Understanding the Stages Behind Your Claim

 

Your claims process is broken down into eight separate stages. This is an overview of how a typical claims process with the VA typically unfolds.

 

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Step 1: Claim Received

This is the official starting point.

At this stage, the VA has successfully received your claim submission - whether it was filed online, by mail, or through VA QuickSubmit. No review has happened yet; the VA is simply acknowledging that your claim exists in their system.

What’s happening behind the scenes:

• Your claim is logged into the VA system.
• A claim number is assigned.
• The VA confirms the type of claim you submitted (new, supplemental, increase, etc.).

What you should do:

• Confirm your claim appears in VA.gov.
• Save your submission confirmation.
• Do not expect immediate updates - this step can move quickly or take several days.

 

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Step 2: Initial Review

During the initial review, the VA ensures your claim is complete enough to move forward. This is not a medical or legal evaluation - rather, it’s an administrative check to confirm the VA has the basic information needed to begin processing.

What the VA is reviewing:

• Your claim form is complete.
• All claimed conditions are listed clearly.
• The information required to identify you and your claim is present.
• Eligibility based on your claim type.

If something essential is missing, the VA may request clarification before moving on.

What you should do:

• Closely monitor your email inbox for VA correspondence.
• Respond promptly if the VA requests basic information. Make sure you notify the VetClaims team if you're unsure about what the VA is requesting.
• Avoid submitting unnecessary documents unless requested, as this could generate additional delays on the VA's end.

 

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Step 3: Evidence Gathering, Review, and Decision

This is the longest and most important stage, where most claims tend to spend the majority of their time. At this step, the VA gathers and evaluates evidence needed to decide your claim. This includes medical records, service records, lay statements, and C&P exams.

What happens during this stage:

• The VA requests medical records (VA and sometimes private).
• C&P exams are scheduled and completed.
• Medical opinions may be requested or clarified.
• Evidence is reviewed as it comes in.

This step is not linear. Your claim may move forward and backward within this step multiple times as new evidence is received or clarification is needed.

Why claims stall here:

• Waiting on exam results.
• Examiner clarification requests.
• Missed or rescheduled C&P exams.
• Additional evidence requests.

What you should do:

• Attend all C&P exams.
• Upload requested evidence promptly.
• Monitor your email, regular mail, and your VA.gov account.
• Be patient! Delays here are common and normal.

 

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Step 4: Evidence Review

At this point, the VA believes it has enough evidence to make a decision and is reviewing everything as a complete file.

This step usually means:

• All exams are complete.
• No additional evidence is currently needed.

However, if a rater identifies gaps or inconsistencies, your claim can be sent back to Step 3.

What the VA is doing in this stage:

• Reviewing medical opinions.
• Verifying diagnoses and service connection.
• Ensuring evidence meets VA standards.

What you should do:

• Continue monitoring for updates (email, postal mail, your VA.gov account).
• Avoid submitting new evidence unless instructed.

 

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Step 5: Rating Decision

This is where the VA determines whether each condition is approved, denied, deferred, or rated at a certain percentage.

A VA rater applies:

• The Schedule for Rating Disabilities.
• Relevant sections of 38 CFR.
• Medical findings and functional impact.

Always remember that each claimed condition is evaluated independently.

Important to understand:

• Some conditions may be decided while others are deferred.
• A deferral sends part of your claim back to Step 3.
• A claim is not fully complete until all conditions have decisions.

 

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Step 6: Preparing Decision Letter

Once decisions are made, the VA prepares your official decision letter. This decision letter is a  document that explains:

• What was approved, denied, or deferred.
• The evidence used.
• The reasoning behind each decision.
• The laws and regulations applied.

Decision letters can be lengthy and highly detailed, and they often contain over 20+ pages. You can learn more about identifying a decision letter in this Help Center article.

Why this step matters:

Your decision letter is the foundation for:

• Appeals.
• Supplemental claims.
• Nexus development.
• Future strategy.

This is one of the most important documents in your VA journey.

 

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Step 7: Final Review

Before releasing the decision, a senior reviewer performs a final quality check.

This includes:

• Confirming accuracy.
• Ensuring regulations were applied correctly.
• Verifying calculations and formatting.
  
  

If errors are found, the claim may be sent back to a previous stage for correction.

 

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Step 8: Claim Decided

Your claim reaches this step when every claimed condition has received a final decision.

Your claim is officially closed when:

• No conditions are deferred.
• All ratings and denials are finalized.

Only at this stage can:

• Appeals begin.
• Supplemental claims be filed.
• Refund eligibility be evaluated.
• Strategic next steps be planned.

 

This last step is critical because:

If even one condition is deferred, your claim is not truly finished, meaning that the VA still has to go through any conditions for which you have not received a decision yet.

Note: The VetClaims Appeals Team cannot begin an appeals process with you if there are any deferred claims, so always double-check your decision letter before attempting to initiate an appeals process.

 

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Key Takeaways

• Claims can move backward. This is normal.
• Step 3 often takes the longest.
• Deferred claims delay final resolution.
• Decision letters drive everything that comes next.

Understanding the process helps set expectations and prevents unnecessary stress during what is often a long wait.