There are three requirements for veteran disability benefits. Each of these must be met in order to qualify for disability benefits. The requirements seem pretty straightforward. However, there many variations and complexities that arise in what would seem fairly clear-cut eligibility criteria.
In order to get to those requirements, it must first be determined that the individual is a qualified veteran. This means that that the veteran was discharged or released from military service under “other than dishonorable” conditions. This threshold requirement itself raises many issues that might not at first be apparent upon a reading of what would seem a simple calculation.
Requirement 1: The Veteran Currently Suffers from a Disability.
A finding of a disability will always require a diagnosis or opinion from a medical professional. In many cases of physical injuries, this should not be a problem. Physical injuries are often, though not always, manifested in clear and certain terms. A medical opinion would generally be readily obtained either through he VA Medical system or through private medical providers.
Often more difficult are cases involving PTSD (post-traumatic stress disorder) and TBI (traumatic brain injury) which have become known as the signature injuries of the Iraq and Afghanistan conflicts. PTSD in particular is much more difficult to diagnose. In addition, the VA is stretched thin on the necessary medical and psychiatric personnel necessary to provide the proper diagnosis in a timely manner. However, there have been significant pushes to address these shortcomings in PTSD diagnosis and treatment.
Requirement 2: There is Evidence of Event, Incident or Injury That Occurred During the Veteran’s Military Service.
This requirement is highly reliant on the veteran’s military records, both personnel and medical. However, there is no requirement that the event, injury or incident be documented in the military records. The VA is required to consider lay evidence. In addition, the standard of proof is significantly relaxed for combat related events, incidents and injuries. If the statements are consistent with the circumstances of service, then there must be clear and convincing evidence to the contrary for the VA to refute the evidence and deny the claim.
Requirement 3: There is Link Established Between the Current Disability and Service Connected Event, Incident or Injury.
There are a number of ways to connect the event, incident or injury to the military service. Each of these can be fairly complicated and entail numerous variations. Each is addressed here only as an overview of the requirements.
The first possibility is a direct service connection. This at first seems a fairly simple determination. But even this has numerous possible variations and complications including considerations for delayed direct, chronic conditions, and continuity of chronic conditions.
The second possible service connection is through aggravation. Military personnel like other workers sometimes come to a job with preexisting conditions. Though there can be no veteran disability benefits for preexisting conditions alone, there are available benefits for the aggravation of these conditions during service.
The third possibility involves presumptive conditions. There is a rather long list of presumptive conditions that are defined and circumscribed by the circumstances, locations and era of service. Perhaps the most recognized are the presumptive conditions arising from Agent Orange Exposure. However, there are many more associated with other wars, conflicts and circumstances of military service.
The next possibility is a secondary connection. Secondary conditions can arise in a vast number of situations. However, simply stated, secondary service connection arises when one service connected injury leads to other injuries. A coupled of easy examples would be a knee injuries leading to back issues or severe pain leading to depression. However, there are many more too numerous to name. Some of the areas on the rise are the many issues related to TBI and PTSD.
Finally, injuries suffered as a result of treatment, therapy or rehab through the VA will be considered service connected. In some cases, these injuries could be related to medical errors that might also lead to a medical malpractice claim, which is an entirely different topic.
As should be apparent, these three requirements raise countless issues in their own right. As such, each requires careful legal analysis and planning to insure that the veteran receives the full and fair disability benefits to which he or she is entitled.