Navigating the VA claims process might seem challenging, but with the right information, it can become manageable and rewarding. Submitting new and material evidence can significantly improve your chances of getting a previously denied claim reconsidered or even increasing the benefits you currently receive. This comprehensive guide provides you with ways new and material evidence can be used, emphasizing timelines and deadlines of the process.
What Qualifies as New and Material Evidence?
Understanding what constitutes new and material evidence is crucial to ensuring that the VA considers your submission.
New Evidence: New evidence refers to information not previously included in your claim file. This could include additional medical records, recent diagnoses, or details overlooked in the initial review. To qualify as “new,” the evidence must provide insights not previously available to the VA.
Material Evidence: Material evidence is evidence relevant to your claim that has the potential to substantiate it by providing a clearer picture of your circumstances. This type of evidence must demonstrate a direct connection to your disability claim or provide crucial missing details.
Examples of New and Material Evidence:
- Medical Records: New diagnoses, treatments, or evaluations. A comprehensive set of medical documentation is vital for the success of any disability claim.
- Service Records: Additional records that clarify or support your claim.
- Lay Statements: Testimonials from family, friends, or coworkers providing context or evidence.
The importance of medical evidence in disability benefit claims should never be overlooked. Presenting a well-documented and cohesive set of new and material evidence can make a significant difference in your claim’s outcome.
The Importance of Timely Submission
Timely submission of evidence is critical to ensure the efficient processing of your claim and to avoid unnecessary delays or dismissals.
Why Timing Matters
- Efficient Processing: Timely submissions reduce processing time and ensure the VA has all necessary documents.
- Legal Deadlines: Missing deadlines can result in dismissal or the need to restart the process, causing unnecessary delays.
Impact on Previously Denied Claims
If your claim was previously denied, submitting new and material evidence can pave the way for reopening and reassessment. For example, updated medical evidence might support a higher disability rating or even approval of a previously denied condition. Remember, the sooner you act, the more streamlined the process will be.
Key Deadlines and Timelines
Understanding VA deadlines is vital to avoid jeopardizing your claim when submitting new and material evidence:
Initial Claim Submission
- Timeline: There is no strict deadline for filing an initial claim, but timely filing establishes the effective date for benefits and impacts retroactive pay.
- Processing Time: It typically takes 3–6 months for an initial decision, depending on the complexity of the claim.
Notice of Disagreement (NOD)
- Deadline: Must be filed within one year of the decision letter date.
- Processing Time: On average, the process can take 12–18 months, depending on the backlog at the VA.
Supplemental Claims
- When to File: You can file a supplemental claim anytime after a decision, provided you have new and material evidence.
- Processing Time: Typically 4–6 months for a decision, with potential variations based on case complexity.
VA’s Review Process
What Happens After Submission
- Initial Review: The VA determines whether the evidence qualifies as new and material. This review typically takes 30–60 days.
- Additional Development: If more information is needed, the VA may request it, adding another 30–90 days to the process.
- Final Decision: After reviewing all evidence, the VA makes a decision. This stage usually takes 60–90 days.
How to Check Your Claim Status
- Online: Visit VA.gov or use the eBenefits portal.
- Phone: Call the VA’s toll-free number to inquire about your claim.
- In-Person: Visit your regional VA office for direct updates.
Staying informed about your claim status is essential to address any issues promptly.
What to Do if More Information is Requested
When the VA requests additional information, respond promptly to avoid delays. You can consult a Veterans Service Organization (VSO) for assistance in preparing your response. Always keep copies of all correspondence and submissions for your records.
Potential Outcomes
Approval of the Claim
If the VA approves your claim, you will receive a decision letter outlining the details of your benefits, including the effective date. Approval may result in retroactive payments and an adjusted disability rating.
Denial of the Claim
If your claim is denied, you have several options for appeal:
- Options for Further Appeal: If your claim is denied, you can appeal the decision by filing a Notice of Disagreement (NOD) within one year of the decision date. You may also opt for a Higher-Level Review or a Board of Veterans’ Appeals (BVA) hearing.
- Timeframes for Next Steps: Notice of Disagreement (NOD): Must be filed within one year of the decision date.
- Higher-Level Review: Typically takes between 4 to 5 months. This process involves a more experienced reviewer looking at your case. They will not consider new evidence but will instead re-evaluate the existing evidence to ensure that the original decision was accurate. It’s an opportunity to identify any possible errors or overlooked information in the initial review.
- Board of Veterans’ Appeals (BVA): It may take over a year, depending on the complexity of the case and the current backlog. The BVA is responsible for handling appeals that require a detailed examination beyond the initial or higher-level review. Veterans have the opportunity to submit new evidence and may request a hearing before a Veterans Law Judge. The timeframe for a decision can vary widely, influenced by the number of cases currently in the system and the specific issues being appealed.
By following these steps and understanding the process, you can increase your chances of a successful outcome when submitting new and material evidence. Remember to stay proactive, keep organized records, and seek assistance when needed. VSOs or accredited attorneys or agents may be able to help. If you need help with clear and concise medical documentation, talk to one of our licensed medical experts for FREE.
