VA Retroactive Benefits: Learn How Unadjudicated Claims Can Cause the Largest VA Back Pays

The back pay, past due benefits, or as the VA puts it, retroactive benefits, is the lump sum payment accumulating from the effective date (day of the filing) to the payment date that the VA provides to the veteran.

VA does this because the veteran deserves compensation from the first day they reported their conditions to the VA. However, without making sure if the veteran’s claim is valid or not, they can’t send any benefits.

So, once they do, they not only start sending the compensations monthly but also the ones from the past (starting from the effective date). Let’s talk more in detail below.

Understanding Back Pay

When the VA grants a claim for compensation you have filed before, they begin sending the monthly payment from the following payment date. However, that doesn’t mean the VA counts the compensation from the day they approved the claim.

Instead, the VA counts this payment from the day the veteran filed the claim. That day is usually called the effective date. VA calculates the number of months from the effective date to the first payment date after approving the claim.

Afterward, they pay the amount to the veteran based on the number of months there are as a lump sum. So, the veteran has nothing to lose here.

The Effective Date In Case of a Increased Claim

For any usual compensation claim, finding the effective date is simple, as it is just the filing date. Even if the VA rejected the claim at some point but reopened or repealed it later and ultimately granted it, the effective date will still be the first date you filed the claim.

However, when it comes to increased claims, finding the effective date can be somewhat tricky. Usually, in this case, the date should be the day when the disability worsens. Let’s give an example to clarify it.

Suppose a veteran filed a claim for increased compensation on March 3, 2011. However, after examining their health, the VA found no worsening of their disease. So, the VA rejected the claim on April 9, 2012. However, after the veteran appealed the case on August 12, 2016, the board reopened it.

This time, the VA doctors ran another examination and found that the disability had worsened from 40% to 60%. However, the worsening happened close to the examination on June 26, 2015. So, the VA approved the claim this time.

The effective date here will be the day when the disability worsened, which was June 26, 2015, instead of the date of the claim, which was March 3, 2011. VA will calculate the number of months for the back pay (two months in our example) and will pay that as a lump sum.

How the Effective Date Can Be Before the Day of the Claim

Under specific circumstances, the effective date for a claim can be even before the day of filing it. They are as below-

Effective Date on the Day of Discharge

In case of a granted original claim, if the veteran filed it within one year of their discharge and their disability manifested during their service days (not after the discharge), the effective date here will be the day of the discharge.

But even if the disability here developed (let’s say on September 15, 2017) after the discharge but before the day of the filing of the claim (suppose January 5, 2018), the effective date will be the former date (September 15, 2017), not the later.

Effective Date If a Disability Worsened Before the Filing of an Increased Claim

In case of an increased claim, the effective date can be dated back up to one year before the filing of the claim. But the disability’s worsening must have happened within that year.

For example, Suppose you filed an increased claim on July 7, 2016, and the VA finds out the worsening happened on October 23, 2015. October 23, 2015, will be the effective date here. However, if the worsening started before July 7, 2015, it will exceed that one-year limit, and the effective date will be the filing day (July 7, 2016).

The same is true for the TDIU benefit. In the past, the effective date for a TDIU claim would be the filing date. But now, it can date back to the day when the underlying service-connected disease manifested or worsened to make the veteran unable to get gainful employment.

Effective Date with Presumptive Conditions

Finally, if a veteran has a presumptive condition that he filed for but wasn’t on the VA’s presumptive list, the effective date can be different than usual. Here, it will be on the day VA first denied the claim.

As the PACT Act is new, the VA is still adding new disabilities to the list of presumptive conditions. Hence, the chances of them denying a claim in the past for a service-connected disability that is now on the list are high. In that case, the first date that they rejected the claim will be the effective date, be that a long time ago.

Yes, in this way, it can be one of VA’s largest back pays.

Unadjudicated Claims and VA Largest Back Pay

Veterans file claims for compensation to the VA now, but things weren’t always such. In the past, the veteran had to file many written applications to the VA. However, these papers of statements were usually informal and followed no clear-cut rules and regulations.

Of course, the pieces of evidence of the disability being service-connected were just as messy, out of order, and informal. Some people would send way more details and documents than necessary, while others wouldn’t send even the most basic information.

Because of this, many VA adjudicators would overlook and ignore many of these applications. In this case, it would remain open. They are called unadjudicated claims. If the VA can’t adjudicate a claim after a Substantive Appeal or provide a proper statement after a Notice of Disagreement, it also becomes an unadjudicated claim.

However, any veteran can request to reopen their unadjudicated claim and adjudicate it. They won’t need to file any new claims, and they shouldn’t. VA will have to evaluate that unadjudicated claim as per the request and provide a statement.

Now, here is the fun thing. Since some of these unadjudicated applications remained open for years and even decades, the time between their filing date and approval date gets long. Hence, if and when the VA approves them, they may have to pay a hefty lump sum to the veteran as the back pay.

Because of this reason, many refer to unadjudicated claims as gold mines. As their effective dates are so far back, the retroactive benefits also get high. And there is no penalty or drawback for it for the veteran.

Conclusion

Before you request the VA to evaluate an unadjudicated claim, it is mandatory to ensure that the VA will grant it. That is why it is better to wait to see if your service-connected disability is actually present. If the VA finds no such conditions in you, they may deny the claim and close it.We suggest getting an eligibility review from the VA Disability Coach to be totally sure about it. You don’t want to lose your chance at getting a large amount for your back pay.