Top Reasons for VA Disability Claim Denials

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You’ve been waiting months to be able to qualify for VA disability benefits, after completing the long and arduous process of filing a claim.

Then suddenly, you get the news: The Department of Veterans Affairs (VA) has denied your claim.

Believe it or not, each year, the VA denies around 30% of disability claims. It can be frustrating to learn that your claim for VA compensation was denied, especially after the amount of effort involved.

You may feel like you did everything asked of you, provided all the evidence that was requested, and even still the VA said no.

Often the VA doesn’t even give sufficient reasons why you didn’t qualify, making the “claim denied” status that much more confusing.

If your VA disability claim was denied, you can always submit an appeal to the VA office.

You must do so within one year of your denial.

It’s important, however, to try and understand what went wrong with your initial application so you know specifically what evidence you should provide with your appeal.

There are a number of reasons the VA may have denied your claim. These are six of the most common.

1. You Missed the Deadline

Probably the most critical reason that your VA disability claim could have been denied, might simply be because you missed the deadline.

Gathering evidence for your claim takes time.

While there is no deadline to apply for benefits, you are only eligible for monthly payments to deal with current disabilities, so waiting around for an injury to fully heal, for example, may make you ineligible for compensation.

You also need to be aware of deadlines to appeal claims.

If you do not appeal within the required period following an initial decision, you will need to refile your claim and start over.

2. You Did Not Submit Enough Evidence

A VA Disability Claims application heavily relies on the support of evidence of your service-related disability.

It can come in a variety of forms, from medical records, buddy statements, service records, etc. 

When there was not enough proof submitted about the disability in a veterans claim, the VA will likely deny it.

There are strict guidelines of what types of medical conditions qualify as disabilities and what level of compensation each veteran can receive based on the impact of the condition.

If you are curious whether or not your disability might qualify you for benefits, or would like to know how much you could potentially receive, check out our VA Disability Compensation Calculator. Click below for more information.

2023 VA Disability Calculator

Additionally, if your doctor did not adequately provide evidence and testing regarding your disability, it could also impact your claim or get it denied. 

The next time you submit an application, you should include as much evidence as possible, to help minimize the likelihood of the VA doubting the legitimacy of your service-related disability.

3. You Do Not Have a Specific Diagnosis

In order for the VA to approve your claim for disability compensation, you must have a diagnosed medical condition that is the result of your military service (otherwise known as a “service-connected disability”). 

The diagnosis must also be current. If, for instance, a veteran suffered from depression following their service, but since made a full recovery, then they are not entitled to receive compensation for the past issue.

4. You Didn’t Show Up to Your C&P

In most cases, as a requirement for your disability claim, the VA will ask you to attend what is known as a Compensation & Pension (C&P) examination.

This exam determines the extent of the current disability, and whether the condition is service-connected, which qualifies you for compensation.

There are a number of things that can occur with these appointments that may have a negative impact on the results of a disability claim. 

They can range from having an examiner that may not be qualified to examine your particular disability, appointments being made without adequately informing the veteran, rushed appointments or overly lengthy appointments, important tests or questions being skipped, etc.

If this happens, you should immediately inform the VA. These appointments are a crucial part of the VA disability claims process, and should be treated as such.

5. Your Condition is Not Considered Service-Connected

In order to receive disability benefits, you must be able to prove that your disability is service-connected.

This means that your disability is a direct result of your military service, or was clearly made worse by your service.

If the VA determines that your medical condition is independent of your time in the military, or it was pre-existing (present before military service began), and wasn’t made worse by service, then you might not be granted disability benefits.

For a disability to qualify as service-connected, you must undergo a C&P exam by a qualified VA examiner.

As long as they determine your condition was to have begun or become worse because of your military service, your disability should qualify as service-connected.

6. Your Disability Rating Does Not Qualify You For Benefits

Even though you may be accepted by the VA to have a diagnosis that is service-connected, you still may be assigned a disability rating that does not actively reflect your medical condition.

If a veteran receives a rating less than 10%, they will not qualify for compensation, leading the VA to deny any financial compensation for their VA disability claim. 

Providing further evidence of your disability, be it more medical records, buddy statements, medical bills, service records, etc. can help in potentially increasing your rating.

The VA denied my claim. Should I appeal or request “reconsideration?”

Veterans face a daunting appeals process, with long processing times and a growing backlog of pending appeals.

The confusion is further compounded when it comes to deciding between appealing or requesting “reconsideration” for denied claims.

Let’s shed some light on this crucial decision.

In the legal realm, “reconsideration” is a term commonly used, but in the context of Veteran benefits, it officially exists only at the Board of Veterans Appeals (BVA) level.

It involves filing an official “motion” and is limited to matters concerning potential “clear and unmistakable error.”

However, some Veterans and even advocates have mistakenly requested “reconsideration” at the Regional Office (RO) level, where no specific laws or regulations govern this process.

This lack of clarity leads to inconsistent and untimely responses from individual ROs, often confusing “reconsideration” requests with intent to reopen denied claims.

Veterans may inadvertently lose their appellate rights and entitlement to an earlier effective date.

“Reconsideration” at the RO level rarely results in favorable outcomes, as the same VA employee is likely to review the claim again.

Requesting “reconsideration” at the RO level does not grant additional time beyond the 365-day limit to submit an official Notice of Disagreement.

With limited time and low chances of success, it’s crucial to carefully consider the risks and benefits before deciding on “reconsideration” or appeal.

When facing a denied claim, make an informed choice.

Understanding the complexities and potential pitfalls will help you protect your rights and make the best decision for your case.

If you are interested in obtaining benefits and have been denied previously for your claim, please contact Hill & Ponton, PA for more information on how we can help you with your case.

We would be happy to assist you.

Click the button below to get more information.

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