Need help with the VA? Call Us: 303-618-6131
Need help with the VA? Call Us: 303-618-6131
This is the most difficult VA Benefit to navigate. You can go to the VA website and apply on your own. The site doesn’t give you a clue as to requirements or what qualifies. Worse, presumptives aren’t mentioned (those are the medical issues that are automatically awarded if you qualify). Regardless of how you apply, you can expect a wait of several months to get a decision. What are the requirements? Your illness or injury must be service connected. Obviously, if you hit an IED and lost an arm or leg, or had a TBI (traumatic brain injury) during your service, you are going to get benefits. If you are retired military, there is a pretty good chance that something happened to you during your service that would qualify you for some disability benefits (and you probably were given support on discharge for applying for these benefits - unless you are Vietnam era or before).
However, if you served 2, 3 or 4 years and got out (especially if this was years ago), it may be tough to prove that your military service is connected to your disease or injury. Most applications for disability will require that you be seen by a VA Disability Doctor (VA Healthcare Doctors are not allowed to help or support your application or suggest that you apply). My experience is that this will occur via outsourced medical exams, usually in Colorado Springs, but it can be somewhere else here in Colorado (you will automatically be paid mileage). Let’s start with some presumptives that I am familiar with: Parkinson’s Disease and Type 2 Diabetes, but only if you served in the Vietnam War or the First Gulf War and Fibromyalgia, but only if you served in one of the Gulf wars and from burn pits more recently. Cancer is common, also. Our website has 163 Presumptives listed under the RESOURCE Button.
You may be asked to get a NEXUS Letter to help verify your request for a VA Disability award. However, another option that became available in March of 2021 to get approved is called Disability Benefits Questionnaires (DBQs). They are forms that guide a physician during an exam to ensure that all the information needed to correctly rate a disabled veteran’s conditions is properly recorded. You can prnt these off your computer and they are free to get. Then give them to your Doctor.
Before this date, DBQs were intended mainly for use by VA staff physicians or VA contract physicians when performing C&P Exams. The new Public DBQs can now be completed by a veteran’s other health care providers (VA or civilian) and submitted as additional evidence in support of a claim or appeal.
It is best for a DBQ to be completed by the health care provider that knows the medical condition the best, either because they have treated it for the longest period of time or because they are the most qualified in the field (i.e. specialists). The VA always gives more weight to evidence that comes from these sources as they are the most likely to provide credible and pertinent information.
The VASRD has very specific requirements for rating every condition, and if the required information is not properly recorded in the veteran’s medical records, the VA will have to send the claim back in order to gather the proper data, thus delaying the entire disability process. If properly used, DBQs prevent this delay by ensuring that the required information is always recorded for every condition.
For example, to rate a scar, the exact dimensions of the scar must be recorded. To ensure that this happens correctly, the Scar DBQ contains a section that prompts the physician to record every measurement needed to rate the scar.
There are more than 60 different DBQs. The majority are for entire body parts or systems, like respiratory conditions, but there are a few specific conditions, like sleep apnea, that have their own DBQs.
Similarly, there are some conditions that do not really have a DBQ that fits quite right. For these, the physician can use the closest one or not use one at all. As long as the appropriate tests are performed and the correct information is recorded in a veteran’s medical records, a DBQ is not essential. They are merely assistive devices.
It is important to note that DBQs are used when applying for both disability and pension. Because of this, there is often information required on a DBQ that is not necessary for rating a particular condition for disability but is necessary for pension purposes. Regardless, as long as it is properly filled out, you should be good to go for your disability.
If you are trying to get your civilian health care provider to fill out a DBQ but they are hesitant or refuse, don’t worry. Again, DBQ’s are not essential. As long as your provider records the information necessary to rate the condition in their exam notes, you can submit those instead. Simply Find Your Condition on our site, take note of the information used to rate it, and let your provider know what tests to perform and information to record.
In other words, if you are asked for a NEXUS letter, DBQ works the same way and your VA Doctor can fill these out.
Here are some examples. Let's start with Agent Orange and burned chemicals. If you qualify here, the minimum award is 30% disability and you get FREE healthcare for that specific diagnosis – including mileage back and forth form the Denver VA hospital and the Colorado Springs Clinic. Additionally, you get a monthly stipend for life, and if you are married, your spouse will receive some financial benefits now and after you are gone.
So, if the VA website isn’t much help, where can you go? Let’s look at what can happen if you do apply without experienced help. There is no way to know what qualifies and what doesn’t. It isn’t obvious. Let’s say that you truly think you have a claim. You submit online, and for whatever reason, they decline your application. You can appeal. A decision should come within 1 day to 3 months. That's down from 6 to 8 years. Yes, years. Things are getting better.
Where can you go for help? First, don’t waste your money on a lawyer. They will take a big chunk of your award and won’t do anything that the groups I’m going to mention will do for free. My favorite is the El Paso County Veterans Services office at 5850 Championship View, Suite 130, Colorado Springs, Colorado (across from the East Costco). Phone: 719-520-7750 - appointments are required. This is paid for by the El Paso County Government. It is totally FREE and staffed by veterans trained to help YOU.
Next, virtually all American Legions and VFWs have trained Veteran Service Officers (VSO) that will help you navigate this process. They typically know what they are doing and they are located in many cities and neighborhoods. However, it's a flip of the coin how good the volunteer VSO is. Membership is not required.
And I am adding one. I recently had a very positive experience helping a widow file for survivor benefits. Not only was it fast (30 minute wait at the Colorado Springs VA Clinic as a walk-in on a Monday morning), but the counselor actually worked to help, insuring that the widow I brought in received her maximum earned benefits. However, they strongly recommend that if you are applying for Disability Benefits, go elsewhere (I am not making that up).
What if you or a loved one is suffering PTSD or other mental issues and needs emergency help? The VA pays for walk-in counseling right here in Colorado Springs. The Colorado Springs Vet Center. The address is 3920 North Union Boulevard, Suite 310 in Colorado Springs. Phone: 719-471-9992. This is for Combat Veterans and Veterans who have experienced sexula trauma only. Anyone else is SOL. The Colorado Springs clinic also offers mental health services and their services have improved dramatically in the last year.
I helped a Veteran who had not served in a war during his service. Much to my surprise (i.e. I hadn't heard this before), he qualified for VA Disability. You need a VSO to apply, but don't assume that you can't receive benefits for an injury or disease that you currently have that you believe is related to your service, but wasn't diagnosed until years after discharge. Apply, the worst that can happen is that they decline your request. Things are changing at the VA and they are getting better for everyone.
Once you are awarded a disability rating, what are the benefits? Rating is in 10% increments, starting at 0% (yes, you can be approved and receive 0% rating - I have three) and going up to 100%. Each approved injury or disease is separately rated and then totaled for your final benefit rating (this is VA addition, so 20 + 40 will end up being 50%). However, once you hit 100%, that’s the cap.
So, how does VA math work. The VA will take your largest award and make that your starting point. Let's say it's 30%. Then they award another 30% for something else. The second 30% will be added at 70% of the 30%, or 21%, for a final total of 51%. That's how 30 + 30 equals 50% (they round down for 1-4 and up for 5-9). Take that a step further and let's say you have a combined award of 90% and then apply for another award, let's say tinnitus and you get 10%. The VA will then add 10% of the 10% and give you 1%. Consequently, you end up with 91% - or no additional benefit.
In other words, it is really tough to get to 100% after being rated at 80 or 90%. That's where the 163 Presumptives come in. Take a look at what is there. Write down the ones that apply to you. Take this list to your VSO. With a little luck, you will have a number of diseases or injuries that will apply. In my case, I had several operations at the VA Hospital in Denver for kidney stones. The result was that I lost 60% of both kidneys. At the time, I thought nothing about it. Then, years later, I checked with my VSO and found out that injuries during a VA surgery qualifies for VA Disability. You don't need to prove negligence or even claim negligence. You just automatically get an award. The VA is full of these "secret" qualifying options.
I stated that the highest VA Disability percentage is 100%, but some Veterans qualify for more. The VA offers something called Special Monthly Compensation (SMC). This is a tax-free benefit paid in addition to the regular tax free VA Disability Compensation, to a veteran who, as a result of military service, incurred the loss or loss of use of specific organs or extremities. The VA has a strange list of compensation amounts, but it usually is approximately $1000 more than your Disability benefit amount - and can be as much as $5000 more for major losses and can be as small as $150 for a minor loss (call me if you want a detailed explanation). SMCs are on top of VA Disability, so it is possible that you have a 30% rating and have a SMC (I actually received a small one years ago). Your VSO will sort this out for you.
Besides the monthly benefit check, which starts at $165.00 for a 10% rating, there are some “secret” plateaus that you want to keep an eye on. First is 30%, where you get free healthcare, including meds, for life, for the specific injury or disease that you were given for the disability award. The VA will also give you mileage to get back and forth from the VA Clinic, VA Hospital and any outside VA Health Care appointments (no one tells you about private Doctor or PT visits, but they must be approved by the VA first). Labs and imaging do not qualify for mileage (go figure), but they are free.
At 50%, all your healthcare is free, regardless of whether it is disability connected or not. And, if you ever wondered how Veterans got their Colorado DV license plates (which are free for life for any one car), this is it. At 70%, you are eligible for free Veterans Home care. In Colorado, this runs from $9000 to over $14,000 per month for non-disability rated Veterans. Additionally, you or your spouse get to keep the benefit money that you were already receiving. Your spouse can also come (space available), but they have to pay, but at least they don’t lose the checks. Veterans Homes may also admit you for free if you have a disability rating under 70%, but they will take all of your disability payment, with the exception of $90 for your personal use.
At 100%, your benefit check increases about 75% from the 90% amount, or to about $3825.00 per month with a spouse. Minor children add additional compensation. At 100% you also receive free dental care - including root canals and tooth implants (those usually cost thousands).
This paragraph is very important. If you think that you have a claim for Disability Benefits, apply. It is very rare that anyone tells you (even at the VA) what is or isn't something that will be approved. Second, if you are receiving benefits and you get a new symptom, apply for an increase.
As example, I was diagnosed with tinnitus (buzzing sounds) in my ears (this is incurable). I had my hearing aids tweaked and it is much better (I now have ocean sounds in my ears which blocks some of the tinnitus sounds, but doesn't affect my ability to hear anything else). This simple diagnosis is $165.00 in monthly payments as your first award (VA math makes this more than confusing if you are already getting Disbility payments).
Google searches will let you know what is approved for benefits and what the benefit amount is (then the VA does their math, so only the first award is what you expect). Additionally, click our RESOURCE Button to view 163 Disability Presumptives (automatically approved if you qualify). There are requirements for each of these, but our 163 Presumptives is a good place to start. If you think you have a claim for something else, Google is a good place to check.
Some quick wrong information that the military either incorrectly tells you or fails to mention. 1) If you get 100% Disability, you CAN still work; 2) If you are retired, you can also receive Disability if your Disability is 50% or more; 3) PTSD, Depression and Anxiety can be rated SEPARATELY, but if you get PTSD, you will automatically get all three.
Most VA Disability awards are for Secondary injury or disease. That means the disease or injury doesn't need to be tied to active duty, but is related to a primary award that was tied to active duty. This typically occurs due to aging, being disease or injury tend to get worse with age and new symptoms occur. In my case, I was awarded 160% for secondary.
There are many other Veteran benefits offered, regardless of disability rating. Any of the support groups that I mentioned can explain those to you, and numerous additional benefits are listed on this website. Click the RESOURCE Button for a list.
For a benefit calculator, go to: Bennefit Calculator
I am going to start this article with an extreme example. A member of the military is on a combat mission. He/She is attacked by the enemy. After running out of ammunition, the soldier kills two of the enemy with his/her bare hands and then is shot and immediately afterwards is hit by a rocket and a leg is blown off. He/She is medevaced and survives. Afterward, the Veteran has repeated nightmares and flashbacks from sounds and visions from that day. Of course, they get a PTSD award. Not necessarily.
Now this person does receive a myriad of VA Disability awards. But PTSD has two "secret" requirements: inability to maintain any relationship; inability to maintain a job. In other words, if you have had one spouse and one job, you will not qualify. Anything in between is a flip of the coin. However, you can still apply for depression and/or anxiety.
Depression is different, and that is why they are evaluated separately. However, just because you are clinically depressed, this doesn't mean it is service connected. So, the first thing you need to do is put a link to your depression to your service. This can be combat, sexual assault or some other dramatic individual or series of events that occurred during your military service.
Let's say that you come home from a combat tour and leave the service. You're married, have two great kids and get a job that lasts for years. Your wife knows that you are changed and moody. You have a quick temper. But she sticks with you. Same thing with your boss. He/she isn't happy that you miss one or two days a month, but you do good work and you stay employed.
First, getting help for depression at the VA is easy. Call any VA Clinic or Hospital, ask for Mental Health, and you are in. No referral is required. You will be asked if you want antidepressant drugs. Say yes, regardless if you actually want them (and you never know, they just might help). Why? This is a check off box during your Disability exam. No drugs means minor depression or maybe now you are cured. VA pays disability for CURRENT issues, not past ones. Start VA counseling - this goes in your VA Health records.
Another option is the Federally paid DoD Colorado Springs Vet Center at 3920 North Union Boulevard, Suite 310 in Colorado Springs. Phone: 719-471-9992. I have heard very good things about this place. However, it is now only for Combat Veterans and those who experienced sexual trauma. Being in VA Health Care is not a requirement. The VA exam doctor will have access to this counseling, so you don't need to get these Doctor notes.
Now, the VA Doctor who does your Disability exam will recommend if you get a disability award. Think for a minute. Are you doing this for the money or to help yourself, your spouse and your family. Getting your head straight is what is important. If you struggle daily and there is no expectation of a cure, then a Disability award for depression is possible - even probable.
One last thought. If the Veteran already has an award for depression or PTSD, think long and hard about applying for an increase. The VA does and will reduce or totally eliminate the current award if they find that you are doing better or that the original award was done incorrectly. Talk to your VSO. If it's the right thing to do, as in you are much worse or the first time you were not correctly evaluated, then go for it. But if you lose your current award, getting it back is next to impossible.
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