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Claims Process
All forms related to the Claims Process can be found in the Resources section.-
Claim Filed
To apply for benefits, you file a claim your local VA office (also known as a Regional Office or RO) or VA medical facility. You can also file your claim online at the VA's website.To get started on your claim, download a copy of the Official Claims Application from the Resources section of our website.
If your claim is for pension benefits--including cause of death--use VA Form 21-534.When a veteran submits a claim to a regional office, the usual procedure is for the RO to contact the National Personnel Records Center (NPRC) to contact any sources of the veteran's post-service medical treatment and acquire records of that treatment.
At this stage, the RO sometimes requests the veteran be scheduled for a physical examination and sometimes does not. There is no consistently applied standard which determines when an examination will be scheduled (examinations should always be scheduled for increased rating claims, however).Bergmann & Moore can help you with your claim at this beginning stage. Contact us today!
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Claim Decided
Your regional office makes a decision on your claim and sends it to you. The RO's decision will either allow or deny your claim. If you are not satisfied with the outcome, you can appeal the decision.If you are denied benefits at the RO level, you have one year from notification of that decision to submit a Notice of Disagreement with the denial.
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Notice of Disagreement
If you disagree with the Regional Office's decision on your claim, you can write a statement to your RO stating that you disagree and want to appeal the decision. This statement is called a Notice of Disagreement (NOD). You have one year from the notification date of the RO's decision to submit a NOD with the denial.Use VA Form 21-4138 (Statement in Support of Claim) for your Notice of Disagreement--this form can be downloaded from the Resources section of our website.
After you send your NOD, you may request that your file be reviewed by a Decision Review Officer (DRO) from your local VA office. DROs offer a second review of your entire file and can also hold a personal hearing on your claim. -
Statement of the Case
After your Regional Office gets your NOD, it will create a Statement of the Case (SOC). The SOC is a detailed explanation of the evidence, laws, and regulations used by the local VA office in making a decision on your claim.Your RO will mail you a SOC along with a VA Form 9 (Substantive Appeal Form).
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Substantive Appeal (VA Form 9)
When you get the Statement of the Case from your Regional Offce, a VA Form 9 should be included with the SOC. The VA Form 9 is the final step in the appeal process. To complete the appeal process, you must fill out the VA Form 9 and send it back to your RO. Your claim is then put on the waiting list to be adjudicated by the Board of Veterans' Appeals in Washington, D.C.If you receive a statement of the case but not a VA Form 9, contact your local office immediately. While doing that you should also signify to the RO in writing as soon as possible that you wish to appeal the denial.
NOTE: A substantive appeal can be filed on any piece of paper. Although a VA Form 9 is helpful, it is not necessary to perfect an appeal.When filling out your VA Form 9, you should state the benefit you want, any mistakes you find in the SOC, and if you want a personal hearing.
Your RO must receive your VA Form 9 within 60 days of the date that they mailed you your SOC OR within one year of the date they mailed you the original decision denying your claim, whichever is later. -
Personal Hearing
When filling out VA Form 9, you may request to have a personal hearing in connection with your appeal. A personal hearing is meeting between you, your representative if you have one, and the person from the VA who will decide your case.There are two types of personal hearings:
1) A hearing with someone from your local VA office
2)A hearing with a member of the Board of Veterans' Appeals (BVA). If you would like a hearing with a local VA official, you can send a written request to your Regional Office. If you would like a hearing with a member of the BVA you should request this when you fill out VA Form 9. -
Decision by the Board of Veterans' Appeals
Once the Board of Veterans' Appeals (BVA) calls a case up, it usually decides the case within 90 days after reviewing the evidence in your file. Files are reviewed in order based on the date a veteran files their VA Form 9 (or generally their substantive appeal). Factors which can affect the turnaround time of a case include:1) The complexity of the claims involved
2) The time it takes the veteran's representative to finish its review of the claims folder (assuming the veteran has national representative, such as The American Legion or Disabled American Veterans) and makes the case available to the BVA. The BVA will then send you a copy of the decision. The BVA's decision will either allow, deny or remand your claim.The BVA will not lower a rating assigned by the RO or hurt the veteran's interest in any other way; thus it’s always in a veteran's best interest to appeal a denial of a claim at the RO level to the BVA.
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Claim is Granted
The BVA's decision will either grant, deny or remand your claim.If your claim is granted, congratulations!
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Claim is Denied
The BVA's decision will either grant, deny or remand your claim.
If your claim is denied, At this point you have four options:
1) Do nothing
2) Try to reopen your claim at your Regional Office
3) File a motion asking the BVA to reconsider your claim or review your case again because there was a clear and unmistakable error (CUE) in the BVA's decision
4) File an appeal with the U.S. Court of Appeals for Veterans Claims
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Claim is Remanded
The BVA's decision will either grant, deny or remand your claim.
If your claim is remanded, this means that the BVA finds that is does not have enough information about your claim to make a decision. When this happens, the BVA will either try to get more information itself or send your claim back to your Regional Office so they can try and get more information.
The BVA only renders a decision in about half the cases that come before it every year. It returns the rest of the cases back to the RO because of defects in the decision by the RO.