Disability Claims | VA Disability Claims Service

Name *

First

Last

City *

State *

Phone *

Email *

Branch of Service:

Job/MOS:

Deployed to any Combat Region?

Any Combat Awards (CIB,CAB,Purple Heart..ect):

Overall current disability rating:

Located at the top of E-benefits disabilities page.

Are you currently under contract with another company providing a similar service? *

Please cancel your contract prior to proceeding since you may be required to pay both companies.

Do you have any open claims that you are waiting on a decision?

Please provide the disability and current status.

Do you have any denied claims?

Do you have copies of your denial letters?

Do you have copies of the following:

VA medical records can be found here via Blue Button Report. myhealth.va.gov

What would you like to discuss with Veteran Mentor or add any additional information? (Please keep it simple and short).

How did you hear about our service?

Requested Veteran Mentor: