Overview of the VA Compensation Claims Process

Under the veterans’ compensation benefits system, a veteran, a veteran’s dependents or a veteran’s survivors are required only to submit a “plausible claim” for an entitlement to VA benefits. Once a plausible claim has been submitted, the burden to fully and completely develop evidence to support that claim lies with the Department of Veterans Affairs (DVA) under federal law.

A claim may be submitted in writing at any one of the DVA’s 58 Regional Offices. Once a decision is reached on the claim for benefits, the veteran will receive a written notice, called a  Notice of Action, setting forth the decision of the VA Regional Office (“VARO” or the “Regional Office”).

In the event that the claim for benefits is denied and the veteran wants to appeal, a Notice of Disagreement (NOD) must be submitted to the VARO. Upon receipt of a NOD, the VARO must prepare a Statement of the Case. In the Statement of the Case, the VARO is required to explain the reason for the denial of benefits, as well as provide the controlling statutes and/or regulations relied upon by the VARO to support the decision to deny benefits. Thereafter, in order to complete the appeal, in addition to a NOD the veteran must submit a VA Form 9 within 60 days of the receipt of the Statement of the Case, or within one year of the issuance of the denial notice by the VARO, whichever is later.

The claim is then transferred to the Board of Veterans’ Appeals (“BVA” or the “Board”) in Washington, D.C. The BVA is the final level of appeal available within the DVA’s administrative appeals process. The BVA may take any of four different actions on a veteran’s appeal. The Board may (1) affirm the decision of the Regional Office; (2) reverse the Regional Office’s decision and grant the benefits sought by the veteran; (3) remand the case for further development back to the Regional Office; or (4) refer the case back to the VARO when the Board feels that an issue or a claim which should have been developed was not. Upon referral, the Board directs the Regional Office to decide the undeveloped  issue.

If the BVA affirms the decision of the VARO, the veteran may appeal to the U.S. Court of Appeals for Veterans Claims (“CAVC” or the “Veterans Court”). If the Board reverses the decision of the VARO and grants the benefits sought by the veteran, the decision is favorable and there is no basis for further appeal. If the Board remands the case for further development, the VARO must complete the instructions or directions for further development provided by the Board. In the event that the prior denial is affirmed by the VARO on remand, the Regional Office must issue a Supplemental Statement of the Case, from which the veteran may again appeal. Upon referral, the Regional Office must deveop and decide the previously undeveloped issue or claim, and then give the veteran notice of the decision, from which an appeal again may be taken. If the BVA’s decision is adverse to the veteran, the veteran has 120 days from the date stamped on the adverse BVA decision to file a Notice of Appeal with the  Veterans Court.

Delays in adjudicating claims for VA benefits are substantial. A veteran must usually wait six months before receiving a decision from the VARO regarding a claim for service-connected compensation.  Then, if the veteran’s claim is denied, the appeals process at the local VARO level can take another six months to two years before it is finally forwarded to the BVA.  Once there, a veteran must wait approximately two years for a decision from the BVA.  Similarly, the delay at the CAVC is, on average, also two years.  Overall, if his or her claim for VA benefits is mistakenly denied, a veteran can spend ten years or more in the appeals process waiting for the VA to make the right decision.

Fortunately, a recent change in VA law now allows a veteran to retain an attorney once the VA appeals process has been initiated; that is, once the veteran has filed a NOD at the local VARO.  Before the change in law, a veteran was limited to appealing the VA’s denial of benefits alone or with inadequate or incomplete assistance from veterans’ service organizations.  But veterans can now hire an attorney trained in military benefits law to fight for the VA benefits and compensation due to the veteran. Veterans who pursue their appeals for VA benefits without professional representation are at a severe disadvantage because VA laws and regulations are complex, convoluted, and constantly changing.  Hiring a professional veterans law practitioner is not a guarantee that the veteran will prevail, but professional advocacy by a well-trained and experienced attorney is definitely a veteran’s best option for obtaining the benefits he or she earned while serving and defending our country.

Thanks to the National Organization of Veterans Advocates, Inc. website for information used in preparing this blog post.