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VA Claims Evidence

Although the proposition of a well-grounded claim technically disappeared with the November 2000 enactment of the Veterans Claims Assistance Act (VCAA), odds are the actual process of winning your disability claim will pretty much remain the same. There is still quite a lot of sorting out to do as to the actual effects of the VCAA, but my bottom dollar is on the idea that it still takes medical evidence to win. That is how it has always worked. A veteran can plead service-connected disability until blue in the face, but it takes a doctor's opinion to prevail.


The three steps in proving a well-grounded claim were:

  1. medical evidence of a current disability;
  2. a problem in the military (service incurrence); and
  3. medical evidence of a link or relationship between (1) and (2).

The VCAA doesn't change much, if any, of that -- it only expands the VA duty to assist you in producing this evidence and to notify you of what evidence is needed. So, without medical evidence -- meaning a doctor's written opinion after an examination -- there will be no compensation.

Many veterans, for financial reasons, must seek medical treatment through the VA. Those VA doctors can be pretty conservative when it comes to putting down in black and white the evidence you need to qualify for disability. Look at it this way. You go to the VA clinic for a bad back. The doctor examines you, has x-rays done, diagnoses you with a bad back, and treats you. He or she writes down that you have a bad back. You tell the doctor that you injured your back in the Navy in 1962. The doctor writes down what you told him. Then, you ask the doc to write down that today's back problem began in the Navy in 1962. You ask for his opinion in writing because that is what you have to have in your claim file in order to win your disability payments.

The doc faces at least three immediate problems:

  1. he doesn't have your service medical records documenting a back injury in 1962 and does not know if you are telling the truth about it;
  2. he is paid to treat you and get on to the next patient -- not to help you prove your claim, and;
  3. his knowledge and training may not enable him to connect, medically and scientifically, today's back condition to trauma which happened almost 40 years earlier. So, if your treating VA doc doesn't give a written opinion linking the military injury and today's bad back, you ask for a free VA Compensation and Pension (C & P) exam.

The VCAA should make it easier to get a C & P exam. The VCAA says VA must help you develop evidence necessary to prove your claim. If it takes a doctor's written opinion to prove your case, and it almost always does, then VA should be required to provide a C & P exam for that purpose, right? Well, that question is still to be answered. In any event, you can always get a private, non-VA doctor to examine you and produce a written opinion, if you can afford it. In fact, that is what I recommend you do. The cost could be recouped in the first month's disability check if your doctor's opinion wins the day for you. Of course, the opinion may not relate the bad back to the service injury, but, if it does, you are on the fast track to service connection.

On the other hand, you may be stuck with a VA C & P exam, if you can get it. There are some things you need to know if scheduled for that C & P exam. We'll talk about that in the next column. Tune in next month.

About the Author:

Clark Evans is an attorney who handles veterans disability and pension claims on appeal. His articles generally discuss the VA compensation process and should not be construed as legal advice. Your specific circumstances should be discussed with a qualified veterans advocate to determine how the generic VA benefits awards scheme may affect you and your claim.

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