VA Claim Helper

The “New Agent” Dilemma

Congratulations, you passed the OGC accreditation exam. Now you have a problem.

You need a system to track deadlines, manage evidence, and file forms. But when you look at the software market, you typically see two bad options:

What a VA Claims CRM *Must* Have

If you are a solo agent or a small firm, do not pay for features you won’t use. Focus on these four “Must-Haves”:

• ✅ 1. Native VA Form Automation
  Does it auto-fill a VA Form 21-22a? If it doesn’t, it’s not a VA CRM; it’s just a database. You shouldn’t be typing addresses twice.
• ✅ 2. Deadline Guards
  Missing a Notice of Disagreement (NOD) deadline is malpractice. Your software must automatically calculate the 1-year appeal window from the Rating Decision date.
• ✅ 3. Cloud Access
  You need to work from anywhere. Avoid any software that requires a “server installation” or a VPN just to log in.
• ✅ 4. Electronic Submission
  USPS is too slow for your claims. VCH allows you to send forms directly to the VA as soon as you are done editing them.

Frequently Asked Questions

Do I need a CRM immediately?
You can survive on Excel for your first 5 clients. But once you hit 10 clients, the “deadline math” becomes dangerous. A Notice of Disagreement deadline missed by one day loses the veteran their backpay forever. Don’t risk it.

Is VCH compatible with Mac?
Yes. Unlike some legacy software that requires Windows, VCH runs entirely in your web browser (Chrome, Safari, Edge).

Can I export my data later?
Absolutely. Your client data belongs to you. We offer full export capabilities so you are never “locked in.”

Everything you need to pass the OGC exam, master 38 CFR, and launch your practice.

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The “Scary” Truth About the Exam

The VA Accredited Claims Agent exam is not a formality. It is a rigorous test of legal knowledge with a pass rate that historically hovers around 20-40%.

The test has evolved. It is typically a 40-question, closed-book exam. You can no longer rely on flipping through the M21-1 manual during the test. You need to know the regulations cold.

What is Actually on the Exam?

You cannot pass without deep knowledge of these three specific sections of the 38 CFR (Code of Federal Regulations):

1. 38 CFR Part 3: Adjudication

This is the core of the claims process. You must understand:

• Standard of Proof: The “Benefit of the Doubt” rule.
• Service Connection: Direct, Secondary, Aggravation, and Presumptive.
• Effective Dates: The single most complex topic. When does the money start? (Date of claim vs. Date entitlement arose).

2. 38 CFR Part 4: Schedule for Rating Disabilities

You don’t need to memorize every percentage for every disease, but you must know:

• The “Bilateral Factor”: How disabilities on both sides of the body boost a rating.
• Combined Ratings: How “VA Math” works (e.g., 50% + 50% = 75%, rounding to 80%).
• Pyramiding: The prohibition against rating the same symptom twice.

3. 38 CFR Part 14: Legal Services & Ethics

The OGC (Office of General Counsel) cares deeply about ethics. Know exactly what you can and cannot charge fees for, and when a fee agreement is valid.

Sample Quiz Question: Effective Dates

Frequently Asked Questions

Is the VA Claims Agent exam open book?
Generally, no. The modern online 40-question format is closed book. You must memorize the core concepts.

What is the passing score?
You typically need a 75% (28-30 out of 40 questions) to pass.

How long does the background check take?
The OGC background check (VA Form 21a) can take 6–12 months. Use this time to study!

VA Form 21-8940, known officially as the “Veteran’s Application for Increased Compensation Based on Unemployability,” is the critical document used to apply for Total Disability Individual Unemployability (TDIU). This form allows veterans to formally request to be paid at the 100% disability rate, even if their combined scheduler rating is less than 100%, because their service-connected disabilities prevent them from securing substantially gainful employment. It bridges the gap between a veteran’s medical rating and their actual economic reality, providing a pathway to maximum compensation for those unable to work.

When to Use This Form

• Applying for Initial TDIU: When a veteran believes their service-connected disabilities render them unable to work, regardless of whether they meet the standard percentage requirements (60% for a single disability or 70% combined).
• Responding to a VA Invitation: When the VA reviews a file and sees evidence that a disability interferes with employment, they may send this form and “invite” the veteran to file for unemployability.
• Documenting Employment History: To provide a detailed five-year employment history (and education history) required to substantiate how specific disabilities caused job loss or reduced earning capacity.
• Protected Work Environments: When a veteran is technically employed but works in a specialized or “protected” environment where accommodations are made that would not exist in a competitive job market.

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VA Form 21-4142 is officially known as the “Authorization to Disclose Information to the Department of Veterans Affairs.” In plain English, this document acts as a permission slip that allows the VA to request your private medical records from non-VA doctors and hospitals on your behalf. Without this signed authorization, the VA cannot legally access the outside evidence needed to support your disability claim, often leading to delays or decisions made on incomplete information.

When to Use VA Form 21-4142

• Requesting Private Treatment Records: Use this when you have received care from a private physician, specialist, or civilian hospital and want the VA to retrieve those records for your claim file.
• Supporting Claims for Increase: If your service-connected disability has worsened and the medical proof of that deterioration is held by a private doctor rather than a VA facility.
• Reopening Claims with New Evidence: When filing a Supplemental Claim based on new medical evidence that originated outside of the military or VA healthcare systems.
• Authorizing Social Security Record Release: When you need the VA to access your records held by the Social Security Administration (SSA), often required for Individual Unemployability (TDIU) claims.

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VA Form 21-0958, officially known as the Notice of Disagreement (NOD), is the document historically used to formally contest a rating decision within the VA’s Legacy Appeals system. This form allows veterans and their representatives to clearly identify specific areas of disagreement regarding a claim denial, disability percentage, or effective date. It serves as the vital first step in the traditional appellate process, signaling to the Department of Veterans Affairs that the claimant intends to dispute their findings.

When to Use This Form

• Contesting Legacy Decisions: Use this form specifically for appeals regarding rating decisions processed under the Legacy Appeals system (generally prior to February 19, 2019).
• Specifying Issues of Disagreement: This document is required to itemize exactly which determinations are being disputed, such as a denial of service connection or an unsatisfactory disability evaluation.
• Responding to a Statement of the Case (SOC): In legacy cases, this form may be referenced when perfecting an appeal after receiving a Statement of the Case.
• Important Regulatory Note: For the vast majority of rating decisions issued on or after February 19, 2019, this form has been replaced by the Appeals Modernization Act (AMA) forms. Representatives should verify if VA Forms 20-0995 (Supplemental Claim), 20-0996 (Higher-Level Review), or 10182 (Board Appeal) are required instead.

VA Form 21P-534-EZ is the streamlined “Application for Dependency and Indemnity Compensation (DIC), Death Pension, and/or Accrued Benefits.” In plain English, this is the primary form used by surviving spouses or dependent children to apply for financial benefits after a Veteran passes away. The “EZ” designation means this form is designed for fully developed claims—where you submit all necessary supporting evidence (like marriage certificates or death certificates) upfront—allowing the VA to process the claim and grant benefits significantly faster than the standard process.

When to Use This Form

This form is critical for survivors looking to secure monthly tax-free payments or income-based support. You should file VA Form 21P-534-EZ in the following scenarios:

• Claiming Dependency and Indemnity Compensation (DIC): When a surviving spouse or child believes the Veteran’s death was caused by a service-connected disability.
• Applying for Survivors Pension: When a low-income surviving spouse or unmarried child needs financial assistance, provided the deceased Veteran served during a specific wartime period.
• Requesting Accrued Benefits: To claim benefits that were due to the Veteran at the time of their death but had not yet been paid (for example, a pending disability rating decision that was finalized after death).
• Dual Applications: When a survivor is unsure if they qualify for DIC or Pension and wants the VA to evaluate eligibility for both benefit streams simultaneously.

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VA Form 21-4138-ARE, officially known as the Statement in Support of Claim, acts as the “Swiss Army Knife” of VA disability paperwork. While most VA forms restrict you to checkboxes and short lines, this document provides a blank canvas for veterans to submit sworn testimony, clarify specific details, or offer personal context that doesn’t fit elsewhere in the file. It is the primary tool used to bridge gaps in medical evidence by allowing you to speak directly to the rating specialist about the history and severity of your condition.

When to Use This Form

• Submitting Lay Evidence: Use this form to describe the frequency, severity, and duration of your symptoms in your own words, especially if medical records are sparse.
• Clarifying Discrepancies: If there are conflicting dates or details in your service treatment records, this form allows you to provide a timeline and explanation to clear up confusion.
• Responding to Development Letters: When the VA sends a letter requesting additional information without providing a specific form for the reply, the 21-4138 is the standard way to submit that data.
• Updating Personal Circumstances: It is frequently used to report changes in dependency status, address updates, or to formally request the withdrawal of a specific contention within a claim.

The Fee Agreement is the foundational contract that establishes the financial relationship between a veteran and their accredited attorney or claims agent. This document is essential because it authorizes the Department of Veterans Affairs to recognize your right to represent the veteran and, crucially, permits the VA to withhold your fee directly from the veteran’s retroactive benefits. By filing this agreement, you ensure that payment terms are transparent and that the mechanism for direct payment is triggered immediately upon a favorable rating decision.

When to Use This Document

• Establishing New Representation: File this immediately when a veteran retains your services to handle an appeal or claim to lock in your effective date for fee eligibility.
• Securing Direct Payment: Use this agreement to officially request that the VA withhold your contingency fee (typically 20%) from the veteran’s past-due benefits and pay you directly.
• Filing a Notice of Disagreement or Appeal: Submit this alongside decision review forms (such as the 20-0995 or 10182) to ensure the VA applies the fee agreement to any resulting backpay awards.
• Updating Fee Terms: Use a new agreement if the scope of representation changes or if you renegotiate the fee structure with an existing client.

VA Form 20-10208, formally titled “Document Evidence Submission,” acts as a standardized cover sheet for veterans and representatives submitting supporting documents to the VA. Before this form was introduced, evidence was often mailed with unstructured cover letters, leading to processing delays or lost files.

Think of this form as a “Table of Contents” for your claim. By listing exactly what you are submitting—whether it’s medical records, marriage certificates, or financial data—you help the VA’s intake centers categorize and digitize your evidence faster. Using this form ensures that every page you send gets routed to the correct department and associated with the right veteran’s file immediately.

When to Use This Form

This form is designed to accompany evidence submitted after an initial claim has already been established. You should include it in the following scenarios:

• Submitting Private Medical Records: When you are mailing or faxing independent medical opinions (IMOs) or private treatment records that the VA did not request but are vital to your case.
• Providing Lay Evidence: When you are submitting multiple “Buddy Statements” (VA Form 21-10210) or personal statements in bulk and need a transmittal sheet to organize them.
• Responding to a Development Letter: When the VA sends a letter requesting specific items (like a birth certificate or divorce decree) to verify dependency status.
• Supporting a Supplemental Claim: When you are submitting “new and relevant” evidence to reopen a previously denied claim and want to ensure the intake team identifies the new evidence correctly.

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VA Form 20-0996 is the official document used to request a Higher-Level Review (HLR), a specific type of appeal designed for veterans who disagree with a VA decision but do not need to submit new evidence. This form effectively asks a senior claims adjudicator to re-examine the evidence already in your file to catch clear and unmistakable errors or differences of opinion. It is often the fastest appeal lane available, intended to correct mistakes regarding rating percentages, service connections, or effective dates without the extended wait times associated with Board appeals.

When to Use This Form

• Disputing a Low Rating: You believe the assigned disability percentage is incorrect based on the severity of symptoms documented in your existing medical records.
• Challenging Service Connection Denials: The VA denied service connection, but you believe the evidence already provided clearly establishes a link to service.
• Correcting Effective Dates: The VA granted benefits but assigned an incorrect effective date, resulting in less retroactive pay than you are entitled to.
• No New Evidence Needed: You are confident the current file supports your claim and do not intend to submit additional medical opinions or lay statements (which would require a Supplemental Claim instead).