What is a Veterans Disability Benefits Fully Developed Claim?
This overview of the Fully Developed Claim process explains how it can speed review of your VA disability benefits claim and the pros and cons compared to a regular claim.
The Fully Developed Claim process is intended to be a fast track way to get VA disability benefits processed. From 2008-2012, the VA experienced a 50% increase in the number of claims submitted, and those incoming claims were more complex – containing 19% more medical conditions. The Fully Developed Claim (FDC) was first tested as a pilot program, to address the increasing delays in processing claims.
What is a Fully Developed Claim
As the VA works to reduce the backlog of claims, the FDC emerged as a way to get claims that are in solid order pushed through the system faster. The FDC concept refers to the fact that VA disability benefits claims are considered “fully developed” when the veteran has no more evidence to submit and the only assistance required from the VA is to secure federal records and order any medical examinations.
The applicant submits an official FDC claim form, and submits all available supporting evidence, like private treatment records and notice of Federal treatment records, to the VA at the time they first file a formal claim; the veterans also certify they have no more evidence to submit.
The VA states that it has provided priority channels for processing claims submitted in accordance with the FDC procedures. According to the VA, “The Fully Developed Claims (FDC) Program is the fastest way of getting your compensation or pension claim processed. Participation in the FDC Program allows for faster claims processing while preserving great quality of service and your right to appeal a decision.”
Using the FDC procedures can cut down on the claim processing time for an initial claim by more than half. In an August 2012 press release, the VA stated, “Currently, FDC claims take an average of 110 days to decide compared to 254 days through the traditional claims method.”
There are a couple of ways that the FDC process cuts down on processing time:
- First, the veteran files an intention to use the FDC system, which sets the effective date of the claim
- The VA tells the veteran precisely what information and evidence is needed to process the claim. Once the vet gathers and submits all of the documentation, the VA begins to process the claim. This can eliminate delays of the back and forth of waiting for further instructions and more evidence. It lets you know up front the documents you need. Veterans and their representatives do much of the development that typically takes the VA up to half a year to gather.
- The up front submission of evidence allows the VA to start processing the claim immediately, without holding it for mandatory wait periods.
- Most Veteran’s Service Organizations have representatives who can help develop a FDC claim for free, although applicants can also seek legal advice.
- If for some reason your claim does not meet the FDC criteria, your claim will be converted to standard processing.
After the veteran submits the claim, the VA will gather all federal records identified, such as VA Medical Center records and the documents from the Social Security Administration. The VA will also send the applicant for a VA medical examination, if needed.
How does FDC compare to a regular claim submission
The main difference is that with a standard application, the VA is the one who tracks down most of your documentation and evidence. With the FDC, the veteran gathers as much documents as possible up front.
The VA website describes the standard claim process this way:
- The VA is responsible for getting relevant records from any federal agency that you identify and authorize;
- The VA will make every reasonable effort to obtain relevant records not held by a federal agency that you identify and authorize.
These may include:
- privately held evidence and information you tell them about (such as records from a private doctor or hospital) and/or
- records from state or local governments or current or former employers.
The VA estimates that it takes an average of 175 days to gather evidence for a standard VA disability benefits claim.
In contrast, the FDC form outlines the evidence that you need to submit. Usually, this is private treatment records. The veteran also notifies the VA precisely where other federal records exists, such as those with VA Medical Centers or the Social Security Administration. Depending on the type of military service, you may need to also assist in locating your service records.
What are the pros and cons of using the FC process?
The main advantage of the FDC system is a speedy resolution. Data shows the FDC process can cut the time to a decision by half – which on average, means a decision coming in less than four months, instead of the standard eight-month time.
Some of the pilot programs were showing 90-day decision windows, outside of any delays caused by waiting for more records outside the VA’s control. The pilot program in Chicago showed great results. Chicago reported that, “By 2010, 25 percent of FDC claims were rated in 69 days, and half were decided in 115 days. These are good results.”
VA regional officers say the FDC involves veterans more in the process, and gives them more control over their claim. Using the FDC process is not intended to affect the quality of care or level of benefits received. It is simply a method to speed up claim review.
Early evidence suggests use of a FDC may also reduce the appeals rate. The FDC also provides an option to request a reconsideration after a decision, and a chance to submit more evidence before needing to go to the appeal stage.
There don’t appear to be active negatives reported. If anything bumps you out of the FDC process, your claim may just be put back in the standard processing pool. This could happen if, for example, your claim ends up requiring the VA’s assistance for more than just ordering federal records or medical exams; or if it’s determined more documents are needed. You can also drop out of the FDC process at any time and have your claim move through the standard processing procedures.
The Fully Developed Claim process currently applies only to the initial application for VA disability benefits, or secondary and increased disability service connection claims. The VA is testing an expedited appeals process.