So it’s time to submit your VA Disability Claim, and you want to make it the best it can possibly be in order to decrease
the processing time and ensure the most accurate ratings for your conditions.
Good for you! You are already so much closer to success than the majority of Disabled Veterans out there.
We cover the basics of submitting a claim
on our VA Disability Claim page, but there are two areas that, with a bit extra
attention, can turn a good claim into an outstanding claim.
#1:
Listing Your Conditions
How you list your conditions is very important.
I’ve heard many theories on the best way to list your conditions, and I’ve come
up with what I believe to be the best approach.
- List
every condition you have. When you are putting together your claim, it is
not your place to assume to know what the VA’s Rating Authorities will and
won’t rate. Yes, you should definitely be knowledgeable about it and have a
pretty good idea, but ultimately, it is the Rating Authority’s decision what
will be rated, not yours. You may hear about things like the Pyramiding Principle that won’t allow conditions that affect the same body function to
both be rated. This is a true principle, but don’t then say, “Well, if they
won’t rate both, then I’ll only list one.”
NO. It’s very nice of you and everything to
want to make the Rating Authority’s job easier, but this part of the claim is
NOT the place to do it. By not listing the second condition, you have ensured
that that condition will not be rated at all. There is no way. They will only
rate conditions that you tell them to consider and rate. If you don’t list it,
they won’t do it. There may be a special circumstance (the VASRD has many) that
you don’t know about that makes an exception to the Pyramiding Principle in
your particular case, and both of your conditions can, in fact, be rated. Since
you chose to not list the one, however, you’ve taken this option off the table.
The Rating Authorities will look at every
condition that you list and will break them down and combine them as needed to
give you the best rating possible for all of your conditions. It’s their job.
List EVERYTHING you have, and you’ll keep from limiting yourself at this stage.
- Only
list diagnosed conditions. While you definitely need to list every
condition you have, let’s not go overboard. List only conditions that have been
officially diagnosed. There are two layers to this guidance.
First, you don’t want to list every single
symptom that you have. A symptom is NOT a condition. If you list every single
symptom you have, you will definitely annoy your Rating Authority, no question.
Not a good idea. List only diagnosed conditions. So if you have GERD, don’t
also list heartburn. Heartburn is a symptom of GERD and would thus be covered
by a rating for GERD. It is NOT a condition in and of itself, but a product of
the GERD. Just list GERD. Similarly, if you have arthritis in your elbow, don’t
also list elbow pain. The number one symptom of arthritis is pain, so it’s
already a given. Arthritis is the official diagnosis, so just list that.
Now all this being said, if you don’t know
if a symptom is covered by a particular diagnosis, it is better to go ahead and
list it separately than leave it off. Use your best judgement here.
Second, do NOT list a condition that has
not been officially diagnosed. For example, if you personally think that you
have PTSD, but nowhere in any official medical record has PTSD been diagnosed
by a psychologist, then listing PTSD is a sure fire way to get your claim
denied. If you disagree with a diagnosis that a physician has made, then you
need to take that up with your physician and have him change the diagnosis.
Never apply for a condition that has not been diagnosed or cannot be found in
your medical record. Your claim for that condition will be denied.
Instead, list whatever HAS been diagnosed.
In the case of PTSD, if your psychologist only listed Anxiety Disorder as a mental
health diagnosis in your medical records, then by all means list Anxiety Disorder
on your claim. The Rating Authority will see that it was clearly diagnosed and
will rate it accordingly. In this particular case, as well, although PTSD may
sound more severe, both PTSD and Anxiety Disorder are rated on the exact same
criteria, so regardless of the name, this vet will receive the same rating. The
name doesn’t make a difference in this case except that a claim for undiagnosed
PTSD will be denied while a claim for Anxiety Disorder will not. List whatever
conditions you have been diagnosed with, and your claim will be processed
correctly.
- Don’t
be vague. I’ve heard some people say to just list a generic idea like
“stomach condition.” What?! What is a stomach condition? Can you be any more
vague? What kind of condition? No doctor will ever diagnose someone with a
“stomach condition.” Again, list your diagnoses. You aren’t covering
more territory by being vague, instead you are making the Rating Authority’s
job harder by having to figure out what the heck you mean by “stomach
condition.” List what you have.
If you have something that has been
recorded in your medical record, like stomach pain, but no official diagnosis
was ever made, then just list it as found in your medical record. Don’t be
vague and call it a “stomach condition.” List it as it appears in your records:
“stomach pain.”
Believe it or not, “pain” is a legit thing
when it comes to Military Disability. In some cases, like pain with motion in
the joints, it can even be rated without an official diagnosis. Regardless, you
have nothing to lose by listing it, so if you don’t have a diagnosis, but do
have pain recorded, list it on your claim.
#2:
Your Supporting Materials
The other day, I was contacted by a service
member who was preparing to submit his VA Disability Claim, and he was wondering
if there was a preferred way of organizing his medical records, like by
condition or chronologically. Now the majority of veterans have probably never
thought a thought like this. As long as they have my records, who cares? But I
say kudos to this service member! I predict that this man’s VA Disability Process is going to go very smoothly. Why? Because not only is he trying to be
prepared and submit a good claim, he is going above and beyond and ultimately
showing RESPECT.
The Rating Authorities who review the
claims and make the rating decisions are very powerful people with the ability
to make a big difference in your future. While they are required to follow the
laws in place, there are many instances where they do have to make judgement
calls. While personal feelings are never supposed to have any sway in their
decisions, I don’t think any of you would argue that a person wanting to get
you the best they can because they like you could in any way be bad, right?
So how do you make friends with someone you
can’t see or talk to? Showing them respect by submitting a superb claim that is
organized to make their job as easy and quick as possible is a great start.
Coming across a claim like this when I worked for the PDBR would definitely
have put me in the right mood…
So, after listing your diagnosed conditions
clearly and succinctly, organizing your supporting material in an easily
accessible fashion will entitle your claim to a smiley sticker.
There is no ultimately right or wrong way
to organize your materials, but here are my recommendations based on my
experiences sorting through thousands of medical records for the PDBR. This is
what I would have liked to see and what I would do if I were submitting my own
claim.
1. Only
include medical records that are for the conditions that you are listing on
your claim. The VA asks you to submit your entire military medical record
to make sure that you don’t miss submitting essential information that will
then cause the process to stop while they scramble to get the right info. In
reality, however, an entire medical record can consists of THOUSANDS of pages,
many of which probably have nothing to do with your claim.
For example, if you are claiming a stomach
ulcer, don’t include all your dental records. Your Rating Authority does NOT
want to have to go through each of your dental records to find the pages that
actually matter for your stomach ulcer. Do include everything you have on your stomach, but leave out anything that
has no relation at all.
If you are in doubt about whether or not a
record is relevant, then definitely include it. It isn’t worth leaving out
something that could end up being really important. Just get rid of the things
are clearly unrelated, and you will have a much happier Rating Authority.
2. Organize
your medical records chronologically by condition. Sort through all your
documents and put them in piles for each of the conditions that you are
claiming. Then organize each pile in chronological order. If submitting a paper
claim, paper clip all the records for each condition together and label the
pile for the condition. Then put the piles in the order you listed the
conditions on the claim. If submitting an electronic claim, try organizing the
files in a similar fashion. Make sure to name each file so that it is clear
without having to open it what the file contains. This will make it super easy
for the Rating Authority to find all the evidence needed for each condition,
and they will be very happy.
That’s it. With clearly listed diagnosed
conditions and easily accessible medical records, the Rating Authority’s job
will be much easier and proceed much more quickly, thus making your VA Disability Claim the best it can be.
