Veterans Disability Info Blog

Decoding VA Disability Claims: A Comprehensive Guide by a VA Disability Benefits Lawyer

Filing for VA disability benefits can seem intimidating given the importance of accurate paperwork and providing sufficient evidence to prove your condition to the VA. You may be required to undergo a Compensation and Pension Exam, commonly called the “C&P Exam,” although, in some cases, providing adequate  evidence from your medical current treating professionals and/or the medical evidence already of record, may prove a C&P Exam to be unnecessary.. 

For your initial VA disability application, there is free assistance available from the VA and Veterans’ Service Organizations (“VSO”)  with accredited representatives, and it is important to know that attorneys cannot charge fees during this stage. Companies offering to help with your initial VA disability benefits’ application for a fee or percentage may not be accredited, so it is best to connect with your local VA or VSO for your initial application. 

Working with a VA disability lawyer is recommended in the following situations:

  • Appeals – If you have filed a VA disability claim for a condition linked to your active service in the US military and it has been denied, a VA disability benefits lawyer can step into your shoes and handle the appeals process on your behalf, supporting the ultimate success of your appeal.
  • Supplemental Claims—When you already have a VA disability rating, but your condition has worsened, or you have developed an additional service-connected condition, you can submit new evidence and file a Supplemental Claim. This adds the new condition or change in your present condition to your VA disability rating so that your benefits accurately reflect your current disability. 

Now that you know when to work with a VA disability benefits lawyer, the next question we generally hear from potential new clients is: How much do you cost? We’ll cover that in the following section, but keep in mind that cases are often unique. We’ll discuss options and answer any questions you might have about payment before we get started. 

What is the most a VA disability lawyer can charge?

After you reach out for your free initial consultation, if your claim fits with our firm, we will present you with VA Form 21-22a, “Appointment of Individual as Claimant’s Representative.” This makes one of our expert VA disability benefits lawyers your attorney by granting them power of attorney, and at this time, we will ask you to sign a free agreement. 

The fee agreement you are presented with varies from one law firm or attorney to the next, and one of the most important factors to take into account is experience. Your attorney’s experience will determine their familiarity with the VA disability appeals or supplemental claims process. They also have a network of medical and occupational experts to use in support of your claim. 

Working with a VA-accredited attorney is important to ensure they have the necessary experience and competence to help with your claim. It is important to know that accredited individuals are not allowed to charge what the VA considers “unreasonable fees” for the services provided to veterans. Oftentimes, when we take a case, we do so on contingency, which means that we only get paid if we win, with our fees coming out of the amount our representation generates, as we’ll explore further below.

How exactly does the VA define “unreasonable fees?” 

Under the U.S. Code, it is clarified that a contingency fee that does not exceed 20 percent of past-due benefits is presumed to be reasonable. When a contingency fee exceeds 33.33 percent of past-due benefits, the fee is presumed to be unreasonable. What this means is that “reasonable fees” for VA-accredited attorneys fall between 20 percent and 33.33 percent of the veteran’s past-due benefits that are awarded. 

Our Firm and the experienced VA disability lawyer you’ll work with always charge within the reasonable range as clarified by the VA. This means that veterans are able to keep between 66.66 percent and 80 percent of the past-due benefits awarded with the assistance of their VA-accredited attorney. This underlines the importance of working with a VA-accredited representative. There are non-accredited individuals on the market charging veterans unfair fees that are excessive and beyond the value they provide to the veterans they take advantage of. 

To determine if your attorney is accredited, you can refer to the VA’s Office of General Counsel’s list. Persons who are accredited by the VA can be found on this list, which can be helpful in differentiating the legitimate VA-accredited options from the scammers on the market. 

How do I win a VA disability claim?

To win a claim for VA disability, you must first meet the basic criteria to receive a VA disability rating, as follows: 

  • A current diagnosis from a medical professional of a physical or mental condition 
  • An event, illness, or injury during your qualifying active duty in the U.S. military that caused or can be causally linked to the current diagnosis 
  • You have an expert medical opinion that links your currently diagnosed condition with your qualifying active military service 

For military service to qualify, you must have been discharged in an other than dishonorable way. Qualifying military service includes the U.S. Armed Forces and other covered organizations. When these three basic elements of a VA disability claim are met, you’ll need to demonstrate that your current diagnosis is a primary or secondary condition. 

You must prove that your current diagnosis is one of the following: 

  • A primary condition – This means that your current diagnosis directly results from an event, injury, or illness that occurred during qualifying active service. This could include cancer that developed as a result of exposure to chemicals during service or PTSD as a result of exposure to traumatic events in the military. 
  • A secondary condition – These conditions are eligible to receive a VA disability rating and entitle a veteran to medical coverage and tax-free payments in certain instances because they are caused by a primary condition. For example, a veteran with a primary condition of PTSD who develops anxiety due to PTSD may apply for an anxiety VA disability rating to add their anxiety to their claim. 

Winning a claim for VA disability benefits demands that you submit sufficient evidence for the VA to find that you have a currently diagnosed condition caused by your active service or a condition resulting from it and that, based on the Diagnostic Codes, you are entitled to benefits. 

What should I claim for VA disability?

Determining what to claim for VA disability depends on the unique facts and circumstances of your condition and how your active service influenced it. For example, VA disability is available in the following circumstances, although many more may also apply: 

  • Chronic pain such as back pain that results in a current diagnosis of related disability 
  • Scar tissue
  • A loss of range of motion 
  • Ulcers 
  • Cancers
  • Traumatic brain injury (TBI)
  • Mental health conditions such as anxiety or depression 
  • Mental and/or physical health conditions linked to military sexual trauma (MST)
  • Posttraumatic stress disorder (PTSD)

For your initial VA disability application, the VA offers questionnaires that will help you identify service-connected conditions that you may be experiencing. From there, you receive assessments to determine what current diagnosis you may have and then review your military records to determine whether or not an expert opinion links your current diagnosis to your active military service. 

Can you lose VA disability benefits?

Under the VA Code of Regulations, the VA is prevented from severing your benefits for a service-connected disability if you have had your benefits in effect for 10 or more years. There are very limited exceptions, including instances of dishonorable discharge, failure to complete requisite service, or if the VA determines that benefits were acquired fraudulently. 

Veterans who are assigned a permanent and total disability rating do not need to worry about losing their benefits, as this rating is permanent. When a veteran has a 100 percent disability rating with a zero or close-to-zero chance that their condition will improve, a permanent VA disability rating is assigned, providing stability in your benefits. The purpose of receiving VA disability benefits is to replace lost earnings linked to your disability and to cover the cost of medical treatment, so maintaining your benefits in the long-term is important. 

Discuss Your Claim with an Experienced VA Disability Lawyer

To learn how an experienced VA disability lawyer can help with your VA disability rating, connect with our highly experienced firm today. We’ll answer any questions you might have, and if we are able to take your appeal or supplemental claim, we only get paid if we win.

We are Here to Help

If you are having trouble obtaining benefits, contact us online or at 888.878.9350 to discuss your case.