How does VA disability back pay work? This is an important question for those who are retiring or separating from military service who may (or may not) file a VA medical claim prior to final out-processing.
VA disability back pay is necessary for reasons that include the VA backlog of claims yet to be processed, the effective date of the original claim, current or pending legislation, and other variables.
In essence, the longer the VA claims process takes before you start receiving disability payments, the larger your back pay could be depending on how long between the first payment and the effective date of those payments.
A Brief Overview Of The VA Disability Claims Process
The VA official site describes VA Disability compensation as a tax-free benefit paid to qualifying vets “with disabilities that are the result of a disease or injury incurred or aggravated during active military service.”
But VA disability pay may also be awarded for disabilities that are an issue post-military service if those conditions, illnesses, or other issues “are considered related or secondary to disabilities occurring in service and for disabilities presumed to be related to circumstances of military service, even though they may arise after service.”
VA disability compensation is intended to (among other things) “compensate for considerable loss of working time” from service-related medical problems.
Filing The Initial Claim
You have the option upon leaving military service to file a VA claim for compensation as part of your final out-processing appointments in many cases, even if you are retiring or separating from an overseas location.
But not all service members will have the circumstance or opportunity to do this; VA rules state that a service member can apply before or after leaving military service, though the window for doing so after becoming a civilian may be limited depending on circumstances.
What does this mean?
Time Limits On VA Claims
In general, the wisdom you will find when trying to get an answer about VA claims and time limits on them can be a bit confusing. Technically speaking, there is no statute of limitations on filing an initial VA claim.
That said, the longer it takes a person to file a claim the more difficult it can potentially be to get VA compensation for that claim. Also, if you START a VA claim, there is a definite time requirement all veterans should respect – you generally have one year or 365 calendar days from the time you file the initial claim to follow up on it and finish the claim with all supporting documentation and other paperwork.
When Filing The Initial VA Compensation Claim
When you apply for VA compensation for service-connected medical issues for the first time, you will need to list all the medical issues, illnesses, and conditions you think may be compensable by the VA.
You’ll be asked about a series of “presumptive conditions” such as symptoms of Agent Orange exposure, military service related to burn pits, depleted uranium, and military service at Camp Lejeune, just to name a few. (Read more about presumptive conditions below.)
You won’t be required to provide all your supporting documentation at the time you fill out your claim, but expect to submit your military medical records, and any records that pertain to out-of-network care, civilian care, etc.
Two Types Of VA Disability Ratings
When the Department of Veterans Affairs receives your claim and begins processing it, it may determine that there is a “direct service connection.” The VA Disability Compensation Effective Date which will help determine whether or not you are entitled to VA disability back pay depending on when your pay actually started versus one of two factors:
- The date the VA receives the claim
- The date you first got the claimed illnesses or injuries
In cases where the VA gets a veteran’s claim within a year of leaving the military, “the effective date can be as early as the day following separation”.
The other type of VA disability claim may fall under a “presumptive service connection.” VA rules in this area state that in many cases, if the VA assumes your condition is related to military service and the agency gets a medical claim for conditions that fall into the presumptive category “within one year of your separation from active service—then the effective date is the date you first got your illness or injury.”
Who May File A VA Claim?
The VA official site has a list of criteria you must meet in order to qualify to apply for VA compensation for service-related injuries, etc.
The criteria includes having served on active duty, active duty for military training purposes, or having served while training on inactive duty. The service member is also required to meet at least one of the following:
- The veteran was sick or injured while serving in the military, not necessarily in combat or on the job
- The veteran has evidence that links the claimed condition to the illness or injury. The VA calls this an “in-service disability claim”
- The veteran had a medical issue prior to military service that got worse while in uniform. This is known in VA circles as a pre-service disability claim
- The veteran had issues related to active-duty service that didn’t appear until after retiring or separating from the military. This is what the VA calls a post service claim.
VA Disability Back Pay
The key to understanding VA back pay is knowing the VA effective dates policy; when VA receives a fully developed medical claim, the clock may start ticking on VA back pay depending on when the claim was filed and/or the start of the medical issues mentioned in the claim. But that will be determined by the timing of your claim.
What does this mean?
Simply that if a service member developed medical problems eligible for a claim and experienced symptoms eligible for VA compensation, the VA back pay would begin on the date the symptoms were documented.
This is known in VA circles as the “date entitlement arose” according to the VA. But that is possible only if the veteran files before leaving the service or within 365 days of discharge.
But you might not be entitled to compensation based on that date IF you apply within a certain date range AFTER leaving military service (365 days–for more info see below). That is an important sticking point that is commonly overlooked as far as back pay is concerned.
The Bottom Line
If you apply for VA disability compensation BEFORE leaving your life in uniform, you may be entitled to the back pay you won’t get if you wait a year or more to apply after discharge–back pay tallied up based on the date of the problem and not the date the VA gets your claim. (More on this issue below)
There are naturally certain exceptions possible associated with errors in processing or handling your claim but do not count on having those exceptions available to you unless there is a specific indication that you should pursue such exceptions.
VA Disability Compensation Back Pay Based On The Date The VA Receives Your Claim
Back pay is possible for those who file a VA claim but have to wait for extended periods to receive their decision and compensation. The timing of the claim plays an important part in determining who will have back pay dated from the time the VA gets the paperwork.
There is a backlog of claims cases the VA must process, and in these circumstances, a claim can take much longer than many veterans and care providers feel they should.
The VA official site says of such back pay that for those who file their claims within one year of leaving military service, there is a good chance the back pay will be affected greatly by the date of submission. If you file for VA compensation before a full 365 days has elapsed since your military discharge, you have a chance to have the back pay start when your injury or other medical problem manifests itself (according to your medical records). But if you wait a year or more to file your claim, you would only be entitled to back pay up to the date the VA receives your claim.
Additional Factors About VA Claims You Should Know
VA disability back pay may also be available for cases where a veteran has appealed a VA decision and the VA finds in favor of the veteran.
You may also be entitled to back pay if a medical condition gets worse during an active appeal with the VA, but this can further complicate how the VA determines how much to pay you.
In general, the back pay may be calculated depending on how much worse the condition got year to year, but in general, the date the VA receives the claim may determine how those numbers are to be calculated.
In some cases during an appeal, the VA may decide that a veteran’s claimed conditions are actually improving, which may also introduce complications if the VA decides that a reduction in benefits is in order.
The Amount Of VA Back Pay Compensation Will Vary
VA back pay does not come in a fixed amount. The VA assigned percentage of your disability plays a major role in determining how much pay you will get whether rated as back pay or not.
The effective date of your claim also plays a role, and there may be cost of living adjustments that are made to the amount which potentially increases the total.
Do Not Assume Your Claim Has Been Processed Mistake-Free
Human error is a fact of life. VA claims may be assigned incorrect effective dates, your actual compensation amount may not match the percentage you were told you are receiving, your claim may be “stuck” in the system, etc.
There are many variables involved in the VA claims process and veterans are strongly encouraged to carefully review all VA communication regarding their back pay and claims; if you find errors or have questions it’s best to contact the VA immediately to start addressing the issue-the longer you wait, the more complicated it may be to fix the problem.
The Department Of Veterans Affairs Has The Final Say
It’s true that the VA has the final word as to whether a claim is approved or denied, and whether a claim is entitled to VA back pay.
But there is also an appeals process that can extend a veteran’s options, and some veterans have better results getting the help of a Veterans Service Officer (VSO) or hiring a lawyer with specific experience with VA medical claims.
The appeals process may seem a bit daunting to some and hiring a lawyer can be expensive. But in cases where the veteran wins the appeal, the difference can be thousands of dollars over the lifetime of a compensable claim depending on circumstances.
It’s best to weigh your options carefully and try whenever feasible to appeal a VA decision that is not in your favor. It can help to discuss your claim with a VSO or a VA representative to learn what options you have to appeal and what your chances of success might be based on past precedent from other cases similar to yours.
Important VA Disability Back Pay Terminology
The potential for missing out on pay is high and it is very important to fully understand the details. These are some terms and definitions to keep in mind:
Claim date: This usually refers to the date the VA received the veteran’s medical claim.
Diagnosis date: The date you received the actual diagnosis of your condition (not the date of evaluation for that condition).
Retirement date: The date you are legally out of the military as a retiree, and officially a civilian. Note that this date is after any terminal leave, permissive TDY for house hunting, etc.
Separation date: The date you are no longer legally obligated to perform active military service. This is the date you are effectively considered a civilian and is after any terminal leave, permissive TDY, etc.
Effective date: The start date the VA uses to determine when VA compensation payments should begin, “based on the veteran’s claim or the date when the veteran is diagnosed with the condition to be compensated.”
VA Rating Reduction: A VA disability rating can be reduced if the veteran’s service-connected medical issues improve after leaving military service. This is generally done via a medical review process and is not arbitrarily determined without reviewing the veteran’s condition.
VA Staged Claim: In some cases, a veteran’s condition may get worse during the review process. In these circumstances, the veteran will have her condition reviewed for a staged rating which may result in a staggered amount of compensation based on the severity of the condition or how severe it becomes over time. It is possible to get retroactive or VA back pay increased in these cases related to the severity year to year when justified.
Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News
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