What are the Requirements for Entitlement to VA Compensation?
There are four requirements that are essential to entitlement and an award for VA Disability Compensation. With the exception of presumptive service connection, all four must apply or there is no benefit.
Here are the four requirements:
- The veteran, alive or deceased, must meet service requirements for the requested benefit
- With the exception of presumed service-connected conditions or diseases, evidence must establish an illness, injury, exposure or aggravation that happened while in service.
- Evidence must establish that the veteran is currently suffering from a disabling condition or disease that could be a result of the illness, injury, exposure or aggravation that occurred in service and generally this condition or disease must be chronic.
- With the exception of presumed service-connected conditions or diseases, there must be convincing evidence of a causative link or nexus between the current disabling condition or disease and the illness, injury, exposure or aggravation that happened in service.
1. Meeting Service Requirements for Veterans Benefits
Establishing service requirements is covered in in the section in the table of contents at the right entitled "Eligibility for Compensation." Please go back and reread that information if you have any questions concerning what it means to be a veteran and meeting duty requirements for benefits.
2. Establishing Evidence of Illness, Injury, Exposure or Aggravation Incurred in Service
In the section entitled "Common Compensation Claims" in the table of contents at the right we list numerous types of compensation claims that are result of illness, injury, exposure or aggravation of an existing condition incurred in service. It is important to remember that every claim is unique. There are thousands of different combinations of disabilities and underlying reasons for those disabilities that result in the benefits packages for roughly 4.6 million claimants receiving Disability Compensation. With the exception of combat injuries or exposures, physical evidence must be obtained to establish the incurrence in service.
Presumptive Service-Connected Conditions or Diseases
Over the years, Congress has felt that certain disabling conditions – presumably developed as a result of service – are automatically considered to be a result of service. These are called presumptive service-connected conditions, diseases or disabilities. The list of these conditions, illnesses or diseases amounts to more than 120 different presumptive conditions or diseases.
With these particular types of claims, the veteran does not have to prove that an illness or injury or aggravation of an existing disability was incurred in the service. Evidence need only be provided to show that the claimant currently has one of these presumptive conditions and meets the service conditions for presumption and a benefit is usually awarded. With presumptive service connection, the burden of proof for the claimant to prove service connection has been eliminated, which makes it much easier for these kinds of claims to be approved. All presumptive service-connected conditions require continuous service of 90 days or more and some require continuous service of six months or more.
Direct Service-Connected Conditions or Diseases
Direct service-connected claims require that the veteran or the survivor on behalf of the veteran must provide some sort of evidence that a particular injury, exposure or disease resulting in disability was incurred while serving in the Armed Forces OR if that condition was pre-existing to entry in the service, it was aggravated through service. These claims do not require any specific amount of duty time as do the presumptive service connected claims.
3. Establishing Evidence for a Current Disabling Illness or Condition
Medical evidence is required for proving existence of a current disabling illness or condition. The Regional Office will want to see the VA healthcare medical file or the current private medical file of the claimant pertaining to the disabling illness or condition that is being claimed. You should be aware that the Regional Office does not want to see medical records that are not pertinent. They are useless and end up bogging down the decision process. It is important that the condition be persistent or long-lasting and not temporary in nature. VA will want to see evidence of the continuity of the disability or condition from discharge or reasons why that is not the case.
4. Establishing a Link between the Current Disability or Disease and the Illness, Injury or Aggravation That Occurred in Service.
Establishing Presumptive Service Connection
It is important to note that some VA-listed presumptive conditions may not actually be the result of service, but many years after discharge may be the result of other non-service health developments. In order to be service-connected, many presumptive conditions must have manifest within a certain period of time after leaving the service – usually to a degree of 10% disability within the first year.
For those presumptive conditions where there is no time limit, and the condition has been recently diagnosed and the time between discharge and the claim is significant, the Regional Office will question whether the condition is service-connected. In this case, a continuity of symptoms must be produced to show that the condition would have been or was manifest – meeting the proper time frame – even though it was not diagnosed. Diagnosis is not required, only evidence of manifesting.
For some presumptive conditions – such as Agent Orange or ionizing radiation or exposure to hazards causing Gulf War Syndrome – there does not have to be a continuity of symptoms, nor do they have to show up within 1 year of discharge. Symptoms from these conditions could show up many years after discharge.
Establishing Direct Service Connection
Because direct service connection is not presumptive, a direct nexus or link between the current disability and any injury or illness or exposure in service that is claimed as the cause of the current disability must be established. There is no required time in service for receiving an award through direct service connection.
The disabling condition that the veteran is currently experiencing could have been caused by an illness, injury, or aggravation in the service. It could also have been caused by exposure to hazardous material or hazardous environment. A veteran seeking service connection for an existing condition, has several ways to prove the connection based on the place, the timing, or the circumstances of his service. The evidence required can include lay statements, Service Treatment Records, private medical records, personnel records, naval group, squadron or battalion records, Disability Benefits Questionnaires and medical nexus opinion letters. Service medical treatment records (STRS) and personnel records are available from the National Records Center in St. Louis for providing this evidence.
For many direct service-connected claims, a medical opinion from a licensed health provider such as a nurse, nurse practitioner or physician's assistant or medical doctor is required to establish the link for service connection.
Please go to the table of contents in the right column on this page to learn more about presumptive service connection and direct service connection. Here are the links:
Presumptive Service Connection
Direct Service Connection.
Please refer to the table of contents in the top right column of this page for more topics on VA Disability Compensation.
TABLE OF CONTENTS
- What is Compensation
- Eligibility for Compensation
- Entitlement for Compensation
- Income Rating Levels
- Presumptive Service-Connected
- Direct Service-Connected
- Secondary Service-Connected
- Common Compensation Claims
- Claims Taking Too Long
- Shorten Claim Decisions
- Options for Bad Decisions
- Claimant Dies before Decision
- Determining Disability Ratings
- Examples of Claims
- Aid & Attendance Allowance
- Other Benefits for Claimants
This 2023 Edition provides detailed instructions on how to submit claims for benefits through the Department of Veterans Affairs new intake center and uses the successful "Fully Developed Claim Process" for faster and better decisions. View the Book...
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