ABOUT VA DISABILITY COMPENSATION
What is VA Disability Compensation?
VA Disability Compensation is meant to compensate veterans for a disease, injury, or event incurred during active duty service that continues to impact his or her life today.
Am I Eligible For VA Disability Compensation?
In order to be eligible for VA disability compensation, you must have active military service that leads to a discharge under circumstances that are other than dishonorable.
Active military service includes full time duty in the Army, Navy, Marine Corps, Air Force, or Coast Guard. Members of the National Guard and Reserves may be eligible for VA disability compensation if they have an injury stemming from the period of time they were ordered to report for active duty or ordered to perform active duty training exercises. If you are not sure if you qualify for VA disability compensation, please contact us for more information.
What is “Service Connection”?
If a condition is “service connected”, the VA has conceded that the condition was incurred in or aggravated by active duty service.
Theories of Service Connection
There are several ways to service connect a condition. The main theories of service connection are:
- 38 U.S.C. 1151
Direct Service Connection
In general, in order to become service connected for a condition, you must provide evidence of three things:
- a current diagnosis or persistent symptoms of a current disability;
- a disease, injury, or event incurred in or aggravated by active duty service; and a “nexus”, or a link between the in-service disease, injury, or event and the current diagnosis or persistent symptoms of a current disability.
The condition does not need to be diagnosed in service in order to be deemed service connected. Many veterans suffer from symptoms for years before
The VA may compensate you for conditions that are secondary to or aggravated by a service-connected condition.
Presumptive Service Connection
Veterans who served during certain periods of time and in certain areas may qualify for presumptive service connection. This means the VA will waive the in service disease, injury, or event requirement as long as you can show you were stationed in a certain place at a certain time and you have one of the presumptive conditions.
Agent Orange Presumption
If you served in Vietnam during the Vietnam era, or along the Korean DMZ between April 1, 1968, and August 31, 1971, you may qualify for presumptive service connection. Other areas including Thailand and other coastal waterways have also been subject to this presumption. In order to qualify for the Agent Orange presumption, you must also have one of the following presumptive conditions:
- AL Amyloidosis – A rare disease caused when an abnormal protein, amyloid, enters tissues or organs
- Chronic B-cell Leukemias – A type of cancer which affects white blood cells
- Chloracne(or similar acneform disease) – A skin condition that occurs soon after exposure to chemicals and looks like common forms of acne seen in teenagers. Under VA’s rating regulations, it must be at least 10 percent disabling within one year of exposure to herbicides.
- Diabetes Mellitus Type 2 – A disease characterized by high blood sugar levels resulting from the body’s inability to respond properly to the hormone insulin
- Hodgkin’s Disease – A malignant lymphoma (cancer) characterized by progressive enlargement of the lymph nodes, liver, and spleen, and by progressive anemia
- Ischemic Heart Disease – A disease characterized by a reduced supply of blood to the heart, that leads to chest pain
- Multiple Myeloma – A cancer of plasma cells, a type of white blood cell in bone marrow
- Non-Hodgkin’s Lymphoma – A group of cancers that affect the lymph glands and other lymphatic tissue
- Parkinson’s Disease – A progressive disorder of the nervous system that affects muscle movement
- Peripheral Neuropathy, Early-Onset – A nervous system condition that causes numbness, tingling, and motor weakness. Under VA’s rating regulations, it must be at least 10 percent disabling within one year of herbicide exposure.
- Porphyria Cutanea Tarda – A disorder characterized by liver dysfunction and by thinning and blistering of the skin in sun-exposed areas. Under VA’s rating regulations, it must be at least 10 percent disabling within one year of exposure to herbicides.
- Prostate Cancer – Cancer of the prostate; one of the most common cancers among men
- Respiratory Cancers(includes lung cancer) – Cancers of the lung, larynx, trachea, and bronchus
- Soft Tissue Sarcomas(other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma) – A group of different types of cancers in body tissues such as muscle, fat, blood and lymph vessels, and connective tissues
Camp Lejeune Presumption
Effective March 14, 2017, the VA will provide presumptive service connection to veterans, former reservists, and former National Guard members who served at Camp Lejeune for no less than 30 days (either consecutively or non-consecutively) between August 1, 1953 and December 31, 1987 who were exposed to toxic water and later developed one of eight presumptive diseases:
- Kidney Cancer
- Non-Hodgkin’s Lymphoma
- Adult Leukemia
- Liver Cancer
- Bladder Cancer
- Multiple Myeloma
- Parkinson’s disease
- Aplastic Anemia and other Myelodysplastic Syndromes
Chronicity & Continuity of Symptoms
Service connection may be established where a chronic disease is diagnosed in service and there are subsequent manifestations of the disease. The VA has a list of conditions that qualify as “chronic.”
If the condition diagnosed in service is not deemed “chronic,” you may still be able to establish service connection by showing that you have had consistent symptoms since service. Consistent treatment in service or since discharge is not a requirement to establish continuity of symptoms. Your statement and the statements of others may establish consistent symptoms, even if you haven’t treated with a physician consistently since you were discharged from service.
A condition may be service connected and treated just like it was incurred in service if the condition was caused by hospital care, medical or surgical treatment, examination, or as the result of VA Vocational Rehab or Compensated Work Therapy Program. The injury must be related to the furnishing of medical services by a VA employee or at a VA Facility. The proximate cause of disability or death must have been the result of either (a) carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on the part of the VA in furnishing hospital care, treatment, or examination, or (b) an event that was not reasonably foreseeable. The failure to provide medical treatment can also serve as the basis for an 1151 claim.
When Will I Start Receiving VA Disability Compensation Payments?
Generally, the effective date of an award of service connection is the date of the VA receives your claim that led to an award of benefits. However, if claim is received within 1 year of separation from service, your effective date will be the day following your discharge from service. There are a few exceptions to this rule. If you think the VA assigned the wrong effective date in your case, contact us for more information.
What if I Am Unemployed?
If you are unable to obtain or maintain substantially gainful employment because of one or more of your service connected conditions, you may qualify for Total Disability Based Upon Individual Unemployability (TDIU). While TDIU is an “implied” claim, meaning the VA should consider this as part of a claim for an increase where there is evidence of difficulty maintaining employment in the record, if this applies to you, you should complete a Veteran’s Application for Increased Compensation Based on Unemployability (VA Form 21-8940).
Download VA Form 21-8940 (PDF)
What Is Convalescence?
The VA will award a temporary 100% rating evaluation if you undergo surgery for one or more of your service connected conditions. You may qualify for convalescent pay if:
- you spent more than 21 days in a VA hospital or you were under hospital observation or other approved hospital for a service connected condition; or
- you had surgery to treat a service connected condition that required a recovery time of at least 1 month and the surgery resulted in severe issues, such as:
- surgical wounds that haven’t totally healed,
- stumps or recent amputations,
- being unable to move due to being put in splints or casts,
- being unable to leave your house, or
- having to use a wheelchair or crutches; or
- you did not have surgery, but one or more major joints was immobilized by a cast.
This temporary 100% rating may continue for 1 to 3 months – depending on your unique case. You may be able to get an extension for up to 3 more months if your case is severe and requires additional time to recover. If you believe you may be eligible for convalescent pay, contact us for more information.
What is Special Monthly Compensation?
Special Monthly Compensation (SMC) is a form of supplemental compensation given for some especially serious or otherwise debilitating conditions.
SMC is an “implied claim.” This means that the VA should automatically award SMC if you qualify. You do not have to directly apply for Special Monthly Compensation (SMC).
What Types of Special Monthly Compensation Are There?
- SMC(k) Loss of Use of a Creative Organ – if your service connected condition makes another body part unable to function any better than it would if it were amputated and a prosthetic device used, you may be eligible for supplemental compensation from the VA. Many service connected conditions require medications that may cause erectile dysfunction, a condition subject to supplemental compensation under SMC(k).
- SMC(l) Aid & Attendance– if your service connected conditions are so severe that you require regular supervision by another person, you may be eligible for supplemental compensation from the VA. You may ask someone to complete an Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680) or A Request for Nursing Home Information in Connection with Claim for Aid and Attendance (VA Form 21-0779) to submit as evidence of the need for regular Aid & Attendance.
Download VA Form 21-2680 (PDF) – family member or home nurse
Download VA Form 21-0779 (PDF) – nursing home facility
- SMC(s) Housebound or 160% + – if your service connected conditions are so severe that you are permanently bedridden, you may be eligible for supplemental compensation from the VA. If you have one or more service connected conditions that add up to 100% combined (including TDIU), and additional service connected conditions that add up to 60%, you may be eligible for supplemental compensation from the VA. The additional disability or disabilities evaluated as 60% or more disabling, must be separate and distinct from the single disability evaluated as totally disabling, and involve separate anatomical segments or body systems.
- SMC(t) Traumatic Brain Injury – if you have chronic symptoms caused by a traumatic brain injury (TBI), you may be eligible for supplemental compensation from the VA if you require Aid & Attendance (as described above), and you would need constant institutional care without in-home Aid & Attendance.
If any of these conditions apply to your situation and you are not receiving supplemental compensation, or you are not sure if you are eligible for SMC, contact us for more information.
Types of Common Conditions:
- Post-Traumatic Stress Disorder (PTSD)
- Traumatic Brain Injury (TBI)
- Hearing Loss & Tinnitus
- Gulf War Syndrome
- Other Environmental Exposures
Types of Claims:
- Original Claim – if you are applying for VA disability compensation for the first time, you will need to file a VA Form 21-526 Application for Disability Compensation.
- Initial Claim – if you want to file a claim for a new condition or if you want to apply for an increased rating evaluation for a service connected condition, you will need to file a VA Form 21-526 Application for Disability Compensation.
- Supplemental Claim – if you filed a claim for a certain condition and you were previously denied. To file a Supplemental Claim, you will need to file a VA Form 20-0995. In order to re-opena previously denied claim, you must also provide “new and relevant evidence,” or evidence not previously submitted that tends to prove or disprove an element of the claim.
I Received a Decision – Now What?
In the new appeals tracking system, called the Appeals Modernization Act, enacted in February 2019, you now have a few options to appeal the VA’s decision within 1 year and still preserve the effective date of your initial application:
- Supplemental claim – if you have new evidence you want the VA to consider, you can file a Supplemental Claim by submitting a VA Form 20-0995 within 1 year of the VA’s decision. VA’s goal for completing Supplemental Claims is 125 days.
Download VA Form 20-0995: Supplemental Claim (PDF)
- Higher level review – if you want someone else to look at the evidence in support of your claim and make another decision, you can file a Higher Level Review Election by submitting a VA Form 20-0996 within 1 year of the VA’s decision. VA’s goal for completing Higher Level Review Claims is 125 days.
Download VA Form 20-0996: Higher-Level Review (PDF)
- Notice of Disagreement – if you want the Board of Veterans’ Appeals in Washington D.C. to review your case, you can file a Notice of Disagreement by submitting a VA Form 10182. VA’s goal for responding to a Notice of Disagreement is 365 days. The Board will take longer to decide your appeal if you submit new evidence or request a hearing in your Notice of Disagreement.
Download VA Form 10182: Board Appeal (PDF)