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Category: Veteran Disability FAQ

How Can I Receive VA Compensation for Burn Pit Exposure?

What is a Burn Pit?

A burn pit is an area devoted to open-air burning of trash and you can receive VA Compensation for burn pit exposure. During U.S. operations in countries such as Kuwait, Iraq and Afghanistan, the military commonly used burn pits for waste disposal. It was a very efficient way to get rid of large amounts of waste. The largest pit was about 20 acres long .

These burn pits disposed of various materials, such as:

  • Human waste
  • Body parts
  • Medical waste
  • Unexploded ordinance
  • Chemicals
  • Plastics and Styrofoam
  • Paints
  • Rubber.

Smoke from these pits contained toxins that may lead to serious health conditions.  This is especially true for those who had prolonged exposure.  This includes service members who personally dumped waste into a burn pit.  In addition, those with pre-existing respiratory conditions were especially sensitive to the smoke.

Basic Eligibility

VA compensation is a monthly payment to veterans for disabilities related to service.  However, VA will not start the process for you.  You must first file a claim.

To win VA compensation, a veteran must satisfy the 3 basic elements of a VA claim:

  1. In-service event, disease or injury,
  2. Current diagnosis of a disability, and
  3. Medical nexus between the first 2 elements.

The first step is to prove you were exposed to burn pits during your active duty service.  If you served in the Southwest Asia Theater of Operations, then your DD Form 214 should confirm this.  Absent official service records, obtain statements from buddies who witnessed your exposure to burn pits.

Second, the veteran must have a current disability.  The time between exposure and diagnosis will vary based on several factors.  For example, the toxins from burned human waste may affect the body differently than those from burned Styrofoam.   

Even so, a short-term adverse reaction to the smoke is not enough.  Shortly after burn pit exposure, many veterans develop medical conditions.  However, many do not develop disabilities until years after discharge. 

Third, VA requires proof that the condition you suffer from today was caused or aggravated during service.  This usually takes the form of a medical nexus letter.  Only a medical professional should write a disability nexus letter.  In limited circumstances, non-doctors such as physician’s assistants and nurse practitioners can write them.  However, VA will find a disability nexus letter more persuasive if written by a doctor in the relevant specialty. 

Does Every Burn Pit Claim Need a Medical Nexus Letter?

Not every burn pit claim needs a nexus letter because in some cases, the link to service is undeniable.  For example, if your service records note a disability you still suffer from today, then VA would probably grant a claim for that disability without a nexus letter.  As of August 2021, VA will concede that burn pit exposure causes certain health conditions.  These are known as burn pit presumptive conditions.

New presumptive conditions, you can receive VA Compensation for burn pit exposure.

On August 5, 2021, VA issued a new rule to remove the medical nexus requirement for 3 conditions:

  • Asthma,
  • Rhinitis, and
  • Sinusitis.

This rule removes the medical nexus requirement for certain veterans.  But that’s not all.  It also makes it easier to prove burn pit exposure.  For veterans with a qualifying period of service, VA no longer requires specific proof of burn pit exposure to burn pits.  If you served in the Gulf War, Iraq, Syria, or Afghanistan, then you qualify.   In those cases, all you need to prove is a current diagnosis.

Why does VA keep denying my burn pit claim?

VA has been slow to recognize the science linking serious conditions to burn pit exposure.  Because the decision-makers don’t see a link, they tend to deny the claims.

The Secretary of Veterans Affairs recently talked about this . He conceded that many vets have come home with ailments that their doctors believe are a result of burn pit exposure. VA has recognized burn pits cause asthma, rhinitis and sinusitis. However, VA has yet to accept the scientific link to many more serious conditions.

Secretary McDonough cited a critical example.  A female veteran was trying to stay healthy in Fallujah, Iraq.  She went running daily around a burn pit.  When she informed her doctor, he said she should get tested early for breast cancer.  It turned out she had stage 4 breast cancer at the age of 38.  The science indicated she was way too young to have such an advanced stage cancer.

When VA denies a claim, the veteran can file an appeal.  However, appeals can take years to win.  With such an advanced cancer, this veteran may not survive before VA decides the appeal.  This is grossly unfair to veterans who served our country with honor.

Are you entitled to VA compensation for burn pit exposure?  The experts at Disability Help Group are standing by.  Contact us for a FREE CONSULTATION.

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You can receive VA Compensation for burn pit exposure.

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

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How to Qualify for VA Compensation While Receiving SSI

How to Qualify for VA Compensation While Receiving SSI. Veterans can receive both VA compensation and SSI.  Both VA compensation and SSI require that you have disabling conditions.  However, the requirements to qualify differ. 

How to Qualify for VA Compensation While Receiving SSI: VA compensation

VA disability compensation offers monthly payments to Veterans who got sick or injured while serving.  You must show that your disabling condition was “incurred or aggravated by your military service.”  The VA does not require total disability.  The VA awards benefits based in proportion to your percentage of disability.  Compensation rates range from 10%-100%, in 10% increments. 

VA pension

The VA also offers benefits for veterans who have non-service disabilities.  VA pension benefits require that you were not dishonorably discharged and you meet certain financial limits.  You must also meet certain service requirements.  Additionally, you show one of the following:

  • You are at least 65 years old
  • Have a permanent and total disability
  • Are a patient in a nursing home for long-term care because of a disability or
  • Are receiving Social Security disability insurance or SSI. The OT and ICS cyber security is what is needed to protect data.

How to Qualify for VA Compensation While Receiving SSI: SSI benefits

Unlike VA compensation, SSI does not offer partial disability.  You must prove that your medical conditions keep you from working in any job.  You must also show that you can’t work for at least 12 months.  SSI also has specific financial requirements.  Specifically, these requirements include:

  • You must have less than $2,000 in assets (or $3,000 for a couple)
  • Have a very limited income
  • Are a US citizen (there are very few exceptions to this)

VA compensation and SSI benefits

Since SSI is a needs-based program, other income affects the amount you receive from SSI.  Therefore, VA compensation will reduce your SSI payments.  Social Security considers VA compensation as “unearned income.”  Social Security deducts unearned income on a dollar for dollar basis with a $20 exclusion.  The SSI federal payment amount for 2021 is $794 per month. 

How to apply for VA compensation

You can apply for veterans benefits online.  You may also apply by using VA Form 21-526, Veterans Application for Compensation and/or Pension.  Once you apply, the VA uses military doctors and other health personnel to evaluate your disability claim.  The VA may ask you to attend a C&P exam to help rate your claim.  The VA assigns a disability rate to each of your conditions.  These rates determine your Total Combined VA disability rating.  The VA then uses this rate to figure out the amount of your benefits. We Can Help You Qualify for VA Compensation While Receiving SSI.

How to apply for SSI

You must contact your local Social Security office to file. Unlike the VA, Social Security doesn’t rate your conditions separately.  Social Security looks at how the combination of your conditions impacts your functioning.  First, they consider if any of your conditions meet certain conditions under their listing of impairments, known as the “Blue Book”.  Most conditions will not meet these strict requirements.  Next, Social Security considers your residual functional capacity or RFC.  Your RFC includes both physical and mental limitations.  If Social Security determines that your conditions keep you from working, they will approve your disability claim.  Like the VA, Social Security may ask you to attend a medical exam to help evaluate your claim. 

Disabled veterans and your age

Social Security has special disability rules the older you are.  They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.”  The grid rules make it easier for older people to win their case.  Social Security considers your age, education and work background.  The older you are, the easier it can be to win your case. 

Can a veteran work and receive both VA and SSI?

If you are working, you may not qualify for SSI.  Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you will not qualify for Social Security disability.  For 2021, SGA is earnings $1,310 per month or more (before taxes).  However, if you earn more than $794 per month, you will not qualify to receive SSI payments.  Unlike Social Security, veterans can work while receiving VA disability benefits unless you receive Total Disability Based on Individual Unemployability (TDIU). We can help you Qualify for VA Compensation While Receiving SSI.

VA and SSI medical benefits

Veterans receiving VA disability automatically receive TRICARE benefits.  TRICARE covers health costs found “medically necessary” for your condition.  SSI recipients receive Medicaid benefits.  If you receive both TRICARE and Medicaid, TRICARE becomes your primary insurance. 

Getting help with your VA compensation and SSI claims

Get help with your case now. Firstly, your advocate helps you with your application and can make sure you provide all necessary information.  Secondly, your advocate walks you through the process and can answer all of your questions. Thirdly, your advocate knows what it takes to get your case approved.

Call Now for a Free Case Review, 800-700-0652

Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

How Receiving Social Security Disability Can Help You Get VA 100%

How Receiving Social Security Disability Can Help You Get VA 100%. Receiving Social Security disability can help you get a 100% VA rating.  However, receiving Social Security disability doesn’t guarantee a 100% VA rating.  It can be used as powerful evidence for your VA claim.  Although, these decisions only help if you can show your conditions are service-connected. 

VA disability benefits

VA disability benefits require that you meet certain conditions.  You must have a current diagnosis.  That diagnosis must be service-connected.  You must also show a medical nexus or connection between your diagnosis and in-service incurrence.  The VA considers your disability service-connected if your medical condition:

  • Firstly, Was directly caused by military service
  • Secondly, Occurred while in the military
  • Thirdly, Was aggravated by military service or
  • Finally, Caused by conditions that are service-connected

VA disability rating and TDUI

Disability ratings range from 10% to 100%.  Next, it can be hard to earn a 100% disability rating when you have more than one disability.  Fortunately, the VA provides an alternate route to total disability rating based on individual unemployability (TDUI).  The VA considers your ability not only get a job but also to keep a job.  You meet the conditions for a TDUI rating if your disabilities prevent you from working and:

  • You have a single service-connected rating or have a combined disability rating of 70%

Social Security disability helps establish a current diagnosis

Firstly, SSDI looks at your medically determinable impairments (MDI).  Secondly, Social Security considers any condition that has an impact on functioning as an MDI.  Thirdly, a Social Security hearing decision includes a list of your disabilities.  Therefore, your Social Security approval helps determine your diagnoses. Receiving Social Security Disability Can Help You Get VA 100%. Call Now for a Free Case Review.

Social Security disability helps establish service-connection

Frequently, applicants for Social Security disability have to testify at a disability hearing.  During the hearing, the judge asks a lot of questions about your disabilities.  Often, applicants provide detailed explanations about their conditions.  They also explain when conditions started.  A Social Security hearing decision includes a summary of testimony.  Therefore, your Social Security hearing decision helps establish service-connection. 

Example:  Social Security hearing decision helps establish service-connection

Likewise, a veteran applied for disability benefits for PTSD.  During the hearing, he testified that he witnessed a young girl get hit by a vehicle while on patrol during his service.  He also testified that since his service, he started blacking out and became violent.  He testified that he didn’t sleep well, had significant paranoia and was very depressed.  The judge’s decision included the veteran’s testimony, helping to establish that his PTSD was connected to his service. 

Social Security disability helps establish severity

Social Security has a difficult standard to meet for eligibility.  You must show that your medical conditions prevent you from working in any job.  A judge’s decision must explain why a case meets the requirements for disability.  The decision includes specific reasons how significantly medical conditions impact a person’s functioning.  Therefore, a Social Security disability decision can help explain how severe your conditions are. 

Example:  Social Security hearing decision helps establish severity

Hence, a veteran applied for Social Security disability due to a lower back impairment, depression and anxiety.  During the hearing, the veteran testified that he injured his back during his service.  He could no longer perform his duties as a postal worker.  As a result of his chronic pain and limitations, he developed significant depression and anxiety symptoms, requiring medication and therapy.

In his hearing decision, the judge explained that his lower back condition caused significant limitations with standing, walking and sitting.  The judge also explained that his depression and anxiety symptoms caused significant problems concentrating.  The veteran provided the VA a copy of the decision, which helped him qualify for TDUI. 

Example:  Social Security hearing decision helps establish severity

For instance, a veteran applied for Social Security disability due to a traumatic brain injury.  He suffered from episodes of aggression, poor memory and difficulty getting along with others.  In his hearing decision, the judge referred to evidence in his record documenting that he needed a lot of help with his daily activities.  Specifically, he needed help with medication management and reminders to take care of his personal hygiene. 

His mother took him to all of his medical appointments and helped manage his bills.  His medical records documented that he could become very aggressive often.  The Social Security judge determined that the veteran would not be capable of maintaining any job.  The decision helped increase the veteran’s VA disability rating. 

Getting help with your Social Security and VA disability claims

Both Social Security and VA have complicated application processes.  The process can be even tougher when Social Security or the VA issues a decision that completely ignores the evidence.  Working with an experienced advocate helps increase your chances of getting approved.  They know how to turn a loss into a win.  An experienced advocate can analyze your case and help you receive maximum benefits.  It helps to have knowledgeable experts on your side. 

Call Now for a Free Case Review, 800-700-0652

Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

Can a Veteran Receive Both VA and Social Security Benefits?

Can a Veteran Receive Both VA and Social Security Benefits? Veterans can qualify for both VA and Social Security benefits.  Frequently, veterans apply for both VA and Social Security benefits.  However, VA and Social Security benefits have different requirements. 

VA benefits for veterans

VA benefits or service-connected disability, have specific requirements.  You must show that your disabling condition was “incurred or aggravated by your military service.”  You will not qualify for VA benefits if you have a dishonorable discharge.  You can receive partial disability benefits from the VA.  VA disability compensation rates range from 10-100%, in 10% increments. 

Social Security benefits

Social Security has two types of benefits, disability insurance benefits (SSDI) and supplemental security income benefits (SSI).  Under SSDI, you must have worked and earned at least 20 work credits.  Generally, this means you must have worked at least 5 out of the last 10 years.  Under SSI, you do not need any work credits.  However, you must meet certain financial requirements.  You must show that your medical conditions keep you from working for at least 12 months.  Unlike VA benefits, Social Security doesn’t offer partial disability. 

Applying for both VA and Social Security benefits

If you get approved for one benefit, it doesn’t increase your chances for getting approved for the other.  Social Security and the VA follow different rules.  However, Social Security considers medical evidence from the VA.  Similarly, the VA considers your Social Security records. 

Expedited processing for veterans

Fortunately, Social Security can fast-track certain cases for veterans.  Social Security expedites processing for veterans with a 100% VA rating.  You should identify as a “Veteran rated 100% P&T” when filing your application.  You should also include your VA rating notification letter.  Additionally, Social Security fast-tracks case for Wounded Warriors.  You should tell Social Security that your injuries happened while on active duty.  

Application process for VA benefits

Both the VA and Social Security reviews medical records.  The VA uses military doctors and other health personnel to evaluate your disability claim.  The VA may ask you to attend a claim exam, known as a C&P exam.  This exam helps the VA rate your disability.  Additionally, the VA assigns a disabling rate to each of your conditions.  These rates determine your Total Combined VA disability rating.  The VA uses this rating to figure out the amount of your benefits.

Application process for Social Security benefits

Unlike the VA, Social Security doesn’t rate your conditions separately.  Social Security looks at how the combination of your conditions impacts your functioning.  First, they consider if any of your conditions meet certain conditions under their listing of impairments, known as the “Blue Book”.  Most conditions will not meet these strict requirements.  Next, Social Security considers your residual functional capacity or RFC.  Your RFC includes both physical and mental limitations.  If Social Security determines that your conditions keep you from working, they will approve your disability claim.  Like the VA, Social Security may ask you to attend a medical exam to help evaluate your claim. 

Disabled veterans and your age

Social Security has special disability rules the older you are.  They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.”  The grid rules make it easier for older people to win their case.  Social Security considers your age, education and work background.  The older you are, the easier it can be to win your case. 

How much can I get from VA and Social Security benefits?

As discussed, the VA calculates your payments based on your Total Combined VA disability rating.  Social Security uses a complicated formula based on the amount of earnings you paid taxes on.  Therefore, everyone’s amount is different.  VA benefits will not affect your SSDI payments.  In other words, you can receive both payments in full.  Unfortunately, any VA benefits will reduce your SSI payments. 

VA and Social Security medical benefits

Veterans receiving VA disability automatically receive TRICARE benefits, which cover health costs found “medically necessary” for your condition.  SSDI recipients qualify for Medicare benefits which start two years after Social Security finds you disabled.  Medicare covers a variety of medical costs, usually regardless of a specific condition.  SSI recipients receive Medicaid benefits.  If you receive both TRICARE and Medicare, Medicare becomes your primary insurance.  However, if you receive both TRICARE and Medicaid, TRICARE becomes your primary insurance. 

Can a veteran work and receive both VA and Social Security benefits?

If you are working, you may not qualify for Social Security disability.  Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA and if you earn over the SGA limit, you will not qualify for Social Security disability.  For 2021, SGA is earnings $1,310 per month or more (before taxes).  You can still qualify for Social Security disability benefits if you earn less than SGA.  However, any work may make it harder for Social Security to approve your claim.  Unlike Social Security, veterans can work while receiving VA disability benefits unless you receive Total Disability Based on Individual Unemployability (TDIU.)   

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

Can a Veteran Receive both VA and SSDI?

Disabled veterans can receive both VA and SSDI benefits.  In fact, it is common for veterans to apply for both SSDI and VA disability benefits.  However, some veterans receive VA disability benefits before applying for SSDI.  

What is SSDI?

Social Security disability insurance benefits or SSDI requires that you have worked and earned enough work credits.  You receive work credits each year that you work and pay taxes.  Generally, you need to earn a total of 20 work credits to qualify for SSDI.  Additionally, you must meet a recent work test.  Like other insurance programs, SSDI coverage ends after a certain amount of time from when you stop working.  SSDI also requires that your medical conditions keep you from working for at least 12 months. Call us now if you are Veteran and Want to Receive both VA and SSDI.

What is the difference between VA and SSDI?

Social Security doesn’t offer partial disability benefits.  Your medical conditions must prevent you from working on a full-time basis.  Unlike SSDI, VA disability benefits don’t require total disability.  Veterans receive compensation rates based on the degree of your disability.  The compensation rates range from 10-100%, in 10% increments.  Call us now if you are Veteran and Want to Receive both VA and SSDI.

SSDI expedited processing for veterans to receive both VA and SSDI.

Veterans may qualify for expedited processing for Social Security disability claims.  You may receive expedited processing under:

  • 100% Permanent and Total Veterans Initiative – you should identify yourself as a “Veteran rated 100% P&T” when filing your SSDI or SSI application.  You also should provide the VA rating notification letter to Social Security
  • Wounded Warriors – if you received disabling mental or physical health injuries while on active duty on or after October 1, 2001, you are eligible for SSDI or SSI expedited application processing.  You don’t need to have been injured during combat operations.  You should tell Social Security that your injury occurred while on active duty.  

What are the medical requirements for SSDI?

First, Social Security considers whether your medical conditions fall under their listing of impairments, known as the Blue Book.  Typically, the Blue Book requires that your medical conditions meet very specific requirements.  If you don’t meet the listings, Social Security considers your residual functional capacity or RFC.  An RFC includes both physical and mental limitations.  Social Security looks at your medical evidence to determine your RFC.  They can also consider the opinions of your doctors.  Call us now if you are Veteran and Want to Receive both VA and SSDI.

What medical evidence do veterans need for SSDI?

Your medical evidence should include records only for the period of time that you became disabled and unable to work.  Your treatment should also be continuous and ongoing.  The VA and Department of Defense (DOD) share medical records electronically with Social Security.  Social Security also considers any treatment veterans receive from civilian doctors.  Medical evidence can include:

  • Treatment notes and physical examinations
  • Imaging such as MRIs, x-rays, CT scans or nerve testing
  • Blood work or biopsy results
  • Pulmonary tests
  • Mental health records

SSDI “Grid Rules” 

Social Security has special disability rules the older you are.  They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.”  The grid rules make it easier for older people to win their case.  Social Security considers your age, education and work background.  The older you are, the easier it can be to win your case.  Call us now if you are Veteran and Want to Receive both VA and SSDI.

Example 1:  applying the grid rules for veterans over age 50

For example, John, a 53 year old veteran, applied for disability due to arthritis in his knees.  John underwent a total knee replacement but continued to have pain and swelling in both knees.  He previously worked in a factory.  John received most of his treatment at the VA hospital.  His medical records included MRIs and x-rays of his knees.  His doctors also documented that he required the use of a cane due to his symptoms.  Social Security found that he could not return to work in the factory.  Since he is over the age of 50, the grid rules allow Social Security to approve his claim.

Example 2:  applying the grid rules for veterans over age 55

As another example, Chris, a 58 year old veteran, applied for disability due to a right shoulder impairment and degenerative disc disease in his spine.  Chris previously worked as a truck driver.  However, he was unable to load and unload the trucks due to his pain symptoms.  Chris received treatment from both the VA hospital and civilian doctors.  His medical records documented his pain symptoms and limited motion in his shoulder and back.  Social Security found that he could not return to work as a truck driver.  Since Chris is over the age of 55 and he could not return to his past work, Social Security approved his claim.  

Working disabled veterans can receive both VA and SSDI.

If you are currently working, you may not qualify for SSDI.  Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you will not qualify for SSDI.  In 2020, earnings S1, 260 per month or (before taxes) are considered SGA. Although, if you are working part-time and earning less than SGA, you may still qualify for SSDI.  However, any work may make it harder for Social Security to approve your claim.  Call us now if you are Veteran and Want to Receive both VA and SSDI.

Does active duty affect eligibility for SSDI?

Active duty status or receipt of military pay doesn’t necessarily keep you from receiving SSDI.  Social Security evaluates your work activity to figure out your eligibility.  You can apply while in a rehabilitation program or attending outpatient programs.  It doesn’t matter whether your treatment is in a VA hospital or civilian facility.   If you are on limited duty or working in a designated therapy program, you should definitely apply for SSDI.  

Does getting approved for Veterans VA benefits help receive SSDI?

Unfortunately, the answer is no.  The VA and Social Security have completely separate processes and requirements for approving claims.   However, Social Security will consider any evidence the VA used when looking at your claim.  Similarly, the VA is required to consider Social Security records.  Call us now if you are Veteran and Want to Receive both VA and SSDI.

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

What is the Difference Between SSDI and VA Disability?

What is the Difference between SSDI and VA Disability? SSDI and VA disability benefits are both government programs that help disabled individuals receive benefits. Both programs have separate application processes.  They also have different requirements for determining disability.

SSDI vs. VA Disability:  general requirements

VA disability benefits provide payments only to US veterans.  The VA does not require any financial contributions.  Additionally, the VA doesn’t require you to have worked within the last 5 or 10 years.  Unlike VA disability, you don’t need to be a veteran to apply for SSDI.  SSDI does require that you meet certain medical and non-medical requirements. 

SSDI does require that you worked and earned enough work credits.  Generally, you need a total of 20 work credits to qualify for SSDI.  Typically, you need to have worked 5 out of the last 10 years.  However, if you are younger, you may qualify for SSDI with fewer credits.  

SSDI disability defined

SSDI requires that you have a medical condition that prevents you from working.  Your condition must keep you from working for at least 12 months.  Unlike VA disability benefits, SSDI does not need your disability to be connected to military service.  They also don’t consider your discharge status. 

VA disability defined

VA disability benefits, also known as service-connected disability, have specific requirements.  You must show that your disabling condition was “incurred or aggravated by your military service.”  You must not have a dishonorable discharge.  You must also submit a formal claim by completing an “Application for Disability Compensation and Related Compensation Benefits” or VA Form 21-526EZ.  Starting to understand the difference between SSDI and VA disability?

SSDI vs. VA Disability:  percentage of disability

SSDI doesn’t distinguish between partial or total disability.  Therefore, you must show that your medical conditions keep you from working in any job.  Social Security figures out your monthly payment based on what you paid into Social Security.  Even so, VA disability benefits don’t require total disability.  The VA awards benefits based in proportion to their percentage of disability.  Compensation rates range from 10%-100%, in 10% increments.  Therefore, SSDI does not have percentages and VA disability does.

SSDI application process

Firstly, Social Security considers whether your medical conditions fall under their listing of impairments, known as the Blue Book.  Secondly, the Blue Book requires that your medical conditions meet very specific requirements.  Thirdly, if you don’t meet the listings, Social Security considers your residual functional capacity or RFC.  An RFC includes both physical and mental limitations. 

Social Security looks at your medical evidence to determine your RFC.  They can also consider the opinions of your doctors.  Social Security may also ask you to attend an appointment with one of their doctors.  Social Security will schedule an exam when they need more information about your conditions.  

VA disability application process

Veterans go through a VA-directed medical review.  The VA uses military doctors and other health personnel to evaluate veterans for their disability.   Similar to SSDI, the VA may ask you to attend a VA claim exam, known as a C&P exam.  The exam will help the VA rate your disability.  The VA assigns a disable rating to each of your conditions.  This determines your Total Combined VA Disability Rating.  The Total Combined VA Disability Rating determines the amount of your benefits.  

SSDI:  your age matters 

Social Security has special disability rules the older you are.  They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.”  The grid rules make it easier for older people to win their case.  Social Security considers your age, education and work background.  The older you are, the easier it can be to win your case.  While SSDI considers your age, VA disability does not consider your age.  

Example 1: applying the grid rules for SSDI

For example, James, a 56 year old veteran, applied for disability due to knee, shoulder and neck pain.  He previously worked as truck driver, receives disability compensation related to a knee injury.  He has trouble standing and walking, needs a cane.  His medical records include MRIs and x-rays of his knees, shoulder and neck documenting his impairments.  His doctors have also documented that he has pain and limited motion of his knees and shoulder.  Social Security found that he could not return to work as a truck driver.  Since he is over the age of 55, the grid rules allow Social Security to approve his claim.  

SSDI and VA disability application wait time

Unfortunately, both VA disability and SSDI can take time to process before issuing a decision.  VA disability applications can take anywhere from a few months to 2-3 years for a decision.  SSDI has several levels of the claims process.  Firstly, it may take 4-6 months to receive an initial decision.  Secondly, if Social Security denies your claim, you file an appeal for reconsideration, Reconsideration can take 3-5 months.  Thirdly, you can file a request for hearing, where it can take several months for your case to be scheduled.  Social Security also has additional appeals if your case is denied at hearing.   

SSDI expedited processing for Veterans 

Veterans may qualify for faster processing for SSDI claims.  You may receive expedited processing if you have a 100% Permanent and Total disability rating.  Additionally, Social Security fast-tracks claims for Wounded Warriors.  It include veterans who received disabling mental or physical health injuries while on active duty after October 1, 2001.  

SSDI vs. VA disability:  medical insurance

SSDI recipients receive Medicare.  Medicare benefits start two years after Social Security finds you disabled.  Medicare covers a variety of medical costs, usually regardless of condition. Though, it does not always cover all primary medical care.  You may need an additional policy to supplement your benefits.

Veterans receiving VA disability are automatically covered by TRICARE benefits.  TRICARE covers health costs deemed “medically necessary” for your condition.  If you receive both SSDI and VA disability, Medicare becomes your primary insurance and TRICARE becomes your secondary insurance.  

Call Now for a Free Case Review, 800-700-0652

Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

Can a Disabled Veteran Receive SSDI?

Can a Disabled Veteran Receive SSDI? Disabled veterans can receive SSDI benefits. An award of VA disability benefits won’t prevent you from also receiving SSDI benefits. However, there are differences between qualifying for these types of benefits.

Disabled Veterans:  SSDI vs. VA disability benefits

SSDI requires that your medical conditions prevent you from working for at least 12 months.  SSDI doesn’t distinguish between partial or total disability.  Unlike SSDI, VA disability benefits don’t require total disability.  In fact, most veterans who receive VA compensation do not receive a total disability rating. 

How do disabled veterans qualify for SSDI? 

To qualify for SSDI, you must have worked a certain number of years and earned enough work credits.  You receive work credits each year that you work and pay taxes.  At most, you can earn four work credits per year.  Generally, you need a total of 20 work credits to qualify for SSDI.  However, there are some age exceptions.  If you are younger, you may qualify for SSDI with fewer credits. 

SSDI financial requirements for disabled veterans

As mentioned, SSDI requires that you earn a certain amount of work credits to qualify.  Therefore, there are no limits to the amount of assets, cash or other resources you own.  For example, VA disability benefits will not keep you from receiving SSDI benefits.  Additionally, they will not reduce your SSDI benefits. 

Working disabled veterans

Since Social Security defines disability as the inability to work, if you are working, you may not qualify for SSDI.  Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you will not qualify for SSDI.  In 2020, earnings S1, 260 per month or (before taxes) are considered SGA.  If you are working part-time and earning less than SGA, you may still qualify for SSDI.  However, any work may make it harder for Social Security to approve your claim. 

Medical requirements for disabled veterans

First, Social Security considers whether your medical conditions fall under their listing of impairments, known as the Blue Book.  Typically, the Blue Book requires that your medical conditions meet very specific requirements.  If you don’t meet the listings, Social Security considers your residual functional capacity or RFC.  An RFC includes both physical and mental limitations.  Social Security looks at your medical evidence to determine your RFC.  They can also consider the opinions of your doctors. 

Medical evidence for disabled veterans

Your medical evidence should include records only for the period of time that you became disabled and unable to work.  Your treatment should also be continuous and ongoing.  The VA and Department of Defense (DOD) share medical records electronically with Social Security.  Medical evidence can include:

  • Treatment notes and physical examinations
  • Imaging such as MRIs, x-rays, CT scans or nerve testing
  • Blood work or biopsy results
  • Pulmonary tests
  • Mental health records

Disabled veterans and your age

Social Security has special disability rules the older you are.  They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.”  The grid rules make it easier for older people to win their case.  Social Security considers your age, education and work background.  The older you are, the easier it can be to win your case. 

Example 1: applying the grid rules for disabled veterans

For example, Michael, a 57 year veteran, applied for disability due to back pain.  He previously worked as janitor, receives disability compensation related to a back injury.  He has trouble standing and walking, needs a cane.  His medical records include MRIs and x-rays of his back documenting his impairment.  His doctors have also documented that he has pain and limited motion of his back.  Social Security found that he could not return to work as a janitor.  Since he is over the age of 55, the grid rules allow Social Security to approve his claim. 

Does my VA approval help improve my chances receiving SSDI?

Generally, your VA approval will not help you get SSDI.  Social Security will consider any evidence that the VA used when making their decision.  Social Security may also use VA or DOD evidence to expedite SSDI claims for Wounded Warriors or veterans with a 100% disability compensation rating.  Similarly, the VA may not give Social Security’s decision much weight.  Usually, Social Security’s decision can be unclear whether the disability is based on service-connected or non-service disability.  However, the VA is required to consider your Social Security records. 

Does active duty affect eligibility for SSDI?

Active duty status or receipt of military pay doesn’t necessarily prevent you from receiving SSDI.  Since you can’t receive SSDI if you are engaging in SGA, Social Security evaluates your work activity to figure out your eligibility.  You can apply while in a rehabilitation program or attending outpatient programs regardless of whether your treatment is in a VA hospital or civilian facility.   If you are on limited duty or working in a designated therapy program, you should definitely apply for SSDI. 

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

VA Benefits Appeal

Posted on by Ken LaVan

VA Benefits Appeal. To win a VA disability claim, a veteran must prove all elements.  Generally, VA will approve a VA benefits claim when a veteran proves the following:

  1. In-service event, disease or injury,
  2. Current disability, and
  3. Medical nexus between the in-service event and the current disability.

After you submit your claim, VA is obligated to issue a decision.  Based on the evidence, VA may decide to approve your claim completely.  Alternatively, VA may either deny the claim outright, or grant your benefits at a low disability rating.  Regardless, veterans have the right to appeal any VA benefits decision to a higher authority.

What is the point of an appeal?

VA decision-makers are not perfect.  They often make mistakes.  For a disabled veteran who is barely making ends meet, VA’s mistakes can be costly.  This is why Congress created the appeals system.  It gives veterans a fighting chance to correct VA’s mistakes without losing years of benefits.

VA benefits appeals are great because they preserve the earliest effective dates.  Take the example of J. Stone, who filed a claim for PTSD in 2011.  VA denied his claim in 2013 because they could not confirm the traumatic in-service event.  His friends told him to just file another claim.  Instead, he consulted the experts at Disability Help Group (DHG). 

A DHG representative helped him file an appeal along with evidence of the in-service event.  In 2015, VA decided the appeal in Mr. Stone’s favor.  As a result, he received a 70% rating effective 2011, the date he filed his claim.  He received

Appeals in the Legacy System

The Legacy system refers to the VA appeals structure for decisions issued prior to February 19, 2019.  When VA first denies a claim in Legacy, the veteran may appeal with a Notice of Disagreement (NOD).  The deadline to file a legacy NOD is 1 year from the date of the decision. 

When you file a timely NOD, you are asking a senior VA officer to overrule the previous decision.  If the VA agrees with you, then it will issue a new decision awarding benefits.  If not, VA will issue a Statement of the Case (SOC) to explain why the previous decision should stand.

Fortunately, an SOC is not the end of the road.  Using a VA Form 9, you can appeal an SOC to the Board of Veterans’ Appeals (the Board).  Unlike the lower decision, you have only 60 days to appeal an SOC.  A VA Form 9 is a request for a Veterans Law Judge to take a fresh look at your case.   If the judge finds in your favor, he/she will award benefits effective the date you first filed.  If the judge finds against you, then you can appeal to the U.S. Court of Appeals for Veterans’ Claims.

The Appeals Modernization Act changed everything

Any decisions issued on or after February 19, 2019 fall within the Appeals Modernization Act (AMA).  If VA denies your claim, or approves it with a very low rating, you can appeal it by filing one of these forms:

  • VA Form 20-0995 Supplemental Claim, 20-0996 Request for Higher Level Review, or 10182 Notice of Disagreement to the Board of Veterans’ Appeals

Each lane has its pros and cons.  Visit this link for more details [Link to the AMA article].

What’s the downside of an appeal?

First, a VA benefits appeal can take a very long time.  Take a look at the search results when you Google “VA appeals backlog.”  Prior to the AMA, VA took an average of 2.5 years to process appeals. 

Second, you may have to appeal several times to get the job done.  If your first appeal is not successful, then you should appeal to a higher tribunal (like the Board of Veterans’ Appeals).  When you believe in your claim, you should never give up.  Don’t let VA win.

Hire an expert to give yourself the best chance to win

Every VA benefits appeal is different.  The best indicator of success is having an experienced representative.  This is a very complex system.  Most veterans are not equipped to force VA to change a decision.  Some cases already have the evidence needed to win, but are lacking a good legal argument.  Other cases lack both evidence and argument.  An experienced representative can plug the holes in your case. 

At DHG, our experts review each case with a fine-toothed comb.  This is how we figure out the best path forward.  We don’t just file a VA benefits appeal and then wait around for VA to act.  Instead, we actively develop winning evidence and arguments to deliver for our clients.

Do you need help with your VA benefits appeal?  Contact the experts at DHG for a free consultation.

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

Get Help Now

Call, 1-800-700-0652

Because memory deficits are common VA TBI residuals, a veteran should always have an advocate. Disability Help Group specializes in TBI cases and is here to answer your questions now.

Additional Information

VA Disability Remand

Posted on by Ken LaVan

VA Disability Remand. After a veteran applies for VA benefits, VA must decide to either

  1. Grant the claim, or
  2. Deny the claim.

Following a VA decision, the veteran has the right to appeal.  If the first appeal fails, a veteran can request review by the Board of Veterans’ Appeals (the Board).

In addition to the first 2 decision options (to grant or to deny), the Board may decide to remand.  When the Board issues a remand, it is ordering the VA Regional Office to take specific action to develop the claim.  Unfortunately, most of VA’s appeals backlog involves remands. 

For many veterans, it takes longer than 2 years for VA to issue a new decision after a Board remand.  For most veterans, the goal is to turn a remand into a grant.  That is exactly what we do here at Disability Help Group.  Keep reading for more information on VA Disability Remands.

Which VA agencies are involved?

VA Disability Remands involve a maze of different decision-makers.  To understand VA Disability Remands, one should first understand the different agencies involved.

  • VA Regional Offices.  Claims start at the Regional Office level.  There are 57 Regional Offices, most of which are based in the United States.At this level, VA Rating Specialists usually decide the claims.  If the Rating Specialist denies the claim or grants it with an inappropriate rating, the veteran can file an appeal.  More experienced VA decision-makers, such as Decision Review Officers, usually process these appeals.
  • Board of Veterans’ Appeals.If the first appeal is unsuccessful, then the veteran has the right to appeal to the Board of Veterans’ Appeals. The Board, which is based in Washington, D.C., is a superior tribunal of VA law judges.  The Board reviews appeals of decisions issued by the Regional Offices.  At this level, VA law judges (instead of local bureaucrats) make the decisions.

What is a Remand?

Put simply, a remand is an order from a superior agency to a lower one.  The lower agency has no choice; it must comply with the remand order.  In the VA disability system, the most common type is a remand from the Board to the Regional Office. 

While it is not a final decision, a Board remand is binding on the Regional Office.

Why would the Board issue a Remand instead of a Grant or Denial?

There are 3 main reasons:

  1. The Regional Office did a really bad job.  Often, the Regional Office fails to meet its duty to assist veterans in accordance with the law.  They may have failed to provide a medical exam, misinterpreted a regulation, or ignored favorable evidence.  Because of these failures, the claim lacks evidence the Board could rely on to grant.  To addressthese failures, the Board uses remands to spell out how the Regional Office can make up for them.  After the Regional Office complies with the Remand, it must issue a new decision. 
  2. New evidence is introduced.  Let’s say the Regional Office denied a PTSD claim because there was no medical nexus.  During an appeal to the Board, the veteran submitted a private medical nexus opinion.  Because the Board is strictly an appellate tribunal, it cannot consider new evidence in the first instance.  In this situation, the Board must remand the case for the Regional Office to consider the new nexus opinion.
  3. Your disability gets much worse.  In an appeal involving a request for a higher rating, the disability may get worse while the veteran waits for the Board’s decision.  The Board is likely to remand for a new VA medical exam if that last exam was over 2 years ago.  Rather than rely on an old exam, the Board may order a new one that reflects the current disability.

What are the Pros and Cons of a Board Remand?

Pros

  • As a matter of law, veterans have the right to compliance with the Board’s remand order.  This means that the Regional Office cannot ignore the order and issue another denial.
  • It preserves the earliest effective date for the claim.  For example, let’s say a veteran filed a claim in February 2012.  He appealed his case all the way to the Board, which issued a remand order in December 2019.  If the Regional Office grants the case on remand, then the benefits will be effective February 2012.

Cons

  • Board remands represent the largest backlog of appeals at most Regional Offices.  VA is slow to process them.
  • If the Regional Office issues a decision on remand without complying with the Board’s order, then the Board will likely remand the case again.  This could drag the case out even longer.

Example

An experienced representative can make all the difference.  Take the example of W.F., a DHG client who served in the Marine Corps.

In October 2012, he filed a claim for multiple orthopedic disabilities.  In June of 2013, VA denied his claim for lack of a medical nexus.  Although he met the criteria, VA failed to provide a medical exam.  On his own, he appealed his case all the way to the Board.  While he waited for a decision, W.F. submitted new evidence from his private doctor.  In October 2017, the Board remanded his case with the following instructions to the Regional Office:

  • Associate the new medical evidence with the file,
  • Schedule the veteran for a VA medical exam, and
  • Re-adjudicate the claim.

Shortly after the remand order, W.F. hired DHG.  First, we regularly urged the Regional Office to comply with the remand.  Next, we developed a private medical opinion to satisfy the medical nexus element.  As a result, the Regional Office granted the claim in full effective October 2012.

Do you need help with your VA disability remand?  The experts at DHG are ready to help.  Call for a free consultation.

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

Get Help Now

Call, 1-800-700-0652

Because memory deficits are common VA TBI residuals, a veteran should always have an advocate. Disability Help Group specializes in TBI cases and is here to answer your questions now.

Additional Information

What is the Appeals Modernization Act?

Posted on by Ken LaVan

What is the Appeals Modernization Act?

The Appeals Modernization Act has reduced the average time to receive a VA disability decision. Older claims typically took 3-7 years to receive a decision. In order to address this issue, Congress passed the VA Appeals Modernization Act in 2017.  On February 19, 2019, VA officially implemented this new law.  As a result, VA’s new goal is to complete claims and appeals in an average of 125 days.  This reflects VA’s renewed focus to deliver timely decisions to veterans and their survivors.

The VA Disability Claims Process Applying the Appeals Modernization Act

Filing an Original VA Disability Claim

The Appeals Modernization Act applies if you have already applied for VA Disability Benefits. Therefore, if you are filing an Original Claim it will not apply at the time of filing.  If you never filed a VA claim before, then you’ll need to file an Original claim.  Per VA rules, you can only file an original claim using a VA Form 21-526EZ.  The form asks for your Social Security number, dates of active duty service, branch of service, and other biographical information.  Most importantly, you must briefly explain why your claimed disability is related to your active duty service. 

Filing a VA Disability Supplemental Claim

When VA denies a claim, it must explain why.  VA has always had this duty.  However, the Appeals Modernization Act has enhanced this duty in the veteran’s favor.  As of February 19, 2019, VA must explain to the veteran which elements he successfully proved.  With that knowledge, a veteran should focus on getting evidence for the unproven element(s).  This New and Relevant evidence could change VA’s mind.  A veteran who obtains such evidence should submit it to VA with a Supplemental Claim.

Take the example of Joe Smith

Joe served in the Coast Guard for 3 years.  In 1991, he filed an Original claim for PTSD.  In a 1993 decision, VA denied the claim because there was no current diagnosis of PTSD.  Joe was so discouraged by this decision that he did not file an appeal.  During a 2019 visit to the local VA hospital, doctors diagnosed Joe with PTSD.  Unsure of what to do, Joe contacted DHG for a free consultation.  The experts at DHG agreed to represent him in a Supplemental Claim.  DHG filed a completed VA Form 20-0995 on Joe’s behalf, along with a copy of the current diagnosis.  Four months later, VA granted his PTSD claim at a 70% rating.

Appeals Modernization Act: Filing a Higher Level Review

This path improves on the Decision Review Officer (DRO) lane from the legacy system.  The main difference is that if the claimant requests a telephonic hearing in Higher Level Review, VA must grant it.  In the DRO lane, VA could reject a request for a telephonic hearing for any reason.  Thanks to the Appeals Modernization Act, VA cannot delay your right to a hearing.

Sometimes, VA denies a claim even though it has evidence to satisfy all 3 elements.  Either VA overlooked evidence, or it misunderstood the law it applied to the case.  In either scenario, it’s not that the veteran failed to prove his case.  VA just made a mistake.  If VA’s decision is infected by that kind of mistake, then your best bet is to file a Request for Higher Level Review.  This path involves an experienced VA adjudicator checking a Rating Decision for errors.  This adjudicator may issue a revised Rating Decision that corrects these errors.  And it does not require new evidence.

Appeals Modernization Act, but with slightly different facts 

In this example, assume Joe filed an Original claim for PTSD in 1991.  He filed the claim with a copy of a 1991 PTSD diagnosis and his service treatment records, which showed an in-service diagnosis related to a combat incident.  In a 1993 decision, VA conceded all other elements were met except the diagnosis.  Joe became discouraged and gave up.  Years later, he asked a DHG rep to review his case.  The DHG rep noticed that VA overlooked the 1991 PTSD diagnosis.  DHG immediately filed a Request for Higher Level Review on VA Form 20-0996.  DHG also attached a two-page argument that explained the legal errors.  Five months later, VA issued a revised Rating Decision that granted his PTSD claim effective 1991. This is the benefit of the Appeals Modernization Act.

Filing a Notice of Disagreement to the Board of Veterans’ Appeals (BVA), using Appeals Modernization Act

What do you do if VA denied your Original Claim, Supplemental Claim, and Request for Higher Level Review?  Your next option is go over their heads to the Board of Veterans Appeals.  VA Form 10182 gives you 3 lanes:

  1. Direct,
  2. Evidence, and
  3. Hearing

The Direct lane is for cases where all evidence and legal argument is already in VA’s records.  The Evidence lane gives you 90 days to provide additional evidence.  The Hearing lane gives you the right to make your case directly to a Veterans Law Judge.  In the Hearing lane, you also have 90 days after the hearing to submit additional evidence.

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Allow us to help you win the most money you can receive in the faster manner possible. You may be entitled to significant compensation that you were not even aware of.  Contact us now for a free consultation, 800-700-0652.

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