The Simpl Man

What it is: An Intent to File is you telling VA, "I'm going to file a claim, hold my place in line." It's not the claim itself. It just locks in a date.

Why it matters: If VA gets your complete claim within 1 year of receiving your Intent to File, VA treats the claim as filed on the Intent to File date. That can mean months of extra back pay. (38 CFR 3.155(b))

Deadline: You have 1 year from the date VA receives the Intent to File to send in the complete claim. Miss it and the ITF simply expires; you'd start over with a new one. (38 CFR 3.155(b)(4))

How to file: Three ways: start an application online and save it, send VA Form 21-0966 (Intent to File a Claim), or call or visit VA and have a designated VA employee record it. It only needs to say the general benefit, like compensation or pension. You don't have to list your conditions yet. (38 CFR 3.155(b)(1)-(2))

Evidence: None needed. This is a placeholder, not a claim.

Heads up: your start date: An Intent to File won't start a Supplemental Claim; it only works for a new claim. (38 CFR 3.155; 38 CFR 3.2501(d)) But here's the good news: the date your ITF locked in doesn't vanish if VA says no. Keep the chain unbroken and a later win reaches all the way back to it.

Keep the chain unbroken: After each decision, file your next step in time: a Supplemental Claim, Higher-Level Review or Board appeal within 1 year of a VA decision, a Supplemental Claim within 1 year of a Board or Veterans Court decision, or a Veterans Court appeal within 120 days of a Board decision. Do that, and when you finally win, your effective date (the date your pay starts counting from) goes back to your original claim, which is your ITF date if you used one. (38 U.S.C. 5110(a)(2); 38 CFR 3.2500(h)(1); 38 CFR 3.155(b))

Break the chain, lose the date: Let more than a year go by after a decision and the chain breaks. A Supplemental Claim filed late can pay no earlier than the date VA receives it. (38 CFR 3.2500(h)(2)) That can cost you months or years of back pay. Simpl Man opinion: put the deadline on the fridge.

Exceptions that can go even earlier: Just got out? If VA receives your claim within 1 year of your discharge, pay can start the day after you left service. (38 U.S.C. 5110(b)(1)) Liberalizing laws (new laws or rules that make it easier to qualify): when a new law or VA rule makes you eligible, like the PACT Act's new presumptive conditions (conditions VA assumes were caused by your service, so you don't have to prove the link), pay can start on the law's effective date if you file within 1 year of it. File later and you can still get up to 1 year of back pay before your claim date. You must have qualified the whole time. (38 U.S.C. 5110(g); 38 CFR 3.114(a)) The PACT Act took effect August 10, 2022, and some of its conditions phased in on later dates. (Pub. L. 117-168) Nehmer (Agent Orange): Vietnam veterans covered by the Nehmer class action (a court case over Agent Orange claims) who were denied for, or had a pending claim for, a disease later added to the Agent Orange list can get an effective date as far back as that original claim, even decades ago. (38 U.S.C. 1116; 38 CFR 3.816(c)) These are tricky, so this is a good time to bring in a VSO, accredited agent or attorney.

Who should file: Self. It takes five minutes. A VSO, agent or attorney can do it too, but only if you've already appointed them as your representative, which is a power of attorney (the form that lets them act on your behalf): VA Form 21-22 for a VSO, or VA Form 21-22a for an agent or attorney. (38 CFR 3.155(b)(5))

What every winning claim needs: Think of your claim like a three-legged stool. Kick out any one leg and you're sitting on the floor. To win service connection (VA agreeing your condition is tied to your service), you need all three: (1) a current disability, (2) something that happened in service, and (3) a medical link between the two. (38 U.S.C. 1110, 1131; 38 CFR 3.303; Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004))

Pillar 1: A current disability: Usually that means a current diagnosis. You need a disability now, not just a bad memory of one. Good news: it counts if you had it when you filed or at any time while your claim was pending, even if it got better before VA decided. (M21-1, Part V, Subpart ii, 2.A.1.b; McClain v. Nicholson, 21 Vet. App. 319 (2007)) And what about pain with no diagnosis? Pain alone can count as a disability if it really limits what you can do, like standing, lifting or working. Just saying "it hurts" isn't enough; you have to show how it gets in your way. (Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018))

Pillar 2: An in-service event, injury or disease: Something has to have happened while you were in uniform: an injury, an illness, an exposure, or an event. Your service records, medical records and buddy statements (written statements from people who saw it) all help prove it. A quick word on terms: folks often call this pillar "service connection," but in VA-speak, service connection is the prize you win when all three pillars are standing. (38 CFR 3.303(a))

Shortcuts: presumptions: Sometimes the law does the heavy lifting for you. With a presumption, VA assumes the in-service event and the link, so pillars 2 and 3 are filled in for you. Examples: Agent Orange and PACT Act toxic-exposure conditions, and certain chronic diseases, like arthritis or high blood pressure, that show up at 10 percent or more within 1 year of leaving service (generally if you served 90 days or more). You still need Pillar 1. (38 U.S.C. 1112, 1116, 1120; 38 CFR 3.307, 3.309)

Pillar 3: The nexus: Nexus is just a fancy word for link. It's usually a medical opinion saying your current condition is "at least as likely as not" caused by what happened in service. That means a 50 percent or better chance, so a tie goes to the veteran. When the evidence is about evenly balanced, VA must give you the benefit of the doubt. (38 U.S.C. 5107(b); 38 CFR 3.102; M21-1, Part V, Subpart ii, 1.A.1.j; Alemany v. Brown, 9 Vet. App. 518 (1996))

Secondary conditions: Got a problem caused by a condition VA already pays you for, like a bad knee that wrecked your hip? That's a secondary condition. Here the nexus links the new condition to your service-connected one instead of to service. It counts if the service-connected condition caused it, or made it worse (aggravated it). (38 CFR 3.310)

Simpl Man opinion: Most denials I see come down to a wobbly third leg. Get a solid, well-reasoned medical opinion and your stool stands a lot steadier.

What it is: Your first claim for a benefit, or a claim for a new condition. For disability compensation, that's VA Form 21-526EZ (Application for Disability Compensation).

Deadline: None. There is no deadline for filing an initial claim, but your pay generally can't start before VA receives it (or your Intent to File date). One big exception: file within 1 year of leaving service and pay can start the day after discharge. (38 U.S.C. 5110(a)(1), (b)(1)) The sooner, the better.

Evidence: Send everything that helps: service treatment records, private and VA medical records, buddy statements, and your own statement. VA also has a duty to assist (a legal duty to help you get evidence): it must make reasonable efforts to get records you identify, and, when needed, give you a medical exam. (38 U.S.C. 5103A; 38 CFR 3.159)

Who should file: Self or a VSO. VSOs are free. Here's the part folks don't know: accredited agents and attorneys are not allowed to charge you for help before VA issues its first decision on your claim. (38 U.S.C. 5904(c)(1); 38 CFR 14.636(c)) If anyone asks for money up front to file your initial claim, that's a red flag. Walk away, and report them to VA's Office of General Counsel, the office that accredits representatives.

What it is: VA said no, and you've got new and relevant evidence that wasn't in front of them before. A Supplemental Claim (VA Form 20-0995) asks VA to decide the issue again with that evidence. (38 U.S.C. 5108; 38 CFR 3.2501; M21-1, Part X, Subpart ii, 2.A)

Deadline: You can file one any time after a decision. But if you file within 1 year of the decision, you keep your original effective date, which protects your back pay. File after the year is up and your effective date can be no earlier than the date VA gets the Supplemental Claim. (38 U.S.C. 5110(a)(2); 38 CFR 3.2500(a)(2), (h))

Evidence: "New" means VA didn't have it before. "Relevant" means it tends to prove or disprove something that matters in your claim, including a new theory of why you should win. If it isn't both, VA will say there's not enough to look at again. (38 CFR 3.2501(a))

Duty to assist: Yes. VA's duty to assist applies, so VA can help gather the new evidence you identify. (38 CFR 3.2501(c); M21-1, Part X, Subpart ii, 2.A.1.d)

Who should file: Self or a VSO for most. An accredited agent or attorney can charge a fee here, because VA has already issued its first decision. Simpl Man opinion: worth it if the case is complicated or there's a lot of back pay on the line. (38 U.S.C. 5904(c)(1); 38 CFR 14.636(c))

What it is: A more experienced VA reviewer who wasn't part of the first decision takes a fresh look at the same file to see if it got it wrong. Think of it as "Hey, can a second set of eyes check this?" On VA Form 20-0996. (38 U.S.C. 5104B; 38 CFR 3.2601)

Deadline: 1 year from the date on your decision letter. (38 U.S.C. 5104B(b)(1); 38 CFR 3.2500(a)(1))

Evidence: None. No new evidence is allowed. The reviewer looks only at the record VA had when it decided. (38 CFR 3.2601(f))

Informal conference: You can ask for one informal conference, a phone call where you or your representative point out the errors of fact or law. You must ask for it on the same form, when you request the HLR, and it's not a chance to add evidence. (38 CFR 3.2601(h); M21-5, Chapter 5)

Duty to assist: The reviewer doesn't gather new evidence, but does check whether VA failed its duty to assist the first time. If so, and they can't grant the full benefit, they send it back to be fixed. (38 CFR 3.2601(g))

Limits: You can request an HLR after an initial or Supplemental Claim decision, but not after a previous HLR or a Board decision on the same issue. (38 CFR 3.2500(c))

Who should file: Self, VSO, agent or attorney. Simpl Man opinion: good choice when the problem is a clear mistake in how VA read your evidence or applied a rule, not missing evidence.

What this covers: These aren't your everyday review lanes, but they're good to know about. Some are true legal remedies; others just get somebody's attention.

Clear and Unmistakable Error (CUE): If a final VA decision had an obvious, outcome-changing error of fact or law based on the record and the law at the time, you can ask VA to revise it. There's no deadline. You can file any time. (38 U.S.C. 5109A; 38 CFR 3.105(a)) For a Board decision, it's filed as a CUE motion (a formal written request) directly with the Board. (38 U.S.C. 7111; 38 CFR 20.1400-20.1411) The bar is very high. A disagreement over how the evidence was weighed, a later change in diagnosis, or VA's failure to help gather evidence is not CUE. (38 CFR 20.1403(d))

Board reconsideration: You can ask the Board to reconsider its own decision for an obvious error of fact or law, newly found service department records, or fraud. The rule sets no deadline. (38 CFR 20.1001) Court deadline tip: if the Board gets your reconsideration motion within the 120 days you have to appeal to the Veterans Court, the clock resets, and you get a fresh 120 days from the date the Board mails its denial. (Rosler v. Derwinski, 1 Vet. App. 241 (1991)) Simpl Man opinion: don't play it close; talk to an attorney before you count on that.

Board vacatur: The Board can vacate, or wipe out, its own decision if you were denied due process (a fair shake on the procedure), such as being denied a hearing you asked for or your right to a representative. (38 CFR 20.1000)

Congressional inquiry: Your U.S. Representative or Senator's office can ask VA about your case. It's not an appeal and it doesn't change the law or extend any deadline, but it can shake loose a stuck claim. Free, and you can do it yourself.

VA Office of Inspector General (OIG): The OIG is VA's independent watchdog. Its hotline takes complaints about possible illegal activity or rule-breaking, fraud, waste and abuse, and gross mismanagement in VA. It won't decide your claim or change your rating. Use it to report wrongdoing, not to appeal.

Who should file: CUE and Board motions: Simpl Man opinion, these are technical, so a VSO, accredited agent or attorney is worth it. Congressional inquiries and OIG reports: Self.

What it is: An appeal to a Veterans Law Judge at the Board of Veterans' Appeals in Washington, D.C. You file VA Form 10182, the Notice of Disagreement (the form that says "I disagree, and I want the Board to look at it"), directly with the Board, not with your regional office. (38 U.S.C. 7105; 38 CFR 20.202, 20.203(a))

Deadline: 1 year from the date on the decision letter. You can ask the Board in writing for more time for good cause, but don't count on it. (38 U.S.C. 7105(b)(1); 38 CFR 20.203(b)-(c))

Pick your docket: A docket is just the Board's waiting line, and there are three of them. You must choose one. (38 CFR 20.202(b))

1. Direct review: The judge looks only at what VA had when it decided. No new evidence, no hearing. Simpl Man opinion: usually the fastest lane.

2. Evidence submission: You can send new evidence with your Notice of Disagreement or within 90 days after the Board receives it. No hearing. (38 CFR 20.303)

3. Hearing: You talk to a Veterans Law Judge in person in Washington, D.C., by video from a VA facility, or virtually from a location you choose. You can add evidence at the hearing and within 90 days after it. (38 U.S.C. 7107(c); 38 CFR 20.302, 20.702) Simpl Man opinion: usually the longest wait.

Duty to assist: The Board doesn't go out and develop new evidence itself. If VA missed its duty to assist before deciding, and the Board can't grant the full benefit, it sends the case back (a remand) to VA to fix it. (38 CFR 20.802(a))

Who should file: Simpl Man opinion: a VSO, accredited agent or attorney is a good idea from here on. Agents and attorneys can charge at this stage, and the docket choice matters.

What it is: Now you've left VA. The Veterans Court (its official initials are CAVC) is an independent federal court that reviews Board decisions. VA is the other side of the case.

Deadline: 120 days from the date the Board's decision was issued. File your Notice of Appeal with the Court, not with VA. (38 U.S.C. 7266(a))

Filing fee: $50, paid with the Notice of Appeal or within 14 days. If paying it would be a financial hardship, you can ask the Court to waive it. (U.S. Court of Appeals for Veterans Claims Rules 3(f), 24)

Evidence: No new evidence. The Court reviews the record that was before VA and the Board. (38 U.S.C. 7252(b)) It looks for legal errors and for factual findings that are clearly wrong. (38 U.S.C. 7261)

Fees: the Equal Access to Justice Act (EAJA): Here's the part that surprises folks. If you win at the Veterans Court, or get a remand (the case sent back to the Board to be done right), and VA's position wasn't "substantially justified" (meaning VA didn't have a reasonable basis in law and fact for what it did), the government pays your attorney fees under the Equal Access to Justice Act (EAJA). Your attorney applies for those fees within 30 days after the judgment becomes final. You qualify if your net worth was $2 million or less when you filed. (28 U.S.C. 2412(d); Veterans Court Rule 39)

If you lose: You don't pay VA's or the government's lawyers, and the Court's rules don't charge a losing veteran for VA's costs. Your out-of-pocket is usually just the $50 filing fee, which can be waived. Simpl Man opinion: most Veterans Court lawyers work for the EAJA fee only, so a loss usually costs you nothing more. Check your fee agreement to be sure.

Who should file: An attorney, or a non-attorney practitioner admitted to practice before the Court. Many veterans' law attorneys take Veterans Court cases at no cost to you because of the Equal Access to Justice Act (EAJA), and the Veterans Consortium Pro Bono Program offers free help to those who qualify. You can represent yourself, but Simpl Man opinion: don't, if you can help it.

What it is: Appeals from Veterans Court decisions. This court only looks at questions of law (what the rules mean, not what happened in your case), such as what a statute or regulation means or whether it's valid. It generally can't review facts or how a law was applied to the facts of your case. Constitutional issues are the exception. (38 U.S.C. 7292(a), (d)(2))

Deadline: 60 days after the Veterans Court's judgment. The law borrows the rule for appeals from district courts, and because the United States is a party, that's 60 days. The Notice of Appeal is filed with the Veterans Court. (38 U.S.C. 7292(a); Fed. R. App. P. 4(a)(1)(B))

Evidence: None. Legal argument on the record only.

Who should file: An attorney admitted to the Federal Circuit. Equal Access to Justice Act (EAJA) fees, paid by the government, may be available here too. (28 U.S.C. 2412(d))

What it is: The last stop. You ask the Supreme Court to hear your case by filing a petition for a writ of certiorari. After that, it's all Greek to me. That's Latin for asking the Supreme Court to take your case; they agree to hear only about 1 to 2 percent of requests (roughly 100 to 150 out of more than 7,000 a year). The cases they take usually matter nationally or settle disagreements between federal appeals courts.

Deadline: 90 days after the Federal Circuit's judgment. A Justice can extend that by up to 60 days for good cause. (28 U.S.C. 2101(c); Supreme Court Rule 13)

Evidence: None. Legal question only.

Who should file: An attorney admitted to the Supreme Court bar. Simpl Man opinion: if you've gotten this far, you already have one.

Inside VA: Initial claims, Supplemental Claims, HLRs and Board appeals are all VA reviewing itself. VA is supposed to be veteran-friendly: it has a duty to assist while it's gathering evidence on your claim, and if the evidence is about evenly balanced, you get the benefit of the doubt. (38 U.S.C. 5103A, 5107(b))

In the courts: At the Veterans Court, the Federal Circuit and the Supreme Court, it's a lawsuit against VA. No new evidence, no duty to assist, and the judges are checking for legal error, not re-deciding your claim from scratch. Often the win is a remand: the case goes back to the Board to be done right.

Law vs. the manual: Here's the pecking order. Statutes, the U.S. Code (38 U.S.C.), are law passed by Congress. Regulations (38 CFR) are rules VA writes under that law, and they bind VA. VA's procedures manual, the M21-1, is VA's instructions to its own claim processors. Regional office raters follow it closely, but the Board is not bound by it. (38 CFR 20.105) It's VA's playbook, not the law. So if the manual and the law disagree, the law wins. Cite the statute and regulation first, and the M21-1 only as backup.

Self: Free. Fine for an Intent to File, simple initial claims, and many Supplemental Claims and HLRs.

VSO (Veterans Service Organization): Free, always. Accredited representatives from groups like the DAV, VFW and American Legion, and many state and county veterans offices. VSOs are not allowed to charge you. You appoint one on VA Form 21-22. (38 CFR 14.636(b))

VA-accredited claims agent: Not a lawyer, but VA has tested and accredited them. Can charge a fee, but only after VA's first decision on your claim. You appoint one on VA Form 21-22a. (38 U.S.C. 5904(c)(1); 38 CFR 14.629(b), 14.636(c))

Accredited attorney: Same fee rule at VA as agents, also appointed on VA Form 21-22a. Usually the right pick at the federal courts, where Equal Access to Justice Act (EAJA) fees, paid by the government, often pay them instead of you.

Check before you sign: Look up anyone on VA's accreditation search before you sign a power of attorney or fee agreement. Simpl Man opinion: if they aren't on that list, they shouldn't be anywhere near your claim.