VA "Fully Developed Claim" process

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Fully Developed Claim Process

[Update 8/13] **The VA has announced a new incentive program for “fully developed” claims submitted from Aug. 6, 2013, through Aug. 5, 2015. The VA states that successful claims will result in an extra year's worth of compensation, beginning one year prior to the date of filing. Only original claims qualify for retroactive payments. Supplemental claims for those already receiving disability pay would not qualify, although fully developed supplemental claims are encouraged by the VA. Get more details in Military Times article here.**

Note: Some experienced advocates are taking a wait and see approach to this announcement.  They are raising questions about how this will actually play out.  One concern, among many, is potential difficulties with navigating the military medical records system, in order to obtain the necessary evidence.  We will post information here as we hear more about how well this initiative is working for veterans.


Some reports indicate that the VA has a backlog of more than 1 million disability claims.  Many of these claims will take years to resolve.

In June 2010, VA created a "fast track" process to handle claims for disability benefits.   The new process applies to original, secondary, and increased disability service connection claims.  The goal is to reach action on your claim very quickly, so you can start receiving benefits.

You can still choose whether to use the standard method or the "Fully Developed Claim Process." 

This is a summary of information about the new process.  The standard method is described step by step in a different document on the website.  You may find it helpful to read about the standard method before you get started with the "fast track." 

Differences between the standard and "fast track" claim

The standard process assumes that VA will be helping gather information about your case.   The "fully developed claim process" requires YOU to gather all of the important information.  You will have to submit that information as part of your application for disability benefits.

The "fast track" requires you to meet certain criteria. If the VA decides that you don't meet those criteria, it will process your claim through the standard process. [We assume they will notify you in writing if they later switch you over to the standard process.]

Application

As with the standard process, file your claim as soon as appropriate since your benefits generally will be tied to the date of claim. If you file your claim with VA within one year of your separation from the military, entitlement will be from the day following the day you left the military.  [Also, see August 2013 update at top of page about one extra year of benefits for successful "fast track" claimants.]

You begin with the filing of a VA Form 21-526EZ. The form is three pages long, and includes 4 pages of instructions. 

NOTE: These VA forms are PDF documents and that requires that you have a free PDF reader installed on your computer.  The Form 21-526EZ on the VA site is "fillable". This means that you may complete the form by using your computer to type information into the required spaces. After you've done that and finished the form, you may print it out for mailing to the VA Regional Office that will serve you.

If you aren't comfortable using the fillable form, you may print out a copy to complete in ink and mail it to VA. If your computer refuses to cooperate, go to any VA facility such as a regional office, VA medical center or clinic and they will give you the form. Or call 1-800-827-1000 to ask that the Form 21-526EZ be mailed to you.

Read the form carefully. You may want to get the help of a VSO or State Bureau of Veterans Office with this process.  If you ask for a lawyer's help, the lawyer cannot charge you fees for this service. (Some legal aid programs may be able to help, but you need to check with those in your service area using our Find Legal Help map.)

Where do I send the form?

Once you've completed and signed the form, it's time to mail it in. The VA doesn't want all those instructions so you may keep those for your records. Also, be sure you keep a good copy of the completed form for yourself.

Mail it to the VA Regional Office (VARO) in the state where you live. If your state has more than one, mail to the closest VARO in your state.

Use Certified Mail with Return Receipt requested.  We strongly recommend that you always use this method for mailing forms and evidence to the VARO. We do not recommend using a fax machine, any sort of email or even hand delivery. Certified mail will provide you with signed evidence of delivery just in case a document goes missing.

Keep copies of everything you send or receive from VA in connection with your claim in an organized folder.  Although the VA is working on improving the online filing system, we are not encouraging use of the VONAPP (the VA automated online application) system at this time.

Evidence Must be Produced Quickly

The VA "fast track" plan assumes that you will be filing the Form 21-526EZ together with all of your needed documents.  If you do this, you should submit the "Fully Developed Claim Certification" with your complete application.

However, you can file the Form 21-526EZ first, and then submit your supporting documents.  If you do this, you should NOT submit the "Fully Developed Claim Certification" as part of the Form 21-526EZ.  Instead, you will need to write to the VA every month to let them know you are working on your application.  That is because the "fast track" process allows the VA to make a decision on your claim after 30 days, unless they hear from you after you file the Form Application. 

If you are still gathering information, write to the VA Regional Office within a month after you file the Form 210526EZ to say that you are gathering the necessary information.  Until you are ready to submit all of your information, send them a similar letter each month.  There is information about how to write a good letter to VA in the longer discussion of standard disability claims on this website. Send any letters or documents to the VA by certified mail, return receipt requested and keep copies.

The new process gives you up to a year to get the information, although the sooner you are done, the faster their decision will be.

Proving the "Nexus"

To get benefits, you must meet three tests. You need to show:

  • eligibility by your military service,
  • diagnosis of a "condition," and
  • evidence that the condition started during your military service or, if your condition was preexisting, that it was aggravated by military service.

This third test is the connection or "nexus" between what happened to you in the military and your current medical condition.

In general, for the the "fast track" process, you are responsible for getting the information, records and documents that will prove your disability claim. 

VA will provide a medical examination for you, or get a medical opinion, if they determine it is necessary to decide your claim. (This is the C&P Exam referenced in our discussion of standard disability claims.)

VA will obtain service treatment records and Federal treatment records only if and when you identify them.

If you serve or previously served in the Guard or Reserves, you must contact your unit to find out if they still maintain custody of your service records (including your medical records). If your unit currently has custody of your service records (including your medical records), you must get a complete copy of these records and provide them to VA.

If it is determined that other records exist, and VA needs the records to decide your claim, or if you do not provide the VA with your National Guard or Reserve records as described above, then your claim will not be processed as an Fully Developed Claim. Your claim will be processed in the standard claim process.

When you have identified and obtained all of the necessary records (medical and otherwise) connected with your claim, you should attach them to the "Fully Developed Claim Certification" which is part of Form 21-526EZ.

Even if the VA decides your claim before one year from the date it was received,  their rules say that you will still have the remainder of the one-year period to submit additional information or evidence necessary to support your claim. 

NOTE: Because this is a new process, it is unclear how it will work "on the ground."  We will post updated information as it becomes available.

June 2010; updated August 2013