The VA claims and appeals process is a notoriously tedious process. The length of the process can vary depending on many factors including the number of claims, the complexity of the case, and which appeals system you are in.
The Legacy Appeal System
What Happens After a Disability Claim is Filed?
- Claim Received. The VA will notify the veteran that they received their disability claim:
- If filed online: by an on-screen message after submitting the form.
- If filed on eBenefits: by a notice in the claims list within one hour of applying.
- If mailed: by a letter received around 1-2 weeks after claim is received.
- Initial Review. A Veterans service representative (VSR) will review the claim. If no more evidence is needed then it moves onto the next step.
- Evidence Gathering, Review, and Decision. The VSR will ask for evidence from the veteran, government agencies, or medical providers. They will also review the evidence and make a decision.
- Claim Complete. The VA will send a packet by mail that includes the details of their decision.
Veterans Appeals Deadlines
The legacy appeals system only has one “lane” in the veterans’ claims and appeals process. This means all veterans filing for VA disability benefits go through the same process and must follow the following deadlines:
- After filing an initial claim the local Regional Office will issue a Rating Decision that gives a decision on their claim. A veteran will then have one year to file a Notice of Disagreement (NOD).
- The VA will then issue a Statement of the Case (SOC). Veterans have 60 days from when the VA issues the SOC to file a Form 9 Appeal to the Board of Veterans Appeals.
- The Board will then issue a decision granting, denying, or remanding a claim for more action. If a veteran wants to appeal a denial they have 120 days to appeal to the Court of Appeals for Veterans Claims (CAVC).
- If a claim is denied at the CAVC, a veteran has 60 days to appeal to the Federal Circuit.
Claims and Appeals Process Timeline
In March 2017 the United States Government Accountability Office (GAO) released a report outlining the VA’s current backlog in processing claims and appeals. According to GAO’s report, some of the average wait times include:
- 419 days: average time between when the VA receives a NOD and when they issue a SOC
- 537 days: average time between when the VA receives an appeal to the Board to when they certify that appeal
- 222 days: average time between when the appeal is certified to the Board to when it is placed on the Board’s docket
- 270 days: average time between when an appeal is docketed to when the Board issues a decision.
Appeals Reform System
The Veterans Appeals Modernization Act was signed into law in 2017 and officially went into effect in February 2019. The VA has since created a system that strives to improve the overall experience of filing a VA disability claim.
Veterans Appeals Deadlines
The VA now only has one way to file an original claim; the VA Form 21-526EZ. A rating decision is supposed to occur within 90 days. The veteran is afforded the Duty to Assist during this period, once a rating decision has been made, the Duty to Assist no longer applies.
If a veteran disagrees with the VA’s decision, they have one year to appeal by choosing one of three lanes: the higher-level review lane, supplemental claim lane, or Notice of Disagreement lane (i.e. Appeal to the Board of Veterans Appeals). After appealing, a veteran will receive another decision.
- Higher-Level Review Rating Decision. If a veteran receives an unfavorable decision in the higher-level review lane, they have one year to either file a supplemental claim or a Notice of Disagreement.
- Supplemental Claim Rating Decision. If a veteran receives an unfavorable decision in the supplemental claim lane, they have one year to file an appeal in any one of the three lanes.
- Board Decision. If a veteran receives an unfavorable Board decision, they can either file a supplemental claim within one year or appeal to the CAVC within 120 days.
- CAVC Decision. If a veteran receives an unfavorable decision from the CAVC, they have one year to file a supplemental claim, or 60 days to appeal to the Federal Circuit.
Claims and Appeals Process Timeline
The VA does not operate under any mandated deadlines, however, the VA has proposed timeframe goals regarding the processing of decisions under Appeals Reform.
For both the higher-level review and supplemental claim lanes, the VA has set a 125-day goal for issuing decisions. In the Notice of Disagreement Lane, there are an additional three dockets veterans must choose from the direct docket, evidence docket, and hearing docket. The VA has set a goal of 365-day for the direct docket but believes the evidence and hearing docket may take longer. In particular, the hearing docket may take 5-7 years.
Overall, the VA expects the appeals process timeline to drop from 5 years to 3 years and has an overall goal to process claims and appeals within 12-18 months.
Expediting VA Disability Claims
There are several situations where veterans may be eligible to have their claims and appeals expedited:
- Extreme Financial Hardship or Homelessness. Veterans can request to expedite a VA disability claim if they are experiencing extreme financial hardship, or if they are homeless or at imminent risk of becoming homeless.
- Advanced Age. If a veteran is over a certain age they can request to have a claim expedited. The age requirement differs at the Regional Office level and the Board level. At the Regional Office, the veteran must be 85 years or older, at the Board level, a veteran must be 75 years or older.
- Terminally Ill. The VA is instructed to prioritize claims where the veteran is terminally ill. Veterans must submit evidence of terminal illness in order to expedite the claim.