Understanding VA Pension Benefits

VA pension benefits are one of many benefits offered to veterans by the federal government. Wartime veterans who meet net worth limitations may be eligible for this benefit.

VA pension benefits can also be awarded to surviving spouses and dependent children of deceased wartime veterans. Before applying for pension benefits, it’s important to understand the eligibility criteria.

What Are Veterans Pension Benefits?

Veterans pension benefits are monthly, tax-free payments made to eligible wartime veterans. This VA benefit is needs-based, and eligibility is subject to income and asset limits. To qualify for VA pension benefits, a veteran must have received any discharge other than dishonorable and have served during one of the wartime periods established by Veterans Affairs.

The process to apply for pension benefits is like filing a claim for VA disability benefits. Applicants should follow the instructions closely when preparing an application for VA pension to help ensure benefits are received as soon as possible.

Surviving spouses or disabled children of deceased wartime veterans can also be eligible for VA pension.

Who Qualifies for VA Pension Benefits?

There are a few eligibility requirements that you should follow when deciding if you can apply for VA pension benefits.

First, veterans are not eligible if they receive a dishonorable discharge. If you have a dishonorable discharge and feel you’d otherwise be entitled to this benefit, you may want to go through the process of petitioning for a discharge upgrade.

Veterans must also have wartime service to be eligible. What periods are considered wartime? According to the VA, there are specific dates signifying wartime periods from the Mexican Border period in 1916 through today.

  • Mexican Border period (May 9, 1916, to April 5, 1917, for Veterans who served in Mexico, on its borders, or in adjacent waters)
  • World War I (April 6, 1917, to November 11, 1918)
  • World War II (December 7, 1941, to December 31, 1946)
  • Korean conflict (June 27, 1950, to January 31, 1955)
  • Vietnam War era (November 1, 1955, to May 7, 1975, for Veterans who served in the Republic of Vietnam during that period. August 5, 1964, to May 7, 1975, for Veterans who served outside the Republic of Vietnam.)
  • Gulf War (August 2, 1990, through a future date to be set by law or presidential proclamation)

To qualify, you must also be 65 years or older, have a permanent and total disability, receive Social Security Disability, or live in a long-term care facility such as a nursing home.

Since VA pension benefits are needs-based, your net worth must be below the established maximum amount. Currently, the net worth limit is $138,489. Your net worth is your annual income and assets, including the following:

  • All countable income (salary, bonuses, commissions, or tips) for you and your spouse
  • Investments, stocks, and bonds
  • Real estate (other than your primary residence)
  • Boats
  • Furniture

The final net worth amount is the total of all these items, minus debts and some medical expenses, and must fall within the net worth limitations.

Now that you’ve seen the eligibility requirements, you may wonder how much VA pension benefits pay? Pension rates change yearly due to cost of living increases and depend on a few factors such as the number of dependents. You will receive a Maximum Annual Pension Rate (MAPR) based on current VA pension rates and then subtract your total net worth to find the annual rate you will receive in pension benefits.

How Do I Apply for VA Pension Benefits?

To apply for VA pension benefits, complete the VA Form 21P-527EZ and submit it online, through the mail, or at a VA regional office.

The following information is needed to complete the application:

  • Social Security number or VA file number
  • Veteran’s military service history
  • Financial information for family
  • Work history
  • Direct deposit
  • Medical information

You may wish to have a VA accredited representative assist you in filing a claim for VA pension. Veterans Service Organizations (VSO) such as the VFW or DAV have experienced representatives that assist veterans with the claims process for no charge.

The Fully Developed Claim (FDC) process is available to pension applicants. The FDC allows for faster processing times by submitting a complete claim packet with all evidence at once. When submitting an FDC, you must include a statement verifying that no further evidence will accompany your claim.

If you want to start the process but need time to gather all the necessary evidence, you can submit an Intent to File, which lets the VA know that you will be completing a claim in the future. You can submit an Intent to File by completing VA Form 21-0966. The date the VA receives your notification will be locked in as a potential start date for benefits and may result in VA back pay if your claim is approved.

What Is the VA Survivors Pension?

Survivors Pension is one of the benefits for family members offered by the VA. It is a monthly benefit paid to eligible surviving spouses and dependent children of wartime veterans. There are several factors that the VA uses to determine eligibility, such as the veteran’s military service, family net worth, and marital status of survivors.

To qualify for the VA Survivors Pension, your family net worth must fall within limits set by Congress, just as it does with the Veterans Pension program. The application process is also similar, but there are a few forms specific to spouses and children that need to be included with the application. Veteran service officers can help family members apply for VA Survivors Pension if needed.

Who Qualifies for VA Survivors Pension?

Unmarried spouses of wartime veterans can apply for VA Survivors Pension if they meet the following criteria:

  • Have not remarried since the veteran’s death
  • The veteran served during a designated wartime period
  • The veteran did not receive a dishonorable discharge
  • Your annual family net worth does not exceed limits set by Congress

The requirements for Veterans Pension and Survivors Pension are similar. One difference is the additional limitation placed on Survivor Benefit Plan (SBP) Minimum Income Annuity (MIW).

In addition to surviving spouses, some children of deceased wartime veterans can receive Survivors Pension benefits. Dependent children must be unmarried and:

  • Under 18 years old or
  • Under 23 years old and attending a VA approved school or
  • Disabled due to a condition that occurred before age 18

How To Apply for VA Survivors Pension

You can apply for the VA Survivors Pension benefit using VA Form 21P-534EZ. This form is also used to apply for Dependency and Indemnity Claim (DIC) and accrued benefits. The form can be completed online or submitted through the mail or in person at a regional VA office.

You must have the following information available to complete the application:

  • Veteran’s military service information
  • Veteran’s death certificate
  • Marriage certificate (spouse) or birth certificate (child)
  • VA Form 21-674 to verify school attendance (child)
  • Medical records related to disability (child)
  • Family income and asset information
  • Medical expenses
  • Direct deposit information

Like the Veterans Pension claim, a survivor can submit the claim through the FDC process or use an Intent to File to lock in an effective date and finish the claim later.

What Is the Aid & Attendance Benefit?

The Aid & Attendance (A&A) benefit is an additional amount paid monthly to VA pension recipients who need significant help to perform their daily duties. Examples of daily tasks are bathing, eating, maintaining a safe home, using the toilet, and operating prescribed medical equipment. You can receive A&A benefits if someone helps you perform these duties in your home or if you are a nursing home resident. You may also be significantly bedridden due to the severity of your disability when receiving A&A.

Even if you qualify, Aid & Attendance is not automatically awarded when applying for VA pension. It’s a benefit you’ll need to apply for separately. To apply, use VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance). Your doctor will complete a portion of the form.

You must also submit medical evidence and other letters describing your limitations of daily activities. Send the application and all supporting documents to your Pension Management Center (PMC).

What Is the Housebound Allowance?

The Housebound Allowance benefit is paid to individuals who receive the basic pension benefit and are deemed 100% disabled (from a single disability) and unable to leave home. Apply for this allowance in the same way as A&A. You cannot receive both the Housebound allowance and Aid and Attendance at the same time.

What’s the Difference Between Veterans Pension and Military Retirement?

The Veterans Pension program should not be confused with military retirement. Veterans pension is a VA-funded benefit offered exclusively to wartime veterans and surviving spouses. Veterans Pension is a needs-based program, and there are several criteria and income limits that recipients need to meet.

Military retirement is an entitlement paid by Defense Finance and Accounting Service (DFAS) to retired military veterans who have been officially retired from service. It is not based on wartime service or need. It is a monthly payment given to all retired service members.

What’s the Difference Between Veterans Pension and Disability Compensation?

While these benefits for veterans are both paid by the VA, they are different benefits with their own set of eligibility requirements. The VA pension is a needs-based benefit that includes income and net worth limitations.

Disability compensation is a benefit paid to veterans with an approved service-connected disability. It is not contingent upon income or net worth, simply on the disability rating awarded by VA officials in response to a disability claim.

Survivors cannot apply for the deceased veteran’s disability compensation as they can with VA pensions. However, if the veteran died because of their service-connected disability or had a 100% rating, survivors can apply for Dependency and Indemnity Compensation (DIC).

VA Pension Benefits

VA Pension is one of many veterans benefits offered by the federal government. The benefit is available to wartime veterans who are disabled or over the age of 65 and meet net worth limits set by Congress.

To apply for pension benefits, submit an application and any required documents, such as medical evidence and net worth statements. If you can submit everything at once, the Fully Developed Claim program can get you a decision faster. But you can also opt to send an Intent to File to start the process and gather your documents within one year.

Surviving, unmarried spouses, and dependent children of deceased wartime veterans may also be entitled to this benefit. The Survivors Pension application process is the same as veterans pension, with a few additional forms unique to dependents.

You may also be entitled to additional funds through Aid and Attendance or Housebound benefits. These programs provide additional aid to pension recipients who reside in a skilled nursing facility, are homebound, or are unable to fully care for themselves without home care.

If you have questions about your VA disability benefits, help is available. Reach out to us today for free medical consultation and benefits review.

How To Appeal a VA Disability Denial

Disability benefits from the U.S. Department of Veterans Affairs provide financial assistance to veterans who have a disability that was either caused or worsened by their military service. These monthly disability benefits can take a while to begin, as the VA claim and decision process can be lengthy. Sometimes, a VA decision does not go in the veteran’s favor, resulting in a denial and VA disability appeal.

How To Appeal a VA Disability Claim Denial

  • Supplemental Claim
  • Higher-Level Review
  • Board Appeal

Veterans have a few options if they choose to move forward with a VA disability appeal, but they must follow an appeals process to escalate the appeal. Most veterans begin with a Supplemental Claim to add new evidence to their current disability claim. If the VA still sends a denial letter, veterans can seek another claim decision through a Higher-Level Review or Board Appeal.

It’s essential to understand the VA disability benefits claims and appeals process before submitting a veterans claim for disability benefits. A disabled veteran can seek the help of an experienced attorney or Veterans Service Officer (VSO) to submit their initial claim with the best possible chances of a successful claim decision.

What Is the Appeals Modernization Act?

The Veterans Appeals Improvement and Modernization Act, also known as AMA, was signed under President Trump in 2017, officially becoming law in 2019. AMA brought about some of the most groundbreaking changes to the VA disability appeal and claims process.

One of the most significant changes was the requirement of the VA to assist veterans with their disability claims until each claim has been approved or denied. In other words, veterans have the right to assistance with the VA disability claims process until the VA reaches a decision.

The AMA also overhauled the veterans appeal process for disability compensation claims. The new law brought forth a more streamlined way to appeal a disability claim denial, offering veterans the option of submitting a Supplemental Claim, seeking Higher-Level Review, or getting a board review.

The law also ensures that the VA provides detailed reasoning for a veterans disability claim denial so that a disabled veteran can determine the best way to begin the appeal process if they choose to do so. VA notices need to include why a claim was denied, what evidence went into the decision, and how veterans can obtain additional evidence if needed.

Perhaps most important to veterans is the AMA’s requirement to review VA claims faster. The AMA created a simpler, more modernized way for the VA to process claims in an attempt to bump down the average claim processing time to reach a decision faster. The law also made the VA disability appeal process faster for any type of appeal.

Additional changes to the veterans disability benefits claims and appeal process include binding veteran-favorable claims decisions unless ample evidence proved otherwise, and allowing veterans up to one year to appeal a VA disability claim decision.

How To Appeal a VA Disability Claim Denial

VA disability benefits are some of the most valuable benefits for veterans. However, not all disabled veterans are eligible for the benefits, and some must go through rounds of appeals to get an approval. Currently, about 30% of VA disability claims get denied.

Veterans should know that they have options after receiving a denial. The VA disability appeal process allows for three different types of appeals veterans can file to receive compensation. The veteran can choose which route to take depending on their specific case.

While the process to appeal can be frustrating and lengthy, it’s worth it if you believe you rightfully deserve VA benefits. According to 2020 data from the VA Board of Veterans’ Appeals (BVA), the BVA approved 33.8% of legacy appeals brought to it for review and remanded – sent back to the veteran for more evidence or changes – another 40.6% of legacy appeals. The BVA approved 37% of AMA appeals and remanded 28.2% of them. 

The following sections detail each of the three appeals processes under the modern AMA law.

1. Supplemental Claim

A Supplemental Claim is typically the quickest and most straightforward type of appeal. Veterans can submit new or relevant evidence to the VA for review with this process. Essentially, this evidence should support your denied claim by providing either brand-new evidence of your disability or relevant evidence that proves information in your claim. A Supplemental Claim is typically best for veterans who believe that additional information or evidence could help their claim push through to approval.

Eligibility for a Supplemental Claim

Supplemental claims are only for veterans who have new or relevant evidence to add to their original claim. Any new or relevant evidence a veteran uses during this appeals process must be evidence that wasn’t originally in the claim.

Because Supplemental Claims aren’t solely for appeals, a veteran can submit one at any time. For example, a veteran might submit a Supplemental Claim if they see a new doctor that provides a similar diagnosis to one they’ve already received and they believe this evidence will help support their original claim.

However, for appeals, the VA recommends filing one within one year from the date of your decision letter for a timelier decision process. This way, it has the most up-to-date information about your case with less likelihood of needing to schedule additional exams and gather evidence that could take more time.

What To Expect From the Supplemental Claim Process

To file a Supplemental Claim, a veteran should fill out and submit VA Form 20-0995. On this form, you can indicate that you are submitting the claim in response to a VA disability denial and list the issues you disagree with. Then, you may either submit the new or relevant evidence you have or fill out the information for the VA facility or non-VA provider that has the evidence. In the latter scenario, the VA will help you locate the evidence to add to your claim.

Once the VA gathers any evidence you have requested, a VA claims adjudicator reviews your original claim and Supplemental Claim, considering any new and relevant information you’ve included.

If the VA determines that it still needs more information to support your claim, it may request that you complete an exam or testing to get the data it needs. Be sure to check for any mail from the VA during the Supplemental Claims process, which may include an appointment date and time. Be diligent about attending scheduled exams to avoid delays in the process.

What Happens After Submitting a Supplemental Claim

The VA currently takes about 4-5 months to review and decide on Supplemental Claims cases. Once it reaches a decision or determines that more information is necessary to process your claim, you’ll receive a letter in the mail. If you receive another denial, you can then escalate your claim to a Higher-Level Review or Board Appeal.

2. Higher-Level Review

A Higher-Level Review is almost like a second-tier decision review system for disability claims. In this process, a more experienced decision review officer evaluates your claim and forms a decision for your appeal. The new reviewer may decide to validate the previous reviewer’s decision or push through your claim in your favor, considering all evidence and information you submitted with your original claim.

This appeals process can occur when the VA has already denied an original or Supplemental Claim. You do not need to first appeal with a Supplemental Claim and can move straight to the Higher-Level Review process if you choose.

Eligibility for a Higher-Level Review

Unlike a Supplemental Claim, a Higher-Level Review cannot contain any new evidence for the VA to review. Instead, it must only include your original claim or your Supplemental Claim if you believe that either one was not reviewed the first time accurately.

What To Expect from the Higher-Level Review Process

The Higher-Level Review process does not allow you to receive help from the VA to gather additional evidence for your claim because you cannot add new evidence. However, you do have the option of speaking with a Higher-Level Reviewer about your claim or having your representative do it for you.

With this option, the reviewer will schedule a time to call you or your representative to discuss the details of your claim and appeal. You can use this time to explain what you believe should be changed in your claim decision, such as your disability rating or disability denial. The reviewer may also discuss errors found in your case that you might be able to correct to assist your appeal.

This conference is informal and should be treated as such. Nothing you say will count against you during the call. Instead, it’s simply an informational call to discuss your case with a reviewer to make sure the Higher-Level Review is the best option for you and provide some background to your case.

To file for a Higher-Level Review, you should submit VA Form 20-0996. If you’d like to speak with a Higher-Level Reviewer prior to the review, you can indicate that on the form. Also, mark what information you’d like reviewed when filing. If you need help completing or submitting the form, you can contact your Veterans Service Organization or a VA attorney to assist.

What Happens After Filing for a Higher-Level Review

After you submit your VA disability appeal and request a Higher-Level Review, you should expect to wait four to five months for a decision, although some cases may be quicker or take longer. Some veterans may need to attend VA doctors’ appointments for additional testing or exams, similar to a Supplemental Claim. Attend any appointments the VA schedules you for a smooth process.

If you still do not agree with the decision from a Higher-Level Review, you may move on to a Board Appeal.

3. Board Appeal

The final potential solution for your VA disability appeal is a Board Appeal through the BVA. A BVA appeal can happen when trying to appeal an original claim, Supplemental Claim, or Higher-Level Review decision, so it’s an appeal option for any claim.

This VA appeals process allows the veteran to choose from three options. First, the veteran can request a Direct Review by a Veterans Law Judge. The Veterans Law Judge will review any information you already submitted and make a Board decision based on that information, similar to a Higher-Level Review.

The second option allows a veteran to submit additional evidence for a decision review by a Veterans Law Judge. If you have any extra information to provide that you either received after your claim or didn’t include with your claim, you can add it with this option.

Lastly, veterans can request a hearing with a Veterans Law Judge. This can either be held in person or virtually. It may be the best option for veterans wishing to discuss their case with the Veterans Law Judge and listen to the decision process.

Eligibility for a Board Appeal

Veterans can choose to request a Board Appeal for any type of appeal, including original claims, Supplemental Claims, and Higher-Level Reviews. If you want to submit any new evidence with your claim, you must do so within 90 days of filing your Notice of Disagreement (NOD) to request a Board Appeal.

What To Expect from the Board Appeal Process

The Board Appeal process takes longer on average than other claims appeals. Typically, a Direct Review is the quickest route, but it still could take about one year. Submitting more evidence and requesting a hearing with the Board could each take more than one year.

It’s a good idea to speak with a VA disability attorney or a VSO before filing for a Board Appeal to determine which option is best for your case. After discussing your case, you might find that a different appeal option could be beneficial and save you time waiting for a decision.

What Happens After Filing for a Board Appeal

The Board Appeal is the highest tier of appeals for VA disability benefits claims. However, veterans may choose to submit additional evidence they may have received after their appeal by filing a Supplemental Claim. You can do this even if you’ve already filed a Supplemental Claim in the past.

Additionally, veterans are allowed to escalate their appeals to the U.S. Court of Appeals for Veterans Claims. The VA allows you 120 days from the date of your BVA appeal decision to file for a court appeal.

What Is a Legacy Appeal?

Legacy appeals are any appeals for VA disability benefits originally dated before February 19, 2019, when the AMA officially became law. Beginning on this date, the VA disability appeal process shifted to allow a more straightforward and speedier resolution process for veterans.

However, the VA kept the old appeals process open so that it could still process current appeals. As a result, any legacy claims fall under the prior process of appeals, while those dated on or after February 19, 2019, immediately went under the new system.

It’s important to note that the legacy appeal process could take longer for the VA to reach a decision. The VA website states that these appeals typically take between 12-18 months for the VA to conduct a review of the appeal, and it may take as much as seven years for a BVA review.

Still, veterans with open legacy appeals could file a new appeal, which would fall under the new AMA appeals system. If a veteran with a legacy appeal files a Notice of Disagreement (NOD) for the VA’s decision, the VA then sends a Statement of the Case (SOC) if it still determines that not enough evidence is available to approve a claim. If the SOC is dated on or after February 19, 2019, the veteran may choose to either continue the legacy appeals process or switch to the AMA appeals process. The VA allows veterans 60 days from the SOC’s date to opt in to the new appeals process.

Under the new AMA appeals process, veterans can choose between the three options for VA disability claims. Veterans have one year from the date of their denial to move forward with an appeal, whether they’d like to appeal their disability claim denial or disability rating decision.

How To Check Your VA Appeal Status

The easiest way to check your VA disability appeal status is to create an online account with the VA website. If you have a DS Logon, ID.me account, or MyHealtheVet account, you can use your credentials to sign in to the VA website and check your appeal status. If you don’t currently have one of these accounts, you can create an ID.me login to get started.

On your My VA dashboard, you’ll find a link to ‘Track Claims.’ Click that link to see your current claims and get their status. The website will include all information submitted online with that claim, including your application and any medical evidence. However, anything you’ve mailed, faxed, or brought into your local VA office won’t be available on the website. You’ll also see details for your VA representative, whom you can contact about your claim.

The site displays the current step your claim falls on in the process, such as the initial review or evidence gathering. You should receive a notification when the claim escalates to the next step.

If you are unable to check your appeal status online through the VA website, you can contact your local VA office or your VA representative directly for assistance.

Should I Hire a VA Disability Lawyer?

A VA disability lawyer is well-versed in veterans law and regulations surrounding VA disability claims. This type of attorney can guide a veteran through the appeals process to ensure that the veteran has supplied all necessary information to the VA. They also uphold the best interests of the veteran throughout the appeal.

A disability attorney may help you find more success with your claim appeal. According to the Board of Veterans’ Appeals 2020 data regarding VA disability appeals, attorneys were responsible for getting the most legacy appeals allowed by the Board at 40.9%.

Other organizations, like AMVETS, the American Legion, and Vietnam Veterans of America, had lower approval rates. Additionally, cases with the assistance of a VA disability lawyer were less likely to get denied by the Board than others, with a 14.8% denial rate.

Consider the following benefits of a disability lawyer for a VA disability appeal:

  • Experience: These attorneys have more experience than you do with the appeals process because they’ve been through it multiple times. They know the typical procedures and can guide you through each step.
  • Communication: Your attorney will keep in close contact with you to update you on your appeal. They’ll also reach out to doctors and the VA on your behalf to get any information necessary.
  • Expertise: An attorney’s deep understanding of each type of appeal allows them to suggest the best path for your case. They’ll also dig into why your claim was denied in the first place to make it easier to gather the appropriate evidence.
  • Affordability: Many VA disability attorneys only charge veterans a fee once they’ve successfully won a case and helped the veteran recover money to which they were entitled.

Understanding the VA Disability Appeal Process

Like VA health benefits and education benefits, eligible veterans can receive VA disability compensation for service-connected disabilities. Although the VA denies many claims, the appeals process has been reconfigured to make it simpler and quicker for veterans to appeal, thanks to the Appeals Modernization Act.

Veterans can choose one of three paths: Supplemental Claim, Higher-Level Review, and Board Appeal. Each path’s eligibility requirements vary and cater to different circumstances.

Consider working with an attorney who knows what your claim needs for its best chance at approval. A VA disability attorney can help you decide which path is best for your situation. Contact our attorneys today for a free legal consultation.

6 Tips for Writing a Nexus Letter

A great VA nexus letter can be the key to getting your VA disability claim approved, so it’s important to submit one that’s clear and informative. There are a few best practices to consider when preparing a nexus letter for your disability claim.

  1. Choose the Right Doctor
  2. Provide the Doctor With All Your Records
  3. Write the Nexus Letter on the Doctor’s Letterhead
  4. Use VA Language
  5. Use the Correct Formatting
  6. Be Concise

Nexus letters are written by medical experts and show the link (or nexus) between your disability and your military service. You want to get your disability compensation claim approved the first time so you can begin receiving the benefits you deserve. A good nexus letter can help you do that.

What Is a Nexus Letter and Why Is It Important?

A nexus letter connects a veteran’s medical condition to their time on active duty. It is sometimes referred to as an Independent Medical Opinion or IMO letter. It is written by a medical expert familiar with your illness or injury who has reviewed your medical history. In turn, they state whether it is likely that your military service caused or aggravated your condition. A nexus letter can give a claim the credibility it needs to be approved by VA raters.

You can submit a nexus letter at any time in the claims process. Since the nexus letter can help get your claim approved the first time, it’s best to submit it with your initial VA disability claim. However, you can also submit it with an appeal or in response to an unfavorable C&P exam.

Why is a nexus letter important? For a disability claim to be approved, it must show three things:

  1. A medical diagnosis of a condition
  2. Medical nexus evidence
  3. Current symptoms and how they affect daily life

Medical nexus, or the link between your disability and military service, can be proved by the medical evidence you submit. If your medical record alone doesn’t provide enough proof, a medical nexus letter is needed.

If your disability case is complex and you lack medical records to back up your claim, a nexus letter is even more critical. For exposure illnesses such as agent orange or burn pit exposure, the nexus opinion of a medical expert can help a claim get approved. Another example is when trying to link a secondary disability. A written account from a doctor who can connect the two may be necessary.

6 Tips for Writing a Great VA Nexus Letter

The key to linking your current disability to your military service to receive disability compensation is providing a solid nexus letter. Here are some tips for writing a great nexus letter that gets results.

Choose the Right Doctor

When choosing a doctor to write your nexus letter, you should select one familiar with your current disability. Ideally, a specialist such as a cardiologist, orthopedic surgeon, or another specialist appropriate to your condition should write the nexus letter for you. Avoid asking a VA doctor or a doctor contracted by the VA for a nexus letter.

Another option is to consult a medical professional who specializes in veteran disability to write your nexus letter. Select a doctor who has experience writing nexus letters and has favorable reviews if you choose this route. You can also ask to see examples of past nexus letters they have written.

Provide the Doctor With All Your Records

To write a comprehensive nexus letter, your doctor will need access to all medical treatment notes, lab notes, test results, or military files relating to your disability. It is also helpful to provide buddy letters or testimonials that you may have. It is best to gather all your medical and personnel records ahead of time and present them all right away instead of adding new documents as you find them.

Your doctor needs a complete picture of your health before and after the disability to write a convincing and detailed statement. The more details provided, the more value the nexus letter will add to your disability claim.

Write the Nexus Letter on Doctor’s Letterhead

For your nexus letter to carry the most weight, it needs to be written by a licensed medical expert in the appropriate medical specialty. What better way to establish credibility upfront than to write the letter on the doctor’s letterhead?

The letterhead shows VA raters right away that the medical opinion they are about to read is from an experienced and licensed medical professional, and there is no need to scan to the bottom to see who the author is.

Use VA Language

Who reads nexus letters? VA claims officials do, and that’s why your doctor must use VA language when stating the medical opinion regarding the likelihood that your disability is service-connected. The VA uses the following terms to describe levels of certainty of service connection:

  • “is due to” means 100% sure
  • “more likely than not” means more than a 50% chance
  • “at least as likely as not” means 50% or more chance
  • “not at least as likely as not” means a less than 50% chance
  • “is not due to” means there is no chance

If you think that you need to prove that your disability stems from your military service without a shadow of a doubt, that’s not true. For a VA disability claim to be approved, the evidence needs to show that it is equally as likely as it is not likely that your disability is a result of your military service.

The above criteria are what VA officials use to decide claims, so they want to see this exact phrasing used in any medical opinion that accompanies your claim. Be sure that your doctor understands these levels of certainty when assessing your case and uses the appropriate language in your nexus letter.

Use the Correct Formatting

You may be wondering, “what should a nexus letter include?” There’s a basic format for nexus letters, so you can be sure you’ve included all the required information. Your nexus letter should follow this format:

  • Credentials
  • Reference of thorough record review
  • The medical opinion expressed in VA language
  • The medical rationale with supporting medical literature and case law

The letter begins with credentials upfront when written on the doctor’s letterhead. Next, the doctor should state that a complete review of medical records was accomplished and list the specific instances that link symptoms to service events. The medical opinion follows, again, making sure the exact VA language is used when assigning probability. As long as the facts support it, you’ll want the medical opinion to be “at least as likely as not.”

Wrap up the letter by giving the reasons to support the medical decision. Here the doctor will cite any medical literature or case law from similar instances that support this medical opinion they’ve reached. Approved cases with similar circumstances and medical studies that link conditions to military service add convincing weight to the nexus letter.

You may want to give your doctor a sample nexus letter as a template to follow. Sample letters are beneficial for doctors who are not familiar with the VA disability claims process. But it can also be a valuable tool for experienced doctors to follow, just to be sure the letter is formatted correctly and includes all the required components.

Be Concise

As of December 2021, nearly 630,000 pending claims are waiting to be reviewed and decided on by the VA. Claims officials have lots of paperwork to read through and need to be as efficient as possible. For that reason, you’ll want your nexus letter to be concise and to the point. The nexus letter should be evidence-based and detailed but not lengthy. Short and sweet is the best rule of thumb.

Do You Need a Nexus Letter?

Does every claim need to have a nexus letter? Probably not. If your disability was diagnosed while on active duty and you have medical documentation supporting your diagnosis, you probably don’t need a nexus letter.

Suppose your medical condition was diagnosed after you left military service and have no medical documents showing symptoms of your condition while still on active duty. In that case, you should get a nexus letter to show the link to the service connection.

Also, when filing an appeal on a denied disability claim, you should include a nexus letter to provide a more compelling case to get your appeal approved. Submitting a claim for a secondary disability is another time when a nexus letter is helpful to show the connection. For example, when proving that sleep apnea is a secondary disability to PTSD.

How Much Does a Nexus Letter Cost?

The cost of a nexus letter can vary depending on the experience and credentials of the doctor writing it. The average cost is $1,500, so it is essential to research and select a reputable doctor. Some organizations will write the letter for free and then charge a flat or percentage fee when the disability compensation claim is approved.

A separate letter is required for each condition, so getting multiple nexus letters can be costly. If you’ve determined that a nexus letter can best help your claim get approved, it can be a worthwhile investment.

Nexus Letter for Your Disability Claim

A nexus letter shows the link (or nexus) between your disability and your military service, which is needed to get your disability claim approved for VA disability benefits. A nexus letter is written by a medical professional who will give their medical opinion on the probability that your current medical condition was caused or aggravated by your military service after a complete review of your records.

For the VA to approve your claim, you must prove that it “as at least as likely as not” that your disability is service-connected. Using this specific language is necessary as this is the standard that the VA uses to determine service connection.

Likewise, it is essential to follow a clear format when writing the letter. The four parts of a nexus letter are credentials, reference of medical record review, medical opinion, and medical rationale. Letters should be evidence-based and concise, along with citations of medical literature and case law that backs the doctor’s opinion.

Not every veteran needs to include a nexus letter with their disability claim. Adding a nexus letter isn’t necessary for those with a disability that is clearly from service with a diagnosis and treatment during their time on active duty. But for veterans whose disability appeared after military discharge or who lack adequate medical records, a nexus letter can provide the missing link between service and their current medical condition needed to approve their claim.

Do You Qualify for VA Back Pay?

Disabled veterans may qualify for VA back pay when their VA disability claim is approved. VA back pay is a retroactive payment of benefits made in one lump sum to cover the period between the effective date of disability and the decision date of a claim. A few different rules apply when calculating VA back pay.

What Is VA Disability Back Pay?

VA disability back pay is retroactive pay given to a disabled veteran after the VA approves their service-connected disability. The disability claim process can take a long time. Veterans wait months, and sometimes years, to find out if their VA claim is approved or denied. Since it is a long process, veterans must endure without benefits during this waiting period.

If a disability claim is approved, the VA will pay retroactive benefits to the veteran in a lump sum from the decision date to the effective date. The effective date is usually the application submission date, but in some cases, the effective date is the date the disability began. Veterans will receive disability pay through direct deposit or check.

The dollar amount of disability back pay depends on a few factors such as disability percentage, annual VA disability rates, and whether the veteran has dependents.

How Do I Qualify for VA Disability Back Pay?

To qualify for VA disability back pay, you must have:

  • A service-connected disability
  • An approved VA disability compensation claim
  • A period between the claim submission and decision date

During the disability claim process, the VA will review medical evidence and determine if your disability is service-connected, meaning it was caused or made worse by your military service. Veterans with approved claims receive a disability percentage rating and will receive monthly payments moving forward.

The VA will owe you those monthly compensation payments for the time that elapsed between filing the claim (the effective date) and the date they rendered their decision, and they pay it in one lump sum.

Veterans or survivors who receive VA pension benefits are also entitled to VA back pay for benefits they would have received between the effective date and the decision date of the claim.

What Does “Effective Date” Mean?

When the VA approves a claim, they assign an effective date for your entitlement to the benefit. There are a few different factors they consider when determining effective dates. 

How does the VA select an effective date?

If a claim is filed within the first year after leaving active duty, the effective date can be as early as the day after leaving service. However, if you file after one year of separation, the day the claim is submitted becomes the effective date.

Veterans who have a medical condition that is considered a presumptive service-connected disability can get an effective date back to when the illness or injury occurred if they file within one year from leaving service. A presumptive condition is one that the VA already recognizes as being connected to service, making it easier to get claims approved. As with a standard disability, filing after the first year will put the effective date at the claim submission date.

Other situations can play a role in establishing an effective date. Requesting an increase in disability may change the effective date to the date that you can prove the disability got worse, or it will be the date of the increase claim. If the VA makes an error in deciding a disability claim, the effective date will become the date it would have been if it had been initially approved.

A change in the law can make previously denied or unsubmitted claims valid. A disability approved due to law change can become effective on the date the law changed or up to a year before claim submission.

What Is an Intent to File?

An intent to file notifies the VA that you plan to submit a claim for VA benefits. As a result, the VA will reserve the date of the intent to file as a potential start date for benefits. Why is the intent to file necessary? By locking in the potential start date, or effective date, an intent to file helps get you the earliest possible VA back pay if your claim is approved.

When starting your application online through the VA.gov portal, the system automatically generates and submits an intent to file. The VA receives notification, and no further action is required on your part. However, if you choose to file your claim through mail or in person, you’ll need to file a hardcopy VA Form 21-0966 for your intent to file.

After submitting the intent to file, you’ll have a year to gather all information and evidence you need to complete your disability claim and submit the completed application to the VA.

How Do I Submit an Informal Claim?

You may have heard of an informal claim and wonder how you go about submitting one. An informal claim is essentially an intent to file. Before March 24, 2015, veterans had to submit an informal claim to let the VA know they planned to apply for VA benefits.

In the past, to file an informal claim, veterans could simply submit any communication that notifies the VA of the claimant’s intent to file a claim. Any type of communication counted: email, letters, or other messages. An incomplete or unsigned application could also serve as an informal claim.

After March 24, 2015, the VA began using the terminology “intent to file” to refer to the action of alerting the VA that you’ll be filing a claim to lock in a potential effective date. The intent to file is now submitted automatically when beginning the online claim process or through the VA Form 21-0966.

How Does VA Disability Back Pay Work?

The first step in the VA disability back pay process is to file your application for disability compensation through either the online application portal, in person at your local Veterans Affairs office, or by mailing or faxing the VA Form 21-526EZ. The application must be filled out completely, signed, and with evidence included.

VA officials review disability claims to determine if your disability is service-connected and eligible for VA disability benefits. Due to many new claims and appeals the VA receives, there is a backlog of cases to review. Waiting for a decision on your claim can take months or even years, depending on the complexity of your case.

Once the VA approves your disability claim, they will give you the following:

  • Disability rating
  • Effective date
  • Monthly compensation amount you will receive going forward

The VA establishes the effective date as the date you became eligible for disability compensation benefits. The VA uses a few factors to determine this date, but it is often either the date you filed your claim or the date your disability began.

Although VA disability payments will start coming after your claim is approved, the VA owes you a retroactive payment of benefits back to the effective date. You will receive the back pay in one lump sum through direct deposit or check. The amount of back pay equates to your monthly payment amount times the number of months between the effective and decision dates unless circumstances apply. For example, if back pay extends to a previous year, those months are paid at the monthly rate established for that specific year.

Back pay is calculated and automatically paid by the VA, and you do not need to initiate the process.

Do I Need a VA Disability Attorney to Get Back Pay?

While no action is required to start the back pay process, you should take an active role in monitoring its payout. The VA says most veterans receive back pay in 15 days, but often this is not the case. As time passes, you may wonder if you need to hire a VA disability lawyer.

It can be frustrating to wait for a VA decision and then wait again for your earned back pay. You may want to hire an attorney if you’ve been waiting for VA disability back pay for a while to help speed up the process. When selecting an attorney, choose one who specializes in veteran law and is experienced in getting benefits for veterans.

How Much Back Pay Will I Receive?

VA disability back pay is calculated by determining the time between the effective date and the date the VA approved your claim. The longer you’ve been waiting for benefits and the higher your disability rating, the more back pay you will receive.  

A few factors play into back pay calculations. VA disability rates can change annually due to cost-of-living increases. If your back pay extends across multiple years, that year’s disability rate will apply to those months of back pay. If you’ve received severance pay, retired pay, or disability payments during the back pay period, those amounts are deducted from your back pay. A veteran cannot receive those payments along with disability compensation.

Do I Have To Pay Taxes on My VA Back Pay?

VA disability compensation is a non-taxable benefit paid to disabled veterans. Any back pay you receive for disability compensation is not taxable.

VA Disability Back Pay

You may qualify for VA back pay if you have an approved VA claim for disability compensation for a service-connected illness or injury. The time between submitting your disability claim and the date the VA decides on the claim can be a long time. The VA pays you retroactive benefits to cover the period from their decision date to your disability effective date.

The effective date of a disability varies depending on circumstances. Veterans can have an effective date set to the day the disability began, the day they left service, or the day they submitted their completed disability compensation claim. It is important to file your VA claim as soon as possible to get the earliest allowed effective date.

To help lock in an early effective date, you should submit an intent to file. This lets the VA know that you will be completing an application for disability benefits. The date they receive your intent to file will become your potential effective date for benefits. You’ll have one year to submit the completed claim.

When the VA approves your claim, they will calculate how much back pay you are entitled to. Generally, the back pay amount is the total of monthly payments they would have paid you back to your effective date. A few factors, such as what year the back payments extend to, may change that monthly amount. There are also certain benefits you cannot receive at the same time, so further calculations may be needed to determine your exact back pay amount.

Unfortunately, you will probably have to wait for your back pay to reach you through direct deposit or check. If following up with the VA does not resolve your issue, you may want to consult an attorney that specializes in veterans benefits to help you navigate the process.

How To File a Fully Developed Claim

Applying for VA disability compensation benefits can be a long process, resulting in delayed benefits for veterans. The VA has created the Fully Developed Claim process to drastically reduce processing time so veterans can receive their benefits more quickly.

Evidence Required for a Fully Developed Claim

  1. Military Medical Records
  2. Military Personnel Records
  3. Private Medical Records
  4. Federal Records the VA Can Request

The VA introduced the FDC program in 2010 to reduce the backlog of claims that were stalling the system. It is a fast-track method of getting claims through the process by putting all the responsibility on the claimant for gathering and submitting evidence related to their claim.

There is more work required on the front end by the claimant, but claims are processed faster, and veterans get compensation quicker. However, if the packet isn’t thoroughly put together and documents are missing that prove service connection, the probability of claim denial is greater.

Veterans should educate themselves in the pros and cons of the fully developed claim process to determine if this route is best for their individual VA claim. Consulting a Veterans Service Officer (VSO) to help assemble and review the claim can also help your odds of getting your claim approved.

What is the Difference Between a Standard VA Claim and a Fully Developed Claim?

You can submit your VA claim in one of two ways: the standard VA claim or fully developed claim route. There are a few differences between the two. It takes the VA less time to decide on a fully developed claim. Results can come in 30 days. The faster process makes this an attractive option to many veterans.

The reason for faster claims processing is that you must do all the research and evidence gathering on your end before submitting the claim. The VA will only assist in getting documents from Federal sources, such as military records and VA medical records.

If you have medical evidence from civilian doctors or witness letters to submit, you must submit everything together when you file your fully developed claim. Essentially, you are telling the VA that you have submitted everything they need to review your claim, and you won’t be submitting anything else.

The VA will treat your fully developed claim with as much attention as the standard claim. If they feel further evidence is needed, they will switch your fully developed claim to a standard claim, and you’ll have up to a year to provide the suggested documentation.

Even though the VA will carefully review your fully developed claim, the chances of claim denial are greater going the fully developed route since there isn’t an opportunity to submit more evidence as you get it.

You should consider the complexity of your case before choosing between the fully developed claim or standard claim processing. If your medical condition is still changing, you won’t be able to add new evidence that may be key in getting your claim approved.

What Is a Standard VA Claim?

A standard VA claim is a claim for VA disability benefits that follows the traditional route. The process takes much longer than a fully developed claim, however, the VA can help you gather evidence.

To file a standard claim, veterans must submit VA Form 210526EZ. Applications are completed online, in person at your VA regional office, or through the mail.

You have up to a year from the application date to submit evidence. Examples of evidence are military orders, medical records, witness letters, or other documents connecting your condition with your time in service.

The VA can request federal records for you, such as military records, VA treatment records, or documents from the Social Security Administration. If you have these documents, you can submit them to save time. The VA can also request documents from non-federal agencies, such as civilian doctors and employers, but you must provide authorization to do so.

As of October 2021, the average length of time to process a standard claim for disability compensation is 144.4 days.

What Is a Fully Developed Claim?

A fully developed claim contains all the evidence necessary for the VA to decide on a VA disability claim. Like the standard claim, you can apply online, in person, or through the mail. You can begin working on the application, save it, and return to it later to complete it. Once you start the claim, you have a year to complete it.

When completing the application, you will need to attach all required evidence when you apply. Common types of evidence are active duty orders, medical treatment records, and service member statements. Once you certify that the claim is complete, you won’t be able to submit any further evidence. 

Who can submit a fully developed claim?

A service member who has a condition caused or aggravated by military service or has a condition caused or aggravated by another disability that the VA has already approved is eligible to submit a fully developed claim. 

Since the claimant provides all the evidence upfront, a fully developed claim takes less time to process than a standard claim. If the claim is approved, the effective date for VA compensation will be the application start date.

Evidence Required for a Fully Developed Claim

To improve the chances of your fully developed claim, you should submit the following types of evidence and documentation:

Military Medical Records

Attach all military medical records related to the condition you are claiming. Presenting all available documentation will help to support your claim. Include documents such as sick call notes, treatment records, military profiles, military hospital records, X-rays, and test results. Also include annual, pre-deployment, or post-deployment physicals that may address the condition. 

Military Personnel Records

Military personnel records are a vital part of linking a service connection to your condition. Submit documents like mobilization orders, temporary duty orders, or PCS orders. Also, include any performance evaluations or counseling statements that may address any limitations you experienced due to injury or illness. If you need help finding these documents, contact previous units or ask the VA to help.

Private Medical Records

Include any records you have from private medical treatment. Obtain copies of treatment notes, test results, emergency room visits, or other documentation related to the condition. If you no longer live near these private medical facilities, you can contact the medical records department for help in obtaining copies of these files.

Federal Records the VA Can Request

The VA can help you to collect records relating to your claim from federal sources. If you need help getting a copy of military orders or your DD214, the VA can request a copy for you. They can also obtain medical records from VA medical clinics. If you are receiving Social Security disability, the VA can get copies of documents that would be helpful to your disability claim. You’ll need to let the VA know what records are required and provide authorization for them to request documents on your behalf.

What Is the Process for a Fully Developed Claim?

Filing a fully developed claim is relatively simple once you have gathered all your supporting documentation. To begin the application, you’ll need to create an account or log in to your existing account on VA.gov. Click on the button to apply for benefits.

Before beginning your application, you will have the opportunity to add a VA representative to act on your behalf if you need assistance from someone like a Veteran Service Office (VSO). VSOs provide free support to help veterans access their benefits.

Step 1: Administrative Information

The application starts by giving you a privacy act notice, an overall explanation of the Fully Developed Claim Program, and important dates to follow. You have one year from the date you begin the claim to complete it, upload all the necessary evidence, and submit it. In this section, you will also add your contact information and account information used for disability compensation payments should your claim be approved.

Step 2: Military Service History

In the next section, you’ll enter your military service history according to the dates on your DD214 or other military personnel records that you have. To accurately prove the service connection, the dates you enter must be accurate. Service periods that the VA has already verified will already appear in the application. These fields are not able to be edited. If you feel there is an error, contact the VA to request a correction.

Step 3: Disability Information

You can either enter a new disability, request an increase to an existing disability, or add a secondary disability from this screen. After selecting the disability type, you’ll choose your condition from a drop-down list of disability conditions. 

Step 4: Treatment Information

The application will ask if you have received treatment for this condition at a VA Medical Center. If you answer yes, you’ll enter specific information about your treatment. Answer no, and you’ll move to the next section.

Step 5: Special Circumstances

You may be entitled to other compensation benefits in conjunction with this claim. In this section of the application, you’ll receive information about benefits for veterans that may apply to your case. You’ll have the option to select any benefits you may be entitled to in this section.

Step 6: Attach Evidence

This next important step allows you to upload all supporting evidence you want the VA to review so that they can decide on your disability claim. Be sure to upload all evidence before submitting it because there will not be an opportunity to upload more documents after the final submission. Files are uploaded from your computer and attached to the application for processing.

Step 7: Review and Submit

You will have the opportunity to review your application along with all attachments and certify that there is no other evidence before submitting the completed application. The VA includes a step where claimants can enroll in VA health care if they have not done so already. After the final application submission, you will receive a confirmation number.

Fully Developed Claim for VA Pension Benefits

The fully developed claim process is an option when applying for VA pension benefits. All supporting documents must be submitted along with the application, just like the disability claim process.

Submit a fully developed claim for VA pension benefits by filling out the application, VA Form 21P-527EZ, either online, in person, or through the mail. Include all necessary evidence with your application at the time of submission. Evidence that is required:

  • Income and net worth information
  • Related private medical records
  • Information about any documents you need to include from federal agencies

Other evidence may be required depending on any special circumstances of your case.

Examples of special circumstances are:

  • Housebound or Aid and Attendance – doctor examination and nursing home information (VA Form 21-2680 and 21-0779)
  • Claiming a minor aged 18-23 that is in school – school attendance authorization (VA Form 21-674)
  • Filing a claim for a severely disabled child – private medical records

All supporting documents will be fully completed and submitted at the time of application.

VA Fully Developed Claim (FDC)

Disabled veterans who plan to file a VA disability claim can choose to file either a standard claim or a fully developed claim. Before selecting a claim process, veterans should familiarize themselves with the benefits and risks of filing a fully developed claim.

The fully developed claim process leads to faster results because claimants gather all evidence before applying for benefits and certify that no further evidence will be submitted. Since the VA does not need to obtain supporting documents, the fully developed claim process is faster. The VA will still assist with getting federal records from agencies such as the military, VA medical clinics, and SSA.

Applicants have one year from opening the application to complete the form, gather all relevant records, and submit the final application. If the claim is approved and the veteran is awarded disability benefits, they will be paid back to the date the application was started. In other words, the veteran gets retroactive benefits back to the time the process began.

Although it is not required to enlist the help of a Veterans Service Organization to file a claim, VA officials recommend using their services. Experienced VSOs can help compile the necessary evidence to connect disabilities to military service and reduce the need for VA disability appeals.

In addition to filing for disability compensation, the FDC program can also be used to apply for VA pension benefits. Thanks to faster claims processing times, veterans needing this benefit for homecare, aid and attendance, or disability compensation can get the help they deserve.