Behind the curtain: The VA Claims Process

In my last post I wrote about my experience with the Veterans Administration during my physical exam process.  It took a few months to get through the paperwork and and to actually see doctor or two, and now I am waiting for the results.  And I am now in month three of waiting…

So why does it take so long?  Sure, there are zillions of us new veterans entering the system, but there must be a method to their madness.  After doing a little research, I found out that there is indeed such a method and that is what this post is about: the VA Claims Process.

My faithful readers have already seen the first part of the process in previous posts, but to make sure nobody gets left behind I will recap my adventures up to this point for those who are just joining the party:

The purpose of the VA medical evaluations and claims process is to document any injuries or physical issues that were caused or exacerbated by military service.  The evaluation is important for two specific reasons; first, if a servicemember is injured while on active duty it is important for that injury to be documented in case it requires treatment after they get out of the military and second, in cases where the servicemember has incurred chronic conditions or disabling injuries they are eligible for financial compensation.

If a veteran breaks his ankle while on active duty, for example, and gets out while while he is still going through physical therapy he isn’t out of luck.  His injury still requires treatment, so it is annotated during the physical exam and he will be able to use the VA medical system to get through the necessary physical therapy and get back on his feet.  Once he is better he goes on his way and he may never need the VA again.  However, since the VA evaluated his ankle and documented the injury, in case the veteran needs future treatment he is in the system and can still have that service-related injury treated by the VA in the future.  Taking the example further, if the veteran with the broken ankle is left with a limp for the rest of his life he will likely be evaluated as having incurred a disability.  Depending on the rating that the disability is assigned (I will devote an entire future post to disability assessment and ratings- don’t worry!) he may be eligible for a small disability check every month.

So being evaluated by the VA is important!

Back to my case.

I started my VA evaluation process as soon as I went on terminal leave, and before my EAS I had completed all of my physicals.  As I posted earlier, however, I slowed down the evaluation and claims process because I submitted the incorrect DD-214, which was caught by the case manager and rectified after I sent in the correct copy.  Although it seemed a bit random to me, there actually is a pretty well defined process that claims go through, which shouldn’t have surprised me because after all the VA is a governmental agency that runs on thoroughly bureaucratic processes.

Here is a breakdown of just what those claims processes are, starting from when my claim was initiated in my first meeting with the VA representative after going on terminal leave:

“Claim Received” – Your claim has been received by the VA. If you applied online with VONAPP (Veterans On Line Application – the web based application for VA benefits) Direct Connect, you should see receipt in your list of Open Claims below within one hour. If you applied through the U.S. mail, please allow mailing time plus one week for us to process and record receipt of your claim.  (Note – the process steps and descriptions are from the VA website)

“Under Review” – Your claim has been assigned to a Veterans Service Representative and is being reviewed to determine if additional evidence is needed. If we do not need any additional information, your claim will move directly to the Preparation for Decision phase.

It is during this phase that my errant paperwork was discovered.  It took about a month, but the system works because the claims representative discovered that I had submitted the incorrect paperwork and notified me.  It cost me a little time, but once I sent in the right documentation, my claim continued along to the next step.

“Gathering of Evidence” – The Veterans Service Representative will request evidence from the required sources. Requests for evidence may be made of you, a medical professional, a government agency, or another authority. It is common for claims to return to this phase, should additional evidence be required.

“Review of Evidence” – We have received all needed evidence. If, upon review, it is determined that more evidence is required, the claim will be sent back to the Gathering of Evidence phase.

I was contacted during this phase to provide a more detailed description of how I incurred an injury while in Iraq.  Again, the system works because the VA identified, through their due diligence, that I did not have enough documentation to support a portion of my claim.  So I filled out the form and described the situation in greater detail, and with receipt of the completed form my claim moved further along the path to completion.

“Preparing for Decision” – The Veterans Service Representative has recommended a decision, and is preparing required documents detailing that decision. If more evidence is required, the claim will be sent back in the process for more information or evidence.

This is where my case currently sits.  It has been there for a couple of months.  I did receive a letter last week from the VA apologizing for the delay in processing, so I know that my file isn’t lost behind a filing cabinet or being used as a doorstop.  I do appreciate that they took the time to let me know that they were just behind schedule and that they were still working on my case.

“Pending Decision Approval” – The recommended decision is reviewed, and a final award approval is made. If it is determined that more evidence or information is required, the claim will be sent back in the process for more information or evidence.

“Preparation for Notification” – Your entire claim decision packet is prepared for mailing.

“Complete” – The VA has sent a decision packet to you by U.S. mail. The packet includes details of the decision or award. Please allow standard mailing time for your packet to arrive before contacting the call center.

So I have three steps to go, and hopefully it won’t take too long!  The good news is that I am eligible for VA healthcare because I am a veteran regardless of when they complete my package.  Having it done will be helpful, however, because then all of my information will be in the system.  It will also be good to know if any of the mileage that comes with a 27 year career in the Marines results in a disability rating…


Lessons Learned:

1.  It takes time.  A lot of time.  I have been working through the process for six months, with the clock starting with my first VA appointment.  It is important to meet with the VA as promptly as possible once you have your DD-214 in your possession because the process is so lengthy.  You procrastinate at your own peril…as I wrote about in a previous post, if you can get your case initiated within 60 days before your EAS you will have your case reviewed by the locally by the VA instead of having it sent to their main evaluation center.  The anecdotal difference is about eight months- I was informed that it should take about four months after all of your information is provided for a local review as opposed to a year or so for a national level review.  It pays to be prompt!

2.  Get all of your ducks in a row before you initiate your package.  Missing or incorrect paperwork will stymie you progress, so avoid having the VA go through the nutroll of contacting you to update the package.  In my case, I provided the incorrect DD-214 and had to provide greater detail about an injury, and both of those transactions took time.  I recommend that when you fill out the pre-appointment paperwork that you go into excruciating detail in regards to any injuries that you suffered. The few extra minutes that you take filling out the form may save you the loss of a month in processing time later.


59 responses to “Behind the curtain: The VA Claims Process

  1. Maybe it’s your rank that is speeding your case up sir. Mine is at Gathering Evidence and has been back at that stage since Oct 2011. I first filed the claimin Jan 2011 so just at 18 months to be sitting at stage 3 of 8. I know one issue that slowed it down some, they requested more documentation. I mailed it in, three seperate times yet they claim they never received it. Finally I mailed it Certified, Return Receipt Requested and that one the received no problem. Go figure, as soon as they have to sign and be accountable they quit losing things.

    • Jason,
      Funny you should mention it- my claim is actually not scheduled to be settled until some time between November 2012 and March of 2013. My early optimism has been crushed by reality!

  2. Sir, I truly appreciate your explanations of the stages of the VA Claims/Adjudication process. My claim is “projected” to be completed August thru October, 2012, a period close to three years since submission. My documentation was thorough, complete, and timely. When VA is contacted on these “projections” the explanation forthcoming is that the “projections” are “estimates” garnered from information gleaned from each VARO and may or may not be factual. I hope that saved you some time.

    • Thanks for your comments. Quite ironic timing as well – I just went to my mailbox and found a letter from the VA telling me I was eligible for benefits and should contact them to initiate a claim. Hmmm….one hand does not seem to be talking to the other.

  3. Thank you Sir you have made plain what I tell people all the time get your paper work together first with a reason of any stressors then send it in. to add file on things that are in you active duty medical records and the timeline from that to how you are disabled till now because of it you must link them or you will have a long wait to prove you case with a nexis letter and that cost money that most veterans dont have. my case took 7 months until complete because I did what I just said and as you stated without any help from a rep just followed the instructions of the website. filed Jan 15,2012 complete Aug 1 2012.

  4. Thank you for posting your experience with the VA Claims process. I am currently receiving VA disability at 10% (migraines), but am rated at 0% for both of my shoulders and back (which is simply VA’s acknowledgement that I suffered injuries in these areas while on active duty). Over the past 10 years (ETS 2002), all of the areas in which I was rated have progressively gotten worse. On 2/11/ 2011, I filed a claim with the VA for a disability rating increase. My claim included a request for increase for migraines, both shoulders, and my back. My case for increase is well documented by my family practice doctor and two different neurologists (ten years of documentation indicating my symptoms have gotten progressively worse). My claim went from the gathering evidence phase to the review of evidence phase in July, 2011; however, it only stayed in this phase for about a week before my file was sent back to the gathering evidence phase. During the VSO’s review, they identified several (8) secondary conditions to my existing claim based on the review of my file. When I noticed my status had changed (negatively), I contacted the VA 1-800-# and was told I needed to provide evidence on the secondary conditions the VA had identified. I thought this request was ridiculous, since the VSO had already identified these conditions based on medical evidence I had already submitted; however, I complied with their request and resent in my medical evidence, along with my service records, and made the case to tie the secondary conditions to the service connected disabilities. In August of 2011, the medical records in my c-file were mysteriously misplaced, and I was asked to resubmit my medical records once again. Again, I complied with the VA’s request and immediately faxed the documentation to the Roanoke Regional Office where my claim resided. I waited several months, periodically checking the status of my claim on the e-benefits web site; however, there was no change in my claim’s status. There was an estimated completion date listed on the top of my claim (12/13/ 2011). This date came with no progress or change in my status; therefore, I contacted the VA 1-800-# again requesting a status of my claim. The VA representative sounded very irritated I had called, and gave me a scripted response- something to the tune of: the length of time it takes to process your claim depends of the complexity of your claim and the number of disabilities needing review- I asked them if they needed anything additional from me, and was told no. Once again, I waited patiently for my status to change- no luck! I contacted the VA in March of 2012 and was informed I needed to send in additional documentation stating I had no other medical evidence or supporting documentation to submit. As instructed, I faxed in the document. My claim skipped the reviewing evidence phase in e-benefits and is now in the preparation for decision phase(as of 9/24/2012- 19 months after the initial submission of my claim). Today is 9/26/2012, and I am still waiting for a decision from the VA. I wanted to do cartwheels when I saw my claim move into the preparation for a decision phase (however, my shoulders and back disabled my excitement (grins)).

    I am posting my experience because wanted to share my story and let my fellow veterans know just how slow the process really is. I did have an interesting conversation with one of the 1-800-# representatives that I find worthy of repeating:

    He told me he was a disabled veteran as well, and said his own experience with the VA claims process was exhausting (no one gets special treatment- not even the veterans who work for VA). He then gave me advice that I wish I had been given at the onset of my claim. He told me that every time I send in a document, my file is sent back to the gathering evidence phase. When I was sending in my medical documentation, I faxed the documentation in as I received it. Hence,VA’s rationale for my claim staying in the gathering evidence phase for so long. He advised me to submit all of my documentation at one-time, if possible, and to be sure my clam was well documented. He said this is important to ensure the VSO did not have to kick the claim back for questions or additional documentation. I then asked the VA representative another question in which I thought would help my claim. Over the course of the year, I had been to the doctor for my disabilities, and had accumulated much more medical documentation; therefore, I asked him for his opinion- Should I submit the additional documentation to ensure my c-file was up-to-date? He told me, in his opinion, NO, I should not submit the additional evidence, especially if my file already provided adequate evidence of my claim. He told me if I did submit the evidence, my claim packet would be pulled so that the additional evidence could be added to my file, then sent to the bottom of the stack for review. I did not realize that every time a document is submitted, your packet is pulled and sent to the bottom of a “pile”. He told me to hold on to the documentation and wait for a decision from the VA so I would start receiving benefits. He also advised, if I was not happy with the VA’s response to my claim, I should then send in the additional documentation I have accumulated and appeal their decision.

    With all of this said, I hope I have shed some light on why the process takes as long as it does. I am just as frustrated as every other veteran submitting claims; therefore, I wanted to share my experience and the advice I was given hoping it will help another veteran with the submission of their disability claim.

    Be well and thank you for your service!

    • Hi Jennifer,
      That is a tremendous response- do you mind if I repost parts of it in an upcoming post? Your insight into the submission of information is a great one.

      • No problem, Mike. I am glad I could provide some insight. Please feel free to repost any portion of my comment you feel would help a veteran submitting a claim. Thank you for sharing your experience. I hope your claim has progressed since your last posting. 🙂

      • Greetings to all:
        I’m reple replying to Jennifer’s quote since it would be fastest. I took an early out under AR 635-200 ch. 5-17. Thought it was best of all Worlds with the $8,000.00 for time in service. Waited, religiously kept VA appts, waited longer. After 34 months, all evidence submitted, received my determination from VA. Twenty percent service-connected. First check $13.51. Yes, thirteen dollars. The seperation pay received has to be paid back once you get your determination. I thought “NO WAY!!! Hello Congressman!” The end being that Congress cannot make exception to CFR 38, or 38 CFR. Those tens of thousands I was banking from VA did not happen.

      • Regarding Clarence’s comments, people do not “take an early out” using chapter 5-17. It is not voluntary, rather it is an administrative separation initiated by the command based on the recommendations from medical authorities. The $8,000 “separation” pay was however, his choice and he had to agree to have his disability checks offset until the amount equal to the severance is repaid in full. It is basically an advance on your disability. I think it is important for people to educate themselves and put out correct information to others so they can make informed decisions as well. This process sucks enough when you are fully informed.

      • Doug,
        That is great information- thanks for sharing. I did not know that about administrative separation and the effect it has on compensation payments.

    • Mike,

      Just as I finish typing my blog to you, I contacted VA to learn my claim has been sent back to the gathering evidence phase. The VA service respresentative could not provide me with a reason why… just the typical blanket statement stating they need additional evidedence. Hence, my claim stayed in the decision phase for two days….ugggg!

  5. My claim with the VA is going on 19 months old in still in the developmental phase. I have completed all C & P Exams as is required. I have all the documentation requested by the VA. Everytime I contact the VA I get the standard script. It is without a doubt one of the most frustrating experiences I have had in my entire life. The problem is compounded by the fact that my VSO office is close due to the lost of a state lottery grant. My VSO is the Daughters of The Purple Heart. That leaves me with absolutely no one to communicate by concerns with the Veterans Administration. I did get a complted and favorable C & P Exam. All of that is totally worthless. Over 2 million veterans had boots on ground in Vietnam. About less that 950,000 are still alive. Many survived the battles of the war to come home to die of Agent Orange complications. My eyes have seen the glory of the coming of the lord. The Veterans Administration needs to speed up the process of disability claims processing if it to fullfill the mission so adwquately described my Abraham Lincoln. Old Vietnam Warrior!

      • I will be contacting one of the VSO’s in the metropolitan areas for sure. I sent an inquiry to the VA IRIS System to see what type of response I will get first.

        Air Assault! Thank you for your service to the nation!

  6. I have just entered my 5 month window before I retire (24 yrs). I am trying to get all of my ducks in a row for my new journey ahead. “This is a drill, this is a drill”….I am ready to man my VA battle station! Thanks for the blog…very informative and in real time. Take car…soon to be retired Chief Petty Officer.

  7. Patiently waiting for error on the VA’s part. Have submitted information. Am overdue per their records. All my facts and documentation are in their hands. It is now going on 1 year. I have received my VA disability at 80%, thank God, but their errors cost me dearly. Have submitted two claims. Be sure that you do not do that as I have found that they only look at one and combine them., then you wait and wait and wait and wait and wait and wait. Get the picture? Nobody at the VA seems to be working… shame on them as the country sure has a lot of vets out here and they are broken…medical care is essential for all our military regardless of their state of retirement or having to leave the service for disabilities…we all served proudly and put our lives on the line. Let’s push to have our service members have a better service by an inadequately staffed VA. Perhaps it is time to get rid of VA personal that do not know how to work. That is what the normal industry does. We have gone to VA centers where the so called VA personal sit and chat with co workers for an hour at a time and do nothing until lunch…Atlanta area…tells you something is wrong with the system or the government workers…get rid of them. That is where some of our hard earned income tax money should be going, not to the countries that do not give a damn about us but for the love of our money to help them out of the situations that they are not smart enough to handle themselves. Just a thought out there. Angry and wanting more for our military members in the whole US. What do you all say? I am saying this for my husband, he is broken and needs help.

  8. My claim on Vonapp ebenefits online has been in the “gathering evidence” phase for 308 days. Whenever I contact the VA at 1-800-827-1000 the VA representatives give me the same information over and over again. I have turned in all the information that the VA required and some of my additional evidence is under the “unsolicited” column. I looked at the interactive map for the New Orleans office and see most claims take at a minimum 365 days. I guess I’m not at the number of “days” to receive a honest response about the “real status” of my case. It’s so frustrating waiting on a broken system to give you a fair and timely decision.

    • It is very frustrating. All you can do is wait, but calling the VA to follow up is the right thing to do. Be patient and your claim will move forward. Unfortunately the VA representative on the other end of the phone really does not know the specifics of your case, but once your case goes from “gathering evidence” to “review of evidence” you will be able to request the status of your case from the team that is working on it.
      Good luck!

    • ALCON (meant for maximum participation):
      Yes, Vets will wait for VA. To get your claim moving (my wait 680 plus) you MUST MUST MUST CONTACT YOUR US HOUSE REPRESENTATIVE . I cannot ALLCAP any louder.
      Very Respectfully,
      Clarence Davis
      enc. Thank you Col Grice for keeping this blog

      • I have contacted my state representatives several times. But to no avail. The only type of response I receive from the VA in New Orleans office is a letter stating that they are working as quickly and accurately on my case to reach a decision. But this of course is untrue because my case (like I said before) is still in the same exact stages it was early on.

        I just checked my case on Vonapp and no surprises absolutely nothing has changed.

    • Col Grice:
      Thank you…I was determined @ 20% about six months ago. I did wait 600+ days before making contact with my Representative that truly got the ball rolling – downhill no less.

  9. 91 days @ Pending Decision Approval and counting…11 months on 5/21 for the claim processing time thus far. I check eBenefits daily to see if it has moved; I call it my daily dose of disappointment.

    • For what it is worth, the people that I spoke with at the VA all indicated that the eBenefits site is often not updated and frequently shows the incorrect status for your claim. Mine was marked as “Closed” when it was still under review.
      Go figure.
      Good luck!

    • You said that the E-benefits site is not often updated. So should I stop even logging in to the site?

      Oh another question for you: If I receive SSD and need my records for my VA claim is it customary for Social Security to charge for these files?

  10. Waiting now 25 Months im 80% Waiting on a DRO review for iu and have been put in independent living program by voc rehab they sent me a chapter 35 Letter and application is this normal to send to me
    this before my claim is done? Or is this a plus?

  11. Thank you so much for the detailed information – I hope and pray for all of the vets here that their claims reach a speedy and positive resolution – You all deserve the highest attention for your valor and service!

  12. I am 50% PTSD and filed a for unable to work because of PTSD. I was contacted by the VA Minnesota Veterans Adminstration and followed instructions to send specific file information for my claim.Yet weeks later they sent a letter stating I sent to wrong office and had destroyed my files and could not forward them to LA. Every time I follow direct information from letters this happens, Why what how and or we never received your file. My Advocate and I had to refile and send to LA Veterans Admin and they told us we were late and had to refile again. Its been 12 months and now after calling the VA at 800/827/1000 every 4 weeks I was told your claim was still pending and working on it and receiving letters about every 3 months. I called today and spoke to a Veterans rep who was very rude. He told my case was canceled and I was shocked and asked why and could I speak to a supervisor He refused so I asked his name and he said I already told you and I am not telling you again So my reply was you are a Ass and I was begining to go back in PTSD mode anger filled my veins hyper ventilating and could hardly breath and wanted to jump through the phone. He mumbled and called me names that I cannot repeat so you could barley hear him because the calls are taped. Then he said he would terminate the call by then I was beside myself. When I got off the phone I had to run up a hill to calm down talking to myself. I am still angry how non service people work at the VA and do not care along with some veterans whom loose your records purposely and shred them. I am so hearthbroken and stressed from being hopeful and then have you hit in the gut with BS after serving your country HONORABLE.

  13. Why can,t we have honest people that work for the VA, from doctors to VA reps. And sometimes I think who are the individuals that make the decisions to give your claim a pass or fail or stamp canceled or shred, trash, destroy files They make sometimes unfair decisions are based on what they say and do behind doors. Why can,t a veteran stand before his peers and give his side of the story up front first time and then make a decision from a committee not one person who has the power to make your life if he has a bad day or angry at this person,or has racist views. Veterans are at risk and are under a microscope constantly and never given a options after waiting months and months from people that only know them by pictures and Veterans number.Believe lies and BS because they control the destiny of all veterans whom are not treated equal and honestly.The ones are caught and proven should be fired and never able to work for the Federal Government including doctors who file untrue reports.If the shoe was on the other foot they would cry like a baby.tHEY COULD NEVER EVER GO THROUGH WHAT THE AVERAGE VETERANS WENT THROUGH BUT THEY CONTROL OUR LIVES BECAUSE THEY MAKE DECISIONS FOR US. I HAVE BEEN FIGHTINING THE WAR IN THE US SINCE I RETURNED FROM VIETMAM. HOW MANY MORE WARS MUST WE FIGHT JUST TO GET OUR RIGHTS BEFORE WE PERISH FROM THIS WORLD.
    Thank you for giving myself a platform to speak, no matter how many laws are passed for veterans its only as good as the people overseeing the laws passed and how the games they play will stop. We have come a long way but still have a LOOOOOOOOOOOG way to go.

  14. Accidentally found your page and I was pretty impressed with the information given and how accurate it is. Thumbs up sir!

    Without a ton of people replying to me here, I currently work at a very large VA in Southern California as a RN within the ER. I am also a US Army veteran (enlisted) then obtained my commission 9 years later (gulp) as a nurses to bring our guys home if needed, so technically- I’m still in (USAR). I have to tell you, the tedious process of government paperwork is overwhelming regardless of what agency it is. I agree with you sir, that the process of filing a VA disability claim isn’t difficult, however………..Step 1 is get your paperwork in order.

    Taking the time to read your blog was informative and will help many veterans who are lucky to find it. I can’t tell you how many times I’ve had veterans/patients come to the ER after serving years ago saying, “I never knew I had benefits”. It’s sad, personally I had no clue either. I was out 9 years before I knew I was eligible (thanks the ETS crew at Ft Benning for dropping that ball in 1992!).

    Needless to say, if anyone reads this, educate all members who are still serving to “make a copy (or 2 or 3) of ALL your medical records, including copies of all hard disc/films of any or all xray reports” Most people do not know, there are two parts to any xray/radiology exam #1 the actual visual photo/film and #2 the “FINAL READ” do not get the preliminary (even though most times it doesn’t change). Also, if you ever have any type of surgery (in the operating room) either outpatient or inpatient, there is always a History & Physical done before by the doctor doing the procedure (basically saying why you need that operation) and there will always be the Operating/surgical/procedure note itself. This is important to identify where they opened you up (scars) what they found, etc….it’s helpful and most of the time, these two forms do not make it into your regular medical records, they are specific to your “Inpatient chart” . The medical records you carry around when PCS’ing are your “Outpatient” medical records.

    For my husband who serves in the Navy and when he is out to sea, medical staff on the ship may use hard copy documents or the old charting system, not computerized. GET A COPY! These get lost and will never be found, I promise you-I was a medic, we lost tons without trying.
    He also had to go to several civilian physicians for an injury the military couldn’t repair to his neck. Trust me when I tell you, he’s set for when he get’s out. I’ve been keeping a hard copy medical record of “Everything”.
    Most charting systems in the military as of today are computerized, however, there has been documented evidence that the storage capabilities for massive amounts of records are being challenged. So again……..KEEP A HARD COPY!
    Also, I was guilty of keeping my hard copy medical records from active duty (putting up hands here-I won’t even try to deny it) but, if you have them UNCLE SAM does not. Make a few copies (2-3) and be prepared to turn in your hard copies when you turn in your claim.
    You can Google how to specifically write each item you feel you should be compensated for. Since I work for the VA, I had to endure TWO separate C&P physicals because I work for the VA and the medical doctor examining me could not access the records to support my claims because as an employee, my records are secured at a level 7. No one without proper security access can access them. It was a pain, so a month later, I was at a separate C&P (civilian) physical yet again. When I went to the regional office to find out what was going on with my claim, no one could access my file because again…….I was a VA employee, only a supervisor could open it to finally tell me……..I need to re-do some paperwork so I’ll keep you informed if you want.

    With all the bad press the VA is receiving at this time I can only imagine how many veterans don’t even want the headache of long wait times. I know that many will feel the Government is turning their back and saying, “thanks for your service but go away we’re too busy to care” HOWEVER, on the contrary, most employee’s of the VA system are veterans themselves. I do not care how many patients come to the ER because they cannot get into their doctor, I don’t care if their appointment is months away, COME if you need us, don’t wait. I will never turn my back on a fellow veteran, I’ve walked and called offices for patients, given them the email and phone number to the Director when all resources have failed to demand in writing an appointment.

    I serve because I care, I work at the VA because I still care, I’m paying it forward whenever I can.

    🙂 Nurse Deb

    • Nurse Deb,
      Thank you so much for your great comments! If it is ok with you I would like to repost them on the blog- you really hit the nail on the head. I agree that the VA is receiving a lot of bad press, the vast majority of which is undeserved. Thanks for all you do!

  15. I applied in 10/13 for parkinsons and unemployability to to agent orange. My case has moved up to Preparation for decision. Received a letter that they received additional evidence va form 21-4138 . They state they are now moving the case from fdc to standard claim processing. Ebenefits still show in same place . Have no record of sending these form . What does this mean and what can I do. Plan on calling DAV Monday am . Thanks

    • Hi – the automated system seems to lag the actual status by weeks or months. I would recommend that you keep checking ebenefits, and call the VA (even though you will be on hold for a while!) and talk to a real person. They are helpful and can assist in explaining where your claim stands.

  16. Hi Mike,

    Happy I found this thread. I joined the army in 69, was in the abn inf for 10years, (served in Vietnam with 173rd Abe Bde). I retired as a Cpt in 1996 when I had my first experience with the VA. They denied everything the counselor at ACAP said I was qualified for. This started a process which continues to today. After two successful appeals I am SC for PTSD, 70%, CHF, 60% hypertension 10%, and Foot injury, 10% (total 90%). The VA admitted they make a clear error in my original determination (they did not have any records of my service in Vietnam, although my 214 clearly stated I served there), Ft. Bragg or Ft. Richardson. Today they called me and said that my reopen claims were moving to the rater and I know what that means. My point to your readers is to “NEVER GIVE UP.” If you believe that you meet the requirements of CFR 38, continue your fight, but do it in a civil manner fitting of being a veteran of the greatest nation in the world. Today I have a clot in my heart that my doctor said could kill me or make me a vegetable, (his words). I may meet my maker before I am finished with the VA, but I will do it with a smile on my face because I have fought a good fight. God bless you and all our veterans, and yes the VA workers also.

    • Thanks for posting!
      Your rater is the person who takes all of the data in your file and assigns ratings to each and every condition. The way it works is they assign a percentage value to each condition, and then at the end they use a formula to determine your overall disability rating. From what you list above, even though the numbers add up to 140% the actual rating is 90% because the formula takes the highest rating, (70%) and subtracts it from 100%. That leaves 30%. Then 30% is multiplied by the next higher rating (60%), which is 18% and rounds up to 20%. That 20% is subtracted from the 30%, leaving 10%. That 10% is multiplied by the next 10% rating, which equals 1%, which rounds down to 0%. Good luck and keep charging!

  17. Hello Mike,
    My clam went to the Prep for notification phase 12/12/14 on Saturday. What does this mean and how long is this process before a decision is made or when it reaches complete? Can you please help me with this? Do you think I will get paid before Christmas?

  18. Mike Grice, there is a lot of information you have provided above and you may have previously answered this question. Why would the VA schedule me for a medical appointment that I did not request? I retired after 20 years and have been out since Nov 2012. Today, I received a call today asking me to report for a medical appointment for my neck. I never requested this appointment, but the lady on the phone insisted that I come to this appointment. What is the VA doing? Are they attempting to add to or remove portions of my disability rating?

    • That is a good question. Here is what I would do:
      1. Check eBenefits – is there a change in your disability status?
      2. Go to the appointment. If they are calling for an appointment there is a reason. When you get to the appointment ask them why you are there. If you don’t go to the appointment it will negatively reflect in your record.
      3. Follow up with the VA. Contact your local VA rep (or call their toll free number) and talk to a representative. Make sure to have any documentation handy so that you can refer to it.

      The VA is doing its due diligence. If you don’t do your part, it is likely that your disability rating will be affected because they are trying to make sure that it is correct, and if you don’t go then they have no information to support your claim.
      Anyhow, this are the actions I would take. Let me know how it pans out!

  19. i filed a claim 8/14 igot a letter 3/30/15 telling me i had an evaluation i haven sent in all my evidence is this good or bad.

  20. @Mike, did you ever get your claim completed as of April 2015? My claim first started back in 2004 and I’ve been waiting 11 years for a final completion. I have waited so long, hopefully no one else has to wait as long as I have. I have been denied 3 times and this is my 4th time submitting an increase due to worsening of my conditions.

    I first started with 50% back in 2005 and have been fighting ever since. Whenever I got denied I would get immensely depressed and suicidal, but after the 2nd year I’ll gather up enough courage to try again. I hate talking about my problems to doctors because I have to explain every single time. Over the years I’ve been addicted to countless medication, and can’t even remember anymore. At one point I was taking up to 8 different meds at once and I would pop them in the morning like it was breakfast, ugh how disgusting.

    I’ve been to VA’s in Manhattan, Baltimore, Long Beach and it’s the same thing over and over. I hate waiting but I suppose as I get older it just drags on mind numblingly. Everytime I submit a new claim, I roughly wait 2-4 years for a final decision. For me it was 2006, 2009, and 2013 and I’m still waiting for that last one. Hopefully this time I have all my ‘ducks in a row’ because in the past they weren’t and I admit I tried going at it by myself (lonewolf); Until I realized having a VSO officer to represent you is by far the most helpful. Take care and God bless~

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