- Step 1-You file your claim
- Step 2-We obtain evidence
- Step 3-You are examined at VA hospital
- Step 4-Complete record is
- Step 5-A decision is made
What causes delays in the claims process?
How does the appeal process work?
is the best way to communicate with the VA?
National Personnel Records Center
Post Traumatic Stress Disorder
In order to make our communications as clear
as possible, we'd like to define some of our
The benefit paid to veterans
whose disabilities arose from service. The
disabilities themselves are often referred
to as Service Connected or "S/C".
The benefit paid to veterans
whose disabilities are not related to
service and who have a financial hardship.
The disabilities themselves are often
referred to as Non-Service Connected or
we use to determine which disabilities we
can pay for and the percent to which they
How we monitor and identify
your claim. Any letters you receive from
this office should have the claim number in
the upper right hand corner. The letters
"C", "XC", "CSS" or "XSS" will precede your
claim number. It is very important that you
have this number available whenever you
contact this office.
Step 1: You File Your
The disability claim process begins when you file a
If you have never filed a disability claim with us, we
need you to complete and submit a VA Form 21-526
(Veteran's Application for Compensation or Pension). You
may complete the form with the assistance of a case
manager at our office or you may call or write and have
this form sent to you. Once you have completed the form,
you should return it to this office.
have questions while attempting to complete this form on
your own, please call this office. It may save our
having to delay processing your claim while we attempt
to get clarification of your answer to the question
about which you were unsure.
If you filed a claim in the past, whether you were
granted or denied benefits, you do not need to complete
a VA Form 21-526 again. However, we do need your signed
statement telling us what you want to claim, why, and
where you were treated for the claimed condition.
Step 2: We Obtain Evidence
Based on the
disability claim you submit to us, we begin compiling
evidence to support your claim. Thus, any evidence that
you are able to secure beforehand and submit with your
claim will expedite this step.
Your disability evaluation will be based on this
evidence, so it is essential that we have complete and
We will assist you by verifying your service dates
(based on the information that you furnish on your
application) and requesting your service medical
records. If you send us a signed medical release (there
are copies attached to VA Form 21-526), we will also
request your private medical records.
request more information from you. This may include
letters detailing specific experiences in service or
information on your dependents, employment history or
income. You can help speed the process by providing
complete addresses for the medical care and be as exact
as possible in reporting dates of treatment. Please send
requested information in as soon as possible. You don't
need to wait until the 60 days we have given you have
expired. You should also make sure that you include your
VA file number on all pages of anything that you submit.
Step 3: You Are Examined at a VA Hospital
(this step takes 1-3 months)
Often we request exams while we wait for other evidence
to arrive. Sometimes, we first have to review the other
evidence to be certain we are requesting the proper
exams. The exams that we request for you will depend on
your claim and treatment history.
The VA Medical Center will schedule you for the
requested exam. They will contact you directly by mail
to let you know when and what exams are scheduled for
you. After each exam, an examination report will be
prepared and sent to our office. You can help expedite
this process by keeping your exam appointments and by
asking your private medical providers to send a copy of
your records to our office. Remember to ask them also to
include your VA file number on the records that they
Step 4: Complete Record is Rated
(this step takes: 2-3 months)
As evidence is received, VA places the records in your
claims folder. When we have all the necessary evidence,
your claim is ready to be rated. Due to our current
backlog, there may be a two or three month wait before
your individual claim can be rated.
evaluate the medical evidence and other documents to
support your medical condition. We then identify how
these conditions correspond to the rating schedule. This
schedule designates what disabilities we can pay for and
at what percent. The schedule is based on the laws
passed by Congress.
We will consider all evidence submitted and will pay the
maximum benefit allowed by law. If there is a change in
your disability after you've filed your claim or if you
want us to evaluate additional disabilities, please let
us know as soon as possible.Step 5: A Decision is Made (this step
takes 1-3 weeks)
After the rating is completed, you will be notified
promptly of our decision. We will provide you with the
reasons for all decisions to grant or deny benefits. If
you do not agree with our decision, we will explain the
If you have any questions, please call
their toll-free number at 1-800-827-1000.
WHAT CAN I DO TO HELP ... ?
Be as thorough as possible in completing your claim application.
Do NOT assume that they have information on file already. ALWAYS
sign your name on the application form.
Respond as quickly
and completely as possible when we ask you for information.
If you are scheduled for a medical exam, please keep your
appointment. If you are unable to keep your appointment (for
whatever reason), please contact the VA medical Center where you
were scheduled to report as soon as possible.
If you have
been treated for your disability by private medical providers,
please ask them to send us a copy of your treatment record.
On any application that you submit, ALWAYS provide a complete
mailing address (to include your specific apartment number if
you live in an apartment building) and, if possible, a daytime
phone number (including the area code) where you can be reached
in case we need to obtain clarification on any part of your
application. Let us know, as soon as possible, if you change
your address or phone number.
If you are in doubt about
what to do at any time, please contact us at
Any time you call their office about your
claim, please have your VA file number available to give to the
person who assists you. You can find this number in the upper
right hand section of any correspondence from this office. If
you can't remember and can't find your VA file number, please
have your Social Security number (or - if you are a survivor of
a veteran - have the veteran's Social Security number) available
since (starting in the mid-1970's) this is usually the number
assigned as the VA file number.
Any time that you write to
VA, you should include your VA file number not only on your
letter but also on any documents that you submit in support of
your claim - in case they become detached from your letter.
You were there when they needed you - now their here for you.
What Causes Delays?
Claims within a specific category are processed in the order
they are received. Time to process is particularly hard to
estimate on cases involving PTSD, Persian Gulf illnesses,
reserve units, and fire-related cases. The time it takes to
process a claim varies for several reasons. First, we need to
get the information needed to make a decision; this includes
medical records, verification of honorable discharges, copies of
certificates, etc. Although we are a government department, we
have no special way to get records from private hospitals, other
government agencies, records centers (such as the National
Personnel Records Center), or military bases, hospitals or
reserve units. Claims with records from several sources take
longer to get records than others. One way to help is to get as
many of your records as possible to submit with your claim.
Tips: 5 reasons for denial will help you navigate the VA
Appeals of Decisions
An appeal of a local decision involves many steps, some optional
and some necessary, and strict time limits. In order, the steps
Notice of Disagreement (NOD)
the Case (SOC)
Notice of Disagreement (NOD)
Formal Appeal (VA Form 9 or equivalent)
Board of Veterans' Appeals (BVA)
United States Court of Appeals for Veterans' Claims (CAVC)
The case may also involve remands at the BVA and/or COVA levels.
Someone may have several appeals at once, and several issues may
be included in the same appeal. Usually, all issues on one VA
decision will be included in the same appeal.
A Notice of Disagreement is the first step in an appeal. It
simply involves a written statement that you disagree with a
decision that has been made. Certain things should be kept in
mind when submitting a NOD:
Be specific about what you are disagreeing with. If a decision was
made on 7 issues, specify the ones you are referring to- don't
simply say you disagree with the decision.
that a decision has been made. For most decisions when benefits
are reduced or terminated, we are required to propose it first;
this is called a pre-determination notice. A NOD can only be
accepted if a final decision has been made, not if a proposal
has been made. If you don't receive paperwork describing the
appeals process (a VA Form 4107), check your letter to see if it
is a proposal.
Check the time limit. A NOD must be
filed within one year of the date of the letter informing you of
the decision. If you were notified of a decision in 1994, it is
too late to file a NOD. Your option at that point is to file
another claim, or request to reopen a claim, for the same
condition as before.
Statement of the Case
A Statement of the Case is a summary of the evidence considered,
actions taken, and decisions made, plus the laws governing the
decision. A SOC must be done when a Notice of Disagreement is
filed or when new evidence is received. Once the first SOC is
done on an appeal, any ones done after that are Supplemental
Statements of the Case (SSOC). An appeal may have several
SSOC's.Formal Appeal (VA Form 9 or equivalent)
An appeal must be formal before it can continue to higher
levels. The standard form for formalizing (sometimes called
perfecting) an appeal is the VA Form 9. This form must be
received no later than one of these two dates:
year from the date of the letter notifying you of the decision
60 days after the date of the Statement of the Case
Hearings are a chance for claimants to present evidence in person;
they are totally optional. They are held at the regional office
by a Hearing Officer (HO). If you have a hearing, the HO will
review the evidence in conjunction with the testimony and make a
decision on your case. If the issue is not resolved in your
favor, the appeal will continue.
Board of Veterans' Appeals (BVA)
The Board of
Veterans Appeals, located in Washington DC, is the highest
appellate body in VA. Although most decision are done in
Washington, BVA does have travel boards that come to local
offices. Travel boards have been limited the past couple of
years, and Manchester would not expect more than one week of
travel board hearings in a year. Due to a number of reasons, the
pending workload at BVA has dramatically increased in the past
few years. It is not unusual for an appeal to take 2 years or
more from the initial NOD to the final BVA decision.
BVA looks at all of the evidence regarding the issue under
appeal. If BVA decides that more information is needed to make a
decision, it will issue a remand to the local office. BVA will
not reconsider the case until its instructions in the remand are
done. If the evidence is sufficient, BVA will issue a decision.
This decision is the final VA one on the issue, and the appeal
will have ended. However, a BVA decision can be reviewed by the
Court of Veterans Appeals if an appeal to the court is filed
within 120 days of the BVA decision.United
States Court of Appeals for Veterans' Claims (CAVC)
The United States Court of Appeals for Veterans' Claims (CAVC),
located in Washington DC, was created in 1988 to review matters
of law about VA benefits and decisions. CAVC is not part of VA;
it is an appellate court in the US judicial system. CAVC will
only consider decisions made by the Board of Veterans Appeals
after 1988. As in most courts, one must have either an attorney
or personal knowledge of legal proceedings in order to file the
correct legal paperwork and conduct the appeal. CAVC decisions
usually concern the procedural, legal issues involved in the
"letter of the law". The deadline for filing an appeal to COVA
is 120 days after the BVA decision (using the date of the letter
to you informing you of the decision).
Communicating with the Veterans Service Center
COMMUNICATION IS NOT ONLY WHAT WE SAY, IT'S WHAT YOU THINK WE
If you get a letter from the VA that is confusing, please let us
know. We are truly interested in improving our communication.
When doing so, provide the date of the letter in question.
In all correspondence to the VA
The VA claim number
Veteran's social security number
Veteran's complete name
Please be sure to keep them informed of address changes.
National Personnel Records Center
National Personnel Records Center (NPRC), located in St. Louis,
is the main center for a military person's records. NPRC has
millions of records. Depending on the branch and years of
service, we will make a request for records to NPRC. If medical
records are available at NPRC, the originals will be sent to us.
No copies are left at NPRC. Any individual can request their
records from NPRC using a standard form (SF 180), which we can
provide to you upon request. However, to reduce the substantial
backlog at NPRC, duplicate requests from VA, individuals, and/or
service organizations should not be made at the same time. If
you receive notification from us that records could not be
located, you may find it more efficient to deal with NPRC
July 1973, a fire broke out at NPRC. The majority of records for
Army and Air Force veterans discharged before 1963 were
destroyed. There are no alternate sources for personnel or other
non-medical records. In the late 1980's, there were Surgeon
General studies discovered that listed names of patients treated
in Army hospitals during World War II and the Korean War. These
records, usually containing only one line of information, can be
requested if you were treated in an Army hospital during one of
the wars. Unfortunately, there remains no alternate sources for
the other burned records.
If you are a reservist, you may want to request that your unit
forward a copy of your medical records to this office. If you
are filing a claim for a disability that occurred while you were
on reserve duty, we also need a copy of the paperwork showing
your duty status on the day you were injured. We frequently
experience significant delays in receiving records from reserve
PTSD cases often take several months to process. In order to
establish a finding of PTSD, as opposed to other mental
conditions, the event causing the stress disorder (the stressor)
must be identified. Sometimes the stressor is apparent on the
discharge document (for example, a Purple Heart). Often, we must
request personnel and other records from the National Personnel
Records Center. However, while personnel records will show
units, job classifications, etc., they do not show events that
happened. For those records, we must make an additional request
to another records center for information they may have on
particular events. This search is why we need as specific
information as possible on the stressor form that we send
(names, dates, units, etc.). The current backlog at this records
center is several months. This time, added what it takes to get
records from NPRC, is why PTSD cases take longer to process.