The Veterans Affairs Department has processed a record-breaking 2,524,115 veteran disability compensation and pension claims in fiscal 2025, exceeding last year's previous high of 2.51 million claims processed. Understanding how the VA disability claims system works provides important context for veterans reviewing their options within this process.
TL;DR
The Modern VA Claims System Explained
The VA claims landscape has undergone significant changes in recent years. Digital systems, updated evidence standards, and revised processing timelines now shape how the VA evaluates disability claims.
The VA disability claims backlog has fallen dramatically from a decade-high of 417,855 in January 2024 to 134,009 in September 2025—a 67.9% reduction, with the average time to complete a claim now standing at 123.4 days, according to VA Claims Insider.
Digital Processing Changes
The VA's eFolder system represents a significant shift in how VA claims move through the adjudication process. Digital storage and tracking have replaced paper files, allowing for more efficient document management throughout the evaluation period.
The digital system has specific requirements for file formats and document organization. The digital system has specific requirements for file formats and document organization, which can influence how examiners access and review uploaded evidence.
Some VA claims have experienced delays when medical records were uploaded as image files rather than searchable PDFs, which can affect how easily examiners are able to review the information.
Recent VA IT challenges highlight the importance of understanding digital systems. The VA experienced significant delays in education benefits processing due to IT glitches affecting up to 75,000 student beneficiaries, demonstrating how technology issues can impact veteran services.
Current Evidence Standards
The VA's evidence-based decision making has become increasingly sophisticated. Examiners use standardized criteria that require specific types of medical documentation to support rating decisions.
Modern VA claims adjudication reviews functional impact assessments, objective medical findings, and clear documentation connecting conditions to military service. The evidence must demonstrate how disabilities affect daily life, work capacity, and overall functioning.
Understanding what evidence the VA requires for disability claims is crucial, as many personal physicians write excellent treatment notes but may not document the specific elements VA examiners need for rating decisions.
Different Types of VA Claims
The VA evaluates different claim types according to specific criteria and evidentiary standards.
Initial claims represent a veteran's first request for service connection for a particular condition. These claims require documentation establishing three elements: current diagnosis, in-service event or exposure, and medical connection between the two.
Increase claims address conditions already rated as service-connected that have worsened over time. The VA reviews medical evidence showing deterioration since the most recent rating decision.
Secondary condition claims address situations where a service-connected condition causes or aggravates another condition, and the VA evaluates whether medical evidence documents that relationship.
Initial Claims for Service Connection
Initial VA claims carry significant evidentiary requirements because the VA must establish service connection from the foundation. The VA reviews three key elements: a current diagnosed condition, evidence of an in-service event or injury, and a medical nexus linking the two.
According to the VA, service members can submit claims with as little as 90 days of active duty remaining. This timing provides access to military medical records and potential witnesses that might be more difficult to locate after discharge.
A Marine veteran submitted an initial claim for lower back pain within 60 days of discharge. The claim included service medical records showing a training injury, current MRI results demonstrating disc degeneration, and an independent medical opinion linking the current condition to the documented service injury. In this example, the VA reviewed the evidence—including service medical records, current diagnostic findings, and a medical opinion discussing the connection—and issued a 40% rating.
Increase Claims Based on Worsening Conditions
Increase claims focus on demonstrating deterioration since the veteran's last rating decision. The VA examiner compares the current condition to the medical evidence from the previous rating.
In increase claims, the VA reviews whether medical evidence shows any documented changes since the last rating. Timing of medical documentation may influence how the VA evaluates progression.
Increase claims often include recent medical records showing objective changes, updated functional capacity evaluations, and detailed documentation of how symptoms impact daily activities.
Secondary Conditions
Secondary condition claims represent an important category within VA disability compensation. When a service-connected condition causes or aggravates another condition, the VA must consider that secondary condition for compensation.
The medical connection for secondary conditions often follows a different evidentiary path than primary service connection. The VA reviews how one current condition led to another rather than evaluating events from military service decades ago.
Common secondary conditions include depression related to chronic pain, sleep apnea connected to PTSD, or joint problems resulting from compensating for other injuries. Independent medical opinions may use terminology such as “at least as likely as not” to describe whether a secondary condition is related to a primary service-connected disability.
Processing Times and Realistic Expectations
The VA's published processing times represent national averages that include simple claims processing quickly alongside more complex cases.
Fully developed claims with complete medical evidence typically process 30-60 days faster than standard claims. However, "complete" means truly comprehensive—missing even one piece of evidence can move a claim into the longer standard processing track.
Regional office variations create significant differences in processing times. Some offices consistently process VA claims faster due to staffing levels, examiner experience, or administrative efficiency.
States with the highest number of backlogged claims include Texas (14,453), Florida (13,109), California (10,189), Georgia (5,740), and North Carolina (5,413), while states with the lowest backlogs include the District of Columbia (161), Vermont (188), North Dakota (397), Rhode Island (377), and Delaware (436).
Fully Developed Claims Program
The Fully Developed Claims (FDC) program offers faster processing in exchange for comprehensive evidence submission upfront. The VA's definition of "complete" requires specific documentation standards.
FDC requires all relevant medical records, service records, and supporting evidence at the time of submission. The trade-off involves faster processing versus the flexibility to add evidence later.
According to the VA, Fully Developed Claims (FDC) may move through the system more quickly when all required evidence is included at the time of filing.
Medical Evidence Standards in VA Evaluations
Comprehensive, properly formatted medical evidence forms the foundation of every VA disability evaluation. The VA reviews this documentation to understand the connection between military service and current disabilities.
Independent Medical Examinations
Independent Medical Examinations (IMEs) provide objective documentation when personal physician records don't meet VA standards or when veterans need more comprehensive documentation than standard medical appointments provide.
The key advantage of IMEs involves working with physicians who understand VA rating criteria. These healthcare providers are familiar with the types of medical information referenced in VA rating criteria and document findings in standardized clinical formats.
Understanding the importance of medical evidence in VA disability claims becomes clear when considering that IMEs can be particularly valuable for complex conditions where symptoms fluctuate or where functional limitations aren't obvious from standard medical tests.
Selecting Qualified Medical Providers
Not all physicians understand VA disability evaluations. A family physician might provide excellent treatment but may be unfamiliar with how the VA rates disabilities or what documentation the VA requires.
Healthcare providers with specific experience in disability evaluations understand the difference between treatment notes and disability evaluation reports. The most qualified IME providers review service records, understand military occupational specialties, and connect current symptoms to potential service-related causes.
Disability Benefit Questionnaires (DBQs)
Disability Benefit Questionnaires (DBQs) represent the VA's standardized template for medical evidence. When completed by qualified physicians, DBQs provide the information VA claims examiners need to make rating decisions.
Veterans interested in understanding the VA DBQ process should know that DBQs cover every aspect of how the VA rates specific conditions, from objective medical findings to functional limitations.
An important feature of DBQs is that they present information in the format VA examiners are trained to evaluate, provides information in a standardized format commonly used in VA evaluations
A veteran with PTSD obtained a comprehensive DBQ from a qualified psychiatrist that documented specific functional limitations including social and occupational impairment, difficulty with work and social relationships, and intermittent periods of inability to function. In this example, the detailed DBQ documented functional limitations, and the VA ultimately assigned a 70% rating rather than the initially proposed 30%.
Building a Comprehensive Evidence Package
Comprehensive medical evidence requires a systematic approach beyond simply collecting medical records. The documentation should create a coherent narrative connecting military service to current disabilities.
Service records can identify potential exposure events, injuries, or occupational hazards that could have caused current conditions. This documentation then shows how service-related factors led to current disabilities.
Comprehensive medical evidence can help VA examiners understand the full picture of a condition.
Pre-Filing Evidence Considerations:
Service Connection Documentation
Independent medical opinions establishing clear connections between current conditions and military service events, injuries, or exposures form crucial evidence for many VA claims.
Medical opinions often include language such as “at least as likely as not” when discussing potential connections between current conditions and service events. These opinions provide detailed medical reasoning, reference relevant medical literature, and address potential alternative explanations.
Veterans seeking understanding of independent medical opinions for service connection should understand that the physician providing the medical opinion must review complete service records, understand military duties and exposures, and explain the medical basis for connecting the condition to service.
Functional Impact Documentation
The VA rates disabilities based on functional impairment, not diagnosis alone. A severe diagnosis with minimal functional impact receives a lower rating than a moderate diagnosis that significantly affects daily functioning.
Documentation that includes specific examples of how conditions limit activities can provide clearer context for evaluators.
Functional impact documentation that includes objective descriptions may provide more clarity. Rather than general statements about difficulty, specific measurements like "walking approximately 100 yards before experiencing severe pain that requires rest" provide clearer information.
Supporting Evidence from Witnesses
Firsthand accounts from fellow service members, family members, and friends can corroborate the onset and progression of conditions, providing valuable supporting evidence. This testimony can establish timelines and document functional changes that medical records might miss.
Buddy statements from fellow service members carry particular weight because they can corroborate in-service events or injuries that might not appear in official records.
Family member statements document how conditions affect daily life and relationships. They can describe changes in behavior, mood, or capabilities that veterans might not fully recognize or articulate themselves.
Common Evidence Problems
Some common evidence issues arise when information is missing or incomplete. These same errors affect thousands of VA claims annually, leading to unnecessary denials and appeals.
Incomplete medical records top the list of evidence problems. Veterans often submit recent records without including historical documentation that shows the progression of conditions over time.
Poor timing of medical appointments relative to claim submission creates another frequent problem. Medical examinations conducted immediately after claim submission, with records added months later, can make conditions appear to have suddenly worsened rather than being consistently severe.
Incomplete Medical Records
Incomplete medical records force VA examiners to work with partial information, often leading to unfavorable assumptions about condition severity or service connection.
The most critical missing records are often the oldest ones showing when conditions first appeared or began affecting functioning. These historical records establish the timeline connecting conditions to military service.
Recent medical records without historical context can make chronic conditions appear acute or unrelated to service. VA examiners review the full record available at the time of evaluation.
VA Claims Filing Processes and Timelines
The VA claims process involves careful documentation review and evidence evaluation. Understanding the steps and typical timelines can help veterans navigate the system more effectively.
Pre-Filing Considerations
Work completed before submitting VA claims often influences ultimate outcomes significantly. Veterans may review available documentation prior to filing to understand what information is currently in their record.
This preparation phase identifies gaps in documentation and reveals whether additional medical documentation may provide a clearer record
Preparation also involves understanding the specific rating criteria for conditions and confirming medical evidence addresses all relevant factors that influence rating decisions.
According to VBA data, the VA processed 300,000 ratings claims in July — the VA's most ever in a single month, with processing times sped up by 17.8% during recent improvements despite receipts being 10% higher than the previous year.
Evidence Assessment
Not every condition warrants a VA claim, and not every claim has strong prospects for favorable outcomes. Realistic evidence assessment can focus efforts on claims with the best prospects.
Professional evaluation can identify potential service connections that might have been overlooked while also highlighting weaknesses in claims that initially seemed strong.
The assessment should also consider timing factors, such as whether additional medical evidence would strengthen the claim or whether current evidence is sufficient.
Service Record Review
Service records contain valuable information beyond obvious injuries documented in medical records. Personnel files might contain evidence of exposures, occupational hazards, or duty assignments that support claims for conditions that developed years later.
Military Occupational Specialty (MOS) and duty locations can establish presumptive exposures to hazardous substances. Combat deployments, specific bases, or time periods of service might qualify veterans for presumptive conditions under various VA programs.
Performance evaluations and fitness reports sometimes document declining performance that correlates with the onset of medical or mental health conditions. These records can establish when symptoms first appeared and how they affected military duties.
After Filing: Claim Management
The VA may request additional information during processing, and responses are reviewed as part of the evaluation.
The VA will likely request additional information or evidence during processing. How quickly and completely veterans respond to these requests affects claim processing time and the examiner's ability to make decisions.
Veterans may monitor claim status through VA systems to stay informed of updates.
Responding to Development Letters
Development letters from the VA request specific evidence or information that examiners need to complete evaluations.
Reading development letters carefully to understand precisely what evidence or information the VA requests allows for complete responses addressing every question, even items that seem redundant.
Late or incomplete responses to development letters can delay claims for months. The VA operates on specific timelines, and missing deadlines can result in decisions based on incomplete evidence.
A veteran received a development letter requesting additional medical evidence for a knee condition claim. Rather than submitting only recent X-rays, the complete package included MRI results, physical therapy notes, orthopedic consultation reports, and a functional capacity evaluation. In this example, the VA issued a favorable decision after reviewing the additional records submitted.
Appeals and Rating Review Options
When initial claims don't achieve desired outcomes, veterans have multiple avenues for pursuing review through the modernized appeals system. Understanding rating calculations and appeals processes can inform next steps.
Recent legislative action demonstrates ongoing support for veterans' benefits. The Senate unanimously approved the Veterans' Compensation Cost-of-Living Adjustment Act of 2025, which will raise certain VA benefits by 2.8%, including disability compensation, to keep pace with inflation.
How the VA Calculates Combined Ratings
The VA's combined rating system differs from simple addition. Veterans cannot simply add individual ratings together to determine combined ratings.
The VA uses a formula that considers each disability's impact on remaining capacity for work and daily functioning. This system often results in combined ratings lower than the sum of individual ratings.
Veterans learning about how to challenge a low VA rating should understand this calculation explains how different combinations of ratings affect VA compensation brackets. Sometimes additional conditions or increases on existing ratings can result in higher compensation brackets even when individual rating increases seem small.
Understanding Combined Rating Formula
The combined rating formula starts with the highest individual rating, then applies each additional rating to remaining capacity. A 50% rating leaves 50% remaining capacity, so a second 30% rating applies to that remaining 50%, not the full 100%.
This system means that multiple smaller ratings often don't significantly increase combined ratings, while one higher rating can have dramatic impact. A single 70% rating provides higher compensation than multiple ratings that combine to 60%.
The compensation brackets create threshold effects where small rating increases can result in significant payment increases.
Combined Rating Examples:
Pyramiding Regulations
VA regulations prevent rating the same disability symptoms under multiple diagnostic codes. Veterans cannot receive separate ratings for "back pain" and "muscle spasms" if they're symptoms of the same underlying condition.
However, pyramiding rules have exceptions. Different symptoms of the same condition can sometimes be rated separately if they cause distinct functional limitations.
Secondary conditions caused by primary disabilities aren't subject to pyramiding restrictions. If a service-connected back condition causes depression, both conditions can be rated separately even though they're related.
The Appeals Modernization System
The Appeals Modernization Act created three distinct pathways for challenging unfavorable VA decisions. Each pathway has different advantages, timelines, and requirements suitable for different situations.
Selecting the appropriate appeals pathway depends on whether new evidence exists, whether the VA made an error in reviewing existing evidence, and timeline considerations.
The appeals process addresses not only overturning denials but also increasing ratings that are too low or addressing decisions that granted service connection but assigned inadequate ratings.
Higher-Level Review
According to the VA, Higher-Level Review provides administrative review by a senior VA employee that can correct errors without requiring new evidence submission. This pathway works best when the VA made clear mistakes in reviewing existing evidence.
A senior reviewer examines the same evidence with fresh eyes to identify mistakes in the original decision. This pathway works best for obvious errors like miscalculating ratings, overlooking key evidence, or misapplying VA regulations.
The major limitation of Higher-Level Review is that veterans cannot submit new evidence. The reviewer only considers evidence that was in the file when the original decision was made.
Supplemental Claims
According to the VA, Supplemental Claims allow veterans to submit new and relevant evidence that wasn't considered in original claims. This pathway essentially provides a fresh start with additional supporting documentation.
New evidence must be "new and relevant"—it can't just be different opinions about the same facts. The evidence must provide information that could reasonably change the outcome.
Supplemental Claims work particularly well when veterans have obtained additional medical evidence, found service records that weren't available during the original claim, or received new medical opinions.
Board of Veterans' Appeals
Board appeals provide the most comprehensive review, with Veterans Law Judges who have extensive experience with complex disability cases. This pathway works best for complicated claims requiring detailed legal and medical analysis.
According to the VA, the Board offers three dockets: Direct Review for cases that don't need additional evidence or hearings, Evidence Submission for cases where veterans want to submit additional evidence, and Hearing Request for cases where veterans want to present their case in person.
Board appeals take the longest time but offer the most thorough review. Veterans Law Judges can consider legal precedents and complex medical issues that regional office reviewers might not fully understand.
Important Considerations for Veterans
Several factors can significantly impact VA claim outcomes. Understanding these elements can help veterans navigate the system more effectively.
Timing Considerations
VA processing follows predictable patterns that create different conditions for various claim types. End-of-fiscal-year processing often moves faster as offices work to clear backlogs, while beginning-of-year processing might be slower as new procedures are implemented.
Examiner workloads fluctuate based on training schedules, leave periods, and administrative priorities.
New VA policies or rating criteria changes create opportunities for veterans whose previous claims were denied under older, more restrictive standards.
Presumptive Conditions
Presumptive conditions represent an important category because the VA presumes service connection based on service location, time period, or specific exposures, eliminating the need to prove that military service caused the condition.
Agent Orange presumptive conditions cover veterans who served in Vietnam, Thailand, and other specified locations. The list of presumptive conditions continues to expand as new research establishes connections between Agent Orange exposure and various diseases.
Burn pit exposure presumptive conditions now cover veterans who served in Iraq, Afghanistan, and other locations where open burn pits were used. Gulf War presumptive conditions cover a range of chronic symptoms affecting veterans who served in the Persian Gulf region.
Regional Office Variations
VA regional offices operate with significant independence, leading to variations in processing times, approval rates, and interpretation of evidence standards.
Some regional offices consistently process claims faster than others due to staffing levels, examiner experience, and administrative efficiency. Processing times vary dramatically between offices.
C&P Examination Considerations
The VA may schedule Compensation & Pension (C&P) examinations to evaluate conditions. Independent medical evaluations and DBQs completed before VA examinations can provide additional clinical documentation.
The VA rates disabilities based on their impact during flare-ups and periods of maximum severity, not during times when symptoms are less severe.
Specific examples recorded in medical documentation can sometimes provide clearer clinical context than general descriptions. Rather than general descriptions of difficulty, specific measurements like "climbing one flight of stairs but needing to rest for several minutes before continuing" offer more precise information.
Documentation of all medications, treatments, and assistive devices demonstrates the extent of medical intervention required to manage conditions.
C&P Examination Documentation:
A veteran preparing for a C&P exam for knee problems documented specific limitations: "Walking about 200 yards on flat ground before experiencing severe pain. Climbing stairs requires using handrails and taking breaks every 5-6 steps. Daily use of a knee brace and prescription pain medication twice daily." In this example, the examiner documented these functional limitations, and the VA assigned a 30% rating rather than the initially proposed 10%.
Medical Documentation Timing
The timing of medical appointments relative to C&P examinations can significantly impact how conditions appear to VA examiners.
Medical appointments scheduled near C&P examination dates result in medical records that reflect current condition severity. Outdated medical records might not accurately represent current functional limitations.
Discussing symptom patterns with medical providers may result in more complete clinical documentation. Many physicians focus on treatment planning rather than disability documentation unless specifically requested.
The timing of new treatments or medications relative to claims can affect how conditions appear. Starting new treatments near the time of evaluation may affect how symptoms appear in clinical notes.
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Veterans seeking medical documentation (whether related to initial, increase, or secondary condition reviews) can explore independent evaluations coordinated through REE Medical.
Veterans can learn more about coordinating independent medical documentation by scheduling a complimentary informational consultation to discuss how REE Medical coordinates connections with qualified healthcare providers.
Final Thoughts
Understanding the VA claims process involves recognizing how medical documentation and evidence standards fit into the overall evaluation. The VA evaluation process places significant emphasis on comprehensive, clearly documented medical evidence.
The VA claims process has evolved significantly, but the fundamental principle remains unchanged: comprehensive, properly documented medical evidence drives VA evaluation outcomes. Whether pursuing first claims or challenging unfavorable decisions, comprehensive medical evidence packages that clearly demonstrate how service-connected conditions impact daily functioning support the VA's evaluation process.
The complexity of the system should not discourage veterans from pursuing the benefits they earned. With proper preparation and quality medical evidence, veterans can better understand the VA claims process and how medical evidence is reviewed in VA evaluations.
DISCLAIMER: REE Medical, LLC is not a Veterans Service Organization (VSO) or a law firm and is not affiliated with the U.S. Veterans Administration ("VA"). Results are not guaranteed, and REE Medical, LLC makes no promises. REE Medical's staff does not provide medical advice or legal advice, and REE Medical is not a law firm. Any information discussed, such as, but not limited to, the likely chance of an increase or service connection, estimated benefit amounts, and potential new ratings, is solely based on past client generalizations and not specific to any one patient. The doctor has the right to reject and/or refuse to complete a Veteran's Disability Benefit Questionnaire if they feel the Veteran is not being truthful. The Veteran's Administration is the only agency that can make a determination regarding whether or not a Veteran will receive an increase in their service-connected disabilities or make a decision on whether or not a disability will be considered service-connected. This business is not sponsored by, or affiliated with, the United States Department of Veterans Affairs, any State Department of Military and Veterans Affairs, or any other federally chartered veterans service organization.
