Your Initial Clain Is Denied
If your initial claim gets denied, you want to appeal the decision. You have up to 180 days to ask for a reconsideration. In that time, you need to collect more medical evidence, and at this time, it is highly advised to hire a disability lawyer to help with your case.Once you appeal, the insurance company has 45 days to make a decision. They can request an additional 45 days if they do not feel they can make a decision.Here is the timeline your insurance company must follow in your long-term disability claim.
Youve Paid Enough Social Security Taxes
One of the first requirements to qualify for SSA benefits is that you must have enoughwork credits.
What are work credits?
When you work in jobs that pay social security taxes, you can earn up to 4 work credits a year. Under social security rules, you need to earn at least 40 work credits to qualify for disability benefits. Twenty of which must have been earned in the last 10 years. But younger workers may also qualifyeven with lesser credits.
If you dont have enough work credits, its impossible to get Social Security Disability Benefits . But you can still apply forSupplemental Security Income .
How The Combined Disabilities Rating Calculation Works
To determine a veterans qualification for benefits, the VA rates the extent of that veterans service-related disability in 10% increments, going from 0% to 100% . Many veterans, especially as they age, have multiple disabilities, which the VA rates as combined disabilities.
However, the combined disabilities rating calculation is not a straightforward system. For example, a disability rated at 20% and a second disability rated at 30% yield a combined rating of 44%, according to the VAs Combined Ratings Table not 50%, as you might expect. Further, once you reach a disability rating of 80%, each additional disability then increases the combined rating by only 2% for each additional 10% rating.
In other words, ratings of 80% and 10% combine to make 82%, ratings of 80% and 20% combine to make 84%, and so on.
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I Did None Of Those Things
Partly, it was due to ignorance. I didnt know that I was eligible for VA benefits, and I didnt know how to apply for them. Although I *did* attend the Transition Assistance Program briefings, it happened very late in my separation process because my unit ignored the guidelines on how far in advance of separation individuals should receive the training and kept sending me TDY until I barely received the training before I separated.
Also, veterans benefits did not receive the same level of emphasis prior to OIF/OEF. They just werent emphasized as much during the briefings as they are now.
And partly it was due to apprehension: my career field required a high level of physical health, and I didnt want to jeopardize my chances of continuing to work in that field after I separated. I think that for many Desert Storm-era veterans, VA benefits especially disability seemed like something that existed for WWII, Korea, & Viet Nam vets, but didnt really apply to us. Plus, I was still relatively young when I separated, and I didnt understand the value of VA benefits.
What I did right: Research! When I finally decided to apply for VA benefits, including disability compensation, I did a lot of research. I had heard that it can be difficult and take a long time, especially if there is a time gap between separating from the military and applying.
Here are a few resources that might be helpful for you as you do your own research.
This video is a good place to start:
Work History And Credits For Ssdi Benefits
Whether youâve worked enough to earn SSDI benefits will depend on your age when disability begins, your income prior to disability, and the number of years youâve been paying taxes.
You get work credits based on your annual income, but you can only get a maximum of four credits per year.
In 2020, if you earn $1,410 during the year, you will get one credit. So, as long as you earn more than $5,640 , you will earn all four credits.
It doesnât matter if you earn that income in one month, or over the entire year.
Note that it is not about how much you pay into social security per year, but the credits are based on how much youâve earned.
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File A Notice Of Disagreement
For those who received a denial prior to February 19, 2019, the only way that you can start an appeal of your claim is by filing a Notice of Disagreement form with your Regional Office . Without this NOD form you wont be able to start the appeals process.
The NOD states that you disagree with the decision you received regarding your claim for disability compensation. The NOD form is the only way to begin your appeal process when you disagree with VAs decision on your claim for disability compensation.
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I’ve Submitted A Claim Now What
You or your VSO has submitted your claim. After it is received at your local VA Regional Office, a claim is established in the VA computer system. The paperwork you sent in is scanned to see which types of benefits you are seeking, and end products are established. The DEERS database is checked to verify your dates of military service. An end product is VA-speak for type of claim, and allows your individual claims to be tracked. One end product may contain multiple parts: a claim for disability compensation may include claims for three different disabilities.
General Stages of the Process for Disability Compensation Claims
Following are the general stages of the process for disability compensation claims. Other types of claims such as education and loan guaranty have different steps and are usually simpler and easier to process. The VA made many automated improvements to the education process and as a result, was able to shift employees from processing education claims to disability claims to reduce the backlog.
Once your claim is established, it will be sent to triage where it will be reviewed and assigned to a lane for completion. The VA sends claims with one or two issues to the express lane. There are also different lanes for specialized issues and standard claims.
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How To Increase Va Rating In Less Time 3 Key Elements You Must Prove In All Va Disability Claims
- Medical diagnosis of a disability condition , VA medical records, OR any private records, but it needs to be in a medical record somewhere). It helps to have a more current medical diagnosis, although its not required.
- Your disability condition was caused or made worse by your ACTIVE-DUTY military service OR its proximately due to or aggravated by ANOTHER service-connected disability rated at 0% or higher for secondary service connection.
- Current symptoms of the disability condition into the present day, aka, Severity of Symptoms
First, you MUST have a medical diagnosis of a disability condition in a medical record.
The medical diagnosis does NOT have to be in your Service Treatment Records , but it must be somewhere, in either VA medical records or private treatment records.
If you think you have a disability condition, but dont yet have it medical diagnosed, GET YOUR BUTT TO THE DOCTOR!
Without a medical diagnosis, youre dead-in-the-water, and your VA disability claim will be denied.
The #1 best way to prove you have a medical diagnosis of a disability is to upload medical records showing a current medical diagnosis in support of your Fully Developed Claim to the VA.
Second, you must be able to prove to the VA that your disability condition was caused or made worse by your active-duty military service OR its proximately due to or aggravated by ANOTHER service-connected disability rated at 0% or higher for secondary service connection.
Guess what veterans?
What Types Of Disability Claims Can I Submit Using Fast Track
You can use Fast Track to submit veterans disability compensation claims for:
- direct service connection, for:
- disability caused by service, or
- pre-existing illness or injury aggravated by service
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Va Benefits Increase Tip #: Get Dbq Forms Completed For Conditions Already Service Connected
Disability Benefit Questionnaire Reviews, also known as DBQ forms, are the #1 best way to increase your VA disability rating for conditions that are already service connected at 0 percent or higher.
Yes, we know the VA removed public use DBQs from its website, BUT, did you know you can still use DBQs in 2021 AND the VA rater must consider it as evidence of record?
Also, you can get something called a Disability Benefits Report completed by a private medical provider for conditions that are already service-connected.
What is a VA DBQ Form?
A DBQ is a standardized .pdf form created by the Department of Veterans Affairs to give veterans more control of their VA claim.
Obtaining a DBQ from a qualified medical provider enables veterans to present their VA disability condition, mainly the medical diagnosis by ICD Code and your current symptoms of your VA disability, to the VSR and RVSR at the VA for rating purposes.
And guesswhat else veterans?
The majorbenefit of using DBQs is that many times the VA will grant a veteran a higherVA rating based upon the information in the DBQ ALONE!
Yes, youheard me correctly
For simple disability increases, the VA Raters are authorized by regulation to grant a VA rating increase using the DBQ by itself.
Now, itsstill very likely youll get a C& P Exam, but at least you have your medicalinformation baselined by another medical professional PRIOR to the C& P Exam.
What Evidence Will I Need To Provide To Support My Claim
You can help to support your VA disability claim by providing documents, such as:
- VA medical records and hospital records that relate to your claimed illnesses or injuries or that show your rated disability has gotten worse
- Private medical records and hospital reports that relate to your claimed illnesses or injuries or that show your disability has gotten worse
- Supporting statements youd like to provide from family members, friends, clergy members, law enforcement personnel, or those you served with that can tell us more about your claimed condition and how and when it happened or how it got worse
Depending on the type of claim you file, you may gather supporting documents yourself, or you can ask for our help to gather evidence.
Well also review your discharge papers and service treatment records.
Please note: You dont have to submit any evidence to support your claim, but we may need to schedule a claim exam so we can learn more about your condition.
You should also know that you have up to a year from the date we receive your claim to turn in any evidence. If you start your application and need time to gather more supporting documents, you can save your application and come back later to finish it. Well recognize the date you started your application as your date of claim as long as you complete it within 365 days.
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Not All Va Disability Ratings Are Awarded At The Maximum
All that said above, you may not be awarded the maximum amount of compensation for a specific medical issue, or you may have been awarded the maximum amount for an issue as-is without added complications.
In those cases, when the condition gets worse or begins showing signs of complications, you may be fully justified in getting your case reviewed by the VA to see if more compensation and treatment are needed.
If you dont know the maximum VA disability rating for your condition in its current state or whether certain complications may increase your eligibility for more care and disability pay, you should definitely review the VA Schedule For Rating Disabilities at the VA official site to see what your options are.
See how much monthly compensation would increase with a Combined Disability Rating increase.
General Steps To Filing A Va Claim For Increased Rating
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Is As A Disability
If you have a severe case of Ankylosing Spondylitis that keeps you from working, you may be eligible to receive monthly disability benefits from the Social Security Administration . AS is a form of inflammatory arthritis that is often diagnosed in young men, but it can impact male or female of any age.
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The New Process Has Reduced Average Waiting Times
In November 2017, the VA launched an interim appeals process called the Rapid Appeals Modernization Program . RAMP was discontinued in favor of the new system in February 2019. But to this day, the VA still faces a significant backlog of cases brought under the legacy appeals process. This means that the Appeals Modernization Act will not have a significant effect on the processing time of older cases.
According to the VA, the new process is a significant improvement. As of April 2020, the average waiting times for different disability claim appeal procedures are as follows:
- Initial Disability ClaimThe time between when you file your disability claim and receive a decision letter is generally 80 days.
- Higher Level ReviewIf you appeal your ratings decision by requesting a case review from a Decision Review Officer, or DRO, the process takes on average 125 days.
- Supplemental ClaimIf you chose to supply additional evidence in support of your claim, it will take on average 125 days for the regional office to review it.
- Board of Veterans AppealsIt generally takes a year for the BVA to review cases, but it could take longer if you request an in-person hearing, or if you submit new evidence.
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How Back Pay Is Calculated
Back pay is all based on your assigned rating , the amount of time elapsed between your effective date and filing date, and a cost-of-living adjustment if enough time has gone by between those two dates. Worsening conditions and filing dates are only two ways that a claim for back pay can become overly complicated, sometimes resulting in the VA making errors at the expense of veterans, which is why its often best to seek professional assistance when filing and appealing your claims for VA disability benefits. Our attorneys at VA Disability Group PLLC are on hand to assist you with your claims today. Make sure you receive the back pay you deserve by requesting a consultation online or calling us at 844-VET-LAWS.
Understanding The Va Claims Process
What happens after filing a disability claim with the VA?
A veteran should first receive notification from VA that the claim was receivedwhich may take up to two weeks after filing a paper form or within a matter of hours if the claim was submitted electronically.
A VA representative will then review your claim to determine if any additional information is needed. They will contact the appropriate sourceswhether its you, a medical professional or government agencyto collect that information. This evidence gathering portion can be the longest part of the claims process, and may require further medical examinations.
Once it is determined that all necessary evidence has been received, the claim receives a review and a final rating decision is recommended. If you are using DAV as your appointed representative, they will review the recommendation and return it to the VA. Then a final determination is made and a claim decision packet will be mailed to you containing the rating decision and additional information regarding your disability rating.
Click here to watch DAVs What to expect after filing a VA claim video.
What should I do after receiving a claim decision from the VA?
If you are satisfied with your decision, you need take no further action. However, if you are not satisfied with any part of the outcome, you have the right to appeal the VAs ruling.
Who can I contact for help?
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