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13.2. Filing an Application for Compensation or Pension
All claims for VA benefits begin with an application. Unless there are very unusual circumstances, a claimant should use the form that the VA specifies for the benefit desired. As with all VA forms, you should read the Form instructions carefully and get help if you are unsure of what is required.
To obtain a copy of the current version of any VA form go to:
- http://www.va.gov click on "VA Forms" in the "Quicklist" menu on the right side of the page and click "Finding a VA Form", or
- visit or write the nearest VA regional office. or
- VA also has implemented an online "Do-it-Yourself" application process for benefits, where veterans can complete and submit an electronic VA Form listed on either https://www.ebenefits.va.gov/ebenefits/homepage or https://benefits.va.gov/benefits/vonapp.asp
Starting March of 2015, the VA introduced a new process know as the "Intent to file" using VA Form 21-0966. This form notifies the VA that you intend to file a claim for VA compensation, pension, or survivors' benefits but additional time is required to obtain the information needed for a completed claim. You will have one year after filing the intent to file form to file a complete claim for either: Compensation (VA Form 21-526EZ), Pension (VA Form 21P-527EZ), and Survivor's DIC/Death Pension/Accured Benefits (VA Form 21P-534EZ). The date that the VA receives your intent to file for each specific benefit will be protected as the effective date for the benefit that you applied. The intent to file process allows the VA to award benefits retoractively to the receivede date of the intent to file. The VA will only recognize one intent to file per general benefit category at any given time. Thus, you can not file for two claims simultaneously for the same benefit category. Once a completed claim is filed, the intent to file for that claim becomes inactive. Then you can submit an new intent to file for the same benefit category for a different issue.
Filing a complete application is important to avoid delays in processing a claim. VA is not required to take action on a claim until a substantially complete application has been filed. In addition, it takes considerable time for VA to review an application, notify a claimant of problems, and review the information received to correct the problems. During this time, nothing is being done to move the claim along. If the requested information is not submitted within 12 months, VA will deem the claim to have been abandoned and the claimant may have to start all over.
When submitting a compensation claim to VA, it is best to include all of the available information. A completed claim includes:
- Medical evidence that supports the claim (statements from your doctors, Nexus letter, examination reports, hospital records, labs, procedure reports, diagnostic studies such as MRI, CAT Scan, etc) The VA has simplified the Private Physicain Statement Process with the use of Disability Benefits Questionnaires, (DBQs) instead of statements or letters. There are 70 DBQ Forms and the forms can be obtained at: http://www.benefits.va.gov/COMPENSATION/dbq_disabilityexams.asp. Note that for one medical condition you might have multiple DBQs. Have your Physician complete the DBQs and submit the DBQs as medical evidence.
- Copies of military service records or records of post-service medical treatment for the condition claimed as service-connected should also be submitted if available. Doing so will lessen the chance that VA will have to ask for these records and delay making a decision on the claim. To receive your military records go to: http://www.archives.gov/veterans/military-service-records, download the "SF-180", complete the form and fax the form to National Personnel Records Center, NPRC Number: 314-801-9195. Note: Record will be sent to the address on the SF180.
There are five ways to file a form,application or information with the VA:
- A Veterans Service Organization (VSO), To find a VA accredited VSO or VSO Representative go to:https://va.gov/ogc/apps/accreditation/index.asp, Service is FREE, or
- An Attorney, registered with the VA, To find a VA accredited Attorney go to: www.va.gov/ogc/apps/accreditation/index.asp VA caps Attorney Fees at 20% of claim amount and 25% of claim amount for malpractice claims, or
- Applying In Person "Do-it-Yourself" by completing the application form and submitting it in person at the VA Regional Office or mailing the completed application to your VA Regional Office (Note: If help is needed when filing in person at the VA Regional Office, a VA regional office public contact representative will assist you) A completed application should be submitted to the VA regional office responsible for processing the claim. This is usually the VA regional office located in the state where the claimant lives. In states with more than one regional office, a claim should be filed with the closest regional office. The locations and contact information for all VA regional offices can be found at: https://benefits.va.gov/benefits/offices.asp. Move the cursor over the state where the claimant lives to find the closest VA regional office. , or
- Applying Online "Do-it-Yourself" application with either: eBenefits at: www.ebenefits.va.gov/ebenefits/homepage or Veterans On-Line Application (VONAPP) at: https://www.ebenefits.va.gov/ebenefits/vonapp, Note: You can not use VONAPP for Compensation benefit filings.
- By phone with the National Call Centers #800-827-1000.
What happens to my completed claim after it is submitted to the VA?
Unless the claimant is participating in a test of a new "paperless" process, when VA receives an application, the VA creates a "claims file" (widely known as a "C-file") for the claimant. The claimant also is assigned a "claim number" that is unique to that person. This number is important because VA uses it to identify that claimant for life. The person's VA claims number remains the same no matter how many other applications are submitted or claims awarded.
VA next reviews the application for compliance with the filing instructions. If the application is not "substantially complete" or is otherwise not acceptable, VA will notify the claimant and give them up to a year to submit the necessary information. If an application is not made substantially complete within a year, the application is considered abandoned and VA will take no further action. A new application has to be filed in such a case.
When a substantially complete application is received, VA will "develop" the claim. The C-file is submitted for review by different teams of VA employees. All incoming claims are reviewed by a "triage" team that looks to remove totally unsupported claims. Claims that pass the triage team are delivered to the "development" or "pre-determination" team who gathers service records, service medical records, private treatment records, and other information that VA needs to make a decision on the claim.
When the claim is deemed sufficiently developed to allow a decision on the claim, the pre-determination team forwards the claim file to a "rating" team for decision. The rating team consists of "rating specialists" who are VA employees trained to evaluate the evidence and decide whether a claim should be granted or denied under the legal rules for VA benefits. Although rating specialists are trained by VA for this job, they are not medical or legal professionals by education or experience.
The rating team has the authority to award compensation and set an effective date, which is generally the date that the application was received by the VA or the received date of the intent to file form (VA form 21-0966). Payments usually start on the first day of the month following the effective date. The rating team can also send a C-file back to the development team for additional development without making a decision. This often occurs when a medical diagnosis is not unanimous among evaluating physicians or because a required record is missing.