How to File a Claim For VA Disability Compensation, Part II

Part II

In Part I of this series we learned that in order to receive VA disability compensation, you need to have a current disability, a in-service event that caused that disability, and nexus that makes the link between the two. We read about what kinds of evidence are necessary to prove your claim. We also looked at several different ways to obtain that evidence. In this part, we will look at what kind of information is needed to make a nexus statement, and how to go about getting one for your claim. We will also discuss the importance of reviewing your C-file prior to filing your claim for disability compensation.

Making the Nexus

Now you have the current medical records that explain your current disability in detail. You also have all of your past medical records which explain the event that caused your current medical condition(s) while you were in the service. What you now need is called a "nexus." A nexus is a written link that joins the in service event and the current disability, and proves that your condition is "service connected" (SC'd). Typically, it can be as easy as asking your VA primary care physician (PCP), or your civillian doctor to write a statement on your behalf telling the VA Regional Office (VARO) that your condition(s) were caused by something in your military service.

Since the VA is a government entity that operates under specific laws and regulations, this whole process has to be approached from a legal standpoint. Very specific language needs to be used both in your medical records when describing your disability and when the nexus is written. Vague or ambiguous language, such as "the patient's condition could have been caused by his time in the service" should be avoided at all costs. Don't be afraid to ask your doctor to change it, or even better, ask him to use specific language up front.

There are five key phrases that the VARO likes to see when reading a nexus statement. They are:
1. Related to
2. Most likely related to
3. At least as likely as not related to
4. Less likely than not related to
5. Not related to

When asking for a nexus statement from your PCP, it is completely acceptable for you to explain this matter up front, and ask that he use this language in your progress notes. There is a form that is widely in use for this exact purpose that can be found at : http://www.hadit.com/forums/index.php?act=attach&type=post&id=793. It is also acceptable to have this form already filled out when presented to your doctor. It is not ok, however, to mark one of the boxes that relates your condition to your military service. This should be left blank for your PCP to mark the one he deems appropriate. I have used this form various conditions on a few occasions, and it was always well received by my VARO, and even noted on my decision letters.

Reviewing Your C-file

Now that you have the evidence and the nexus statement, it would be a good time to look over your C-file. If you have never filed a claim with the VA for anything, then you will not need to worry with this step. If you have ever filed for anything with the VA in the past, though, you should do this. You C-file is your claims file that is kept at the VARO that is nearest to you, and typically in the same state that you live. It is supposed to have every piece of information regarding every claim you have ever filed in it. This is rarely the case, however. Therefore it is very important to inspect the file, correct any mistakes, and then get your own copy of this folder. To schedule a appointment to view your file, simply call the VA's 800-827-1000 number and request a time.

Before driving to the VARO, you should make a list of the pieces of evidence that should be in your folder. Highlight any key documents that you will want to bring to the attention of the rater when filing your claim. This will give you a clear plan of attack when looking over your file. This is important, because the time the VARO allots for a veteran to look over their C-file can be brief, and some of us have very large, or multiple folders to go through. Also, be sure to take along a pen and some paper so you can make notes about what you find. While at the VARO, be polite and courteous. We never know what kind of notes they may make about us, plus our moms have all told us that "you can always catch more flies with honey instead of vinegar."

When reviewing your claims file, the first thing you should do is make a quick scan of the documents to make sure that everything in it belongs to you. There have been numerous reports of veterans finding someone else's documents in their folder. You should bring this to the attention of the VARO employee who is present while you are viewing the folder. This will help you by reducing the clutter that a rater will have to sift through when it comes time to adjudicate your claim, and it will help the other veteran by returning their documents to their folder.

Next you will want to ensure that all of the evidence you expected to see in the folder are actually there. If they are not, then make a note of the missing documents, so you can either submit them with your claim, if they are pertinent, or you can submit them at a later date if they are not important to this particular claim. Once you've verified that everything is there, then you should make a note of the date stamps, and any other identifying marks on the pieces of evidence that you highlighted on your list. You can use this in your claim to easily point a rater to the correct documents. Be sure to thank the VARO employee for their time to set up some good karma.

Requesting a copy of your C-file isn't the same as requesting a copy of your medical records from the VA Medical Center (VAMC). Since it is held at the VARO, you will have to contact them, and they will want it in writing. You should write a brief letter to the regional office, requesting a complete copy of your claims file, and all of its contents. Also, fill out and send in a VA Form 3288 along with your letter. At the top of your letter, and on the outside of the envelope, write in bold letters, "Freedom of Information Act Request." This will ensure that it goes to the correct person needed to retrieve, copy and send you folder. Be sure to send this request via certified mail, return receipt requested. This will cost a few dollars more, but is well worth it to know that your request arrived at the VARO. This method should be used for any correspondence with the regional office.

You should know that you DO NOT want to request a copy of your folder while a claim is processing. There has been speculation that if this is done, your folder will be pulled out of line in order to make the copy, then it will be placed at the back of the line when returned. I have been unable to verify that this is what happens, but at the very least it will slow your claim down. Also, there are more and more veterans requesting copies of their files these days, and fewer VARO employees available to fill these requests, so in some cases it can take several months (or more) to actually receive your copy.