Independent Medical Evaluations (7)

The IME doctor will review your doctor’s records and any objective medical records including x-rays, CT scans, MRI reports or anything similar. This will help them determine if there are any “objective” signs of an injury related to your VA active military service-related accident, injury, or disability.

During the examination, the doctor will likely start out by asking you how your injury happened, what your relevant medical history is, and the course of your treatment so far. The doctor may also conduct a physical exam and tests (such as physical tests to measure your grip strength or range of motion).

Independent Medical Exam: the evaluation of an injured party that utilizes a third party, independent medical professional to issue an unbiased opinion on the injury.

Following the exam, the IME doctor must then generate a report with their findings. If the report finds the need for surgery is appropriate and connected with a service-related accident, the VA will authorize payment. If not, the insurance company will deny authorization.

Conducting an independent medical examination does not establish a typical doctor/therapist-patient relationship as exists when a clinician treats a patient in the hospital or at an outpatient clinic. However, the independent, objective (unbiased) nature of the examination does not absolve the doctor from all professional responsibilities. For example, in most independent medical examinations, the clinician should assess for possible psychiatric disorders and ask the individual if he or she has been thinking of hurting or killing themselves or someone else. If upon further questioning after an affirmative response it becomes apparent that the person poses a significant risk of imminent harm to self or others, the examiner must take steps to prevent such harm and to facilitate referral to appropriate treatment and psychosocial support. Thus, a “limited doctor-patient relationship” exists when conducting independent medical examinations.

An independent medical examination is a medical evaluation performed by a medical professional on a patient who was not previously involved in the treatment of that patient, to evaluate the patient’s course of prior treatment and current condition.

An independent medical examination is a medical evaluation performed by a medical professional on a patient who was not previously involved in the treatment of that patient, to evaluate the patient’s course of prior treatment and current condition.

Independent Medical Opinions (IMO) (4)

You can expect a VA rating decision roughly 2 to 4 weeks after your final C&P exam. If it’s been longer than 4 weeks, pick up the phone and call the VA hotline at 1-800-827-1000.

C&P exams are often considered to be the most important piece of evidence in a veteran’s claim file. If an exam is incomplete or not conducted, VA is not fulfilling its duty to assist the veteran in developing his or her case.

C&P exam is an important part of the VA claims process. During the exam, the examiner will ask you questions about your mental health condition and how it affects your daily life. This helps the VA properly rate your condition, so you can receive the right amount of VA disability compensation.

A C&P examination is a medical examination of a veteran’s disability, performed by a VA healthcare provider or a VA contracted provider. VA uses C&P exams to gather more evidence on a veteran’s claimed condition before issuing a decision and assigning a rating.

NEXUS Letters (14)

Category: NEXUS Letters

doctor must establish the service connection between a disability and your time in the military by a medical opinion (also called a nexus letter). Our doctors provide NEXUS letters that link a claimed disability condition(s) to a veteran’s time in service. However, you can have your family doctor write a nexus letter.

Category: NEXUS Letters

Yes. You can use the VA.gov claim status tool to upload new evidence. From the Files tab, under “Additional evidence,” click the Add Files button to submit more evidence. Note: You can’t use the VA.gov tool to file a claim. Please don’t upload claim forms on the VA.gov. We accept these file types: PDF, GIF, JPEG, BMP, and TXT. The maximum file size is 25 MB. If you can’t upload your additional evidence because the file is bigger than 25 MB, please mail it to us instead. You can send it to the same address where you mailed your claim. You can also bring your additional evidence to a regional office near you. If you need help, you can call the VA at 800-827-1000. We’re here Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.

Category: NEXUS Letters

The nexus, or link, between a veteran’s current disability and an in-service event, is often the hardest element of service connection to prove for a VA disability claim. However, without a nexus, a veteran’s claim with the Department of Veteran Affairs (VA) won’t survive.

Category: NEXUS Letters

While NEXUS Letters can be helpful, they are not guarantees that the VA will grant your claim. If there is strong evidence that the condition could have developed in a way unrelated to your military service, then there simply may not be enough evidence in your favor.

Category: NEXUS Letters

Our doctors provide NEXUS letters that link a claimed disability condition(s) to a veteran’s time in service.

Category: NEXUS Letters
  1. The veteran must have a current diagnosis of PTSD.
  2. The in-service event/stressors must be supported by credible evidence.
  3. A connection (called a nexus) between the current diagnosis of PTSD and the in-service event/stressor must be supported by medical evidence.
Category: NEXUS Letters

The importance of a good nexus letter cannot be overemphasized. The content of your nexus letter can determine whether you receive VA disability benefits. It is extremely difficult to convince a claims reviewer that your health condition is linked to your service without a nexus letter. Our doctors provide NEXUS letters that link a claimed disability condition(s) to a veteran’s time in service.

Category: NEXUS Letters

A claim for a Veterans Benefits Administration (VBA) disability compensation award must be based on irrefutable evidence. If the claim leaves any doubt in the mind of the rating specialist who makes that award decision, you may be denied.

This is often the case when the veteran alleged that an injury or illness that occurred in service has worsened over the years. While the condition may have been relatively minor then, it’s significantly disabling today.

To show that there exists a connection between his/her documented service event (exposure to CBR elements, wounding, illness) and a condition today (cancer, worsening of original injury, etc.) requires that the veteran present a favorable opinion of an expert who agrees with his/her thought process. This is known as a nexus letter. A simple definition of nexus is: Tie; bond; link; connection or interconnection.

When writing a nexus letter, a few points to remember are in order:

  • The letter should be as brief as possible while stating facts
  • The author must be an expert.
  • This is most often a medical doctor who is board-certified in the area of health that’s at issue.
  • If cancer is the condition, an oncologist is preferred.
  • If an old injury to a bone is in question, an orthopedic surgeon is the obvious choice.
  • PTSD has become more controversial in recent years and it’s accepted today that a clinical psychiatrist or psychologist is the gold standard for opinions related to the condition. The expert who signs the nexus letter must have thoroughly reviewed all available and pertinent medical records (to include Service Medical Records) and state that fact in the letter. If the expert can’t  reasonably verify that all records were reviewed, the letter won’t be of much value.
  • The nexus letter should be as detailed and complete as the circumstances dictate.

Although it may not always be an absolute requirement, it will lend a lot of weight if the writer of the nexus letter has recently examined the veteran. The doctor who writes the letter does not have to use absolutes or conclusions in his or her statements. Opinions are made based on conjecture of observing facts and possibilities arising from those facts.

This means that the author isn’t required to say that one thing definitely caused another only that it might have or is likely to have led from point A to point B. The preferred language to describe an expert’s opinion should express whether “it is more likely than not (i.e., probability greater than 50 percent), at least as likely as not (i.e., probability of 50 percent), or less likely than not (i.e., probability less than 50 percent) that (the condition) was incurred or aggravated during active service.

In practical terms, the nexus letter is a powerful tool for the veteran to use to establish a claim. Often the VA will recognize that the physician who writes your nexus letter is better trained, better experienced or spent more time examining you than a VA Compensation and Pension (C&P) examiner did. In many cases at the VARO level as well as the Veterans Board of Appeals and in higher courts, the expert opinion expressed in a nexus letter has been the deciding factor that wins a Veteran those well deserved benefits.

Many physicians, both civilian and VA doctors, are reluctant to write such a letter. Sometimes, they are concerned that there are legal pitfalls that can arise from writing disability letters and they want to avoid such. While there probably are some legal issues to consider, I’m not aware of any physician ever suffering any repercussions from writing a truthful, factual nexus letter.

In my experience, the physician is most often simply too busy to write such letters or isn’t sure of the proper statements to make. Keeping it simple is your best chance for the doctor signing the letter. It is also best to have your doctor write the letter on his letterhead.

If the veteran’s personal doctor won’t write such a letter, the veteran will have to seek out a physician who specializes in Independent Medical Examinations or IME’s. The doctor who is a specialist in Independent Medical Examination is usually thought to be above reproach as their living depends on their reputation as an impartial reporter of facts. They will often know the language that’s needed very well and they spend a lot of time examining the patient and reviewing the records.

The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. These IME opinions may cost from $600.00 to $1500.00 or more.

There is no guarantee that the IME doctor will agree with the veteran’s thinking and if the report is not in agreement with the veteran, he/she will not get their money back.

Category: NEXUS Letters

Generally speaking, a nexus letter is a document prepared for a veteran by a medical professional that explicitly connects an in-service event to the current condition for which a veteran is seeking service-connected compensation.

Category: NEXUS Letters

The term “Nexus” in the VA appeals context simply means “causation.” In applying for VA benefits, veterans need to produce a medical opinion stating that their disability is the result of their time in service. This medical opinion is written up in a nexus letter.

Category: NEXUS Letters

The required medical opinion is called a Nexus letter. The letter must be written specifically for the individual and explicit to that individual’s claim. It is important that the opinion be expressed as a degree of likelihood.

Category: NEXUS Letters

nexus letter is a document prepared for a veteran by a medical professional that explicitly connects an in-service event to the current condition for which a veteran is seeking service-connected compensation.

Category: NEXUS Letters

Nexus Letter or Medical Opinion is a letter written by a medical clinician, a PA, NP, MD, DO, Audiologist, Podiatrist, or Psychologist with a Ph. D. after reviewing your case files and medical records. The letter outlines the evidence for your VA claim and provides a medico-legal statement required by the VA.

Category: NEXUS Letters

Nexus Letter or Medical Opinion is a letter written by a medical clinician, a PA, NP, MD, DO, Audiologist, Podiatrist, or Psychologist with a Ph. D. after reviewing your case files and medical records. The letter outlines evidence for your VA claim and provides a medico-legal statement required by the VA.

VA Medical Benefits For Veterans (45)

You may be eligible for VA disability benefits or compensation if you have a current illness or injury (known as a condition) that affects your body or mind and you meet at least one of the requirements listed below.

Both of these must be true. You:

  • Served on active duty, active duty for training, or inactive duty training, and
  • Have a disability rating for your service-connected condition

And at least one of these must be true. You:

  • Got sick or injured while serving in the military—and can link this condition to your illness or injury (called an inservice disability claim), or
  • Had an illness or injury before you joined the military—and serving made it worse (called a preservice disability claim), or
  • Have a disability related to your active-duty service that didn’t appear until after you ended your service (called a postservice disability claim)

Presumed disabilities

Who’s covered?

  • Veterans
  • Qualified dependents

Only “current” disabilities are considered service-connected disabilities eligible for compensation. For example, if you injured your knee during physical training in the military and have since fully recovered without any complications related to the injury, that injury is not a service-connected disability.

Can You Receive VA Disability Benefits for Life? Yes, it is possible to receive VA disability benefits for life.

You can only recover VA disability compensation benefits for a serviceconnected medical condition. Service connection means there is a direct link between your type 2 diabetes and an event, injury, or illness you suffered during your military service.

If you’re in one of the lower priority groups, you could lose your VA health care benefits in the future. If you don’t keep your private insurance, this would leave you without health coverage.

Yes, your PTSD rating can be reduced. The U.S. Department of Veterans Affairs (VAcan lower your disability rating and reduce your monthly benefits for PTSD if it finds evidence that your condition has improved.

The claim status tool won’t provide an exact date. But if the status of your claim is “complete,” you can estimate when you’ll receive your decision letter. This status means we’ve already mailed your letter, and it will take 7 to 10 business days to arrive from the date we mailed it. Note: The tool will show this message just below the status of the claim: “We sent you a decision letter.” If you don’t receive your letter within 10 days, please call the VA at 800-827-1000. We’re here Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.

The drug use must be the direct and proximate cause of the disability for the VA to deny disability benefits. The VA defines drug abuse as using drugs to enjoy getting intoxicated.

VA Disability benefits are tax-free. Veterans may be eligible for disability compensation if they have a service-related disability and they were discharged under other than dishonorable conditions. Notice that there aren’t any income restrictions for VA Disability!

VA will provide health care insurance coverage for the spouses of certain totally disabled (whether rated 100 percent or receiving TDIU benefitsveterans under the Civilian Health and Medical Program, or CHAMPVA.

No.  You can still file a claim for service-connected disability compensation even though you did not serve on active duty during a period of war.

Yes. To be eligible for most veterans benefits and programs you must have been discharged or released from military service under conditions other than dishonorable. You will always be eligible for veterans benefits and programs when the character of your military service is Honorable.

You may still be eligible for service-connected disability compensation if the character of your military service is listed as a Discharge Under Honorable Conditions or a General Discharge.

If your character of military service is listed as Discharge Under Other Than Honorable Conditions, Undesirable Discharge, Bad Conduct Discharge or Dishonorable Discharge, in most cases you will be barred from receiving benefits.

Yes, it does.  Even if you can prove that you have a service-connected disability you will not receive compensation for the disability if you have been discharged or released from military service under conditions other than honorable.

You can check the status of your VA claim, appeal, or decision review on VA.gov. You’ll need to sign in first with DS LogonMy HealtheVet, or ID.me. If you don’t have any of these accounts, you can get one now. If you need help, please call the VA at 800-827-1000. We’re here Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.

If you’re past the 12-month window to appeal, you can simply start a new claim inside eBenefits or VA.gov, and upload the new medical evidence showing that you do, in fact, have a diagnosis of the disability.

If you need help filing a disability claim, you can contact a VA regional office and ask to speak to a counselor. To find the nearest regional office, please call 800-827-1000. An accredited representative, like a Veterans Service Officer (VSO), can help you fill out your claim. Get help filing your claim.

If you served on active duty, active duty for training, or inactive duty training and you have a current illness or injury that occurred, was aggravated by, or was caused by another service-connected condition, you may have a service-connected disability.

If you meet these requirements, you may file a claim with the Department of Veterans Affairs requesting compensation for your disability. Free application assistance may be obtained through your county Veterans Service Office, the Texas Veterans Commission, or other veterans organizations in the state.

You can check the status of your VA claim, appeal, or decision review on VA.gov. You’ll need to sign in first with DS Logon, My HealtheVet, or ID.me. If you don’t have any of these accounts, you can get one now. If you need help, please call the VA at 800-827-1000.

You prove service connection of your disability by showing what is called “continuity of symptomatology“: that you have had continuous symptoms of your disability from service to diagnosis.

If your decision notice shows at least a 10% disability rating, you’ll get your first payment within 15 days. We’ll pay you either by direct deposit or check. If you don’t get a payment after 15 days, please call the Veterans help line at 800-827-1000, Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.

There is no time limit.  A service-connected disability may occur anytime while you are on active duty.

Anyone who has reached 20 years of service, even if they were never activated on a [federal] order for more than 180 days outside of training, will now be considered a veteran.”

Generally, 12 years of separation from service or within 12 years of being awarded serviceconnected VA disability compensation.

The amount of compensation is based on the disability rating percentage.  Once the Department of Veterans Affairs makes the decision that your injury or illness is a service-connected disability, your disability will be assigned a disability rating between 0% and 100%.

The Department of Veterans Affairs begins paying compensation at the 10% rating level.  In 2021, a 10% rating is equivalent to $144.14 per month while a 100% rating is equivalent to $3,146.42.*

*Ratings depicted reflect the amounts received by single, childless veterans. Additional compensation may be received for veterans who are married as well as veterans with children or dependent parents.

As of December 2018, 100% VA disability is $3,057.13 per month. The U.S. Department of Veterans Affairs (VA) adjusts this amount each year, typically raising it to account for increases in the cost of living.

Veterans may apply for VA health care enrollment at any time. No enrollment fee, monthly premiums, or deductibles. Most Veterans have no out-of-pocket costs. Some Veterans may have to pay small copayments for health care or prescription drugs.

The Department of Veterans Affairs’ rating system is based on how severe your disability is and how it impacts your earning capacity. When assigning disability ratings, the VA raters review a schedule of over 800 diagnostic codes, each relating to a specific medical condition or set of conditions. Each diagnostic code contains different criteria which correspond to disability percentage ratings. For example, a veteran with symptom A may receive a 10% rating, while a veteran with symptoms A, B, and C may receive a 50% rating.

You may be able to get VA disability benefits for conditions such as:

  • Chronic (long-lasting) back pain resulting in a current diagnosed back disability
  • Breathing problems resulting from a current lung condition or lung disease
  • Severe hearing loss
  • Scar tissue
  • Loss of range of motion (problems moving your body)
  • Ulcers
  • Cancers caused by contact with toxic chemicals or other dangers

You may also be able to get VA disability benefits for:

  • Traumatic brain injury (TBI)
  • Posttraumatic stress disorder (PTSD)
  • Depression
  • Anxiety

Any injury or illness that occurred or was aggravated during the time you were on active duty is an injury or illness that occurred “in the line of duty”.  For example, injuries you sustained in a Humvee accident while training are considered injuries that occurred in the line of duty.

However, any injury or illness that resulted from your own misconduct or abuse of alcohol or drugs will not be considered “in the line of duty.” In most cases, your claim for service-connected disability will be denied if the disability was a result of your own misconduct or abuse of alcohol or drugs.

To be 100disabled by VA standards means that you are totally disabled. Veterans awarded disability at this level receive the maximum in scheduler monthly compensation. The Department of Veterans Affairs (VA) has stringent criteria veterans must meet in order to receive this rating.

Disability compensation is a monetary benefit paid to Veterans who are determined by VA to be disabled by an injury or illness that was incurred or aggravated during active military service. These disabilities are considered to be service-connected.

Generally speaking, service connection is the way that VA recognizes that a disability is related to a veteran’s military service in some way. Once service connection is granted, then a veteran is eligible to receive VA disability compensation benefits for that condition.

A service-connect disability is an injury or illness that was directly caused by military service, sustained while in the military (both on duty and off duty injuries may be service connected, i.e. knee injury playing basketball off duty), was aggravated by military service, or was caused by conditions that are themselves service-connected.

Service-connected means that the veteran is disabled due to injury or illness that was incurred in or aggravated by military serviceNonservice connected means that the veteran is disabled due to injury or illness not related to military service. … Compensation is paid to a veteran with serviceconnected disabilities.

The most common VA Disability Claim is tinnitus. According to 2018-2019 VA disability claims statistics, Tinnitus was the most common VA disability claim. In total, there were 57,152 compensation recipients. Tinnitus involves the sensation of hearing sound when no external sound is present.

The VA can’t reduce your disability if it has been paid for five years unless the condition has improved and is shown to remain so. A similar rule, the “10Year Rule” says a condition cannot be reduced after being compensated for a full decade unless there is medical evidence of improvement of the condition.

The VA disability 5year rule says that a Veteran cannot have their rating reduced if their condition has not improved in the first 5 years after they received their initial rating for the condition.

In 2020, the VA National Income Thresholds are as follows: $34,171 or less if you have no dependents. $41,005 or less if you have one dependent. $43,356 or less if you have two dependents.

You can find out:

  • Where your claim, appeal, or decision review is in the review process, and
  • Which documents and forms (called evidence) we need from you, and
  • Which documents we’ve already received from health care providers, government agencies, and other sources, and
  • Details like your claim type, the date we received your claim, and the name of your representative

Note: The claim status tool won’t show documents you brought to us in person or sent by mail or fax. You also won’t find documents online that we protect because they have private information.

If you served in the active military, naval or air service and are separated under any condition other than dishonorable, you may qualify for VA health care benefits.

If you’re a current or former member of the Reserves or National Guard, you must have been called to active duty by a federal order and completed the full period for which you were called or ordered to active duty. If you had or have active-duty status for training purposes only, you don’t qualify for VA health care.

If a Veteran does not submit enough proof about their disability in their VA claim , the VA will likely deny their claim. The VA has strict guidelines about what types of medical conditions qualify as disabilities and what level of compensation each veteran can receive based on the impact of the condition.

An injury or illness that results from honorable service to our country may impact your ability to earn a future living for yourself and your family.  Service-connected disability compensation provides monthly tax-free payments to disabled veterans to assist financially with the reduced employment capability or opportunities related to service-connected disabilities.

No, a veteran’s disability compensation payments are not continued for a surviving spouse after death. However, survivors may be entitled to a different type of benefit called Dependency and Indemnity Compensation.

2021 VA Disability Rates saw 1.3% cost-of-living increase based on the COLA calculations. For a 50% disabled veteran with a spouse and one child who currently receives $1,056.04 per month, this amounts to about $29.68 more per month. … VA Disability payments are monthly.