Expansion of the Decision Ready Claims Initiative
In December of 2017, the Department of Veterans Affairs expanded the Decision Ready Claims (DRC) initiative. With DRC, the VA guarantees a decision within thirty days. When the program launched, it could only be used for claims for increase; now, however, there are many other forms of claims that can be filed through the DRC program.
You can now file for direct and secondary service connection, certain presumptive conditions, and pre-discharge claims. We’ll go through each of these kinds of claims to see what they are and what kinds of exceptions exist, but every claim, no matter what kind, needs a current diagnosis of the condition in order to be granted.
Direct service connection means that a condition was caused by an event, injury, or illness in service. There are a few ways to prove this. One such way is a continuity of symptoms—you began to have problems with, for example, your knee after a fall during service. You can point to evidence of the injury in your Service Treatment Records (STRs) and of continuing knee problems throughout the years since your separation in your VA or private provider records.
Another way to prove direct service connection is to have what is called a nexus statement from a doctor. This is a statement that connects your current condition with an event, injury, or disease in service. It is extremely important that the doctor provides their rationale in this statement; the VA will not grant service connection for a condition that the doctor says was caused by military service if the doctor does not say why he or she believes this to be true.
The following conditions cannot be claimed through DRC: posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), conditions that are on appeal or proposed to be reduced, and conditions that have been denied before.
Secondary service connection is granted for conditions that are caused by service-connected conditions. For example, if a veteran has diabetic retinopathy and is service connected for diabetes, he or she could file for diabetic retinopathy secondary to diabetes. For this type of claim, a veteran should have an opinion statement from a doctor confirming the link between the condition they are claiming and a service-connected condition, or the doctor should write it in the “remarks” section when filling out a Disability Benefits Questionnaire. Remember, in every type of claim, there must be a current diagnosis of the claimed condition.
Presumptive conditions are considered to be incurred in or aggravated by military service, even if there is no evidence of them in service. There are some diseases that are presumptive for anyone who served in the military; you can find these in 38 CFR 3.309(a), which you can look up online. Most of these have to manifest to a compensable degree within a year of separation from active duty service in order to be considered presumptive. However, Hansen’s disease and tuberculosis are considered presumptive if they manifest within three years, multiple sclerosis is considered presumptive if it manifests within seven years, and amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) is considered presumptive regardless of when it manifests.
One of the most common causes of presumptive service-connected conditions is Agent Orange, the herbicide used in Vietnam, the Korean DMZ, and Thai Royal Air Force bases in the Vietnam War Era. The conditions that are recognized to be associated with herbicide exposure can be found by searching the VA website, as can the places and times that the VA recognizes veterans may have been exposed. To get any Agent Orange presumptives connected, a veteran must prove that he or she was in one of these places at a time when Agent Orange was being used. While there are areas outside of Vietnam that are recognized exposure sites, and veterans who served in Vietnamese inland waterways can also show exposure, only veterans who served on the ground in Vietnam can file for service connection for Agent Orange presumptive conditions through DRC, unless their exposure has already been established in another claim.
There are also Gulf War environmental hazards that many veterans were exposed to. For these conditions to be presumptive, they must have manifested either during active military, naval, or air service in the Southwest Asia theater of operations or to a degree of 10% or more by December 31, 2021, AND by history, physical examination, and laboratory tests the conditions cannot by attributed to any known clinical diagnosis. For these conditions and the definition of the Southwest Asia theater of operations, please visit the VA Gulf War Exposures page.
Active duty servicemembers who are less than ninety days from discharge can also file for compensation through the DRC program now. Their claims must fall into the same categories as above, and there are a few other exclusions. The claim cannot require a character of discharge determination. The servicemember cannot be enrolled in IDES, awaiting discharge while hospitalized in a VA or military treatment facility, or pregnant. The claim itself cannot be for Gulf War Undiagnosed Illness, PTSD, or TBI; aggravation of a condition that preexisted the military; or previously denied conditions.
The Decision Ready Claims expansion has made it possible for many veterans to file claims and receive decisions quickly, but not everything is DRC eligible. Additionally, DRC claims must be filed through a Veterans Service Organization, such as BVA. If you would like to file a DRC claim, or would like to see if your claim is eligible for this program, please call the BVA Field Service Office at844-250-5180.