Using Private Medical Evidence to Support Your Disability Claim

Thorough documentation of your condition is crucial when you’re seeking VA disability benefits. Although much of your medical evidence will come from the VA healthcare system, you are encouraged to submit any private medical evidence that you believe supports your claim.

What Is Private Medical Evidence?

Private medical evidence refers to any evidence from a provider who is not part of the VA healthcare system. This includes treatment records, diagnostic tests, doctor’s notes, and other types of information provided on your patient file.

The Department of Veterans Affairs values evidence from private treatment providers because they are often familiar with your medical history over an extended period of time and can thus speak authoritatively on your condition or prognosis. Your private medical evidence will likely have some overlap with notes from VA treatment you’ve received, but it can often provide additional insight that will support your claim for benefits.

How Can You Submit Private Medical Evidence?

If you want to submit private medical evidence for your claim, such as evidence from your family physician, a specialist you’ve previously consulted, or an urgent care visit, you should inform your care provider that you are filing a claim for VA benefits. You’ll then have two options for handling this evidence:

• Complete your healthcare provider’s release of information form, obtain your records, and submit the records with your claim for VA disability benefits.
• Complete VA Form 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA), and VA For 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA), and submit the completed forms with your claim. When the forms are received, the VA will attempt to obtain your records through its Private Medical Records contract. 

When Can You Submit Private Medical Evidence?

Although it’s best to make your initial application as complete as possible, you can still submit evidence after you’ve first filed for benefits. VA regulations allow you to upload more evidence for up to one year to support your claim.
If you’ve been previously denied benefits, you can summit private medical evidence or other forms of new evidence with your Notice of Disagreement (NOD). The NOD is the document that begins the VA appeals process. After completing the NOD, you can file a Form 9 substantive appeal to take your case to the Board of Veterans’ Appeals (BVA).

It is important to remember you should only submit evidence the VA hasn’t previously reviewed. Never resubmit evidence with your appeal. This common mistake will only delay the process unnecessarily.

If you’ve already been approved for benefits, but your condition has worsened, you may submit private medical evidence to support your request for a higher disability rating or Total Disability Individual Unemployability (TDIU) benefits. TDIU benefits are particularly difficult to obtain, so any additional evidence you can provide will likely strengthen your case.

Are There Fees for Obtaining Private Evidence?

The VA is not allowed to pay a fee for obtaining copies of your private medical records. Most facilities will waive their normal fee and provide copies free of charge for the purpose of a VA disability application. However, if payment of a fee is required to obtain a document, the VA will notify you and provide instructions so you can secure the evidence on your own.

How Can an Attorney Help?

Unfortunately, the process for obtaining VA disability benefits is lengthy and filled with opportunity for error. You are not required to have an attorney, but enlisting the services of someone who understands VA disability law is the best way to protect your right to the benefits you’ve earned in service of your county. An experienced Veterans disability attorney will know how to gather evidence that best supports your claim and how to determine which arguments will be most effective for your appeal.

At the office of Sean Kendall, Attorney-at-Law, we’ve been helping Veterans access their VA disability benefits for over 20 years. Fill out the contact form on this page or call our office today to schedule a free, no-obligation initial consultation.