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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 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 during your service that would qualify you for some disability benefits (and you probably were given support on discharge for applying for these benefits).
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. 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 chemical burning more recently. Cancer is common, also. Our website has 112 Presumptives listed under the RESOURCE Button.
Why? 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 or 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. But 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 120 days to 3 years. 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 Service 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 Colorado State 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 really know what they are doing and they are located in many cities and neighborhoods. 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 officers right here in Colorado Springs. The address is 3920 North Union Boulevard, Suite 310 in Colorado Springs. Phone: 719-471-9992. No appointment is necessary. You fill out a 1 page form and within minutes you see a counselor. Individual, couple and group counseling is offered until you believe you have resolved your issues. Months, years, decades, it doesn’t matter, and they are always FREE. VA Health Service acceptance or a disability rating is not required. The Colorado Springs clinic also offers mental health services, but my personal experience was not positive.
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. 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 several) 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 get 10% (that is the only award you can get for this). 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% unless you get a single award of 100%. That's where the 112 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 claims.
I stated that the highest VA Disability percentage is 100%, but some Veterans qualify for more. The VA offers something called Special Monthly Compen-sation (SMC). This is a tax-free benefit paid in addition to the regular 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 is approximately $1000 more than your benefit amount - and can be as much as $5000 more for major losses and can be as small as $110 a minor total 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. Your VSO will sort this out for you.
Besides the monthly benefit check, which starts at about $140 for a 10% rating (if you have a spouse, you get a little extra), 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 the disability for. 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 that one, 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), this is it. At 70%, you are eligible for free Veterans Home care. In Colorado, this runs from $7500 to $10,000 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 50% from the 90% amount, or to about $3300.00 per month. At 100% you also receive free dental care - including root canals.
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 recently diagnosed with tinnitus 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 the tinnitus sounds, but doesn't affect my ability to hear anything else). This simple diagnosis could add as much as $250.00 per month in your compensation. Ask, you never know. Google searches will let you know what is approved for benefits and what the benefit amount is. Additionally, click our RESOURCE Button to view 112 Disability Presumptives (automatically approved if you qualify). There are requirements for each of these.
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.
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