HomeVeterans Guide to VA BenefitsFiled Claim - What Happens Next?Award Process

14.5. Award Process

If VA grants the claim, it will award a benefit. For service-connected medical conditions, a disability evaluation or "rating" will be established that determines the amount of monthly payments. The numerical value of the rating is based on a schedule of disabilities established by Congress. The "rating schedule" is a listing of disorders, categorized by body systems, that include a description of symptoms for each disorder in an increasing order of severity. Each listed or "scheduler" disorder is assigned an unique diagnostic code.

VA assigns percentages of disability to each level of symptoms from zero (non-compensable) to 100 percent (totally disabling) in 10 percent increments. The rating is supposed to approximate the percentage of impairment to the employment of the claimant from the service-connected condition. If a particular condition is not listed, a rating is determined by analogy to the listed condition that it most closely resembles. VA pays the same dollar amount at each rating level, regardless of the rated condition, so the monthly payment for a 20% rating is the same whether the claimant suffers from diabetes, PTSD, or migraine headaches.

A claimant may be awarded more than one rating either because of multiple conditions or multiple effects from a single condition. A common source of multiple ratings is a "secondary" rating. A secondary rating is awarded when a service-connected condition directly or indirectly causes another condition. If properly claimed, the indirectly caused condition will be treated as if it were a result of the veteran's military service and will be evaluated for a separate rating. In the same way, if a claimant suffers from a condition that existed prior to a service-connected disability and the condition was aggravated by the service-connected disability, the amount that the pre-existing disability was aggravated by service may also be assigned a rating.

The amount of monthly benefits due to multiple ratings can be tricky to calculate because ratings are not added together but are combined by VA in a specific way to produce a total or "combined" rating for all of a claimant's service-connected conditions. In no case, however, can a combined rating be greater than 100 percent disabled.

After rating the conditions for which an award was granted, VA will establish an "effective date" of the award. This is a very important date because it determines the date from which VA will pay the benefits for the award. As a general rule, the effective date of an award of VA benefits is the date that VA received the application on which the award was granted, but there are exceptions. An important exception is that the effective date for veterans who submit an application within one year of separation from the military is the day after the veteran's discharge from active duty. Other exceptions include Nehmer claims, inferred claims, and informal claims, which are discussed elsewhere in this KNOWLEDGE BOOK. The payment of awarded compensation generally begins on the first day of the month following the effective date.

Claimants should understand that the effective date is not when a condition first occurred or was diagnosed. This is important because waiting to file an application can result in lost benefits which cannot be recovered later. For claimants who filed more than one application for the same condition, the effective date is not the date of the first application or any other application that was denied and become final: the effective date is the date of the granted application.

The process for deciding DIC awards is similar to compensation except that the claimant is the surviving spouse or other eligible survivor. The key issue in a DIC claim is usually whether the evidence establishes that theveteran died from a service-connected condition. If so, a surviving spouse can receive a monthly monetary benefit. Although a surviving spouse, or in some cases certain children and dependent parents, can file a DIC claim at any time even decades after the veteran died, the effective date of a DIC award is usually the date that VA receives the application. The exception in DIC cases is that if the application is received within one year of the veteran's death, the effective date is the date of death.

This page was: Helpful | Not Helpful