What happens to a VA Disability Claim?

On Saturday April 13, 2019 leadership from the local Veteran Benefits Administration office joined the America’s Heroes Group radio talk show to discuss the “Claims Process” problems and solutions. The panelists were Director Hughes S. Turner, Reginald Hoskins and Stacie Bonner.

Panelists explained that the goal of the VA Disability Process is to determine if a veteran’s conditions are connected to his or her military service and if they qualify for VA Disability compensation. The discussion continued into a breakdown of the Claims Process, which includes submitting the claim, establishing the claim, reviewing the claim, deciding the claim and authorizing the claim.

Step by step, panelists explained how veterans must use the VA Form 21-526EZ to submit a claim.

The form can be submitted via mail, fax or online. The veteran will be notified when the claim is received. If the application is submitted online via Ebenefits, the applicant should see his confirmation within an hour of submission.

Once the claim is received, a probable end product is established for tracking purposes that controls the whereabouts of the claim in the process. The end product allows the VA to track the claim from establishment until final authorization.

Next, the claim will be assigned to a Veteran Service Representative (VSR), via the National Work Queue (NWQ). VSRs review the claim to determine if additional evidence is needed.

Development for additional evidence can include, but is not limited to, verifying military service, requesting military treatment and personnel records, requesting private treatment records and follow-up on incomplete documents submitted by the applicant. The claim is moved to the next phase when it has been confirmed that all the necessary evidence for the claim for benefits have been received.

A Rating Veteran Service Representative (RVSR) will receive the claim to decide the level of severity of the claimed disability/disabilities. The level of severity will be determined using all the evidence that was gathered by the VSR. It is imperative that all the evidence requested is submitted as the evidence is used in the decision-making process.

The final stage of the process is the authorization of the decision(s) made by the RVSR. A representative will review the claim from beginning to end, confirm the proper steps have been taken for the claim, the decision is correct, the proper language is used in the notification to the veteran and the financial figures are correct. When the authorization is complete the veteran will receive a copy of the decision as well as information on how to appeal the decision.

For any additional questions or assistance veterans may contact the Department of Veterans Affairs at 1-800-827-1000. If a veteran uses a Telecommunication Device for the Deaf (TDD), the Federal number is 711. Veterans may also send electronic inquiries through the Internet at https://iris.custhelp/com/. The VA now uses a centralized mail system. For all written communications, veterans should put their full name and VA file number on their correspondence.

Please mail all written correspondence to:

Department of Veterans Affairs

Evidence Intake Center

PO Box 4444

Janesville, WI 53564