Applying for disability benefits through The Department of Veterans Affairs (VA), can be a lengthy and daunting process. And the most frustrating part of it all? Many veterans end up being denied for their PTSD disability claim, even when they have medical evidence.
Being denied after the long, arduous task of filing a benefits claim can be a tremendously frustrating experience–especially after putting in hard work, time, emotional and mental efforts, and even efforts from family and friends.
However, even if you were denied benefits, there is still hope. Consider applying for an appeal to your claims decision, and potentially getting help through this process, to ensure success the next time around.
Watch the following video to learn more about PTSD ratings and the disability claim process or read on to find out the main reasons for denying PTSD claims.
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get a free case evaluationTop 4 Reasons for PTSD Disability Claim Denials
Even though PTSD has been found to be one of the most common conditions suffered by veterans, the VA has been known for denying many of the claims submitted to get disability benefits.
Under 38 CFR § 3.304(f), service connection for PTSD requires medical evidence diagnosing the condition under 38 CFR § 4.125(a).
You must provide evidence that there is a link between current symptoms and an event that caused the in-service distress or trauma (a stressor). There must also be credible supporting evidence that the claimed in-service stressor actually occurred.
Even though 38 USC § 5107(b) provides that the VA must give you the “benefit of the doubt,” the VA continues to deny PTSD claims because of errors and evidence issues. Denials are actually relatively common, and you aren’t alone. Here’s why your PTSD claim may have been denied.
Generally, there are four main reasons for denying a disability claim. Even one of these can be enough, but it’s possible you could qualify for more than one.
1. Insufficient Evidence
This is probably the biggest reason why your PTSD claim may be denied. Evidence of a link between an in-service stressor and the current PTSD diagnosis is absolutely critical in order to win your claim.
The requirement for corroborating evidence is waived only if the following is true:
- PTSD was diagnosed in service
- The stressor event occurred during combat with hostile forces
- The stressor event was related to the veteran’s fear of an actual threat of hostile military or terrorist act
- The stressor event was related to the veteran’s time as a prisoner of war
Most of the time extra evidence will be needed about the event that caused the in-service distress or trauma. Some examples of the types of proof could be treatment records or personnel reports, news reports, witness statements, buddy letters or similar documentation.
Do you have enough medical evidence to prove your disability? And do you have proof of service connection (nexus)? These are the biggest questions you should ask!
2. You Submitted the Wrong Forms
The VA requires disabled veterans to fill out specific forms to apply form VA disability. Similar to how submitting incomplete forms or information, an incorrect form can also trigger a denial. For those claiming Post-Traumatic Stress Disorder (PTSD), they must send in a statement on VA Form 21-0781 – Statement in Support of Claim for Service Connection for PTSD.
3. Your PTSD Stressor is Unclear
If you can’t provide a clear service-connected stressor that was the cause of your clinically diagnosed PTSD, then your claim will most likely be denied. You must have a clear service-related stressors in order to qualify for VA disability benefits for PTSD.
4. A Mistake the VA Made
The VA is constantly working through thousands of veteran disability claims, and their employees sometimes are only human. It’s not uncommon to hear that the VA is at fault for a PTSD claim being denied.
An important thing to note, is to keep track of everything in regards to your claim and to assume nothing when it comes to the VA’s assistance. Keep track of your records, double check that they’ve been received, report bad C&P exams and be sure to file an appeal to correct your claim, if it is necessary!
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get a free case evaluation How To File a PTSD VA Claim Appeal
After receiving a denial of benefits, you have one year to file an appeal with the VA. There are a few steps for appealing the decision made about your PTSD disability claim:
1. Know the dates of your appeal
You only have one year to file an appeal from your denial date. Know exactly how long you have to appeal. You don’t want to miss this opportunity.
2. Consider why your claim may have been denied
You want to try and understand why the VA might have denied your claim. Review your rating decision carefully. Make a plan for addressing your appeal based on this information and what may have been missing the first time around.
Did you forget to submit a proper form? Was there insufficient evidence? Did your C&P exam not go as well as expected? These are all things to consider.
3. Strengthen your medical evidence
Gather as much medical evidence as you can in regards to your condition. Submitting strong evidence will only help your chances of a successful appeal. Also take time to start gathering other supporting evidence like military personnel statements, buddy statements, and statements from family and friends.
4. File appropriate paperwork
You want to know for certain what paperwork you are filing is correct. For example, you will need to submit a statement on form VA Form 21-0781 – Statement in Support of Claim for Service Connection for PTSD.
Get Help with Your Appeal
The attorneys at Hill & Ponton are here to support you in your claim and determining your PTSD disability percentage. Get a free evaluation of your case to see if we can handle your appeal. Our firm will only be paid if and when we win compensation for you. We win 96% of the cases we take on!