My post about the “surprise” some veterans had when they didn’t find their cost of living in their January 1st payment reminded me that I hadn’t discussed how the VA determines the effective date of the claim. This subject can be a little confusing. I’ll do my best to help everyone understand.
The regulation covering the effective date can be found in Title 38 Code of Federal Regulations (CFR) § 3.400. (For those who are new to my blog, the “§” is a symbol meaning, “section”.) If you would like to read the regulation, please click on the following link: http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=c0bbf2f94f405b4fae31d00977b2579b&rgn=div8&view=text&node=38:220.127.116.11.18.104.22.168&idno=38.
To determine the effective date, in general, there are two (2) criteria that must be met. One criterion is the date the entitlement arose. So what does that mean? I like to use the example of almost any medical condition. Let’s use Diabetes Mellitus, for this example today. When a patient is diagnosed as a diabetic, if the veteran meets all the other requirements for service-connecting that condition. The date of the diagnosis is the date the entitlement arose. I know one veteran, very recently, was really upset because the VA would not service-connect his condition. When I reviewed his medical report, the report he submitted to the VA Regional Office, his physician stated he was a “pre diabetic.” In this instance, the veteran is not a diabetic. He had the symptoms but not the disease. The same principle is used for the other conditions. Just remember the date of the official diagnosis is the date the entitlement arose.
The other criterion is the date the claim was sought. Ok, what does that mean? A better question would be, “How do I seek a benefit?” A veteran seeks a benefit by asking for the benefit. The veteran needs to ask for the benefit in writing. The request can be given to their VSO or they can give it directly to the VA. I always recommend the veteran submit their claim to their VSO. The VSO typically ensures everything is submitted properly which can greatly speed-up the claim process.
Quite often veterans will ask me for a special form they should use. My first response is usually, “NO. The VA does not require any special forms.” In all reality, the veteran can use a piece of toilet paper and a crayon. The veteran just needs to make their intent to file the claim clear. Veterans however usually like forms with form numbers. I admit, being an ex-Navy guy, I like pieces of paper with a form number too. The form used for almost any application is VA Form 21-4138 (Statement In Support Of Claim). Here is a link to the form: http://www.vba.va.gov/pubs/forms/VBA-21-4138-ARE.pdf. Other forms may be more specific and may speed the processing of a claim. Veterans should ask their VSO or the VA for any specific forms.
Now, once the date the entitlement arose AND the date the claim was sought are known, according to Title 38 CFR § 3.400, the later date will be the effective date of the claim. Most often, a veteran will develop a medical condition before they submit a request for a claim. In presumptive cases like the medical conditions caused by exposure to herbicides like Agent Orange, the veterans may have submitted a claim and been denied. Later the veteran discovers the VA issued a new ruling and now their condition is service-connectable. That recently was the case with veterans who have Ischemic Heart Disease (IHD). There were many veterans who felt their heart condition was related to Agent Orange exposure. If they submitted a claim before October 2010, the claim would have been denied. With the addition of IHD as a presumptive condition the VA has reconsidered many of those claims.
Now that we know the effective date of the claim, the next thing to consider is the payment date. Again, according to Title 38 CFR § 3.400, the payment month is the month following the effective date of claim. I know it is sounding a little confusing again. Here is an example. Lets say I went to my mailbox today and found a rating decision that established a new service-connected effective July 10 2010. The pay month would be the following month; August. I would then receive my first check on September 1, 2010. But since that was the past, I would receive a retro-payment for September 1, October 1, November 1, December 1, and January 1. My regular monthly payment would start February 1.
I hope I explained this well. I do realize how confusing this is. If you have a question, please don’t hesitate to send me your questions.