Effective Dates: The Date VA Received the Claim or the Date Entitlement Arose

Getting VA Disability Benefits

If you are a Veteran with a disability, you may be entitled to receive monthly compensation from the Department of Veterans Affairs (VA). The primary criteria for receiving VA disability benefits is that your condition is service-connected. This means your disability is directly linked to your time in the military. The VA recognizes both physical and psychological disabilities as eligibility for receiving compensation, provided that it can verify a Veteran’s condition was caused during active service.

The first step towards getting compensation for a service-connected disability is filing a claim. You can submit a disability claim in person at your regional VA facility or mail the original claim to the facility. The VA website offers further resources and information regarding filling out disability claims. If you have questions about how to file your disability claim, make sure to visit your regional VA facility to get the assistance that you need.

When you submit your disability claim, make sure to provide the VA with any necessary information and documentation to play a role in your claim’s outcome. The VA requires that a Veteran submits several pieces of documentation alongside their claim, including military service records, medical records, and forms of identification. Failure to include any of the documents that the VA requires with your claim can result in a deferral – this means your claim has neither been approved nor denied. 

To avoid a deferred claim, make sure to carefully follow the VA’s instructions when submitting your application for disability benefits. If your claim is missing any necessary information, the VA will contact you to let you know that they need more documentation from you before they can proceed with reviewing your claim.

Once you submit your disability claim, the VA will start reviewing your application and determining whether you can qualify for benefits. 

What Happens If My Claim Gets Approved?

If the VA determines that you have a service-connected disability that is at least 10% disabling, you will start receiving disability benefits based on your claim’s effective date.

The general rule for effective dates is the date the VA received the claim or the date entitlement arose, whichever is later. 38 C.F.R. § 3.400 (2013).

A claim is defined as “a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement, to a benefit.” 38 C.F.R. § 3.1(p) (2013). “Any communication or action, indicating an intent to apply for one or more benefits . . . from a claimant . . . may be considered an informal claim. Such informal claims must identify the benefit sought.” 38 C.F.R.§ 3.155 (2013). The claim must be in writing. 38 C.F.R. 3.1(p).

VA Disability Ratings 

If the VA approves you for disability benefits, they will assign you a specific rating decision between 10% and 100%. A rating below 10% indicates a denied VA disability claim – a Veteran with a rating below 10% may have a service-connected disability, but the VA views their condition as not disabling enough to warrant compensation.

Your disability rating directly corresponds with the amount of compensation you will receive each month for your service-connected condition. Your disability rating can be the sum of the rating for multiple disabilities. However, even if you have multiple conditions that are all severely disabling, your disability rating can never be above 100%.

If the VA gives you a rating that you feel is too low, you reserve the right to appeal the decision. Even if your claim has been approved, you can still request that the VA review its decision on your claim and the rating you have received. An experienced attorney can represent you throughout the appeals process, helping you to make a case to the VA for am increased rating.

In addition, it is important to note that your VA disability rating may be subject to change. If the VA presumes that your condition’s symptoms will improve over time, they may reduce your rating by default. To ensure that you are receiving the amount of monthly compensation you deserve, you can request that the VA re-evaluates your condition to either maintain or raise your disability rating.

Entitlement Date: What It Means  

The date entitlement arose is the initial date on which Veteran satisfied all of the substantive criteria for entitlement to the benefits, as determined from a review of all the evidence. In other words, the date the disability first manifested and the date entitlement arose to benefits was authorized by law and regulation.

The date of initial claim is used for the effective date when Veteran has the disability already and can prove that such disability exists and is related to his or her military service. Based on these criteria, a Veteran may receive VA disability compensation dating back to when they initially developed their service-connected disability. However, this is not always the case.

For example, if a Veteran submits a claim for post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) and is properly denied by the regional office due to lack of material evidence—but the Veteran appeals to the Board of Veterans’ Appeals (BVA) and submits critical evidence indicating Veteran satisfied requirements for service connection at the time he filed the claim—the date the claim was received is the effective date for his VA disability benefits. In this circumstance, a Veteran will not receive any disability benefits for the time prior to the VA approving their claim.

However, if the critical evidence shows the Veteran did not meet all the requirements for PTSD and TBI at the time of his claim, but later met the requirements after the claim was filed and received, the date entitlement arose. Therefore the effective date would be after VA received the claim. This is because the date entitlement arose “later” than the date VA received the claim. If you are unsure about when you should start receiving VA disability benefits, you can find out by determining what the entitlement date is for your compensation. In most cases, this date correlates to when the VA officially approved your disability claim.

What To Do If Your Disability Claim Is Denied

In some cases, the VA will not grant a Veteran disability compensation, even if the Veteran has a service-connected disability. The VA can deny disability claims for several reasons, but below are the two most common factors that can lead to a denial of your claim.

  • Lack of sufficient medical evidence. Whenever a Veteran applies for disability benefits, they must undergo a VA Compensation & Pension (C&P) exam. In this examination, a VA-affiliated doctor examines a Veteran’s condition and their military medical records to determine whether they have a disability that is significant enough to warrant monthly compensation. If the VA concludes that, based on the results of the C&P examination, a Veteran does not have a verifiable disability, the VA will deny the Veteran’s claim. 
  • Lack of a verifiable nexus (link) between your condition and your military service. In some cases, the VA will conclude that, while a Veteran has a disability that is indeed severe, there is not enough evidence that the condition is service-connected. The VA can only grant benefits to active duty members with disabilities that are directly linked to their military service.

If the VA has denied your claim for either of the above reasons, don’t give up. You may still be able to qualify for the compensation that you need and deserve. One of the best steps to take after a denied disability claim is to appeal the VA’s decision. In an appeal, the VA will review their decision regarding your claim, and you can make a case that you should be approved for benefits with the help of an attorney.

Recruiting an experienced attorney is an essential aspect of successfully appealing a VA decision. If you need help getting a better outcome for your disability claim, contact Berry Law Firm today. Our skilled team of lawyers includes Veterans from numerous branches of the Military, including the Army, Navy, Air Force, and Marines. Our attorneys know how difficult it can be for disabled Veterans to get the compensation they need and deserve for their service-connected conditions, and they’re here to help you make a strong appeal.

Contact us today for a free consultation.

 

Sources:

https://www.va.gov/disability

https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

https://www.cdc.gov/traumaticbraininjury/index.html