VA Disability - Step 5: Getting the Initial Decision on Your Claim

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VA Disability - Step 5: Getting the Initial Decision on Your Claim

When VA can't find needed information

The law requires VA to make "reasonable efforts" to help you prove your claim.  The VA is supposed to make "as many efforts as necessary" to get files from federal agencies, including military service and military or VA medical records.  For records that are not kept by the federal government (including personal medical records), the VA is required to make at least one request and one follow-up. (Authority: 38 USC 5103A.)

If the VA can't find something, it is supposed to tell you which records could not be found. It is also supposed to tell you what it did to try and find them. Even if they tell you in person, this notice is also supposed to be providing in writing.

You may be able to find the missing records yourself. If you do this quickly and send them to the VA office,  the initial decision will include that information.  It may make a difference in whether your claim is successful.  Always be careful to copy what you mail to VA and send it by certified mail, return receipt requested. 

Even if you get the files or records later, they can be very important on appeal. Many appeals are won on the basis of information that should have been in the original file.

The initial decision

After the Rating Veterans Service Representative has attempted to secure all the records (or evidence) required by law, he/she reviews your file and makes a decision on the claim according to the law and the particular facts in your case.

In the rating decision, the Rating Veterans Service Representative lists the evidence, the decision, and the reasons for it. VA then sends the decision with a cover letter to you or your representative.

If benefits are granted, the letter provides the monthly payment amount and the effective date. Payments usually begin soon after you receive the letter (see Disability Award Attachment Information).

However, if benefits are not granted and you think the decision was in error, or if you think the percentage evaluation or effective date is wrong, you may appeal.

 June 2010