Many Veterans wonder “What happens to my claim once it’s submitted?” The standard government answer is “It depends on the current VA pending workload and the complexity of your claim.” What does that really mean, and how can I make my claim stand out to go faster?
What You Need to Know on How VA Claims Processing Works
The Veterans Benefits Administration (VBA) is the arm of the VA in charge of all things benefits related for VA. In each Regional Office, there is a Claims Team that works Original Claims that are submitted via Fax, Mail, or Electronically (via eBenefits or an approved VSO, CVSO, or Attorney). Once a Claim is submitted, it is indexed and prepared by a Claims Assistant (CA) for placement into the work queue for the Veteran’s Service Representative (VSR), who does the majority of the work on the Claims. The VSR does all of the work to prepare it for a decision, sends it to a Senior VSR for review, and is sent to a Rating VSR for approval. Once that is approved, a Rating Award Letter is generated and sent to the Veteran and the digital record is updated.
The VSRs are on a point system for everything they do, and have a daily, weekly, and monthly quota. Closing a file by recommending an award action is the highest point total for them. While the VA has a mandated “Duty to Assist” the Veteran in the assembly and processing of their claim, that is the lowest point value in the quota system. If a Claim requires too much work, it will be pushed aside for another claim that is easier to process in order for the VSR to make their point quotas. Members of our team saw that first-hand when they worked for VBA in in recent years. It sucks for both sides (the VSR & Veteran), but knowing how to approach it can help you in the end.
What does VBA consider to be “Complex”
VBA classifies a Claim as “Complex” if a Claim has multiple claimed conditions and/or supporting documentation is incomplete. Incomplete documentation can be anything from not providing proof of military service, not providing full medical documentation, to not defining what conditions you’re claiming. These will result in your claim being pushed aside for easier to work on claims and your claim taking longer to be worked on, and subsequently, decided on.
How Can I Make My Claim Not Be Complex
The goal is to make the VSR’s job easy so they will snag your file quicker and do yours first before someone else’s that may be less complicated. The goal is to make the VSR at VA that opens your file look at it and say “this looks like a claim I can look through and finish quickly.” Make it so that the dots of what you’re claiming and the evidence to support it are easily connected & supported – that’s how to make a claim more appealing to a VSR to work on first, and hopefully, produce a more successful outcome. Here are some tips on how to organize your files in your claim:
- Organize the documents in a way where everything is separated by each claimed condition.
- In each file, start with when the first sign of the condition when it was documented during service
- Proceed chronologically with each reference to that condition until present day
- Label each file with the condition name as it is listed in the Schedule of Ratings, Citing the Condition Number and Name (for example: 5242 – Degenerative arthritis of the spine)
- Again, this is to make the VSR’s job easier.
No matter which way you choose to submit your claim, organizing it in a way to make it complete and more appealing to a VSR to complete will work well not only for you, but the VSR as well. As far as the best way to submit your claim (self-represent, Veteran Service Organization, County Veteran Service Officer; paper by mail, fax, electronic), it all depends on what you feel most comfortable with. We will cover that topic in another post.
Veteran Benefit Resource Guide 