VA Disability Benefits:
Getting service-connected
Your VA Benefits are largely affected by whether you have a service-connected disability and the percentage of your disability rating.
Disability Ratings
If you are a Veteran with a service-connected disability, the VA assigns you a disability rating. The disability rating ranges from 0-100% and is based on how much your disability decreases your overall health and functioning. If you have multiple service-connected disabilities, the VA will calculate a combined disability rating.
(The calculations aren’t as simple as 10% + 10% = 20%. See the VA Disability Calculator to estimate your combined disability rating.)
Disability Compensation
Your disability rating determines your eligibility for VA benefits, including Disability Compensation. Disability Compensation is a VA Compensation & Pension (C&P) benefit that provides tax-free payments to Veterans with a service-connected disability. Your disability rating determines the amount of disability compensation you will receive every month.
How do you get service-connected?
When you file a claim with the VA for mental health disability C&P benefits, there two criteria the VA assesses.
#1: The VA determines that you have a diagnosable mental disorder.
#2: The VA determines that your mental health diagnosis began or worsened either during your active duty or because of another established service-connected disability.
If the VA determines that you meet those criteria, you become service-connected.
When you become service-connected, the VA will determine your disability rating percentage. Percentage ratings for mental health disabilities are based on the level of your social and occupational impairment.
Each disorder has a different diagnostic code, but all mental disorders (except Eating Disorders) have the same rating criteria. Mental health disorders can be rated at 0%, 10%, 30%, 50%, 70%, or 100%, depending on the severity and frequency of the symptoms. Therefore, it doesn’t matter which mental disorder you have or how many mental disorders you have, your disability rating is based on which symptoms you are experiencing for any/all mental disorders. You will receive one rating for any/all mental disorders.
“Winning” Your VA Disability Claim
Ideally, your mental health disability claim would result in a Disability Rating that reflects the symptoms you experience. That depends on accurately conveying these three factors to the VA:
- Your mental health diagnosis
- How your mental disorder is connected to your service
- What symptoms you are experiencing
All three factors are important. You need the first two factors to get service-connected, but the last factor determines the percentage of your Disability Rating.
Dr. Belanger can help with all three factors. Your diagnosis and your symptoms would both be covered in an Independent Medical Examination (IME). Connecting your mental disorder to your service or another service-connected disorder would be covered in a Nexus Letter. (A “nexus” is a connection that links things together.)
Understanding the Process
File a VA Disability Claim
You can get more information on your eligibility and how to file a claim on the VA website.
If you need further help filing your claim, you may want to work with an accredited attorney, a claims agent, or a Veterans Service Officer (VSO). To find one: Go to eBenefits. Click on the link under “Search for a New Representative for VA Claims” to search for a local representative (including a recognized VSO, an attorney, or a claims agent) by state/territory, zip code, or the organization’s name.
You can submit evidence to help support your claim.
Some veterans choose to include an Independent Medical Exam (IME) and/or a Nexus Letter with their original claim. Dr. Belanger can assist you with either of these, but please know that you can file your claim without having been officially diagnosed. The VA will provide a free medical examination to assess your symptoms. Your VSO can advise you about when you may want to start off with the free option before paying for an IME and/or Nexus Letter.
VA Reviews your Disability Claim
When you file a claim for VA disability benefits, the VA’s decision-making process begins with a review of your records. Your records will need to provide sufficient evidence to clear these hurdles and accurately depict your level of impairment.
If you have enough medical evidence in your file to support your claim, the VA will follow the Acceptable Clinical Evidence (ACE) process. That means they’ll review your medical records and ask you to submit more evidence if needed, instead of asking you to have an exam.
C&P and DBQ
If your records do not provide sufficient evidence to meet the eligibility criteria and to determine your rating, you will be asked to go through a VA claim exam, also known as a Compensation and Pension (C&P) exam. At your C&P exam, an examiner will interview you and then fill out the appropriate Disability Benefits Questionnaire (DBQ). These exams are provided for free by the VA.
Disability Benefits Questionnaires (DBQs) are VA forms that help guide examiners during the C&P. (Since the C&P is based on the DBQ, you may hear some people use these two terms interchangeably.)
The DBQ needs to be completed by a qualifying mental health provider/examiner. There are three types of Mental Health DBQs: PTSD, Eating Disorder, and Mental Disorders (that don’t include either PTSD or an Eating Disorder). You can view the different DBQs online, so you know what the examiner is filling out.
Learn what to expect if your exam is scheduled with Dr. Belanger.
Rating Decision
After the VA has gathered and reviewed the relevant information, they will send you a rating decision. Your rating decision will say if your claim was approved or denied as a service-connected disability. It will also provide your disability rating percentage.
Disagreeing with the Decision
If your claim got denied and/or your rating doesn’t accurately reflect your level of impairment, you still have options available to you.
To get help with the process, you may want to work with an accredited attorney, a claims agent, or a Veterans Service Officer (VSO). To find one: Go to eBenefits. Click on the link under “Search for a New Representative for VA Claims” to search for a local representative (including a recognized VSO, an attorney, or a claims agent) by state/territory, zip code, or the organization’s name.
There may be situations where your representative recommends that you get an Independent Medical Exam (IME), a Nexus Letter, or both.