filing a fully developed claim (FDC) using VA Form 526-EZ. Filing a FDC means you provide VA with all the information they need to research and decide on the claim.

How can I help the claim move through the process quickly?
To move a claim through the VA process quickly by providing all the evidence up front in a well-organized manner. Read up on the benefits for which the veteran for whom you care might qualify, and make an appointment to take him or her meet with a VSO. You can see a listing of all accredited service officers published by VA’s Office of General Counsel (central law office for the VA). VSOs will never charge a fee for services; agents and attorneys may charge a fee and usually handle appeals rather than initial claims. If there is not a VSO near you, the VA employs public contact representatives or veteran service representatives who can help you file the paperwork.

The VA encourages veterans and representatives to present FDCs by expediting the claims process. If the VA does not need to obtain private medical records to decide your claim and you do not send in any evidence after your FDC package, the period the VA takes to request records and wait for you to provide more evidence is not needed. The claim can go to the next phase of the development process. FDCs are filed on EZ forms, which provide a notice on the form of the types of evidence that should be submitted to decide the claim. VA Form 526-EZ is the form to file an FDC for service-connected disability compensation. However, exactly what evidence the VA is looking for is not necessarily noted on the notice form. For example, the VA Schedule for Rating Disabilities (VASRD) is not listed on the notice form, so you might not know which test results or symptoms are relevant unless you read the VASRD. The VASRD is Part 4 of Title 38 of the Code of Federal Regulations, found at www.ecfr.gov.

One issue with filing an FDC is that benefits cannot be paid before a claim is filed, and it can take some time to gather the paperwork to file an FDC. The date benefits start is called the effective date and is usually the first day of the month after a claim is filed (or if a claim is filed during military service, the day after military separation or retirement). So taking more time to find documentation can result in a lower overall amount of benefits paid. The advantage to the FDC program is a law that provides for up to one year of retroactive benefits for claims filed between August 2013 and August 2015 in the FDC. For initial claims (the first claim a veteran files), the effective date of the claim can go back to up to a year prior to the date of filing. See 38 U.S.C. § 5110(b)(2). This eliminates the incentive to file a piece of paper to lock in a claim date without having all the evidence ready and preserves the veteran’s entitlement to benefits.

What should I prepare before meeting with a claims representative?
Doing some legwork upfront to find and organize the veteran’s records will go a long way toward filing an FDC and receiving all his or her earned benefits. MOAA’s Claims Checklist has some suggestions for preparing and tracking a compensation and pension claim. It is much easier to track a claim when you know what has been filed, where it was filed, and when it was filed.

Bring copies of the veteran’s military records (especially the discharge papers or DD Form 214 that show he or she left the service on good terms). (See the National Personnel Records Center website for information on how to send for military records.) Bring copies of all relevant medical records. Organize these records by facility and by ailment; it makes it faster for the representative and VA to find important words. Give the VA copies of the veteran’s medical records from private doctors; it takes the VA a long time to get those records. If you absolutely cannot get them, write down the doctors seen, the doctors’ addresses, and the dates of treatment. Also, write down the dates of treatment and address for each military hospital and VA clinic or hospital so the VA can get those records. Although VA medical records now are electronic, not all of them are in the centralized database. A VSO can help you to file an FDC.

Bring legal documents such as power of attorney or guardianship, marriage and divorce decrees, and birth certificates for any dependents. A veteran with a 30-percent or higher disability rating or a disability pension receives an additional amount of compensation if he or she has a spouse and/or children to support.

What is a veteran service organization and how do I find one?
Veteran service organizations help servicemembers on terminal leave and veterans and their families apply for VA benefits. They are not part of the federal government. In fact, federal government employees and active duty servicemembers may not be VSOs. Veteran service organizations might be nonprofit veterans’ associations or even state governments. Currently 47 states are recognized as veteran service organizations to provide claims help. Also, county governments might appoint and employ VSOs.

These associations and states are listed on the VA Form 21-22 — the form a veteran signs to allow a VSO to help him or her prepare a VA claim and receive information about the claim from the VA. There is a slightly different form called the VA Form 21-22a for attorneys and agents, who may charge a fee for their services. No one can obtain information on your claim without one of these completed forms (or another form called a “third party authorization form”) and your consent.

Veteran service organizations can help you file for a range of VA benefits and state veterans’ benefits. Some veteran service organizations and law school clinics will help with Medical Evaluation Boards and Physical Evaluation Boards. VSOs may also assist with requests to the Boards for Correction of Military Records or Discharge Review Boards.

Veteran service organizations do not receive federal funding, but some have some access to VA facilities. The VA offers free office space to veteran service organizations so VSOs can meet with clients, review claims files, and receive updates on claims status without compromising the security of the veterans’ private information. VSOs also may have access to VA computer databases to check on the status of a claim and submit evidence for a claim, but they do not have the authority to update any official records.

VSOs train individuals and submit their names to the VA for accreditation. The VA’s Office of General Counsel reviews and approves accreditation requests and maintains an official list of all VSOs, attorneys, and agents qualified to represent veterans. Each veteran service organization has certain rules and policies their VSOs must follow, and most will have client responsibilities as well. Some of these rules for representatives and clients were made by Congress and can be found, with all VA laws, at Title 38 of the U.S. Code, found at the Government Printing Office website.

Some county employees and members of veterans’ associations may provide information and advice about VA benefits even if they are not accredited. If someone helps you with your claim and says he or she will send it on to headquarters or another VSO, ask for a contact with whom you can follow up on your claim. If a VSO helped you file your claim, you will want to check with him or her about the status of your claim. First try to contact your local representative. If you are unable to get an answer from him or her, call the headquarters office for up-to-date information on another representative who can help.

Is there anything of which I need to be aware surrounding a power of attorney granted to the VSO for the purposes of help with my veteran’s claim?
If a veteran is receiving help in filing his or her claim through a VSO, an agent, or an attorney, the veteran will need to sign what VA calls a power of attorney. This is also called a “21-22,” the form number on the authorization. It is limited to VA claims representation, so it has no effect on the veteran’s legal or financial situation apart from VA benefits. Without a power of attorney, the VSO or attorney will not be able to receive any information about the claim. A state-issued general or durable power of attorney has no effect in VA claims. However, a guardian may sign for a veteran. For more information about Veterans Benefits Administration power of attorney, VA’s Compensation and Pension Manual Rewrite (Manual M21-1 MR), Chapter 1, Part 3: Power of Attorney. Note: The compensation and pension manual has almost all of the information you could want to know about how the VA processes claims, but it has a lot of jargon in some places.

If you are not the veteran’s guardian, it is best for the veteran to sign and participate in his or her claim. However, if the veteran for whom you care is so disabled he or she cannot sign the power of attorney form, certain people can sign that document for him or her. The best thing to do in that situation would be for the spouse, parent, or next of kin to sign the power of attorney form and select a VSO to represent the veteran.

What happens once I’ve filed a claim?
The claims process will differ depending on when you filed a claim: while the veteran for whom you are caring is in a wounded warrior transition unit still on active duty, soon after discharge from active duty, or many years after separation of retirement. Even if you begin a claim and receive a decision on the day the veteran for whom you care becomes a civilian, you might need to continue with the process of payments, increases, or management of a program of educational or vocational rehabilitation long after separation or retirement from the military.

Generally, the VA will review the paperwork you send in, search for federal records such as records from the Social Security Administration and military hospitals, schedule any necessary exams, and make a decision on the claim. After a decision is made, another team must authorize the payment by asking the U.S. Treasury to start paying the veteran. For more information on the VA claims process, please see MOAA’s claims process article, “ I’ve Submitted a Claim, Now What?”

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