Plain language
VA terms that confuse everybody
These are the words on your rating decision and your claim letters. Nobody explains them. Here is what each one means, and the deadline or the form that goes with it.
Veterans Crisis Line — dial 988, then press 1. Text 838255. Chat at
veteranscrisisline.net. TTY 711 then 988, or
1-800-799-4889. 24 hours a day, 7 days a week. You do not have to be enrolled in VA benefits or
VA health care to connect.
Why I built this page. A claim gets lost over a word somebody did not understand. I put the
definition and the thing that costs you money in the same place, so you do not have to go looking twice.
One note on wording: VA does not call a Supplemental Claim or a Higher-Level Review an "appeal." VA calls
those decision review options. Only the Board route is an appeal.
Service connection & nexus
Everything else in a claim sits on these two.
- Service connection — VA agrees your condition was caused by your military service, or that service made a condition you already had worse. That agreement is what turns a medical problem into a paid benefit.
- Nexus — the medical link between the condition you have now and what happened in service. VA's own words for it are plainer: "There's a link between your current condition and the event, injury, or disease that happened during your service."
A nexus is usually a written opinion from a doctor saying the link is at least as likely as not. No link
on paper, no service connection — even when everybody involved knows the injury happened.
See va.gov/disability/how-to-file-claim/evidence-needed.
★ Prove the link, not just the injury.
DBQ — Disability Benefits Questionnaire
A medical form that records the diagnosis and how severe the condition is.
VA publishes a set of these forms so that, in VA's words, you can "submit medical evidence from your health care providers." For those published forms, your own private doctor can fill one out and you file it with your claim. That is an evidence path you control.
VA does not release every DBQ to the public. Some are held back because of regulatory limits or
because the examiner needs specific training. The ones not available for public use include: Initial
PTSD; Hearing Loss and Tinnitus; Initial and Review Residuals of TBI (traumatic brain injury); Medical
Opinion; General Medical for compensation and General Medical for pension; Gulf War General Medical;
Former POW Protocol; Cold Injury Residuals; and Separation Health Assessment Part B. For those
conditions the exam has to be done by a VA examiner or a VA-contracted examiner.
Hearing loss, tinnitus and initial PTSD are among the most-filed claims there are — and they are on
that withheld list. A "PTSD Review" DBQ, for PTSD that is already service connected, is public.
Initial PTSD is not. Check the current public list at
benefits.va.gov/COMPENSATION/dbq_publicdbqs.asp
before you pay a private doctor for a form that does not exist — and never skip a VA exam because
you think your doctor's form replaced it.
★ Some DBQs are yours. Some are not.
C&P exam
Compensation and Pension exam — the exam VA orders to evaluate your claim.
It is not treatment. The examiner is there to document your condition for the rating, not to fix anything. Details at va.gov/disability/va-claim-exam.
If you miss it without good cause, it costs you. Under 38 CFR 3.655, when VA cannot decide the
claim without the exam and you fail to report: an original compensation claim is decided on whatever is
already in the file, and a claim for increase, or a supplemental claim for a benefit that was
previously denied, is DENIED outright.
Good cause includes things like illness, hospitalization, or a death in your immediate Family. If
something comes up, call and reschedule. A phone call beats a no-show every single time.
★ Go to the exam.
Effective date
The date your benefits legally begin — VA calls it "the day you can start getting your disability benefits."
It is generally the date VA received your claim, or the date you became entitled, whichever is later. Any back pay is measured to that date. It sets your start date whether back pay results or not. See va.gov/disability/effective-date.
Two ways to hold an earlier date.
- Intent to File. If VA receives your complete application within one year of receiving your intent to file, the claim is treated as filed on the date the intent to file came in (38 CFR 3.155(b)). You can establish it three ways: start and save an application in VA's online claims system, submit the intent-to-file form (VA Form 21-0966), or make an oral statement to designated VA personnel that they document in writing.
- Within one year of separation. A direct service-connection claim filed within one year of leaving service can take an effective date of the day after your discharge.
★ Every month on that date is money.
After a decision: three review options
A denial is not the end of the road. There are three routes, and the deadlines are not the same.
- Supplemental Claim — VA Form 20-0995. You submit new and relevant evidence. No filing deadline. You may file it any time after VA issues notice of a decision. va.gov/decision-reviews/supplemental-claim
- Higher-Level Review — VA Form 20-0996. A more senior reviewer rechecks the existing record. No new evidence. One year from VA's decision on your initial claim or on a Supplemental Claim — the clock restarts with each new decision. va.gov/decision-reviews/higher-level-review
- Board Appeal — VA Form 10182 (Notice of Disagreement). Goes to the Board of Veterans' Appeals. One year. Three dockets: Direct Review (no new evidence, no hearing), Evidence Submission (new evidence within 90 days), and Hearing. va.gov/decision-reviews/board-appeal
Keep the chain unbroken. If you keep filing in succession, on time, any of the available review
options, your effective date stays fixed at the date VA received your initial claim or the date
entitlement arose, whichever is later (38 CFR 3.2500). Break the chain and a later grant is dated from
the later filing. That is lost retroactive pay you cannot get back.
★ A missed year is not recoverable.
Inside a Higher-Level Review
No new evidence is allowed. The record is frozen as of the prior decision. So the argument is everything.
- Ask for the informal conference. You or your representative may request one on the same form (38 CFR 3.2601). In a lane where you cannot add evidence, that call is your only chance to point out the error out loud. Most people never check the box.
- Duty-to-assist error. If the higher-level reviewer finds VA failed its duty to assist you, the claim is returned for correction of the error and readjudication. An HLR is not a dead end when VA did not develop your claim properly.
- When you cannot use it. You cannot use a Higher-Level Review after a prior Higher-Level Review or a Board Appeal on the same issue. It is also not available on a simultaneously contested claim — that is where two or more parties claim the same benefit. In those situations the Board route is where you go; ask an accredited representative to walk it with you.
★ Check the box. Make the argument.
TDIU
Total Disability based on Individual Unemployability. Paid at the 100% rate because service-connected conditions prevent substantially gainful employment.
Working does not automatically disqualify you. Marginal employment is not substantially gainful
employment. VA generally treats earned annual income at or below the Census Bureau poverty threshold for
one person as marginal (38 CFR 4.16(a)), and VA's own page says plainly that "odd jobs (marginal
employment) don't count." Work in a protected environment, such as a Family business, is also not counted
as substantially gainful.
- The usual rating thresholds: one disability rated 60% or more, or two or more disabilities with at least one rated 40% or more and a combined rating of 70% or more (38 CFR 4.16(a)).
- Below those percentages? Not a closed door. 38 CFR 4.16(b) allows referral for extra-schedular consideration for a veteran who is genuinely unable to hold substantially gainful employment. Say so in your claim and ask for it by name.
- The forms: VA Form 21-8940, your application, and VA Form 21-4192, which your last employer completes with your employment information. VA asks for both. One alone is an incomplete package.
va.gov/disability/eligibility/special-claims/unemployability
★ A job does not end the conversation.
P&T — Permanent and Total
Two separate words, and both have to be met.
- Total — the impairment is such that it makes it impossible for the average person to follow a substantially gainful occupation.
- Permanent — the impairment is "reasonably certain to continue throughout the life of the disabled person" (38 CFR 3.340).
You do not need a 100% schedular rating. A veteran paid at the 100% rate under TDIU can be rated
permanent and total. If you assume P&T is only for schedular 100%, you will never go looking for what
it unlocks.
- P&T generally ends scheduled reexaminations (38 CFR 3.327(b)), which also excuses exams for static disabilities, for findings that have gone five years or more without material improvement, and for veterans over 55 except in unusual circumstances.
- It is the gateway to CHAMPVA health coverage for your spouse and dependent children — va.gov/health-care/family-caregiver-benefits/champva
- And to Survivors' and Dependents' Educational Assistance (DEA, Chapter 35) — va.gov/education/survivor-dependent-benefits/dependents-education-assistance
★ P&T pays your Family, not just you.
Help with a claim — and what it costs
You do not have to do this alone, and you should not have to pay to file.
- An accredited representative of a recognized veterans organization — a VSO — is free. Under 38 CFR 14.636, those organizations and their accredited representatives acting as such are not permitted to receive a fee at all.
- An accredited attorney or claims agent may charge, but only after VA has issued notice of an initial decision on the claim.
- A fee of up to 20% of past-due benefits awarded is presumed reasonable. A fee over 33 1/3% is presumed unreasonable (38 CFR 14.636).
If somebody wants a cut of your back pay before VA has ever decided your claim, walk away and go find an
accredited VSO representative.
★ Free help exists. Use it first.