As a veteran, you should be able to claim your benefits promptly and without complications. Fortunately, the VA has a tailored program to expedite this process for you. This article will guide you in submitting a fully developed claim, providing clear and actionable insights. We’ll cover the nuances of the FDC program, comparing it to standard claims and exploring its significance.
We’ll also outline a comprehensive timeline for your claim, dive into the necessary documents you’ll need, and discuss how to successfully file your claim. Finally, we’ll discuss what to do if your claim is denied.
The Fully Developed Claim (FDC) Program: An Overview
How do you file a fully developed claim? Filing your claim follows a process similar to a standard VA claim. The first step is deciding how to submit your claim to the VA—through the online portal, mail/fax, or in person. If filing online through va.gov, there’s no need for a paper application. However, if you prefer mailing or delivering it in person, you must download and complete the appropriate form: VA Form 21-526EZ for Disability Compensation or VA Form 20-0995 for a Supplemental Claim for a secondary condition. Regardless of the application method, gathering essential information is crucial.
To submit a fully developed claim in 2023 require four distinct components:
- An existing diagnosis.
- An incident during service that led to an injury, disease, or worsening of a prior condition.
- A medical nexus connecting both elements.
- The intensity of symptoms.
Ensure you have dates of service, duty stations, medical conditions, treatment dates, and any other pertinent data related to your military service or medical condition.
Fully Developed Claim Versus Standard Claim (FDC)
Filing an FDC requires submitting all necessary documentation, medical records, and supporting evidence upfront, including pertinent medical and service records. In contrast, with a standard claim, the VA gathers evidence on your behalf.
It offers the advantage of a streamlined assessment without additional information, leading to faster decision-making. However, if the VA requires non-federal records, your claim will be converted to a standard claim. The FDC process can expedite claim decisions, reduce stress by minimizing interactions with the VA, and provide greater control over the claims process by submitting all evidence at the outset. If you seek a quicker, less stressful, and more controlled VA claims process, consider opting for the FDC program.
Fully Developed Timeline: Current Standards
The claims process, given that all necessary evidence for your claim is provided, usually results in a decision on your VA disability claim within 3-5 months from your submission date.
As per recent statistics from April 2023, the average processing time for a fully developed claim is approximately 122 days. In comparison, a standard claim averages around 130 days.
VA Fully Developed Timeline: A Comprehensive Look
| Step | Process | Estimated Waiting Time |
|---|---|---|
| Step 1: Claim Received | The VA acknowledges the receipt of your disability claim. Online submissions get immediate feedback, while mailed applications receive a letter within 7-14 days. | Immediate for online filing; 7-14 business days for mailed applications |
| Step 2: Initial Review | A Veterans Service Representative (VSR) reviews your claim. If more evidence is needed, the process advances to step 3. | 7-21 business days |
| Step 3: Gathering of Evidence | The VA might request additional evidence from various sources, schedule a Compensation and Pension exam (C&P), or assign your claim to a Ratings Veteran Service Representative (RVSR). If more information is required during the review, your claim may return to this step, sometimes multiple times. | 30-60 business days |
| Step 4: Review of Evidence | The assigned VSR reviews all necessary information. If missing evidence or further information is needed, the process may return to step 3. | 7-14 business days |
| Step 5: Preparation for Decision | The complete VA disability claim file is sent to the RVSR, who reviews the application and all supporting evidence, then starts preparing the necessary documents to outline the decision made. | 7-14 business days |
| Step 6: Pending Decision Approval | The RVSR’s recommendations are reviewed further, and a final award decision for your claim is determined. | 7-21 business days |
| Step 7: Preparation for Notification | Once a decision on your claim is made, a Senior Veterans Service Representative (SVSR) reviews the completed documentation, authorizes the release of your award letter and payment, if applicable, and mails the entire VA disability ratings decision packet to you. | 7-21 business days |
| Step 8: Claim Completed | This is the final step of the entire claim process. The claim is officially closed, and the VA mails your disability claim decision packet. | Within 14 business days |
Essential Types of Evidence for Your VA Disability Claim
When building your VA disability claim, there are three crucial types of evidence to consider: medical evidence, lay evidence, and expert opinion evidence.
- Medical Evidence: To support your claim, include medical records from your service and subsequent treatment for your disability. These records can be obtained from the VA. Remember to include all relevant information, even if it may not directly align with your claim.
- Lay Evidence: Statements from individuals with personal knowledge of your disability, such as friends, family members, and coworkers, constitute lay evidence.
- Expert Opinion Evidence: Obtaining opinions from medical experts, vocational experts, or specialists in fields related to your disability can provide valuable insights into the impact of your condition on your life and career.
Your Nexus Letter, The Essential Key
When it comes to supporting your claim, a nexus letter serves as a crucial piece of evidence. This letter is vital in bridging the gap between your in-service incident and your present medical condition. Crafted by a qualified medical professional, a nexus letter holds significant weight and is considered one of the most potent forms of evidence you can provide. By explicitly linking your current condition to your military service, the nexus letter strengthens the foundation of your claim, providing compelling support and bolstering the credibility of your case in the eyes of the VA. Nexus letter example.
Once you’ve completed the application and attached the evidence, verify that the application is comprehensive, and no further evidence will be submitted. The final step is attending any required VA direct exams, such as a VA compensation and pension (C&P) exam.
Filing Your Fully Developed Claim
To ensure your claim is processed under the Fully Developed Claims program, it’s important to follow these steps when submitting your application:
- Complete the application: Fill out the Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ). You can submit it online, via mail, or at your local VA office. Remember to check the box indicating “Fully Developed Claim Program” or “FDC Program” instead of “Standard Claim” on the application.
- Provide evidence: Include all relevant supporting documents you have or can easily obtain along with your claim. Retain copies of all the evidence you submit to keep track of the information the VA has received.
- Certify: Verify that the VA requires no additional evidence to decide on your claim.
- Attend VA medical exams: If necessary, attend any VA medical exams that are essential for the VA to evaluate your claim. The VA will notify you if any examinations are needed.
Possible Outcomes and Understanding why your claim might be denied
The possible outcomes for your fully developed claim include approval, partial approval, or denial. Full or partial approval means you will receive your entitled benefits. In case of denial, you have the right to appeal. Understanding the reason for denial can help you formulate a robust appeal. Common reasons include lack of evidence, missing documentation, or failing to meet the disability ratings criteria.
Steps To Take If You Wish To Appeal The Decision
If you decide to appeal, you can choose from three options: requesting a Higher-Level Review, submitting a Supplemental Claim, or taking your case to the Board of Veterans’ Appeals.
Collecting evidence for a VA disability claim can present challenges and consume valuable time, yet it plays a vital role in securing the success of your claim. To navigate this process more effectively, we highly recommend contacting a VA accredited law group like VetsForever or a Veterans Service Officer (VSO) who can provide invaluable guidance and assistance.
FAQs
What is a fully developed claim for VA benefits?
It is a claim submitted by a veteran or their dependents that contains all necessary evidence and supporting documentation required to decide on the claim, which allows the VA to process the claim more quickly.
How does a fully developed claim differ from a traditional claim with the VA?
A fully developed claim differs from a traditional one in that it contains all necessary evidence and supporting documentation at the time of submission. In contrast, a traditional claim may require additional evidence gathering by the VA.
What are the advantages of submitting a fully developed claim?
The advantages of submitting a fully developed claim include faster processing times and reduced wait times for benefits decisions.
What documents and evidence are required for a fully developed claim?
The specific documents and evidence required for a fully developed claim will depend on the type of claim being submitted. Still, they can include service records, medical records, and other supporting documentation.
Can I submit a fully developed claim on my own, or do I need assistance?
While it’s possible to submit a fully developed claim independently, assistance from a veteran’s service organization or attorney can help ensure that all necessary evidence and documentation are included.
How long does it take for a fully developed claim to be processed by the VA?
Processing times for fully developed claims can vary depending on the complexity of the claim and the workload of the VA, but the goal is to process these claims within 125 days.
Are there any specific eligibility criteria for a fully developed claim?
No specific eligibility criteria exist for submitting a fully developed claim, as any veteran or dependent can choose to submit a claim in this manner.
What are some tips for preparing a strong and successful fully developed claim?
For the best chance of receiving a successful outcome, you should gather all necessary documentation and evidence before submitting the claim, providing detailed and relevant information supporting your case, and ensuring that all forms and paperwork are completed accurately and completely.
Can I appeal a decision on a fully developed claim if it’s denied?
Yes, if a fully developed claim is denied, the veteran or dependent can file an appeal and request a review of the decision.
Is there any assistance available to veterans in filing a fully developed claim?
Yes, veterans service organizations and VA accredited attorneys like VetsForever can assist and guide in filing a fully developed claim.
Is a Fully Developed claim faster?
Yes, a fully developed claim can be faster since all of the information and documentation are submitted at the time of the claim filing.