Evidence Review is a critical step where your VSR thoroughly examines all the information submitted to your claim. If more evidence is required during this phase, your claim may return to this step more than once.
After the RVSR completes this step, the VA will prepare a decision packet mailed to you. If you disagree with this decision, you can appeal through the higher-level review, supplemental claim lanes, or the Board of Veterans Appeals.
Initial Review
Once the VA has processed your claim, the initial review will begin. This is when they determine whether there is a medical diagnosis and service connection (also known as a medical nexus). VA has a 125-day goal to decide on your case at this step.
During this step, your case is assigned to a Veterans Service Representative (VSR), who will begin reviewing all the evidence submitted. During this time, they will request additional evidence from you, health care providers, governmental agencies, and anyone with information to help them decide on your case. They will also schedule a Compensation and Pension (C&P) exam. This step is where you will usually see the longest wait times because the VSRs review your case and gather all the necessary information before making a decision. If they need more evidence, your case will repeatedly return to this step.
Evidence Gathering & Review
Now, how long does a VA claim take? This is a common question among veterans seeking disability benefits, as the duration of the claims process can vary widely depending on factors such as complexity, evidence availability, and caseload volume.
This step involves gathering evidence and reviewing it. This can take months. During this phase, the VSR (Veteran Service Representative) carefully examines each piece of evidence provided, from medical reports to personal testimonies. They ensure that each piece of information supports the veteran’s claim.
They may also request additional evidence, like medical examinations or rebuttals to previous exams. The length of this step can vary depending on the field office that the VA is working with and how many veterans they serve.
The RVSR will recommend a decision, either approval or denial, based on the evidence gathered. They will also prepare the required documents to explain the decision.
The length of this step can vary, but if the RVSR recommends you are awarded benefits, it means they have found your condition is related to your service. They will then schedule a Compensation and Pension (C&P) exam to confirm their findings. Once this step is complete, you will receive a notification of your final rating decision.
Final Decision
Once the RVSR has all the information it needs, it will prepare a decision recommendation and send it to a higher-level reviewer. This process may take months, especially if the VA is waiting on federal records or needs to schedule you for a C&P exam. It’s important to check eBenefits regularly and contact your representative to ensure the VA has all the necessary information to decide on your claim.
If you disagree with the decision, you can appeal through one of three lanes: higher-level review, supplemental claim, and Notice of Disagreement. Under Appeals Reform, veterans can expect a rating decision within 125 days in the higher-level review, additional claim lanes, and a Board decision within one year for appeals to the Board. However, veterans should remember that these timeframes are goals and not guarantees. They will still be subject to wait times based on the number of cases in each lane.
Appeal
When you file a supplemental claim, the VA will review it and send you a Statement of Case. This is a further explanation of the original denial and identifies why they are denying you benefits. You can opt to have an informal conference call with a senior reviewer or submit more evidence.
If you disagree with this decision, you have one year to file a formal appeal with the Board of Veterans’ Appeals. This process is called a Substantive Appeal, and you must complete VA Form 9.
If your claim has been expedited, it will enter the queue of other expedited claims and may take longer to be processed. Having a qualified VA-accredited attorney by your side can make this process faster and more effective. It can also increase your odds of winning your appeal, as veterans with legal representation win their cases three times more often than those who go it alone.