What Goes On in the Claims Process?

There are eight distinct steps that most claims for disability compensation follow. These phases may vary in time depending on the complexity of the claim, the amount of evidence that must be gathered to support the claims, and the type of evidence. You are strongly encouraged to submit as much evidence as possible with your claim to help minimize processing time. Take a look into having your healthcare provider fill out a Disability Benefits Questionnaire (DBQ), as those tend to speed up the claims process.  Remember that the more evidence you have, the less time it will take the claims processors to recognize your need for compensation. This article is going to go over those eight steps that most claims go through before they are fully processed.

The first step is for you claim to be received.  When your claim has been received by the VA, if you applied online with VONAPP Direct Connect, you should see receipt in your list of Open Claims within one hour. If you applied through the U.S. mail, please allow mailing time plus one week for us to process and record receipt of your claim. Please not that if you apply and send in a claim online, it is processed much faster than using paper.

Step 2 is when your claim is being reviewed.  Your claim has been assigned to a Veterans Service Representative and is being reviewed to determine if additional evidence is needed. If the VA does not need any additional information, your claim will move directly to the Preparation for Decision phase, which is Step 5.

Step 3 is gathering more evidence.  The Veterans Service Representative will request evidence from the required sources. Requests for evidence may be made of you, a medical professional, a government agency, or another authority. It is common for claims to return to this phase, should additional evidence be required.

Step 4 is reviewing the new evidence.  The VA will have received all needed evidence. If, upon review, it is determined that more evidence is required, the claim will be sent back to the Gathering of Evidence phase, or Step 3.

Step 5 is preparation for a decision.  The Veterans Service Representative has recommended a decision, and is preparing required documents detailing that decision. If more evidence is required, the claim will be sent back in the process for more information or evidence.

Step 6 is where more waiting happens as the claim is pending decision approval.  The recommended decision is reviewed, and a final award approval is made. If it is determined that more evidence or information is required, the claim will be sent back in the process for more information or evidence.

Step7 is preparation for notification.  Your entire claim decision packet is prepared for mailing, with detailed descriptions of why you are or are not receiving compensation.

When you reach Step 8 that means it is complete!  The VA has sent a decision packet to you by U.S. mail. The packet includes details of the decision or award. Please allow standard mailing time for your packet to arrive before contacting a VA call center.

The length of time it takes to complete a claim depends on several factors, such as the type of claim filed, complexity of your disability or disabilities, the number of disabilities you claim, and the availability of evidence needed to decide your claim.

You can track the status of your claim by registering for eBenefits atwww.ebenefits.va.gov. You can also visit VA’sASPIRE web site. Here you can find the average processing days for the regional office that is working on your claim. To find the average processing days for your state:

·        Find your state on the map, place your cursor within the state and click

·        This will open the Veterans Benefits Administration Aspire Benefits site. Click “Enter”

·        You should see a split table. On the left table click on “Compensation”

·        This will expand the table. Approximately five rows down is “Rating Claims Processing Time”

·        Follow that row to the right until you locate the cell located within the column of your regional office.

·        The number you see is the average processing days to complete a claim that requires a disability rating. The average is based on completed claims since October 1 in a given fiscal year.

 

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