VA DISABILITY CLAIM CHECKLIST

Claim Checklist OCR Single

VA Disability Claim Checklist Using VETbot Artificial Intelligence

Create personal statements as a FREE starting point to organize your claim

IT'S ALL ABOUT THE EVIDENCE!


  1. Determine eligibility: Talk to VETbot about any general questions. The VA basic eligibility requirements for VA disability are:

    1. Have a currently diagnosed chronic disability or continuing health condition;

    2. that was the result of military service, a preexisting condition was made worse by military service, or was the result of an already service connected disability; and

    3. your character of discharge was Honorable (includes General, Under Honorable); and you served on active duty (AD), active duty for training (ADT), or inactive duty training (IDT).

  2. Prepare a personal statement narrative – “ TELL YOUR STORY!: Write a compelling personal statement narrative in a SEPARATE narrative detailing EACH disability or health condition, how it affects daily life, and why it's connected to military service. This is EVIDENCE to help organize and strengthen the claim. For EACH claimed disability, health condition or symptom:

    1. – Clearly describe the disability or disabilities claimed as service-connected. VETbot will assist with naming the four digit diagnostic code, diagnosis and rating factors.

    2. – Service details: When and where served, the branch of military, job roles, etc. Provide description of the event, situation or toxic exposure with details about what happened, when and where, without omitting important facts. Explain when disability began and why it should be service-connected and/or why rating should be increased;

    3. – Medical care details: Information about diagnosis, treatment, medical opinions, prognosis, etc. Try to use the language of the VA Rating Factors, list all identified symptoms with frequency, severity, and duration.

    4. – Impact of the event or injuries: How the incident or conditions in the service affects Veteran physically, emotionally, and mentally. Explain how the disability negatively impacts work, life, and social functioning.

  3. Document service-connected disability: Provide evidence of the in-service event or injury that caused or aggravated your condition. VA requires EVIDENCE of service connection in 1 of 5 ways:

    1. preferably direct service connection by in-service manifestation, event or service record/health record entry OR Doctor provided Independent Medical Opinion (nexus letter) that condition “as likely as not” (50/50) caused by service;

    2. presumptive service connection;

    3. Doctor says secondary service connection to another service-connected disability;

    4. Doctor says service connection based on aggravation; or

    5. service connection based on 1151 (VA messed up) claims (uncommonly used).


  4. Obtain medical records: Request copies of your service medical records and any relevant private medical records. These documents are EVIDENCE to support claims and show the connection between disability and your military service. There are exceptions, but don’t count on them. (https://www.archives.gov/veterans/military-service-records/medical-records.html).

    Whenever possible get an Independent Medical Opinion that says your disability “as likely as not” (50/50) was caused by an in-service event or exposure or secondary to a service-connected condition.

  5. Obtain buddy statements: Request statements from fellow service members, co-workers, friends, or family who can corroborate your disability or the in-service event that caused it. These statements can provide additional EVIDENCE to support your claim.

  6. Research similar claims: Review past decisions made by the VA on similar claims to better understand how they evaluate and rate disabilities. This can help you present your case more effectively. Talk to VETbot.

  7. Prepare to electronically file by filling in the actual forms. This will familiarize you with the questions and help you organize and prepare to file and answer questions electronically.

    1. New claim or increase on VA Form 21-526EZ: Fill out the paper or online PDF Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ) accurately and thoroughly.

    2. Supplemental Claim Appeal with new evidence on VA Form 20–0995 Decision Review Request: Supplemental Claim. Fill out the paper or online PDF Decision Review Request: Supplemental Claim (VA Form 20-0995).

    3. Veteran Statements/Lay Statements/Buddy Statements on VA Forms 21-4138; 21-10210; PTSD FORMS 21-0781/0781a; other forms as needed. Fill out the paper or online PDF.

    4. Have all of your records available in electronic form, ready to upload at one sitting when you submit your electronic application.

  8. Submit your electronic application:

    Sign in at: https://www.va.gov/disability/how-to-file-claim/ to file a claim online

    File your completed VA Form 21-526EZ or VA Form 20-0995, other VA forms, personal statement forms, medical records, personal statement narrative, and any supporting documentation to the VA online. Try to stay electronic, but you can complete forms and submit by mail, or in person at your local VA office.

  9. Monitor your claim status: Regularly check the status of your claim on the VA website, and be prepared to provide additional information or attend a VA medical examination if requested.

  10. Review your decision: Carefully review the VA's decision on your claim. If you disagree with the decision, consider your options for appealing the decision, such as filing a Higher-Level review, filing a Supplemental Claim, or appealing your case to the Board of Veterans Appeals.

Remember: Every claim is unique, and the specific requirements for your claim may vary. This checklist is meant to serve as a general guide to help you navigate the confusing VA disability claim process.

VA Disability Interview – Already service connected:

1: What are you service-connected for and the %s of each? 2: What have you been denied?

3: Years of service? 4: Deployments?

5: Anything else you want me to know about your claim situation?

Goal:

Increases Secondaries Denials Presumptive/Initial

Format:

Service-connected: % (hard disability % and rounded disability %) Disability x – %

Disability y – % etc

Denials:

Disability a Disability b etc

Notes:

Claims currently in process

Any other important notes like reason for denial, etc.

Recommendations: (most important…look for increases, secondaries, combatting denials, and new claims) EXAMPLE:

PTSD increase from 50% to 70% recommend DBQ from Dr. Sharma, contact info below Lumbar strain 20%

  • Radiculopathy left leg SECONDARY to lumbar strain

  • Radiculopathy right leg SECONDARY to lumbar strain

    Denied for knee strain – recommend supplemental with IMO/DBQ from Quality Health, contact info below PACT Act:

  • Sinusitis

  • Rhinitis

*Note: Advise Veterans at the end to submit all claims with a current diagnosis/complaint from either VA/Private healthcare provider. If private, give VA access to those records.

CHEAT SHEET – Common Disabilities

  • Tinnitus 10%

  • Hearing loss – most commonly rated at 0 or 10%

  • Mental Health: PTSD combat/non-combat, Depression, Anxiety, Insomnia, etc. – 0, 10, 30, 50, 70, 100%

  • Lower back conditions: Lumbar strain, IVDS, etc. – most common 10, 20, 40%

  • Knee strain left and right – most common 0, 10, 20% (easy 20% if prescribed brace/assistive device like a cane)

  • Foot conditions – most common – 50%

    – Migraines – 0, 10, 30, 50%

    SECONDARY DISABILITIES:

  • Tinnitus: Migraines, Anxiety

  • Mental Health: IBS, GERD, Migraines, Sleep Apnea

  • Lower back conditions: nerve damage (radiculopathy in legs), bladder disabilities, depression (for more severe back conditions like IVDS at 40%)

  • Foot conditions: ankle conditions, knee conditions

  • Knee conditions: back conditions

  • Respiratory conditions (sinusitis, rhinitis, asthma): Sleep Apnea

  • Sleep Apnea: Hypertension

    CLAIMS ROPED TOGETHER: (share the same rating)

  • Sleep Apnea and Asthma

  • All mental health conditions with the exception of TBI if TBI has different symptoms than other mental health disabilities

  • IBS and GERD

  • Tinnitus and Vertigo WITH Meniere’s Disease

    PACT Act Disabilities: (if they qualify for PACT Act time requirements) https://www.va.gov/resources/the-pact-act-and- your-va-benefits/

    Most common PACT Act Claims:

  • Sinusitis

  • Bronchitis

  • Rhinitis

  • Asthma

  • IBS (in some cases)

REDDIT IS AWESOME! 38 CFR Cheat Sheet