Frequently Asked Questions About Veterans Disability Benefits Claims

Navigating the complex landscape of disability benefits can be overwhelming, particularly when it comes to understanding the relationship between different government programs, such as the Department of Veterans Affairs (VA) and the Social Security Administration (SSA). One common question that arises is whether receiving a 100% disability rating from the VA guarantees automatic qualification for Social Security Disability benefits (SSD). In this comprehensive guide, we will delve into the nuances of these two programs, shed light on their distinct eligibility criteria, and provide insights into how they interact. 

Understanding VA Disability Ratings: 

The VA assigns disability ratings to veterans based on the severity of their service-connected disabilities. A 100% disability rating indicates that a veteran has been found to be fully and permanently disabled due to their service-connected conditions. This rating often comes with substantial monthly compensation from the VA, reflecting the severity of the veteran's disabilities. However, it is crucial to recognize that while the VA's disability ratings are influential within its own framework, they do not directly dictate eligibility for other disability benefit programs, such as SSD. 

Social Security Disability (SSD) Eligibility Criteria:

The Social Security Disability program, overseen by the Social Security Administration, is distinct from VA disability benefits. SSD provides financial assistance to individuals who are unable to engage in substantial gainful activity (SGA) due to a severe medical impairment expected to last for at least 12 months or result in death. To qualify for SSD benefits, an applicant must meet the following criteria:

1. Medical Condition: The applicant must have a severe impairment that prevents them from working. 
2. Duration: The impairment must be expected to last for at least 12 continuous months or result in death. 
3. Inability to Perform Substantial Gainful Activity (SGA): The applicant must be unable to engage in any substantial gainful activity due to the impairment. SGA refers to work that generates a certain level of income, which is reviewed annually. 

Interaction Between VA and SSD:

While both VA disability benefits and SSD are government programs that provide financial assistance to disabled individuals, their eligibility criteria differ. A 100% disability rating from the VA does not guarantee automatic approval for SSD benefits. The SSA evaluates disability claims independently and uses its own criteria to determine eligibility. The fact that the VA recognizes a veteran as fully disabled does not necessarily mean that the SSA will arrive at the same conclusion. 

Medical Evidence and SSD Application Process:

When applying for SSD benefits, regardless of VA disability ratings, medical evidence plays a pivotal role. The SSA requires substantial medical documentation that supports the severity and impact of the applicant's impairment on their ability to work. This evidence should demonstrate that the applicant meets the SSA's definition of disability, which may not align exactly with the VA's standards. 

 

In conclusion, receiving a 100% disability rating from the VA is a significant recognition of the severity of a veteran's service-connected disabilities. However, it does not guarantee automatic eligibility for Social Security Disability benefits. The SSA evaluates disability claims using its own criteria, with a focus on the applicant's ability to engage in substantial gainful activity. Veterans who are considering applying for SSD benefits should be prepared to provide comprehensive medical evidence and go through the SSA's application and review process. It's recommended to seek legal advice or assistance when navigating the complex terrain of disability benefits to ensure the best chance of success in securing the benefits they rightfully deserve. Give our office a call to schedule a free consultation at (575) 300-4000, or fill out our online contact form here.

You may qualify for VA disability benefits if you suffer from a disability that was caused while you were in the Armed Forces. The Veterans Administration considers some medical condition more serious and may award you Special Monthly Compensation (SMC), which can result in you receiving a significantly higher monthly disability payment.

When Are Veterans Eligible for Special Monthly Compensation?

Special Monthly Compensation is a benefit that certain Veterans, their spouses, surviving spouses, and parents may qualify for. It is paid to Veterans who have special circumstances, such as the need for personal care at home, due to the nature of their disability. Here are situations when a Veteran may qualify for these benefits:

• Aid and attendance. A Veteran who needs daily supervision by a family member, home nurse, or home personal aide because his disability is so serious may qualify for these benefits.
• Loss of use. If a Veteran has the loss of use of a body part and it is severe enough, he may be entitled to SMC. The use of the body part must be no better than if it was amputated and the Veteran used a prosthesis.
• Permanently bedridden. A Veteran who cannot get out of his bed due to his service-connected disability can qualify for SMC benefits.
• Blindness. If the Veteran suffers from vision loss, and it meets the VA’s definition of blindness, the VA may consider their condition debilitating enough to pay them Special Monthly Compensation.
• Homebound. Veterans qualify for these payments if their disability is so severe that they cannot leave their homes and will not be able to for the rest of their lives. An individual may also be considered homebound if they cannot leave a hospital or other care facility.

 Some disabilities that can qualify a person for SMC include:

• Loss of a foot or hand or use of this body part
• Paralysis or immobility of a joint
• Blindness in one or both eyes
• Deafness in both ears
• Loss or loss of the use of a reproductive organ
• Inability to communicate with others through the use of speech
• Loss of or loss of use of the buttocks
• Loss of tissue in one or both breasts because of radiation treatment or a mastectomy

If you qualify for SMC benefits, the VA is supposed to automatically pay you the additional monthly payment you are entitled to. However, this does not always happen..

Let our experienced VA disability legal team help you file your application and ensure that you and your family receive all the disability payments you deserve. Call our Roswell office to schedule a free consultation today to learn more about how we can help you.

Related Links: How Will the VA Rate My Disability? Eligibility for VA Disability Benefits How the VA Review of Your Disability Application Works

 

If the Veterans Administration (VA) claims that they overpaid your VA disability benefits, they will send you a letter advising you of this and that they will deduct a portion of the overpayments from your monthly benefit check. Fortunately, you have options. You can dispute the overpayment, ask for a waiver of the requirement that you repay it, and make an offer of compromise.

How to Dispute That You Were Overpaid

You have the right to dispute that you were overpaid or that the amount they want you to pay back is accurate. If you plan to dispute the overpayment, you need to send the VA written notice of your dispute and request that they send you written documentation of how they calculated your overpayment. Once the VA receives your notice, they must conduct a review of their determination.

If you dispute the overpayment within 30 days of receiving the VA’s letter, they cannot collect any money from you until your dispute is resolved. Once they complete their review, they will prepare a Statement of the Case, which is an explanation of their decision and a notice of your right to appeal their decision.

How to Request a Waiver of the Overpayment

You can request a waiver of the overpayment at the same time that you dispute it and should take both actions simultaneously. Here’s how to request a waiver:

• You have 180 days from the date of the notice of overpayment to file a request for a waiver. However, it is best to file it within 30 days so that the overpayment is not deducted from your benefits while the VA considers your request.
• You have the right to request a hearing and should file it in writing within 30 days of the letter advising you of the overpayment to avoid the VA from deducting the overpayment from your benefits.
• You should submit your request in writing on the Statement in Support of Claim form. In your request, you should explain how the overpayment would be a hardship for you and how it would prevent you from paying your housing, food, or other essential costs.
• The VA will consider a number of factors, such as whether the overpayment was your fault and whether the overpayment would cause you to suffer undue hardship in making its decision.

Making an Offer of Compromise

Another option is to make an offer of compromise where you agree to pay less than the full overpayment in a lump sum payment. If the overpayment is less than $100,000, the VA has the authority to settle for less than what is owed.

Did you receive a letter from VA advising you that they overpaid you? Call our Roswell office or start a live chat to schedule a free consultation with a member of our skilled legal team to discuss your legal rights and the options that are best for you.

Related Links: Can My VA Disability Claim Be Reopened? How Will the VA Rate My Disability? How to Appeal a VA Disability Benefits Denial

 

Once you apply for Veterans disability benefits, it can take the Department of Veterans Affairs (VA) months or longer to review your application and send you a decision. You can shorten this period considerably by filing a claim under the Fully Disability Claim (FDC) program.

When Can You File a Fully Disabled Claim?

The FDC program is a way for Veterans to obtain a faster decision from the VA on their application for disability benefits. This type of claim is considered fully developed because the Veteran has obtained all of the evidence needed for the VA to make a decision on his application except for government records and a medical examination if necessary. These claims are eligible for the program:

• An illness or medical condition that was caused by or worsened due to active duty service
• An illness or medical condition that was caused by or worsened due to a disability that was already determined to be service-connected by the VA

How Do You File a Fully Developed Claim?

For the VA to consider your claim fully developed, you must do the following:

• File a completed Application for Disability Compensation and Related Compensation Form (VA Form 21-526EZ)
• Submit all necessary supporting evidence with your application
• Certify that the VA will not need any other evidence to decide your claim
• Attend a medical exam if the VA requires one

What Happens If Your Claim Is Not Fully Developed?

There is no risk to you if you file a FDC rather than a routine application. Once you file it, you will have one year to complete the application. If the VA determines that your claim is not fully developed, they will remove your application from the FDC program and will process it as a standard claim.

Are you wondering if you should file a fully developed claim? Do you have questions about your eligibility for VA disability payments? To schedule a free consultation with our knowledgeable disability lawyers in Roswell, fill out our online form or start a live chat today.

Related Links: What Is a Service-Connected Disability? Eligibility for VA Disability Benefits How to Appeal a VA Disability Benefits Denial

 

Once you file your application for VA disability benefits, one of your top questions will probably be, “How long will it take to start receiving monthly benefits?” Unfortunately, the time period for the Department of Veterans Affairs (VA) to make a decision on a Veteran’s eligibility can vary widely. According to the VA website, in April of 2022, the average number of days to complete a disability-related claim was 152 days which is nearly 5 months. In our experience, it can take anywhere from months to a year or longer for an application to be approved.

Factors That Can Affect the Time it Takes to Begin Receiving VA Disability Benefits

The VA estimates that it takes them 94 days to review a VA disability application. However, many cases take much longer than that. Here are some factors that can shorten or extend the time it takes to reach a decision:

• Type of claim filed. There are many different types of claims filed for disability benefits, and some take longer than others to process. For example, if you file your claim under the “fully developed claim” program, you may receive a quicker decision. However, if you must appeal a denial of benefits or are reopening your claim, it could take longer to obtain the evidence you need and for the VA to review it.
   
• Number of disabilities claimed. The number of disabilities or injuries you are claiming benefits for, and their complexity, can affect how long the application process will take. If you have numerous, complex injuries, it will take the VA longer to make a decision.
   
• Evidence needed. If you do not include all the evidence necessary to support your application or the VA requests additional documents, this could slow down the VA review process.
   
• Field office location. The time period can also be affected by the field office where you file your claim. If you live near one that serves more Veterans, it could take longer for the VA to reach a decision than if you lived near an office that serves fewer Veterans.

In some situations, you can ask that your claim be expedited. For example, if you suffer from a terminal disease, are 77 years old or older, or are suffering severe financial hardship, such as possible homelessness, you can ask that your application be fast-tracked.

What You Can Do to Make Your Application Review Process Go Faster

If you want your application to be decided as quickly as possible, you should retain an experienced VA disability lawyer in Roswell to help you collect the evidence you need to support your disability claim and to file your application, so it is done properly. He can also follow up with the VA to be certain that they are reviewing the claim and can provide them with any additional information they need to approve your claim. To learn how we can help, call our office to schedule a free consultation today.

Related Links: Steps Involved in Filing a VA Disability Claim Am I Eligible to Receive VA Disability Benefits? How the VA Review of Your Disability Application Works

 

When you file an application for VA disability benefits, you must establish that you are eligible for benefits. How do you do this? You provide the United States Department of Veterans Affairs (VA) with the evidence they need when making a decision on your application.

Evidence You Should Include When Filing Your VA Disability Application

In order to receive disability benefits, you must prove that you suffered a disability that is connected to your service in the Armed Forces. Here is the evidence that the VA requires you to submit to establish this:

• Service records. You must prove that you were in the military service and were not dishonorably discharged. You do this by providing the VA with your DD214, which is the separation document you would have received when you were discharged from military service, or another separation document.
• Medical records. You will need to provide your medical history, VA hospital records, private physician medical records, diagnostic tests, and any other medical documentation to prove that you suffered a disability and that it is connected to your time in the Armed Forces.
• Family records. Supporting statements from family, friends, people you served with while in the military, or other individuals who have information about your disability can be helpful. They can share information on how your disability occurred, how it got worse, and how it affects your life.

You can provide your evidence directly to the VA or give them permission to obtain this documentation when reviewing your application. If you suffer from certain disabilities, such as traumatic brain injuries, you may be required to submit additional types of documentation.

Contact Us for Assistance in Filing Your VA Disability Application

If you are applying for VA disability benefits, providing the correct evidence is crucial to being approved for benefits. Our experienced VA disability attorneys can help you collect the documentation you need and complete your application so that you receive the disability benefits you deserve. Call our Roswell office or fill out the online form on this page to schedule your free, no-obligation consultation today.

Related Links: Steps Involved in Filing a VA Disability Claim Am I Eligible to Receive VA Disability Benefits? Crucial Mistakes to Avoid When Filing an SSDI Benefit Claim

 

When the United States Department of Veterans Affairs (VA) approved your application for VA disability benefits, they gave your physical or mental impairment a disability ranking of between 0 and 100 percent. This rating directly affects the amount of disability benefits you receive. If your medical condition has gotten worse over time, which is common, you have the right to ask for an increase in your disability rating.

How to Obtain an Increase in Your VA Disability Rating

If you are thinking about asking for an increase in your disability rating, it is important to understand how to do this properly and the possibles outcomes of your request. Here are the steps you need to follow:

#1: Consider the Possible Consequences

When you ask the VA to increase your disability rating, they will review your entire file. They could decrease your benefits if they determine that your condition has gotten better or that a mistake was made in the initial determination of your disability benefits. Before deciding whether to request an increase, you should consult with your physician and an experienced VA disability lawyer.

#2: Make the Correct Request

The way that you request an increase in your disability rating will be based on how long it has been since your claim was approved. If it has been less than a year since the VA awarded you disability benefits, you cannot file a motion for reconsideration. You will need to file an appeal, which can require you to attend hearings and court proceedings.

If your request for disability benefits was granted more than a year ago, you can request a reconsideration of your rating. You do this by filing Form 21-526b.

#3: Provide Medical Documentation

You will need to provide the VA with medical records showing that your condition has worsened. If you are being treated by a private doctor, you will need to complete Form 21-4142 so that he is authorized to speak with the VA and to release your medical records to them. If your doctor is a VA physician, you will need to provide the name and address of the VA medical facility where you are being treated.

Contact a Roswell VA Disability Attorney for Assistance With Your Claim

Do you need to ask for an increase in your disability rating? Call our Roswell office or fill out the online form on this page to schedule your free consultation to discuss your situation and whether filing this request is in your best interests.

Related Links: Disabilities That Often Qualify for VA Benefits Steps Involved in Filing a VA Disability Claim How to Establish a Service-Related Disability

 

If you received a letter from the Department of Veteran Affairs (VA) denying your application for VA disability benefits before February 19, 2019, you must file a Notice of Disagreement (NOD) to appeal their decision. You would also file a NOD if the VA approved your application, but their rating of your disability was wrong. If you received a denial on or after February 19, 2019, you must follow a new process to file an appeal.

What Is a Notice of Disagreement?

A Notice of Disagreement is a VA form that must be completed to begin the appeal process. This Notice should be provided to you by the VA when they send you a decision on your application.

The deadline to file the NOD is one year from the date of the VA’s notification letter to you.

Tips on Filing Your NOD

If you want to receive a favorable decision, you need to complete the NOD properly. Here are seven tips you should follow:

• Use the correct VA form. This form is VA 21-0958 “Notice of Disagreement.”
• Do not miss the one-year deadline to file the NOD.
• Select whether you want a Decision Review Officer Review (DRO) or a Traditional Appellate Review. An experienced VA disability lawyer can advise you which option is best for you.
• Be specific on what decisions of the VA you disagree with and why.
• Include any additional supporting evidence that supports your right to VA disability benefits and refutes the VA’s decision denying your application.
• Retain a skilled attorney as soon as possible to help you file your NOD and collect all the evidence you need to be successful.
• Keep a copy of your NOD and any supporting documents for your records.

Are you considering filing an appeal of the VA’s decision to deny your application for disability benefits? Call our Roswell office to schedule a free consultation with a member of our legal team to get your questions answered and learn how we can assist you.

Related Links: Disabilities That Often Qualify for VA Benefits Steps Involved in Filing a VA Disability Claim Am I Eligible to Receive VA Disability Benefits?

 

Filing for VA disability benefits can be a long and frustrating process. If you were denied benefits or have completed the appeals process unsuccessfully, you may have another option other than starting the process over again by reapplying. You may be able to request that the VA regional office reopen your claim.

However, you do not have an automatic right to reopen your claim. You must provide the Department of Veteran Affairs (VA) with new and material evidence, and your claim must be one that is eligible to be reopened.

What VA Disability Claims Can Be Reopened?

You may be eligible to reopen your claim for benefits if you have exhausted all of your appeals and they were denied, or you missed a deadline to appeal. There is no statute of limitations, or deadline, to file a request to reopen your claim.

Only certain types of VA disability claims can be reopened. These types of claims are eligible:

• Service-connected disability benefits
• Burial benefits
• Dependency Indemnity Compensation (DIC)

Other types of claims, such as for an increased disability rating, must be started over by filing a new application.

What Is Considered New and Material Evidence?

If your claim is eligible to be reopened, you must provide the VA with new and material evidence for this to happen. New and material evidence is evidence that you did not submit before that is substantial to your claim. It has to address the specific reasons for the last denial of your claim by the VA. The information must be so substantial that it would be unfair for the VA to refuse to reopen your claim.

Let Us Help You With Your VA Disability Claim

Filing a VA disability claim, appeal, or request to reopen your claim is complicated. Let our VA disability lawyers help you file your claim and provide the VA with the documentation that they need for your application to be approved. Call our Roswell office today to schedule your free consultation.

Related Links: Disabilities That Often Qualify for VA Benefits Steps Involved in Filing a VA Disability Claim Am I Eligible to Receive VA Disability Benefits?

 

When you file an application for VA disability benefits, you must establish that you qualify for these benefits. One of the most difficult elements to prove is the nexus, or link, between your illness or disability and the in-service event that caused it. One of the best ways to establish this is to submit a strong nexus letter to the Department of Veterans Affairs (VA).

What Is a Nexus Letter?

A nexus letter is a document prepared by a physician or other medical professional that explains how a Veteran’s medical illness or condition is directly related to his military service. While a nexus letter is not required when applying for VA disability benefits, it can make the difference between an application being approved or denied. A nexus letter can be submitted with an initial application, while the VA is evaluating whether the Veteran is eligible for benefits, or after an adverse C&P exam.

A nexus letter is especially crucial if no medical records were provided in support of the application and the C&P examiner does not find a link between the Veteran’s illness or disability and his military service. In this situation, the application will be denied unless a nexus letter is submitted.

How to Make a Nexus Letter Stronger

It is best to choose a doctor that is currently treating you to write a nexus letter on your behalf. You should select a doctor that is board-certified in the area of health that is at issue in your case. 

The physician must use specific language, certain phrases, and the correct medical standard when writing the letter. Here are some tips on how he can ensure that the nexus letter strongly supports your claim:

• The letter should be brief, but thorough. It should focus on the facts and the doctor’s conclusions.
• The doctor should mention in the letter that he has reviewed your entire VA file and medical records. If he fails to do so, the VA may disregard his letter.
• The letter should mention that the doctor has recently examined you. The VA may find the physician’s conclusions more persuasive if this is true.
• The physician does not need to draw an absolute conclusion as to the nexus between your disability and your military service. It is sufficient if “it is at least as likely as not.”

Ask a VA Disability Lawyer If You Have Questions

If you are a Veteran applying for VA disability benefits, the experienced VA disability attorneys at The Injury & Disability Law Center can help you file your application and work with your doctor so that he understands what information should be included in your nexus letter. Start a live chat to schedule for your free consultation to learn more about your rights to benefits.

Related Links: Disabilities That Often Qualify for VA Benefits Medical Records You Need for a VA Disability Claim How to Establish a Service-Related Disability