Helping Veterans Qualify for VA Disability Benefits
At Lozier, Thames & Frazier, we help Disabled Veterans obtain the benefits they have earned. By law, Veterans who served in the active military, suffered an injury, sickness or disability during their service and who have received an honorable or general discharge are entitled to monthly, non-taxable benefits called "disability compensation" or "service-connected benefits". A compensable disability can be caused by something that occurred on active duty (even on an authorized leave), a pre-existing condition made worse by military service, or even a new condition that manifests itself years after military service if that new condition was caused or contributed to by the original service connected injury.
Most disability benefits are not based on financial need, so a Veteran's income or assets do not affect either entitlement to or the amount of benefits. A Veteran who is working, or receiving other types of income, such as Social Security disability benefits, can still qualify for VA disability.
In order to establish a successful claim, two basic elements must be shown.
Medical evidence of a current physical or mental disability. This usually requires a medical diagnosis from a physician; and
An injury or event that occurred during service which caused or aggravated the disability. Please note that some disabilities can be service-connected even though they are not directly linked to an injury or event during service. For example, if you suffered a back injury during service and then developed depression because of chronic back pain, you can file claims for both your back and depression. Similarly, if your back injury causes you to develop a problem with your leg, you can file a claim for your leg as well.
The VA will rate the severity of your service-connected disability using a percentage scale from 0% to 100%. You must have at least a 10% rating to receive monthly payments, and at least a 30% rating to qualify for benefits for your dependent spouse, children or parents. If you have more than one service-connected disability, the VA will rate each disability separately and combine them to give you an overall disability rating. Higher percentage ratings means higher monthly payments.
FREQUENTLY ASKED QUESTIONS:
1. How do I apply for VA disability benefits?
You can apply by filing VA Form 21-526, Veterans Application for Compensation and/or Pension, with your VA Regional Office or you can also apply on the Internet at the VA Online Application website (VONAPP) at https://vabenefits.vba.va.gov/vonapp/main.asp. You should attach the following documents to your application: Discharge papers (DD 214), Dependency records (marriage and children's birth certificates), and Medical evidence such as doctor and hospital reports.
2. How long with my claim take to be resolved?
At Lozier, Thames & Frazier, our objective is to successfully resolve your claim as soon as possible by providing the VA with all the necessary evidence and documentation required to win your claim early in the appeals process. Due to the extensive backlog of cases, some claims are stuck in the VA appeals process for years. It can take up to a year to get a rating decision from the VA after filing your initial application. If you are not happy with the rating decision, you have 1 year to appeal by filing a Notice of Disagreement. Information from the Board of Veterans Appeal (BVA) shows that it currently takes 222 days from the date you file a Notice of Disagreement until you receive a Statement of the Case from the VA. If you appeal the Statement of the Case, then you have to file a VA Form-9 requesting a hearing with BVA. From the date you file your Form-9 until you get a decision can take more than 2 years. Therefore, it is extremely important the VA be provided with all the medical evidence at the earliest opportunity so that your claim does not get unnecessarily delayed by denials based on incomplete medical evidence or by multiple requests for additional evidence.
3. Can I work and still receive VA disability benefits?
Entitlement to VA Disability benefits is not based on income or assets, so you can continue to work and receive your full VA Disability benefits.
4. Can I receive both Social Security Disability benefits and VA Disability Benefits at the same time?
You can receive VA Disability and Social Security Disability benefits at the same time.
5. Can I receive VA Disability benefits if I was injured on authorized leave from active duty?
If you were injured during an authorized leave, you are eligible for VA Disability benefits. For example, if you injured your knee while playing football while on authorized leave, you can file a claim for your knee injury.
6. I am receiving benefits for my service-related injury to my left shoulder. The injury caused me to favor my right shoulder and now I am having problems with it as well. Am I eligible for disability benefits for my right shoulder?
If an existing service-related disability causes another disabling condition, then you can file for benefits for the new condition.
7. My disability has worsened since I was approved for benefits. Can I apply for an increased rating?
If you feel you are entitled to a higher rating because your service-related disability has worsened, then you can apply for an increased rating.
8. What is Total Disability based on Individual Unemployability (TDIU)?
You should apply for this benefits if you are unable to work as a result of your service-related disability. You may be eligible for payment based on total disability at the 100% rate even though your combined rating may be less than 100%. TDIU is paid to Veterans who cannot work due to a service connected disability, but have less than a 100% scheduled rating.
There are two ways to qualify:
(1) Ratings based qualification - You must first have one service-connected disability of 70% or a combination of ratings totaling 60% with one of the included ratings being at least 40%. If you meet one of those requirements, and you can show that one of your service-related disabilities has caused a total inability to work, you can qualify for TDIU; and
(2) Severity-based qualification - If you have a service connected disability that does not meet those scheduled rating requirements, but the disability prevents you from working, then you can still file a claim for TDIU. This is especially useful if you meet the maximum rating for a condition, but do not meet the rating-based qualifications listed above. The maximum ratings for some diseases are less than 100%. For example, the highest rating for migraines is 50%. If you have migraines that prevent you from working, then you should file for TDIU, even though your rating is only 50%.
9. What other benefits are available?
Many Veterans will eventually require long-term care. Medicaid will help pay for nursing home stays, but usually will not pay for assisted living. Therefore, Veterans who would prefer assisted living or home care often end up in a nursing home instead. Additionally, they risk losing all their savings and assets. Fortunately, another option is available. The Aid and Attendance Program is available to Veterans who need assistance with basic daily activities such as bathing, dressing, and eating. The benefits can be paid to someone outside the home, (including family members) or to the Veteran's spouse, or most importantly, to an assisted living facility. If the benefits are paid to the spouse, the funds are considered income when determining eligibility for the program. Veterans may use these funds in any manner they wish, including to care for a spouse. The top benefit rate is now almost $2,000 a month and the amount changes each year.
To be eligible for Veterans Aid & Attendance benefits, you must have 90 days of active military service with at least one day of service during a war time period (but with no requirement to have actually been in battle) and either suffer from a permanent and total disability or be 65 or older. The most recent official periods of war include World Wars I and II, the Korean conflict, the Vietnam era, and the Persian Gulf War. Your income and net worth must fall within certain limits as well.
To qualify, the Veteran's household cannot have more than the allowable countable assets. This figure varies depending on the specific situation. The household income cannot be more than the Aid & Attendance pension benefit amount.
Other benefits available through the VA to Veterans and their families include: Dependency and Indemnity Compensation, Disability Compensation, Employment & Training, Parents' Dependency and Indemnity Compensation, Special Monthly Compensation, Survivor Benefits, Veterans Health Care, Veterans Life Insurance, Burial and Memorial, and Death Pension.
10. Do I need representation?
No. However, the VA claims process is very complicated and difficult to understand. Getting all of the medical evidence necessary to meet the specific criteria of the scheduled ratings is essential. The VA is a huge government bureaucracy with complex rules and regulations. Unfortunately, the VA may not give your case the attention it deserves. We will deal with the government for you and will work hard to make sure your file contains all of the relevant documentation required to prove your case. When filing a claim for Veterans Benefits, the VA is more than likely going to review your private medical records. We can help by obtaining these records for you. Also, we will make sure that your medical records are regularly updated and get to the VA so that the VA won't delay your case with unnecessary requests for additional records or with denials based on incomplete medical evidence. Finally, your physicians often do not directly address the specific ratings-based disability qualifications found in the regulations. We can make sure that your physicians answer the specific questions that the VA requires in order to favorably resolve your claim.
11. When can you represent me?
As soon as you receive your initial decision from the VA, we can represent you. If you already filed the initial appeal, called the Notice of Disagreement, we can represent you if this was filed on or after June 20, 2007.
12. What are your fees?
There are no fees or costs unless we successfully recover benefits for you. Our fee is 20% of any past due benefits the VA owes you and your dependents, plus any costs such as medical records or physician reports. No money is deducted ever from your future monthly disability checks.
