Filing a VA disability claim can be a daunting and uncertain process, leaving many veterans wondering about their chances of approval. As a provider of independent medical nexus letters, we often hear from veterans who are eager to understand their odds of success. While every claim is unique and evaluated based on specific criteria, certain indicators can suggest that your application is on the right track. In this blog, we’ll explore key signs that you will be approved for disability benefits and how to enhance your chances.
1. You Have a Clear Service Connection
One of the most important factors in a VA disability claim is demonstrating a clear service connection between your military service and your current medical condition. The Department of Veterans Affairs (VA) requires three main elements to establish this connection:
- A current medical diagnosis of your condition.
- Evidence of an in-service event, injury, or illness that caused or aggravated your condition.
- A nexus (link) or an expert medical opinion connecting your current condition to the in-service event.
If your claim includes solid evidence of these three VA standards, it’s a sign that your claim will likely be approved. Documented injuries in your service records or diseases caused by VA-recognized presumptive conditions are examples of clear service connections.
2. You Have a Medical Diagnosis of a Current Disability
For your VA disability claim to be approved, you need to have a current, documented medical diagnosis. Without a diagnosis, the VA cannot assess your condition or determine if it’s service-connected. If your claim includes a condition listed in the Veteran Affairs Schedule for Rating Disabilities and its thorough records of medical diagnosis from a qualified physician, this is a positive sign.
Medical documentation proving your current disability may include diagnostic reports, history of previous conditions, imaging results (X-rays or MRI scans), treatment descriptions, and receipts for medications.
Furthermore, alignment between your diagnosis and findings from a Compensation and Pension (C&P) exam can strengthen your claim. Chances are the more relevant medical evidence you submit to the VA, the more likely your application may be considered favorably.
3. You Provided Evidence of an In-Service Event or Exposure
To secure VA disability benefits, veterans must prove an in-service event, injury, or exposure caused their condition. The strongest evidence often includes service treatment records (STRs) documenting medical care received during active duty and service records detailing incidents like falls, fractures, training accidents, or combat injuries.
If official records are unavailable, veterans often submit lay statements describing the event and its impact, supported by buddy statements from fellow service members who witnessed it.
Certain conditions don’t require direct proof including those related to the Vietnam War, Gulf War, or exposure to certain toxic substances which the VA automatically recognizes as service-connected. Similarly, Military Sexual Trauma (MST) claims don’t require event documentation since many incidents go unreported. Instead, behavioral changes, lay evidence, and witness statements can support the claim.
Hence, if you’ve submitted credible evidence of such an event and linked it to your diagnosis, your claim may get approved.
4. You’ve Submitted a High-Quality Nexus Letter
A nexus letter is an independent medical opinion from a qualified healthcare provider that connects your current diagnosis to your military service. While never required, they can sometimes be helpful. A well-written nexus letter often includes:
- A clear, evidence-based rationale for direct, secondary, or aggravated service connection.
- A statement explicitly linking the condition to the veteran’s military service, using the phrase “as likely as not” to meet VA standards.
- References to medical literature, service treatment records, and relevant studies supporting the connection.
- The nexus letter provider’s qualifications to establish credibility.
If your nexus letter is detailed and written by a reputable doctor, it’s a great sign that your claim has a solid foundation. Prestige Veteran specializes in Independent Medical Opinions (IMOs) written by professionals well-versed in the medical opinion aspects of the VA claims process.
5. You’ve Received Favorable Feedback on Your C&P Exam
The Compensation and Pension (C&P) exam is critical in the VA disability claims process where an examiner assesses your condition to determine the severity and its connection to your service. While the examiner doesn’t make the final decision, their report carries significant weight. If you have attended the C&P exam and received favorable verbal or written feedback, it’s one of the signs that you will be approved for disability benefits.
Signs of favorable C&P exam results include:
- The examiner provides an explicit opinion that your condition is “as likely as not” (50/50 probability) connected to your military service.
- Their findings align with your medical records and other submitted evidence.
- You felt the C&P examiner thoroughly evaluated your symptoms and documented them clearly.
Sometimes, veterans feel that the examiner didn’t fully understand their condition or that the C&P results are unfair. In such cases, many veterans challenge bad C&P exams by submitting a written request for a review, providing additional evidence, or including a Memorandum for Record (MFR) to detail any discrepancies.
6. You’ve Submitted All Required Documentation on Time
If you’ve submitted all required forms, evidence, and documentation within the appropriate timeframes, you’re taking important steps toward a successful VA claim. For example, filing your claim within a year of discharge may qualify you for presumptive service connection for specific conditions.
Veterans seeking disability compensation file a Fully Developed Claim (FDC) along with supporting documents based on which the VA makes a decision. An FDC typically includes relevant medical records, both from active duty and after separation, supporting buddy letters from colleagues and family, and documentation of symptoms and their impact on the veteran’s daily life.
Providing all required evidence in a timely and comprehensive manner reduces the likelihood of delays or requests for additional evidence.
7. You’re Pursuing a Secondary Service Connection
Many veterans overlook the opportunity to file for secondary service-connected conditions. For instance, if a service-connected traumatic brain injury has resulted in migraines, the migraines may qualify as a secondary claim. Identifying and filing for secondary connections with additional evidence, can strengthen your case and potentially increase your VA disability rating.
If your claim has provided strong medical evidence (at times including a nexus letter when applicable) linking your primary service-connected disability to your secondary condition, this could indicate a higher likelihood of approval. Again, if the VA has already acknowledged your primary condition, it will strengthen your secondary claim.
Consider seeking professional guidance from an accredited legal professional to understand the VA’s process for secondary claims and present your case effectively.
8. Your Condition Qualifies for Presumptive Service Connection
Certain conditions are presumed by the VA to be service-connected based on specific circumstances, referred to as VA presumptive conditions. Suffering from a condition under the VA’s Presumptive List reduces your burden of proving a direct service connection. If you are diagnosed with one of these, your claim has a high chance of approval.
Here are certain conditions presumed to be service-connected:
- Agent Orange Presumptive Conditions: Diabetes mellitus type 2, certain cancers, and ischemic heart disease for veterans exposed to Agent Orange in Vietnam or other qualifying locations.
- Gulf War Syndrome: Chronic fatigue syndrome, fibromyalgia, and other undiagnosed illnesses for Gulf War veterans.
- Burn Pit Exposure-related Conditions: Respiratory issues, certain cancers, and other toxic exposure illnesses for post-9/11 veterans.
- Former Prisoners of War: Former POWs held captive for more than 30 days are presumed service-connected for conditions like psychosis, anxiety, depression, PTSD, traumatic arthritis, and heart diseases.
While this can be a promising sign, establishing a presumptive service connection still needs careful attention. For instance, veterans may have to demonstrate that their disease is on the VA’s presumptive conditions list for their service era or location. Additionally, providing solid medical evidence of current diagnosis and service records confirming eligibility is helpful.
9. You Meet the Minimum Rating Criteria
Each condition in the Schedule for Rating Disabilities (38 CFR Part 4) has specific criteria for approval. If your symptoms meet or exceed the minimum requirements outlined in the VA’s schedule of ratings, your claim is more likely to be approved if the nexus itself is established. For example:
- Hearing Loss: If your audiology test results show an average pure tone threshold of 55 dB or more in one ear and speech recognition of 88% or lower, you may qualify for a 20% rating. This level of hearing loss indicates moderate difficulty understanding speech, especially in noisy environments.
- Post-Traumatic Stress Disorder: If you experience occupational and social impairment with reduced reliability and productivity due to symptoms like panic attacks more than once a week or impaired judgment, you may qualify for a 50% PTSD rating.
- Knee Replacement: If you have chronic residuals such as severe painful motion or weakness in the affected limb following a knee replacement, you may receive a 60% disability rating.
- Sleep Apnea: If you experience persistent daytime hypersomnolence (excessive daytime sleepiness) due to sleep apnea, you may qualify for a 30% rating. This rating applies if your condition does not yet require a CPAP machine but still significantly affects daily functioning.
Being aware of the rating criteria for your condition and ensuring your evidence aligns with it is a strong indicator of success.
10. The VA Actively Fulfills Its Duty to Assist
The VA has a duty to assist veterans in gathering evidence for their disability claims. While it may seem counterintuitive, a VA request for additional information, such as updated medical test results, service personnel records, or lay statements from family or fellow service members, can be a positive sign. It likely means your claim is under active review, and the VA is ensuring all necessary evidence is in place for a fair decision.
Other signs the VA is fulfilling this duty include scheduling C&P exams, guiding veterans on missing information, and maintaining follow-up communication. If the VA is asking questions, it usually indicates that your claim has potential and is being carefully considered.
While the VA’s assistance is valuable, veterans should proactively organize and submit evidence to strengthen their claims with the assistance of an accredited legal professional like a VSO, accredited claims agent, or an attorney when applicable.
11. You Have Strong Lay Statements or Buddy Letters
When submitting a VA disability claim, having well-documented lay statements or buddy letters can significantly strengthen your case in some instances. These statements may provide crucial firsthand accounts of your disabilities, offering insight into how they impact your daily life and supporting the connection between your condition and military service.
Lay statements, written by you, family members, or close friends, describe observable symptoms, functional limitations, and the progression of your condition. These personal testimonies help illustrate the severity and frequency of your symptoms, especially in cases where medical records alone may not fully capture your struggles.
Buddy statements from fellow service members may corroborate in-service events, injuries, or exposures that led to your condition. These statements add credibility by providing direct accounts of incidents that may not be thoroughly documented elsewhere.
12. Your Claim Has Smoothly Progressed Through the System
The VA takes an average of 140.8 days to approve a disability claim, which is approximately 4.6 months. However, disputed cases can take anywhere from several months to a year or longer. If your VA claim is progressing without delays or requests for clarification, it may be a positive indicator that your case is straightforward and well-documented. Another possible reason behind this smooth claims process is that your condition is on the VA presumptive list.
However, a fast timeline doesn’t guarantee approval, and delays don’t necessarily mean denial. The VA’s processing times can vary based on factors like workload, the complexity of your case, or regional office capacity. Staying responsive and consistent with providing evidence can help veterans avoid unnecessary delays.
Consider working with a VA-accredited representative, attorney, claims agent, or Veteran Service Organization (VSO) that can assess the likelihood of a claim’s success based on your evidence. These professionals assist veterans gather evidence, present their cases effectively, and advocate or guide through appeals if needed.
Conclusion
While no single factor guarantees VA disability claim approval, strong evidence and thorough documentation significantly increase your chances. Each case is unique and approval ultimately depends on the evidence presented and the VA’s evaluation. Staying proactive, gathering relevant documentation, and seeking expert guidance from accredited legal professionals can help you navigate the system more effectively. If you’re unsure about your claim’s strength or need assistance, consulting with professionals who specialize in VA claims can be a valuable step toward securing the benefits you deserve.
FAQs
How do you tell if you will be approved for VA disability benefits?
You can never absolutely tell if you will be approved for VA disability but some positive factors include having a well-documented medical diagnosis, clear evidence of service connection, a strong nexus, and favorable C&P exam results.
What illness automatically qualifies for VA disability?
Presumptive illnesses automatically qualify for VA disability such as Agent Orange conditions, burn pit respiratory cancers, combat PTSD, and toxic exposure illnesses like Camp Lejeune contamination if they meet outlined criteria and are approved by adjudicators.
How do I know if my VA claim is going to be approved?
You can get a sense of whether your VA claim is likely to be approved by reviewing how well your evidence shows a service connection, the severity of your condition, and how closely it meets VA guidelines.
How will I be notified if my VA disability is approved?
The Department of Veterans Affairs will notify you of your disability approval through an official decision letter sent by mail. You can also review and download your decision letter by checking the claim status tool on the VA’s online portal.
Also read: VA Claim Denied Even With A Nexus Letter? Prepare For Appeals
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
