Fully Developed Claim

Department of Veterans Affairs FULLY DEVELOPED CLAIM NOTICE:

(Notice to Claimants of Information and Evidence Necessary to Substantiate a Claim for VA Disability Live Compensation)

VA established the Fully Developed Claim Program to expeditiously process claims certified by the claimant or his/her representative as meeting the Fully Developed Claim criteria.

Fully Developed Claim Criteria:
For the purposes of this notice, your claim must be a rating-related claim for live compensation (original, secondary, and increased disability service connection claims only) submitted on VA Form 21-526EZ, Fully Developed Claim (Compensation).
You must Submit, with your claim, the Fully Developed Claim Certification signed and dated by you or your authorized representative.
You must submit with the Fully Developed Claim Certification:
All, if any, relevant, private medical treatment records for the disabilities you are claiming and an identification of any treatment records from a Federal treatment facility such as a VA medical center.
For Guard and Reserve members, any and all Service Treatment and Personnel Records in the custody of your Unit(s).
If claiming dependents, a completed VA Form 21-686c, Declaration of Status of Dependents.
You must report for any VA medical examinations VA determines are necessary to decide your claim.

Note: VA forms are available at www.va.gov/vaforms
This notice, is applicable to any and all conditions claimed for service connection with your Fully Developed Claim. Upon receipt of the Fully Developed Claim Certification, we will expedite your claim under the Fully Developed Claim Program. If it is determined that your claim does not meet the Fully Developed Claim criteria we will process your claim through our standard claim process.

What The Evidence Must Show To Support Your Claim .
Generally, veterans are eligible to receive compensation for disabilities related to military service. To support a claim for service connection, the evidence must show:
You had an injury in military service, or a disease that began in or was made permanently worse during military service, or there was an event in service that caused an injury or disease; AND
You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence of persistent and recurrent symptoms of disability that are visible or observable; AND
A relationship exists between your current disability and an injury, disease, symptoms, or event in military service. Medical records or medical opinions are generally required to establish this relationship. However, under certain circumstances, VA may presume that certain current disabilities were caused by service, even if there is no specific evidence proving this in your particular claim.The cause of a disability is presumed for the following veterans who have certain diseases:
Former prisoners of war; Veterans who have certain chronic or tropical diseases that become evident within a specific period of time after discharge from service;
Veterans who were exposed to ionizing radiation, mustard gas, or Lewisite while in service;
Veterans who were exposed to certain herbicides, such as by serving in Vietnam; or
Veterans who served in the Southwest Asia theater of operations during the Gulf War.

Department of Veterans Fully Developed Claim Notice .

To support a claim for compensation based upon an additional disability that was caused or aggravated by a service ­connected disability, the evidence must show:

You currently have a physical or mental disability shown by medical evidence, in addition to your service-connected disability; AND

  • Your service-connected disability either caused or aggravated your additional disability. Medical records or medical opinions are required to establish this relationship. However, VA may presume service-connection for cardiovascular disease developing in a claimant with a certain service-connected amputation(s) of one or both lower extremities.

 If VA previously granted service connection for your disability and you are seeking an increased evaluation of your service-connected disability, we need medical or lay evidence to show a worsening or increase in severity and the effect that worsening or increase has on your employment and daily life.

 To support a claim for service connection based upon a period of active duty for training, the evidence must show:

  • You were disabled during active duty for training due to disease or injury incurred or aggravated in the line of duty; AND
  • You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence of persistent and recurrent symptoms of disability that are visible or observable; AND
  • There is a relationship between your current disability and the disease or injury incurred or aggravated during active duty for training. Medical records or medical opinions are generally required to establish this relationship.

 To support a claim for service connection based upon a period of inactive duty training, the evidence must show:

  • You were disabled due to an injury incurred or aggravated during inactive duty training or suffered an acute myocardial infarction, cardiac arrest, or cerebrovascular accident during inactive duty training; AND
  • You have a current physical or mental disability. This may be shown by medical evidence or by lay evidence of persistent and recurrent symptoms of disability that are visible or observable; AND
  • There is a relationship between your current disability and your inactive duty training.
  • Medical records or medical opinions are generally required to establish this relationship.
  • How VA Determines The Disability Rating. Note this is very important to the Veteran !
  • When we find disabilities to be service connected, we assign a disability rating. That rating can be changed if there are changes in your condition. Depending on the disability involved, we will assign a rating from 0 percent to as much as 100 percent.
  •  VA uses a schedule for evaluating disabilities that is published as title 38, Code of Federal Regulations, Part 4. In rare cases, we can assign a disability level other than the levels found in the schedule for a specific condition if your impairment is not adequately covered by the schedule.

We consider evidence of the following in determining disability rating:

  • Nature and symptoms of the condition;
  • Severity and duration of the symptoms; and
  • Impact of the condition and symptoms on employment.

Examples of evidence that you should tell us about or give to us that may affect how we assign a disability evaluation include the following:

  • Information about on-going treatment records, including VA or other Federal treatment records, you have not previously told us about;
  • Social Security determinations;
  • Statements from employers as to job performance, lost time, or other information regarding how your condition(s) affect your ability to work; or
  • Statements discussing your disability symptoms from people who have witnessed how the symptoms affect you.

 Department of Veterans Affairs Fully Developed Claim Notice

How The VA Determines The Effective Date.

If we grant your claim, the beginning date of your entitlement or increased entitlement to benefits will generally be based on the following factors:

  • When we received your claim;
  • When the evidence shows a level of disability that supports a certain rating under the rating schedule or other applicable standards.

If you filed your claim with VA within one year of your separation from the military, entitlement will be from the day following the day you left the military.

Generally, payments are effective from the first of the month following the date of your entitlement or increased entitlement based on the above criteria.

Examples of evidence that you should tell us about or give to us that may affect how we determine the effective date of any benefits we give you on your claim include the following:

  • Information about continuous treatment or when treatment began;
  • Service treatment records in your possession that you may not have sent us; or
  • Reports of treatment for your condition while attending training in the Guard or Reserve.

Fully Developed Claim Process

In order for you to participate in the Fully Developed Claim Program, you must obtain records and provide them to VA. VA will provide a medical examination for you, or get a medical opinion, if we determine it is necessary to decide your claim. For this program, VA will only obtain service treatment records, and Federal treatment records when you identify them. If you serve or previously served in the Guard or Reserves, you must contact your unit to find out if they still maintain custody of your service records (including your medical records). If your unit currently has custody of your service records (including your medical records), you must get a complete copy of these records and provide them to VA.

 If it is determined that other records exist, and VA needs the records to decide your claim, or if you do not provide us with your National Guard or Reserve records as described above, then your claim will not be processed as an Fully Developed Claim. Your claim will be processed in our standard claim process.

Standard Claim Process

VA is responsible for getting relevant records from any Federal agency that you adequately identify and authorize VA to obtain. These may include records from the military, VA medical centers (including private facilities where VA authorized treatment), or the Social Security Administration. VA will provide a medical examination for you, or get a medical opinion, if we determine it is necessary to decide your claim.

 VA will make every reasonable effort to obtain relevant records not held by a Federal agency that you adequately identify and authorize VA to obtain. These may include records from State or local governments, and privately held evidence and information you tell us about (such as private doctor or hospital records), or current or former employers.

What You Need To Do

You must submit all relevant evidence in your possession and provide VA information sufficient to enable VA to obtain all relevant evidence not in your possession.

 Fully Developed Claim Process

If you provide VA information sufficient to enable VA to obtain relevant service treatment records and Federal treatment records, if any, and you give VA all other records relevant to your claim, the claim may be decided under the Fully Developed Claim Process. This means that, if you are aware of relevant records that are not in your possession, you should obtain them and provide them to VA in order to participate in the Fully Developed Claim Process.

If your claim involves a disability that you had before entering service and that was made worse by service, please provide any information or evidence in your possession regarding the health condition that existed before your entry into service.

 Department of Veterans Affairs Fully Developed Claim Notice

Standard Claim Process:

If you know of evidence not in your possession and want VA to try to get it for you, you must give VA enough information about the evidence so that we can request it from the person or agency that has it. If the holder of the evidence declines to give it to VA, asks for a fee to provide it, or otherwise cannot get the evidence, VA will notify you and provide you with an opportunity to submit the information or evidence.

It is your responsibility to make sure we receive all requested records that are not in the possession of a Federal department or agency.

If your claim involves a disability that you had before entering service and that was made worse by service, please provide any information or evidence in your possession regarding the health condition that existed before your entry into service.

When You Should Send What We Need. Very Important !

Fully Developed Claim Process:

Send the information and evidence with the: (1). Fully Developed Claim Certification ( Compensation ), along with VA Form 21-526EZ. ( call VA Toll-Free 1-800-827-1000 ask for those documents sent to you.

For this program, you must obtain and submit any and all Service Treatment and Personnel Records in the custody of your Guard or Reserve Unit. If we decide your claim before one year from the date we receive this claim, you will still have the remainder of the one-year period to submit additional information or evidence necessary to support your claim.

Standard Claim Process. Very Important !

We strongly encourage you to send any information or evidence as soon as you can. If we do not hear from you, we may make a decision on your claim after 30 days. However, you have up to one year from the date we receive this claim to submit the information and evidence necessary to support your claim. If we decide your claim before one year from the date we receive this claim, you will still have the remainder of the one-year period to submit additional information or evidence necessary to support your claim.

Special Very Important Note: Almost all of the Documents and/or information the VA request for the Fully Developed Claim Process is needed for the VA Standard Claim Process, that possibly will enhance your Chance for your claim to be approve, and/or to get a fair % percent rating.

Therefore, it may be to your best benefit to send all and every thing you can.

See entire web site for other VET help ! Please tell other Vets about the site http://www.vetsguide.net