As a veteran, if you have a disability claim denied, your fight isn’t over. Claims Examiners decline 1-in-3 claims, leading many veterans to feel frustrated and stuck in their situation. As a vet, you have two main choices if your claim is declined:
- Accept the decision
- Appeal the decision
If you accept VA’s decision, you’re stuck in the same situation you’re in right now without benefits to help you in your day-to-day life.
First: Understand Why You Received a Disability Claim Denial Letter
If you’re going to file an appeal, the first step is to understand why the VA denied your claim. For many people, denials are due to errors and can be overturned. The most common reasons, aside from errors, that your claim can be denied include:
- You missed your filing deadline or the deadline to submit additional evidence
- The wrong forms were submitted
- Incomplete information was provided
- There’s a lack of medical evidence backing your claim
- You suffer from a pre-existing condition
- Your doctor’s statement wasn’t accepted
The VA also has the authority to determine that you’re either not disabled or that the symptoms you’re experiencing don’t warrant compensation.
If the VA doesn’t accept your doctor’s statement or doesn’t believe that your symptoms warrant disability, there are steps that you can take to fight back.
Your decision will often cite the following issues:
No Diagnosis
If the denial is due to no diagnosis, it’s because you didn’t provide enough proof to determine a diagnosis. For example, you could claim that you’ve been exposed to a certain chemical during combat, but there must be proof of:
- Exposure
- Disability from exposure
There needs to be a link between the disability and exposure or the incident for the claim to go in your favor.
No Proof of In-Service Incidents Occurring
On top of the evidence of the disability, there also needs to be proof that your disability is related to an event that occurred while in service. For example, if you need a mobility device because of an injury, you need to prove that this device is required due to an in-service issue.
Perhaps you were injured in the field or during basic training. In this scenario, you would be able to claim disability if you started to document the issue early on.
If you leave the military without a documented injury and two years down the road claim that an injury led to your mobility issues, you’ll need to provide substantial proof linking the two. Ideally, you’ll be able to discuss specific stressor events that caused the injury.
The good thing is that you’ll often be able to connect your disability to a direct cause.
Next: Go Through the Appeals Process
Decision reviews underwent a major overhaul in February 2019, and if your claim’s decision was made after this date, you’ll need to follow the new appeal process outlined on the VA’s official website.
If your claim was denied after 2/18/2019, you’ll need to first choose your review option, which includes appealing the decision to the Veterans Law Judge, requesting a higher-level review, or adding new evidence to back your claim.
Providing additional evidence is the easiest option if you believe that your claim was denied due to a lack of evidence.
It’s always best to discuss a denial with a lawyer who specializes in VA denials because they’ll have a better understanding of how to improve your chances of approval during an appeal.
A few quick notes on choosing your review option:
- Adding new evidence requires you to fill out a Supplemental Claim form and attach any evidence that you think is required to have your claim approved.
- Requesting a higher-level review allows you to speak to the reviewer over the phone to explain your situation and why you think the decision should be overturned. A new party will review your claim in this case.
- Appealing to a Veterans Law Judge is the most intense appeal, which will require you to bring your case to a judge. The hearing takes place in Washington, DC, but you can request a video conference. This type of appeal can take a year or longer to complete. This is the last level of appeal available unless you’re able to provide supplemental documentation to prove your case or elevate the claim to the federal level.
Once an appeal for a disability claim that was denied is filed, you’ll need to wait. The VA may ask you for more information, and if this is the case, be sure to provide the information as quickly as possible.
The VA may also schedule exams that you must attend.
If you miss an exam, this can derail your appeal. In the event that you cannot make the date of the exam, be sure to alert the VA and reschedule immediately.
You can also check on your VA claim status at any time if you’re anxious to see any progress made on the claim.
