What’s the Difference Between a Claim and an Appeal?

Anyone who has filed for disability payments through the VA knows how easy it is to become overwhelmed by the jargon, abbreviations, and sheer amount of information that gets sent back to you. When you’re in pain or struggling with a disability, the last thing you want to think about is how to decode it all. And to make matters worse, you may not be sure whether you have filed a claim or an appeal, or even what the difference between them might be.

When you initially file for veterans disability benefits with the VA, you are submitting a claim. This means that you are trying to prove to the VA that you have a medical condition (or conditions) that you believe you are suffering from as a result of your military service. There are a few different ways that you can file a claim. Recently, as a part of an overall attempt to become more efficient and user-friendly, the VA has allowed online filing through eBenefits but, if you prefer, you can still mail your claim in or just head to your local regional office (or RO). You will need your service records, medical records, and any other evidence (like “lay statements” from service buddies, your children, or your employers) that could possibly back up your claim for disability.

Once you provide all of this information, the VA begins to analyze your claim. Case law, statutes, and complicated federal regulations determine whether or not the VA will provide you benefits for your claim. At a very basic level, the laws governing disability claims will require you to show three things: an injury or an illness that you suffered while serving, a current disability, and some sort of connection between your current illness and your in-service injury. This is usually in the form of medical records, but can even be provided by the lay statements of family and friends. While these laws are complex, they are applied very liberally and usually work in the favor of you and your family. They even allow for veterans to recover for conditions that arose after their service period that were caused by the service-connected injury (these are known as secondary service connected claims).

After the VA weighs the evidence you have provided and determine that your claim is actually connected to your period of service, the VA will begin to decide the degree of disability you are suffering from. Many elements may factor into this, such as how your injury affects your ability to work, drive, or perform other activities of daily life – like bathing – without assistance. You may have heard other veterans referring to a percentage level, and this is what they are talking about. Your percentage level will be decided under the VA Schedule for Rating Disabilities. Because the laws are generally favorable to veterans, the evidence will be weighed on a 50/50 scale and the claim will be granted the higher of the two possible outcomes.

If, for some reason, you disagree with the VA’s decision, you have the right to appeal the decision in an attempt to receive a higher disability rating – or even total disability benefits. To do this, you file a notice of disagreement, or NOD. There are many reasons you may want to file an appeal, and there are many levels of the appellate process. And your appeal, should you choose to file one, will be re-examined many different times. Each time you submit new or different evidence or legal arguments, your appeal will be reviewed again. The drawback of submitting new evidence is that it will add more time on to the determination of your appeal. It may take over a year to hear a response to your notice of disagreement. On average, the processing time for appeals in 2015 was just over three years.

It is important to remember that you can work with a service organization to help you file your claim. There are various organizations that work at the state, county, or national level, and they can provide you with assistance in deciding what the best option for you is. These organizations will not charge a fee to help you file your claim, and they know that there is no one approach to claims, because they are as distinct as the veterans filing them.

When you reach the appellate level, however, you may choose to have an attorney assist you. Unlike the service organizations that helped you file a claim, though, attorneys will charge a fee, generally taken from any reward provided by the VA. Since appeals are more complex and you may even have several different appeals pending at the same time (depending on how many injuries and claims you have), you may feel more comfortable having an attorney assist you. The choice is still entirely yours.

If you think you may be entitled to a higher disability rating, or even TDIU, but aren’t sure, call George Sink, P.A. Injury Attorneys today for a free case review. Our South Carolina veterans disability attorneys are passionate about guiding those who have served our country through the complex VA disability claim process. Attorney George Sink is himself a disabled Marine veteran who served two tours of duty in Vietnam. As a disabled veteran, Attorney George Sink knows the struggles other disabled veterans face, and his team of disability attorneys could help you navigate the multi-layered veterans appeals process to help get you the benefits you deserve.